Diagnosing ADHD and Autism in Adults


Diagnosing ADHD and Autism in Adults

Bored lazy student girl hands wasting time playing with pens sitting on a desk at home

If you work hard to stay organized but never seem to be able to get it together; if social situations that seem easy for others frequently end in blunders for you; or if you’ve always had the feeling that you’re just not quite like everyone else, you might be neurodivergent.

The term neurodivergent is used to describe individuals with autism, ADHD, and more, and means that an individual’s brain functions differently than the “average” (neurotypical) person.

Conditions like autism spectrum disorder and ADHD (which aren’t always accurately portrayed in popular media) are more common than most people realize. If you think you may be neurodivergent, even as an adult, it’s never too late to benefit from an accurate diagnosis.

Neurodivergence and Executive Functioning

Neurodivergence is a relatively new word – it’s only been in use since the 1990s – that refers to individuals whose brains process information differently from most people. Dr. Lee Kearns, clinical neuropsychologist at WWMG, explains that neurodivergent conditions like autism and ADHD “are both constellations of executive functioning challenges,” that can impact life.

Executive functioning skills include the ability to plan, organize, and manage processes and oneself to achieve a goal.

Someone with executive function disorder may:

  • be easily distracted
  • be emotional
  • be impulsive
  • have poor time management skills, and
  • Have trouble starting or completing tasks

Crossover Between ADHD and Autism

Developmental issues such as ADHD, autism, social pragmatic communication disorder, and some attachment issues can all present in overlapping ways. ADHD and autism often co-occur, meaning many people on the autism spectrum also have ADHD. But not all folks with ADHD necessarily have autism.

Although ADHD stands for attention deficit hyperactivity disorder, some people with ADHD are not noticeably hyperactive. As early as the 1980s, most hyperactive kids got diagnosed, while ADHD kids who were not disruptive in class – especially girls – were overlooked and often still are.

“If you sit quietly and look out the window at birds, the teachers don’t complain, and you don’t get diagnosed. I see a lot of smart, inattentive females who clearly have struggled their whole life,” said Kearns. At the same time, “The old diagnostic criteria for autism were so restrictive that nobody fit in those little boxes.”

That means many adults with executive function challenges remain undiagnosed today.

Symptoms of Autism and ADHD

Typical symptoms of autism include:

ADHD also comes with social challenges, and is associated with:

But the symptoms of both conditions are highly variable among individuals and can differ both by age and gender.

Masking Executive Functioning Challenges

“Boys get diagnosed with ADHD a lot more than little girls. Is that because it’s more common? I don’t know that it is,” said Kearns. Executive functioning has a social element, and from a very young age, girls are socialized in ways that tend to mask executive functioning challenges like autism and ADHD.

“Camouflaging or masking is really three different parts: how hard have I worked to develop skills that didn’t come naturally, how hard will I work to utilize those skills, and how hard am I working to try to keep people from seeing how hard I’m working,” said Kearns.

Women mask a lot more often and more effectively than men. “I’ve found that adult females oftentimes are really good at masking and getting along in a way in which other people don’t necessarily notice it.”

With age, people of all genders learn how to mask and how to create compensatory structures in their life that help them function, which can also make their differences less obvious to others as they become adults.

Diagnosis of Adults with Autism Spectrum Disorder

The criteria for an autism diagnosis changed in 2013 with the publication of the DSM-5, which eliminated Asperger’s and other diagnoses and folded them into autism spectrum disorder.

Today, autism diagnoses are assigned to three levels reflecting the amount of support a person needs to function in daily life, ranging from high functioning to those with considerable social and behavioral challenges that require significant support.

The CDC reports that the occurrence of autism spectrum disorder in the U.S. increased from one in 68 in 2010 to one in 44 in 2018, probably resulting more from the changing diagnostics than from an actual increase in occurrence. But even with much broader diagnostic criteria, most screening is given to young children vs adults. It can still be hard to find a doctor who will evaluate an adult for autism.

Seeking a Diagnosis

Although many adults have found effective ways to compensate for their neurodivergence, a diagnosis can still be valuable for both practical and emotional reasons. WWMG’s Psychology clinic offers evaluations for autism and ADHD, to determine if a diagnosis is appropriate for an individual.

Kearns says many patients are relieved when they receive their diagnosis. They often say, “I have spent my entire life feeling different and I don’t know why. Now I understand why I’ve struggled so much.”

Practically, a diagnosis can pave the way for interventions and support that may improve a person’s life.

Diagnosis “has a life-long impact, [and with interventions] people can get so much better,” said Kearns. Medications can help treat ADHD. Sensory integration treatment can help with sensory issues. Using “theory of mind” therapists can help neurodivergent individuals develop important communication and social skills.

“It’s unfair, but a lot of life is dependent on whether you can pull off social interactions with other adults. There is treatment available. There are ways in which someone can improve upon their ability to interact with others at work and at home,” said Kearns.

External structures also play a major role in helping neurodivergent individuals maximize their potential. For example, Bellevue College has a program called the Neurodiversity Navigators that provides structured social opportunities, coaching, and executive functioning seminars for students with ADHD and autism.

Beyond school, workplace accommodations are available and can be helpful for adults with a diagnosis.

“It’s not about getting a bunch of stuff because they can’t do their job, it’s that there are ways they can do their job much better and it’s in the employer’s best interest to provide those supports,” said Kearns.

How to Get Evaluated for ADHD or Autism

“Both ADHD and autism bring superpowers and challenges. There is a good argument that the degree of work an autistic person puts in to figure out patterns of behavior, looking for the ways in which people interact with one another so that they can figure out the social part of life, trains their brain to be the world’s best data scientists,” said Kearns. “Those early social challenges help them build those skills in a way that allows them later to do exceptional things.”

Most insurances will cover an evaluation for ADHD, Autism, or other executive function challenges. Whether an individual’s difficulties are associated with a developmental difference or something else, the first step to making life easier is assessing and identifying the problem. If you suspect that you or a family member may be neurodivergent, contact WWMG Psychology to request an evaluation today. Our team is here to help.