Autism and ADHD in Children: Overlap, Diagnosis and Support

Yes, a child can have both autism and ADHD. Since the DSM-5 came out in 2013, doctors can diagnose the two together [5][9]. It is common: a large meta-analysis found about 28% of autistic people also have ADHD [1]. Knowing about both helps you find the right support.

What is AuDHD? Understanding autism and ADHD together

Autism is a difference in how a person communicates, relates to others, and experiences the world. To be diagnosed, a child must show social communication differences plus restricted or repetitive behaviors. These can include a strong need for sameness, intense interests, and sensory differences [13]. Our guide What is autism? explains more.

ADHD (attention-deficit/hyperactivity disorder) affects attention, activity level, and impulse control. Signs include daydreaming, losing things, careless mistakes, fidgeting, talking a lot, trouble waiting for a turn, and interrupting [14].

“AuDHD” is a word many autistic people and families use for having both. It is a community term, not a diagnosis. On a medical report, you will see two separate diagnoses.

Why the rules changed in 2013

Under the older DSM-IV, doctors could not diagnose autism and ADHD together. The thinking was that ADHD-like signs in an autistic child were simply part of autism [4]. Many researchers disagreed. The DSM-5, published in 2013, now mentions each condition in the description of the other and allows both diagnoses [5][9].

How common are autism and ADHD together?

Quite common. A 2019 meta-analysis in The Lancet Psychiatry pooled 96 studies. It found ADHD in about 28% of autistic people, making it the most common co-occurring condition in the study [1]. A 2021 meta-analysis of 63 articles found a higher figure: about 38.5% had ADHD at the time of the study [2]. Age, intellectual disability, how people were recruited, and which diagnostic rules were used all changed the numbers [2].

It works the other way too. A 2020 review of 22 studies with nearly 62,000 children found that about 21% of children with ADHD had autism traits high enough to meet the threshold for autism [3].

Some experts think the numbers may be inflated. They point out that attention problems in an autistic child may come from autism itself, not a separate ADHD [5]. This is one reason a careful assessment matters.

Autism vs ADHD: how they overlap and differ

Both conditions can affect attention, social life, and planning skills. Researchers agree there is real overlap, but also real differences in how these show up [6]. The same behavior can have different causes.

• Attention. A child with ADHD may drift from task to task or get distracted easily [14]. An autistic child may focus deeply on an interest and find it hard to shift away. Some attention differences in autism relate to shared attention with others, not ADHD [5].
• Social difficulties. Both groups can struggle socially [6]. A child with ADHD may interrupt or miss turns because of impulsivity [14]. An autistic child may communicate and connect in different ways than other children expect [13].
• Routines and change. Many autistic children feel safest with sameness and routine [13]. ADHD traits, like restlessness and trouble finishing tasks, can pull the other way [14]. A child with both may want predictable days but still need variety to stay engaged.
• Impulsivity and movement. Fidgeting and acting quickly are core ADHD signs [14]. Repetitive movements, like rocking or hand flapping, are part of autism [13]. They can look similar but serve different purposes.

Support needs vary widely. Our guide to autism levels explains how doctors describe them.

Shared genes

Autism and ADHD both run strongly in families, and they seem to share some genetic roots [4]. A Swedish study of nearly 1.9 million people found that relatives of autistic people were more likely to have ADHD. The link was strongest in identical twins, which points to shared genes [8]. This does not mean you caused either condition.

Why it matters to recognize autism and ADHD

Missing one condition can delay the right help. In a US study of about 1,500 autistic children, around 20% were diagnosed with ADHD first. Those children got their autism diagnosis about 3 years later than children diagnosed with autism first or at the same time. They were also much more likely to be diagnosed with autism after age 6 [7]. The authors urged doctors to consider autism in young children with ADHD signs [7].

Treatment plans also work better when both are known. Reviewers note that autism supports work best when ADHD is considered, and the reverse is true too [6].

Getting assessed for autism and ADHD

Major guidelines now ask doctors to look for both conditions:

• The American Academy of Pediatrics (AAP) 2019 ADHD guideline says doctors should at least screen for other conditions when evaluating ADHD. Autism is named on that list [9].
• The AAP 2020 autism report lists ADHD among the co-occurring conditions that affect autistic children’s daily life [10].
• In the UK, NICE lists ADHD as a factor linked to higher rates of autism. It also asks clinicians to consider ADHD as a possible co-occurring condition during an autism assessment [12]. The NICE ADHD guideline notes ADHD is more common in people with autism [11].

An assessment usually includes information from parents and teachers, since ADHD signs need to show up in more than one setting [9].

