Most research about attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) focuses on children because symptoms of the conditions are first recognized during those early years. However, both disorders can complicate lives for adults, especially if they are not adequately diagnosed and treated as children. Studies have shown that ADHD and ASD are frequently co-occurring disorders with probable genetic links, so adults who suffer from both conditions may experience more severe impairments.
Co-occurring Conditions
So far, there is little research available on co-occurring ADHD and autism in adults, but existing studies suggest comorbidity rates of 20-37%. Diagnosis of the two conditions are particularly challenging in adult patients.
Diagnosing Adult Autism
Autism is characterized by the existence of repetitive behaviors and problems with social skills. Doctors look for intellectual disabilities, language impairment, and genetic, medical, and environmental contributing factors when assessing for autism. In addition, they use screening tools, developmental histories, observation protocols, and adaptive behavior assessments to evaluate the following domains that may signal an adult is on the autism spectrum:
- Issues with non-verbal communication, including lack of eye contact and an inability to interpret body language of others
- Difficulty with social-emotional reciprocity
- Problems creating and maintaining all types of relationships, including family, friends, acquaintances, and romantic connections
- Repetitive behaviors, including motor skills (pacing, flapping, unusual finger motions) or speech (limited repertoire to start conversations, repeated use of unusual phrases)
- Insistence on routines, with discomfort due to rapid transitions or changes in the expected order of things
- Fixation on interests with a high level of intensity for a period of at least three months
- Unusually strong or weak response to stimuli, such as sounds or smells
Related Assessment: CARS™2
Diagnosing Adult ADHD
ADHD is generally marked by hyperactivity, inattention, and impulsivity, which differs from the restricted behaviors and communication problems that characterize autism. Doctors will use questionnaires, surveys, and observations to diagnose ADHD. The typical adult with ADHD may display behaviors such as:
- Careless errors or inaccuracies on tasks
- Forgetfulness
- Failure to pay attention to others
- Trouble organizing
- Difficulty staying focused
- Failure to follow-through
- Reluctance to participate in tasks requiring effort
- Tendency to lose things
- Fidgeting
- Restless feelings; trouble remaining seated
- Inability to remain quiet
- Excessive talking
- Frequently interrupting others
- Difficulty waiting or taking turns
Related Assessment: ADHDT-2
Supports for Autistic Adults with ADHD and ASD
Because of the lack of research focused on adults with ADHD and ASD diagnoses, most treatment options are adapted from those deemed effective with children. However, most clinicians agree on the interventions that are most important for adults by improving quality of life and personal independence. Recommended interventions include the following:
- Executive functioning therapies
- Cognitive behavior therapy (CBT)
- Psychoeducation
- Educational supports, including applying for schools and establishing appropriate accommodations
- Vocational support, including identifying career goals, finding volunteer or internship opportunities, applying and interviewing for positions
- Assistive technology
- Organizational coaching and supports
- Medical treatments
Adults with concurrent ADHD and ASD face different challenges than children with these conditions. Accurate diagnosis of these disorders in people of all ages will help to ensure they receive the proper treatments to lead fulfilling lives. WPS can provide additional information about diagnosing these neurodevelopmental disorders so that the appropriate support can be implemented.
Sources:
https://www.wpspublish.com/blog/accurate-diagnosis-asd-and-adhd
