You crave routine but get bored by it. You can hyperfocus for hours on something fascinating, yet can’t make yourself start a simple task. You need quiet to recover from people, then feel restless when things get too quiet. If one diagnosis has never fully explained you, you may be living with both autism and ADHD, often called AuDHD. A combined evaluation looks at both conditions together, so you get one coherent answer instead of two partial ones.
Evaluations are conducted by Dr. Alan S. Jacobson, Psy.D., MBA, a licensed clinical psychologist with more than 25 years of experience in adult diagnostic assessment. He is licensed in Massachusetts, California, New Hampshire, and New York, and holds PSYPACT authority to evaluate adults virtually across 44 states.
A free 15-minute consultation helps you decide whether a combined evaluation or a single-focus evaluation fits your situation.
Quick answer: “AuDHD” is an informal term for having both autism and ADHD. Since DSM-5 was published in 2013, clinicians can formally diagnose both in the same person, and research estimates that 50 to 70 percent of autistic people also have ADHD. A combined evaluation assesses both conditions in one integrated process, which matters because their traits overlap and can mask each other. The result clarifies whether you have autism, ADHD, both, or neither, and what each means for treatment and support.
What “AuDHD” Means
AuDHD isn’t a separate diagnosis. It’s a community term for people who meet criteria for both autism spectrum disorder and attention-deficit/hyperactivity disorder. Until 2013, the diagnostic manual didn’t allow clinicians to diagnose ADHD in someone with autism, so many adults who have both were only ever identified with one. DSM-5 removed that restriction, and research has since confirmed how often the two occur together. A 2022 review in Frontiers in Psychiatry cites meta-analytic estimates that 50 to 70 percent of autistic people also have ADHD.
Why the Combination Is So Easy to Miss
Autism and ADHD pull in different directions in some areas and overlap in others. When both are present, each can hide or reshape the other, so neither looks like the textbook version:
| Area | Autism tends toward | ADHD tends toward | When both are present |
|---|---|---|---|
| Routine | Needing sameness and predictability | Seeking novelty; bored by routine | Needing routine but struggling to keep one; distress when plans change, restlessness when they don’t |
| Attention | Deep focus on interests; difficulty shifting attention | Difficulty sustaining attention on uninteresting tasks | Intense hyperfocus alternating with scattered attention; hard to start and hard to stop |
| Social interaction | Difficulty reading unwritten social rules | Interrupting, losing track of conversations | Social exhaustion compounded by impulsive missteps; often misread as rudeness or disinterest |
| Sensory experience | Overwhelm from noise, light, or textures | Seeking stimulation and movement | Needing stimulation and quiet at the same time; easily overloaded yet under-stimulated |
| Organization | Rigid systems that break under change | Chronic disorganization and time blindness | Elaborate systems that are hard to maintain; burnout from constant compensating |
Masking adds another layer. Many adults, especially women, have learned to hide autistic traits, which can leave only the ADHD visible. Others have built such rigid structures to manage ADHD that the underlying autism goes unnoticed. See autism evaluation for women and ADHD in women.
Is a Combined Evaluation Right for You?
Diagnosed with ADHD, but it doesn’t explain everything
Medication or coaching helped your focus, but social exhaustion, sensory sensitivities, rigid thinking, or meltdowns remain. Autism may be part of the picture.
Diagnosed with autism, but still chaotic
You understand your autistic traits, yet chronic disorganization, time blindness, impulsivity, or restlessness persist. ADHD may be co-occurring. Our adult ADHD testing can be added on.
Suspecting both from the start
You recognize yourself in both autistic and ADHD descriptions and want one evaluation that sorts out the overlap rather than two separate processes.
Treatment hasn’t fit
Approaches built for one condition, or for anxiety or depression, have helped only partly. Clarifying the full neurodevelopmental profile often explains why. See second-opinion testing.
What the Combined Evaluation Includes
The evaluation follows DSM-5 criteria for both conditions and is designed to separate overlapping traits rather than simply count symptoms:
- In-depth developmental interview. Childhood, school, friendships, sensory experiences, attention, and coping strategies, with attention to which difficulties came first and how they interacted.
- Collateral history. With your permission, a parent, sibling, partner, or someone who knew you as a child completes questionnaires or a brief interview. Early history is essential for both diagnoses.
- ADHD measures. Adult ADHD rating scales from you and an observer, plus a retrospective childhood scale.
- Autism measures. Self-report instruments such as the RAADS-R and SRS-2, a camouflaging measure when masking is likely, and structured observation such as the ADOS-2 where appropriate.
