ADHD and ASD - a duel diagnosis
/ADHD and ASD - a duel diagnosis
Understanding the Complex Relationship Between ADHD and ASD in Children
While having a child with neurodivergence can be a wonderful rollercoaster ride, it is most definitely a rollercoaster. Having a child with ASD can be tricky, as can having a child with ADHD. Both come with an array of wild and wonderful traits and behaviours. But what about those kids who have both ADHD and ASD? That is an entirely different ball game, which can be very confusing, as the behaviours of these two conditions often overlap and conflict, creating a complex mix of new behaviours.
We need to understand how these conditions interact so we can better understand these kids, give them the support they need and enjoy the rollercoaster ride together.
ADHD vs. ASD
Children with ADHD are typically impulsive, hyperactive, and easily distracted. They thrive in dynamic environments but struggle with structure and focus. On the other hand, children with ASD tend to prefer routines, predictability, and often experience discomfort in fast-paced, unpredictable settings. This fundamental difference can lead to unique behaviors when the two conditions coexist.
Your child may be overly organised and obsessive about structure and routines. That’s the ASD. The next minute they’re messy, impulsive, living in the moment, with no thought of what is coming next. Hello ADHD.
Your child may prefer to be on their own and may struggle being around people, needing their own space. Again, typical of ASD. But at other times they might like to be the centre of attention, the performer. They invade people’s personal space, they’re the “class clown”, telling the same joke again and again because they got a laugh. ADHD.
The ASD brain often hates too much noise and is easily overwhelmed in busier places. Your child can’t concentrate because of all the noise. At the same time, the ADHD brain needs something to help it concentrate, your child may listen to music or TV on full volume or constantly make noises.
Here lies the battle between the diagnoses: The autistic brain is constantly striving for control, structure and organisation, while the ADHD brain is chaotic, impulsive and spontaneous. the ADHD is often louder, but the ASD is constantly fighting against it. Both want centre stage.
A child with both ADHD and ASD might have difficulty following instructions (common in ADHD) while simultaneously becoming highly anxious or distressed when routines change unexpectedly (typical of ASD). This combination can result in meltdowns or withdrawal, making it hard for parents to identify whether the root of the problem is impulsivity, anxiety, or both.
The impulsivity of ADHD may push a child to act without considering consequences, while the rigid thinking common in ASD makes it difficult for the child to adapt to unexpected outcomes. For example, if a child with ADHD runs impulsively into a new situation, their ASD might make it hard for them to handle the sensory overload or changes that come with it.
These overlapping and conflicting behaviours often create frustration, not just for the child, but for parents too. The impulsivity might seem to undermine efforts to establish routines, while the need for routine might make managing impulsive behaviours more stressful.
A few tips…
Consistent Routine with Flexibility: Create a structured routine that offers some flexibility. For children with ADHD and ASD, having a predictable environment helps reduce anxiety, but including room for unplanned activities or breaks can help manage impulsivity.
Clear and Simple Instructions: Both children with ADHD and ASD benefit from clear, step-by-step instructions. Visual aids, schedules, and checklists can also help them stay on task without overwhelming them.
Address Sensory Needs: Be aware of sensory sensitivities that may trigger certain behaviours. For example, loud noises or crowded spaces might be especially overwhelming for a child with ASD, but an impulsive child with ADHD might not recognize when a situation is too much until they’re overwhelmed.
Positive Reinforcement: Celebrate small wins and praise effort as well as success. Children with ADHD and ASD often face a lot of challenges, so focusing on their strengths and efforts can boost their confidence and motivation.
A final thought
Managing both ADHD and ASD requires patience and understanding, as these conditions can pull your child in different directions. By recognising the unique challenges posed by both, you can create a supportive environment that helps them thrive. Every child is different and we know what works for one may not work for another, but with the right strategies in place, you can help your child navigate the complexities of both ADHD and ASD and become a superhero.
