16 FEBRUARY 2026
AuDHD refers to the co-occurrence of both ADHD and autism. Because the traits of these two conditions often overlap, AuDHD can be difficult to recognise and diagnose, making it challenging to determine the most effective ways to provide support. In this article, we’ll provide an overview of what AuDHD is, highlight common traits and challenges, and offer practical strategies to help you support your child or young person.
In 2013, the DSM-5 was updated to allow for a dual diagnosis of autism and ADHD. Before this change, children could only be diagnosed with one or the other, even when their presentation clearly reflected both. This shift marked an important moment in recognising that neurodevelopmental profiles do not fit neatly into single categories.
Why AuDHD was often overlooked
For many years, families noticed that their children met the diagnostic criteria for autism, showing social differences, sensory processing differences, and repetitive behaviours or interests. At the same time, those same children often showed clear signs of hyperactivity, impulsivity, and a constant drive for movement.
Traditional autism-friendly strategies were not always effective for these children. Parents frequently found themselves comparing their child to others in support groups and wondering why approaches that worked well for some autistic children did not seem to help their own. This led to confusion, frustration, and a sense that something important was being missed.
We now understand that while labels can be helpful, children cannot be made to fit them. Instead, our understanding must flex to reflect the child in front of us.
How does AuDHD impact children?
Children with AuDHD often experience the world at a fast pace. Impulsive actions may happen suddenly and be forgotten just as quickly, leaving parents trying to make sense of what just occurred. However, this impulsivity is often followed by reflection, rumination, and worry.
This creates a striking contrast. On the outside, a child may appear impulsive or chaotic, while internally they may be deeply thoughtful, anxious, and self-critical. Many children with this dual profile spend a great deal of time replaying events in their minds, wishing they had acted differently.
Over time, this can lead to increased anxiety and lower self-esteem, particularly as children become more aware of how their behaviour affects others.
Anxiety and self-esteem in AuDHD
In practice, many children with AuDHD experience higher levels of anxiety than might be expected. They are often very aware of their differences and may worry about getting things wrong, upsetting others, or not meeting expectations.
This emotional load can be exhausting. Children may appear confident or energetic on the surface, while internally managing feelings of self-doubt and worry. Recognising this hidden emotional effort is essential when supporting children with a dual diagnosis.
The importance of structure with choice
One approach that is often particularly helpful for children with AuDHD is the use of clear structure combined with meaningful choice. Everyday situations that involve too many options or sudden changes can quickly become overwhelming.
During busy or unfamiliar times, such as holidays, children may struggle to make decisions when faced with multiple possibilities. Their detailed and fast-paced processing can cause options to blur together, making it difficult to choose what to do. When this happens, some children may avoid choosing altogether and move towards less suitable activities instead.
Providing visual structure, breaking options into clear categories, and allowing children to take control within those boundaries can be very supportive. Simple tools, such as lists, visual prompts, or tick-off systems, can help children organise their thoughts and feel more in control of their environment.
Creating supportive, accessible environments
The aim is to reduce anxiety by making environments feel predictable and manageable. When children understand what is available to them and can make choices in a structured way, they are less likely to become overwhelmed or stuck in cycles of rumination.
Supporting children with AuDHD means creating spaces where they can engage, explore, and make decisions without fear of getting it wrong.
A note on diagnosis pathways
It is also worth noting that ADHD is often identified before autism. ADHD-related behaviours tend to be more noticeable earlier on, while autism may be recognised later in childhood. Being mindful that these two diagnosable profiles often run in parallel can help families better understand their child’s needs and experiences.
Recognising AuDHD is not about adding labels, but about gaining clarity and responding with understanding and flexibility.