Combined ADHD & ASD Comorbidity Assessment

Adult ADHD traits can include difficulties in the regulation of concentration, being easily distracted, procrastination, poor processing of information and a tendency towards hyper focus or defocus depending upon the level of interest in a task.

An adult with ADHD may also experience physical restlessness, usually a pumping motion of the lower limbs and fidgeting in the fingers.

A final group of ADHD symptoms are related to impulsivity, which may present as a tendency to vocalise and interrupt, having a dysregulated appetite and/or problems with impulsive spending. 

A diagnosis of ADHD does not require the presence of all these symptoms. For example, you may be identified as having a ‘combined type’ if you exhibit both hyperactivity and impulsive behaviour, or as ‘predominantly inattentive’ if distraction is your main symptom. What’s important is how the symptoms you experience impact your ability to function in various areas of your life.

Autism Spectrum Disorder (ASD) is an umbrella term for a wide range of neurodiverse profiles that share traits including difficulties in interpersonal relationships, a tendency to find it hard to gauge the social content of a conversation or communicate feelings effectively, problems of rigidity of action, a tendency to stick with the same patterns of behaviour regardless of the environment, a tendency to overfocus on one subject and resistance to change. 

ASD in its mildest forms often also presents with sensory processing difficulties, including an exaggerated emotional reaction sometimes to sight, sounds, bright lights or textures. Increasingly it is being recognised that many people with mild Autism also have what is called Rejection Sensitive Dysphoria, which is an overreaction to perceived comments, which can lead to ruminative and negative thinking ADHD. 

Milder forms of Autism Spectrum Disorder and ADHD are often found together in individuals and in fact about 70% of people with ADHD have features of Autism, and approximately 80% of people with Autism have features of ADHD.

They are, therefore, often two sides of the same coin; the ADHD representing a delay in the development of cognitive processes, and Autism could be regarded, for example, as a delay in the emotional recognition circuit in the brain. 

Neurodevelopmental disorders also attract what is known as vertical comorbidity. This refers to a higher rate of secondary mental health issues in neurodiverse individuals. These can include Personality Disorders (particularly Borderline Personality Disorder), Adjustment Disorders, problems with self-esteem, depression and Bipolar 2 Disorder. 

Given the high incidence of overlap between ADHD, Autism and other mental health challenges, a comorbidity assessment is the most useful next step. It provides a comprehensive and informative overview of an individual’s neurodevelopmental and psychological profile, helping in the effective management of these conditions.