Treatment and support options

Behavioral parent training and school supports

For ADHD, the AAP recommends parent training in behavior management and classroom behavior supports as the first step for children aged 4 to 5. For children aged 6 to 11, it recommends medicine together with these behavioral supports [9]. NICE also recommends ADHD-focused group parent training for families of children under 5 [11].

In a trial of 128 autistic children with ADHD signs, parent training alone improved ADHD symptoms more than placebo [19]. At school, an IEP can include supports for both attention and autism needs. See our guide to IEPs for autism.

Medicine

Medicine is a personal choice to make with your child’s doctor. Here is what research shows:

• Stimulants (methylphenidate). In a key trial of 72 autistic children aged 5 to 14, about half (49%) responded. But the benefit was smaller than in children with ADHD alone, and side effects were more common. About 18% stopped because of side effects [15]. A Cochrane review found methylphenidate may reduce hyperactivity in the short term, but the evidence was low quality. Reduced appetite was the main side effect, and the review found no evidence that it worsened core autism traits [16].
• Atomoxetine (a non-stimulant). In a trial of 97 children aged 6 to 17, it moderately improved ADHD symptoms and was generally well tolerated [18]. In another trial, it also helped, with decreased appetite as a side effect [19].
• Guanfacine (extended-release). In a trial of 62 autistic children, 50% improved a lot, compared with about 9% on placebo. Drowsiness, tiredness, and lower appetite were common side effects [20].

A 2021 meta-analysis concluded that methylphenidate and atomoxetine can help ADHD symptoms in autistic children, but the quality of evidence was low and long-term data are limited [17]. NICE suggests offering the same ADHD medicine choices to autistic children, with slower dose changes and closer monitoring [11]. Your doctor will advise the right medicine and dose. Read more in our guide to autism medication options.

Questions to ask your child’s doctor

• Could my child’s attention or behavior be explained by autism, ADHD, or both?
• Have you screened for other conditions, like anxiety or sleep problems?
• What non-medicine supports should we try first?
• If we try medicine, what side effects should we watch for, and how will we track progress?
• How will we share information with my child’s school?

What you can do at home

Many strategies help with both autism and ADHD. Visual supports and exercise and movement are both listed as evidence-based practices for autistic children [21].

• Use visual supports. Picture schedules, timers, and checklists show what comes next. Try our guide to visual schedules.
• Break tasks into small steps. Short steps with a clear finish line help with focus and planning.
• Build in movement breaks. A quick walk, jumping, or a wiggle break can help your child reset before the next task.
• Keep routines, but add choices. A steady daily structure can feel safe. Inside that structure, offer small changes, like choosing the order of tasks or a new activity, to keep things interesting.
• Adjust the space. NICE stresses changes to the environment, like reducing distractions, before or alongside medicine [11].
• Notice strengths. Praise effort, follow your child’s interests, and celebrate what works.

When to talk to a professional

Talk to your child’s doctor if attention, impulsivity, or activity level are causing problems at home and school, or if your autistic child seems very restless or distracted. Also ask about autism if your child has an ADHD diagnosis but you notice social, sensory, or routine differences. Researchers urge doctors to consider autism in children with ADHD signs [7], and NICE lists ADHD as a factor linked to higher rates of autism [12].

Frequently asked questions

Can a child have autism and ADHD at the same time?

Yes. Older diagnostic rules (DSM-IV) did not allow doctors to diagnose both. The current manual, DSM-5, released in 2013, allows a child to have both diagnoses when each one fits. Large reviews suggest that roughly 3 in 10 autistic people also have ADHD, though estimates range widely between studies. Your child’s care team can assess for both.

What does AuDHD mean?

AuDHD is a community term some people use for having both autism and ADHD. It is not a medical diagnosis and you will not find it in the DSM-5. On reports, doctors write the two diagnoses separately, such as autism spectrum disorder and ADHD. Many families and autistic adults find the word helpful for describing how the two conditions mix in everyday life.

Do ADHD medicines work for autistic children?

They can help some children. In a large trial, about half of autistic children with hyperactivity responded to methylphenidate. But the benefit was smaller than in children with ADHD alone, and side effects were more common. Atomoxetine and guanfacine have also helped in trials. Your doctor will advise whether medicine fits your child, which one, and the right dose.

Should my child with ADHD be checked for autism?

It is worth asking, especially if you see social or sensory differences or a strong need for sameness. The AAP says doctors evaluating ADHD should at least screen for other conditions, including autism. One US study found children diagnosed with ADHD first got their autism diagnosis about 3 years later than other children. Earlier answers can mean earlier support.

