Getting tested for autism and ADHD as an adult

Why autism and ADHD are often assessed together

Autism and ADHD are separate neurodevelopmental conditions, but they overlap in real life. Both can involve difficulty with attention, organization, emotional regulation and social situations, though often for different reasons. Many adults recognize themselves in descriptions of both, and some people have both.

Since the DSM-5 was published in 2013, clinicians in the US can diagnose both conditions in the same person. Before that, an autism diagnosis formally ruled out ADHD, which is one reason some adults diagnosed years ago only had one condition named.

How the two can look alike, and how they differ

These are tendencies, not rules. Many adults show items from both columns, and that is part of why a single assessor looking at both is valuable.

Options for getting assessed

• Combined evaluation: one psychologist or neuropsychologist assesses both conditions, usually over several sessions. This is often the clearest route.
• Sequential evaluation: you are assessed for one condition first, then referred for the other. This can happen when different clinicians specialize in each.
• Adding autism after an ADHD diagnosis: if you already have ADHD and treatment helped only partly, you can ask your prescriber or therapist about an autism assessment.
• Adding ADHD after an autism diagnosis: if executive function and restlessness remain hard to manage, ask your clinician whether an ADHD evaluation makes sense.

ADHD can be diagnosed in adults by psychiatrists, psychologists and, in many places, primary care clinicians or nurse practitioners. Autism assessment is usually done by a psychologist or psychiatrist with specific autism experience. Not every ADHD clinic assesses autism, so ask before you book.

How to ask for a combined assessment

When you contact a practice, say plainly that you would like both conditions considered. Example wording: I have noticed patterns that fit both autism and ADHD, and I would like an evaluation that looks at both and at how they interact. Do you offer that, and what does it include?

Ask whether the fee covers both, how many appointments are involved, whether they use an observation measure for autism alongside ADHD rating scales, and whether they speak to an informant. For insurance billing, ask whether both evaluations can be authorized together.

What to bring

• School reports, especially comments about attention, daydreaming, chatting, friendships or behavior.
• Examples from work: how you handle open-plan offices, deadlines, unexpected changes and long meetings.
• Notes on sensory experiences such as noise, textures and lights, since these point more toward autism.
• Notes on impulsivity, time blindness and restlessness, which point more toward ADHD.
• Any medication history, including stimulants, and how they affected you.

What the assessment itself involves

A combined evaluation usually blends the methods used for each condition. For ADHD, expect rating scales completed by you and someone who knows you, questions about whether attention and impulsivity differences showed up in childhood, and a look at how they affect work, money, driving and relationships now. For autism, expect a detailed developmental interview, questions about social understanding, sensory experiences and routines, and often a structured observation.

Some neuropsychologists add cognitive testing, such as tasks of working memory, processing speed and attention. These do not diagnose either condition on their own, but they can show a profile of strengths and weaker spots that is useful for planning work or study accommodations.

At the end, you may hear that you meet criteria for one, both or neither. Each outcome is useful. Knowing that restlessness is better explained by anxiety, for example, or that social exhaustion is linked to autism rather than inattention, changes which strategies are worth trying.

Mental health and timing

Anxiety and depression are common in adults with either condition and can blur the picture. If you are struggling right now, it is fine to address that first or alongside the assessment. Tell the assessor about current mental health so they can interpret results with care. If you ever feel in crisis, help is available now, regardless of where you are in the process.