- Objective attention testing, carefully interpreted. Computerized measures such as the Conners CPT or TOVA. Results are read in context, because attention difficulties in autism can reflect trouble shifting focus or sensory overload rather than ADHD.
- Cognitive, executive, and sensory measures. Working memory, processing speed, executive functioning, and sensory processing, which reveal specific strengths and support needs.
- Screening for other look-alikes. Anxiety, depression, learning disabilities, sleep problems, and emotional dysregulation.
- Validity measures. Standard performance validity testing confirms results reflect your genuine functioning.
- Integrated feedback and report. One written report explains how the pieces fit together, with recommendations that address both conditions at once.
Four Possible Outcomes
A combined evaluation doesn’t assume you have both. It’s designed to find the most accurate answer, which could be any of these:
- Both autism and ADHD. Recommendations account for how the two interact, for example building routines flexible enough to stay engaging.
- Autism only. Attention difficulties are better explained by autistic traits such as difficulty shifting focus, sensory overload, or social exhaustion.
- ADHD only. Social or sensory differences are better explained by ADHD, anxiety, or other factors.
- Neither, or something else. Another explanation, such as anxiety, trauma, a learning disability, or a sleep problem, accounts for your difficulties.
Each answer is valuable, because each points to different supports. For a deeper look at how clinicians tell the two apart, see ADHD or autism?
Medication and Treatment Considerations
Getting the combination right matters for treatment. ADHD medication can be very effective for people with both conditions, but some research suggests autistic people may respond differently to stimulants, so prescribers often start carefully and monitor closely. Psychologists don’t prescribe; the evaluation gives your physician, psychiatrist, or nurse practitioner a clear picture of both conditions and baseline measures to track treatment. See ADHD evaluations for medication decisions.
Non-medication supports often work best when tailored to both: coaching that respects sensory needs, therapy that addresses burnout as well as attention, and accommodations that combine structure with flexibility. Therapy is available through Dr. Jacobson’s therapy practice, including ADHD coaching.
Accommodations at School and Work
A combined diagnosis supports accommodations that address both conditions, such as a quiet workspace plus written deadlines and check-ins, or extended exam time plus a reduced-distraction room. Our reports link each recommendation to specific findings, which is what colleges and employers look for. See workplace accommodations, college accommodations, and ADHD testing for college students.
Case Examples
These composite examples reflect common presentations. Details have been changed to protect privacy.
ADHD diagnosis that only explained half the story
- Presentation
- A 29-year-old software developer was diagnosed with ADHD at 22. Medication improved his focus, but he still felt drained by meetings, was overwhelmed by open-office noise, and struggled when plans changed at the last minute.
- Key findings
- ADHD confirmed; lifelong social communication differences, sensory sensitivities, and need for predictability described by his parents; elevated autistic traits on self-report and observation.
- Outcome
- Diagnosed with autism in addition to ADHD. He requested noise-canceling equipment and written agendas before meetings, and his therapist shifted focus toward energy management and recovery time.
Autistic adult who still couldn’t get organized
- Presentation
- A 38-year-old graphic designer had been diagnosed with autism two years earlier. The diagnosis helped her understand social and sensory differences, but she still lost track of time, missed deadlines, and abandoned routines within weeks.
- Key findings
- Childhood history of distractibility and impulsivity confirmed by her mother; elevated ADHD ratings across settings; inconsistent sustained attention on objective testing, even on tasks without sensory demands.
- Outcome
- Diagnosed with ADHD, predominantly inattentive presentation, in addition to autism. She discussed medication with her psychiatrist and began coaching that built flexible routines with built-in novelty.
Suspected both, found one
- Presentation
- A 24-year-old graduate student strongly identified with AuDHD descriptions online and wanted a combined evaluation. She described distractibility in class and intense focus on her research.
- Key findings
- Autism clearly supported. Attention difficulties occurred mainly in noisy, unpredictable settings and reflected difficulty shifting attention and sensory overload; ADHD criteria were not met across settings, and childhood history showed no early ADHD pattern.
- Outcome
- Diagnosed with autism; ADHD not supported. Sensory accommodations and a quiet study space improved her focus substantially. Knowing which condition drove her difficulties helped her choose the right supports.
Cost and Logistics
Because it covers two diagnostic questions, a combined autism and ADHD evaluation typically ranges from $2,000 to $3,000, depending on scope. If you’ve already been diagnosed with one condition, an add-on evaluation for the other may cost less. The fee is confirmed before testing begins. We don’t bill insurance directly, but we provide a superbill for possible out-of-network reimbursement. Most of the evaluation can be completed by secure telehealth in any PSYPACT state or in Massachusetts, California, New Hampshire, or New York, with in-person options in greater Boston and San Diego. See testing costs and our virtual testing guide.
