Written by Lesley Taylor, Chartered Clinical Psychologist | Spectrum North West | HCPC Registered
Last Updated July 2026
Until 2013, autism and ADHD could not be formally diagnosed together. Clinicians were required to choose one diagnosis or the other, despite many children clearly showing characteristics of both. With the publication of the DSM-5 in 2013, this changed, and autism and ADHD became recognised as conditions that can co-exist.
This was an important step forward, as we now know that many autistic individuals also have ADHD, creating a unique profile of strengths, challenges and support needs.
At first glance, autism and ADHD can appear to pull in opposite directions.
Autism is often associated with a need for routine, predictability, sameness and the comfort of familiar interests. Many autistic children thrive when life feels structured and consistent, and they may enjoy spending long periods focused on subjects they are passionate about.
ADHD, on the other hand, is characterised by a drive for novelty, stimulation and dopamine. Children with ADHD may crave excitement, seek out new experiences and struggle with repetitive or predictable activities. Their attention can be drawn towards whatever feels most interesting or rewarding in the moment.
Autism and ADHD together symptoms: what to look for
When these two neurodevelopmental conditions occur together, the result can be a constant internal tug-of-war.
One part of the child may desperately want things to stay the same, while another part seeks something new.
- They may long for routine but become bored by it.
- They may want to focus deeply on a favourite interest but struggle to sustain attention.
- They may feel overwhelmed by change while simultaneously craving stimulation.
From the outside, these opposing tendencies can sometimes appear to cancel each other out, making a child’s needs less obvious to parents, teachers and professionals.
Internally however, the experience can be very different. Many children describe feeling stuck, frustrated or exhausted by the competing demands of their own brains. This can contribute to overwhelm, emotional dysregulation, decision paralysis and inertia.
Why co-occurring autism and ADHD is so often missed
For clinicians, this means assessment requires careful exploration. The interaction between autism and ADHD can be complex, and if we only look at what is visible on the surface, it is easy to miss the underlying difficulties.
A child who appears to have fewer needs may, in reality, be working incredibly hard to manage competing demands internally. Understanding this experience requires a thorough assessment process that carefully unpicks how traits present, interact and impact daily life.
This growing understanding of co-occurring autism and ADHD highlights the importance of in-depth, face-to-face assessments that go beyond surface observations. It also underlines the need for assessment tools and diagnostic approaches that are regularly updated to reflect advances in clinical knowledge and our evolving understanding of neurodevelopmental differences.
Recognising the strengths
Recognising the co-existence of autism and ADHD helps us move beyond surface-level observations and better understand what a child may be experiencing beneath the surface. Rather than seeing fewer needs, we should recognise that these children are often navigating a complex internal balancing act every day.
With understanding and appropriate support, they can be helped to manage these competing needs and build on the many strengths that come from their unique neurotype.
These strengths may include:
- creativity
- innovative problem-solving
- deep knowledge in areas of interest
- strong pattern recognition
- curiosity
- adaptability
- the ability to think about the world from unique perspectives.
When their strengths are recognised and nurtured alongside appropriate support, children with co-occurring autism and ADHD can thrive in ways that reflect their individual talents and potential.
Concerned your child may have co-occurring autism and ADHD?
At Spectrum North West, we offer private ADHD and autism assessment for children and young people, carried out face-to-face by a qualified clinical team with expertise in complex and co-occurring profiles.
About the author
Lesley Taylor is a Chartered Clinical Psychologist and co-founder of Spectrum North West, based in Warrington. She is registered with the Health and Care Professions Council (HCPC). Lesley also hosts the podcast Masking For It, which explores neurodevelopmental topics with honesty and insight.