References

1. Lai MC, Kassee C, Besney R, Bonato S, Hull L, Mandy W, Szatmari P. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(10):819-829. doi:10.1016/S2215-0366(19)30289-5 Link
2. Rong Y, Yang CJ, Jin Y, Wang Y. Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: a meta-analysis. Res Autism Spectr Disord. 2021;83:101759. doi:10.1016/j.rasd.2021.101759 Link
3. Hollingdale J, Woodhouse E, Young S, Fridman A, Mandy W. Autistic spectrum disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analytical review. Psychol Med. 2020;50(13):2240-2253. doi:10.1017/S0033291719002368 Link
4. Rommelse NN, Franke B, Geurts HM, Hartman CA, Buitelaar JK. Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry. 2010;19(3):281-295. doi:10.1007/s00787-010-0092-x Link
5. Hours C, Recasens C, Baleyte JM. ASD and ADHD comorbidity: what are we talking about? Front Psychiatry. 2022;13:837424. doi:10.3389/fpsyt.2022.837424 Link
6. Antshel KM, Russo N. Autism spectrum disorders and ADHD: overlapping phenomenology, diagnostic issues, and treatment considerations. Curr Psychiatry Rep. 2019;21(5):34. doi:10.1007/s11920-019-1020-5 Link
7. Miodovnik A, Harstad E, Sideridis G, Huntington N. Timing of the diagnosis of attention-deficit/hyperactivity disorder and autism spectrum disorder. Pediatrics. 2015;136(4):e830-e837. doi:10.1542/peds.2015-1502 Link
8. Ghirardi L, Brikell I, Kuja-Halkola R, et al. The familial co-aggregation of ASD and ADHD: a register-based cohort study. Mol Psychiatry. 2018;23(2):257-262. doi:10.1038/mp.2017.17 Link
9. Wolraich ML, Hagan JF, Allan C, et al; Subcommittee on Children and Adolescents With Attention-Deficit/Hyperactive Disorder. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528. doi:10.1542/peds.2019-2528 Link
10. Hyman SL, Levy SE, Myers SM; Council on Children With Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447. doi:10.1542/peds.2019-3447 Link
11. National Institute for Health and Care Excellence (NICE). Attention deficit hyperactivity disorder: diagnosis and management. NICE guideline NG87. Published March 2018; last updated September 2019. Link
12. National Institute for Health and Care Excellence (NICE). Autism spectrum disorder in under 19s: recognition, referral and diagnosis. Clinical guideline CG128. Published 2011; recommendations amended 2017. Link
13. Centers for Disease Control and Prevention (CDC). Clinical testing and diagnosis for autism spectrum disorder (DSM-5 criteria). Last reviewed May 2025. Accessed October 2026. Link
14. Centers for Disease Control and Prevention (CDC). Symptoms of ADHD. Last reviewed July 2026. Accessed October 2026. Link
15. Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Arch Gen Psychiatry. 2005;62(11):1266-1274. doi:10.1001/archpsyc.62.11.1266 Link
16. Sturman N, Deckx L, van Driel ML. Methylphenidate for children and adolescents with autism spectrum disorder. Cochrane Database Syst Rev. 2017;11(11):CD011144. doi:10.1002/14651858.CD011144.pub2 Link
17. Rodrigues R, Lai MC, Beswick A, et al. Practitioner review: pharmacological treatment of attention-deficit/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta-analysis. J Child Psychol Psychiatry. 2021;62(6):680-700. doi:10.1111/jcpp.13305 Link
18. Harfterkamp M, van de Loo-Neus G, Minderaa RB, et al. A randomized double-blind study of atomoxetine versus placebo for attention-deficit/hyperactivity disorder symptoms in children with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2012;51(7):733-741. doi:10.1016/j.jaac.2012.04.011 Link
19. Handen BL, Aman MG, Arnold LE, et al. Atomoxetine, parent training, and their combination in children with autism spectrum disorder and attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2015;54(11):905-915. doi:10.1016/j.jaac.2015.08.013 Link
20. Scahill L, McCracken JT, King BH, et al; RUPP Autism Network. Extended-release guanfacine for hyperactivity in children with autism spectrum disorder. Am J Psychiatry. 2015;172(12):1197-1206. doi:10.1176/appi.ajp.2015.15010055 Link
21. Hume K, Steinbrenner JR, Odom SL, et al. Evidence-based practices for children, youth, and young adults with autism: third generation review. J Autism Dev Disord. 2021;51(11):4013-4032. doi:10.1007/s10803-020-04844-2 Link

Professional review: this guide is waiting for review by a qualified clinician. It was written and checked against the published sources listed above. How we check our guides.

This guide is general education, not medical advice. Always talk to your child’s doctor or care team. Last checked: October 2026.