Frequently Asked Questions
What is AuDHD?
AuDHD is an informal, community-created term for people who have both autism and ADHD. It isn’t a separate diagnosis in DSM-5; instead, a person receives two diagnoses, autism spectrum disorder and attention-deficit/hyperactivity disorder. The term caught on because the combination creates a distinct experience, such as needing routine while craving novelty, or hyperfocusing deeply while struggling to start ordinary tasks, that neither diagnosis fully captures on its own.
Can you have both autism and ADHD?
Yes. Before 2013, the diagnostic manual didn’t allow ADHD to be diagnosed alongside autism, so many adults were only ever given one diagnosis. DSM-5 removed that restriction, and clinicians can now diagnose both when criteria for each are met. Co-occurrence is common: research estimates that 50 to 70 percent of autistic people also have ADHD. A careful evaluation determines whether both are truly present or whether one explains the other’s apparent symptoms.
Why evaluate for autism and ADHD at the same time?
Because their traits overlap and interact. Attention problems, social difficulties, emotional intensity, and disorganization can come from either condition or both. Separate evaluations may attribute everything to whichever condition is being tested. A combined evaluation lets one clinician weigh the evidence together, identify which traits come from which condition, and produce one integrated report with recommendations that account for both. It’s usually also more efficient than two separate processes.
Can autism and ADHD mask each other?
Yes. ADHD’s need for novelty can disguise autism’s preference for routine, while autistic rigidity and elaborate coping systems can hide ADHD disorganization. Social camouflaging, especially common in women, can leave only ADHD traits visible. As a result, many people with both conditions are diagnosed with one, or with anxiety or depression instead. Evaluating both together, with a detailed developmental history, makes it far less likely that one condition is missed.
I already have an ADHD or autism diagnosis. Can I be evaluated for the other?
Yes. Many adults come to us after one diagnosis that explained only part of their experience. We review your prior report, then focus testing on the remaining question while confirming that the original diagnosis still fits. An add-on evaluation may be shorter and cost less than a full combined evaluation. If your earlier report is unavailable or very old, a complete combined evaluation may be more appropriate. We’ll discuss this during your free consultation.
Does ADHD medication work for people who are also autistic?
It can be very helpful for many people with both conditions. However, some research suggests autistic people may respond differently to stimulant medication, so prescribers often start carefully and monitor closely. Psychologists don’t prescribe; your physician, psychiatrist, or nurse practitioner makes medication decisions. A combined evaluation helps by documenting both conditions clearly and providing baseline measures, so your prescriber can tailor treatment and track how well it works.
What if I suspect AuDHD but only one condition is found?
That’s a valuable result, not a failed one. Autism alone can cause attention difficulties through sensory overload or trouble shifting focus, and ADHD alone can cause social and emotional challenges. Knowing which condition is actually driving your difficulties helps you choose supports that work. The report explains why the evidence pointed one way and what to do next. If your experience changes or new information emerges, reassessment is always possible.
Can a combined autism and ADHD evaluation be done online?
Most of it can. Interviews, collateral input, questionnaires, many cognitive measures, and computerized attention testing work well by secure telehealth. Dr. Jacobson can evaluate adults virtually in any PSYPACT state or in Massachusetts, California, New Hampshire, or New York. Some structured observation may be done in person in greater Boston or San Diego when it adds meaningful information. We’ll recommend the best format during your free consultation.
How much does a combined autism and ADHD evaluation cost?
A combined evaluation typically ranges from $2,000 to $3,000, depending on scope, because it answers two diagnostic questions. If you already have one diagnosis, an add-on evaluation for the other may cost less. The fee is confirmed before testing begins. We don’t bill insurance directly, but we provide a superbill you can submit for possible out-of-network reimbursement, so check your plan’s out-of-network benefits before scheduling.
Related Services
One Evaluation, the Whole Picture
If you’ve never felt fully explained by a single diagnosis, a combined evaluation can show how autism and ADHD fit together in your life and what will actually help. Start with a free 15-minute consultation. Current wait time is about 10 to 14 days. For community and education, CHADD and AANE offer resources for adults with ADHD and autism, and the National Institute of Mental Health provides a clear overview of autism.
Evaluations conducted by Dr. Alan S. Jacobson, Psy.D., MBA, licensed psychologist in Massachusetts (7110), California (PSY 34380), New Hampshire (1650), and New York (024941), with PSYPACT authority (#14929). Member, National Register of Health Service Psychologists.
