Assessing ASD+ADHD: Top Tools, Techniques, and Approaches

ASD + ADHD, also known as AuDHD or Autism-ADHD, is a dual diagnosis. It means, in simplest terms, that the patient you are assessing has both ASD and ADHD. Like any ASD diagnosis, however, AuDHD or ASD + ADHD can and will present differently from person to person.

The co-occurring nature of these two conditions can mean one or the other gets diagnosed, but not both. Trauma, masking, and other disorders could also complicate your assessment. That’s why it’s essential that you use the top recommended tools, techniques, and approaches with the children in your charge so that you can provide the most accurate and comprehensive approach that identifies as many of the conditions they have.

What is ASD + ADHD?

The latest scientific literature places the comorbidity rates of autism spectrum disorder (ASD) + attention-deficit/hyperactivity disorder (ADHD) between 50 to 70%, meaning this percentage of individuals diagnosed with ASD also present with ADHD traits (Hours et al., 2022). Now, there is an argument that the prevalence of ASD + ADHD may mean that ASD has attentional traits that are currently being conflated with ADHD. It also highlights the challenges of emphasizing a polythetic diagnosis in psychiatry.

Regardless, the literature today suggests the importance of assessing each individual as an individual. ASD is a spectrum. Being able to accurately assess attention deficit traits is essential for clinicians, therapists, and counselors in the field

Top Tools, Techniques, and Approaches for Assessing Co-Occurring ASD + ADHD

There are several tools, techniques, and approaches that you can use to help you more accurately assess and diagnose ASD + ADHD.

(ADOS®-2) Autism Diagnostic Observation Schedule, Second Edition

Clinicians often consider the ADOS-2 the gold standard diagnostic tool for ASD, but they should use it alongside other tools to effectively diagnose co-occurring ASD and ADHD (De Giacomo et al., 2024). For example, the ADOS-2 can help differentiate social difficulties caused by ADHD versus ASD, but clinicians must include additional tools to avoid false negatives, especially in cases involving masking.  

(MIDGAS-2) Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition

MIDGAS-2 is highly recommended to assess and diagnose ASD + ADHD, as it uses an in-depth interview approach that helps identify and understand potential masking behavior and how the individual experiences the specific traits they have.

(ABAS-3) Adaptive Behavior Assessment System, Third Edition

The ABAS-3 can also be used to help those with ASD + ADHD by assessing their current adaptive skills, so that a more effective understanding of the individual’s strengths and support needs can be gained.  

Further Your Training

Diagnosing only a portion of a child’s condition can lead to ineffective intervention strategies, so to improve outcomes, both ASD and ADHD (if occurring) must be successfully diagnosed (Antshel & Russo, 2019).

There isn’t, however, a single test to determine ASD and ADHD at once. Only with a broad-spectrum approach towards your diagnostic practice can you accommodate comorbid conditions, as well as the effect of masking, into your assessment process. You can learn more about how using ADOS-2, ABAS-3, and the interview-based MIDGAS-2 can help children in your charge.