Do I Have Autism? ADHD? Both? An Adult’s Guide to Diagnosis and Treatment (w/ Benjamin Yerys, Ph.D.)

Autism and ADHD coexist at significantly elevated rates, and adults with both disorders face unique challenges. Symptoms of both conditions can resemble one another – one reason why clinicians typically screen for both during assessment. While research on adult autism and ADHD is scarce, clinicians largely agree on best practices in the evaluation and treatment of patients with both disorders. In this hour-long ADDitude webinar with Benjamin E. Yerys, Ph.D., learn about autism in adults, and how ADHD may complicate the picture.
#adhdawareness

2:00 Conflict of Interest
2:18 Formal Diagnostic Criteria
2:36 Social Communication and Social Interaction
5:13 Repetitive Behaviors
11:38 ASD Specifiers
13:24 Levels of Support
18:26 What Prompts An Autism Referral?
19:29 ASD and ADHD
23:32 ASD Evaluation
26:04 Adaptive Behavior
27:34 Psychiatric Assessment
37:48 Take Away on Functional Impact of ADHD Symptoms

Related Resources:
1. ADHD and Adult Autism: Symptoms, Diagnosis & Interventions for Both

3. Download: The Truth About Autism in Adults

[SavageThrifter]

It is literally so hard to take those questionnaires when you have adhd and suspect autism. It's like 2 opposite people living in one body so I can't really answer one answer to those questions. Because I am different all the time

[ItsjustBeth-wkqi]

As far as masking… females have more pressure from family and society to not act irritated or angry or tolerance for meltdowns. We are forced at an early age to stifle that and made to learn “acceptable” behavior.
My opinion on “loosing a diagnosis” is that people learn to mask. This may be helpful during your 20-30’s but it becomes mentally exhausting as you age and causes shutdown. Shutdown causes people in their late 40’s-50’s-60’s to lose jobs, relationships and become recluse. There is no cure. And ignoring the harm in masking is where you are going wrong in research for adults.

[dmcsunshine]

It honestly feels like no one cares. Im tired of being misunderstood and or disbelieved. I looked in the mirror when I was 35 and I could see the pain showing through my camouflage. I never even knew that was what I was doing. I had to try to get help and no one has even mentioned autism but it makes total sense. Its been a nightmare! Now new information is available via YouTube and I am 55. I’ve been told it’s too late to diagnose because my mother is passed away and I have no one to verify my story.
I feel pathetic.

[sgall]

I think he’s wrong to say you can outgrow it. It is a part of one’s neurology. Can one learn to live with it? Yes. Will it always be a part of someone who is correctly diagnosed? Also yes.

[vickicarringer]

When I drive at night I get overwhelmed. It took me awhile to figure out why I had such bad anxiety when driving at night. I finally realized it was due to the enhanced external stimuli. Lights from cars...sounds of cars..music playing..I get overwhelmed. If it raining at night that adds another layer. Just wondering if anyone else experiences this meltdown when driving?

[zia_kat]

yikes. "learning to cope" is not "growing out of autism". no one "grows out of autism". also find it horrendous that autism speaks was included as a resource. it's a hate group. please don't do that.

[bennywright]

I got diagnosed with ADHD a couple of years back and started medication. They also recommended CBT because i have developed a poor self image. In my first session the therapist says sounds like you have high functioning autism… my only concern is if you go looking for problems are probably going to find some. Doesn’t everyone have their issues and struggles?? I worry i’m just collecting labels which at the end of the day won’t change anything… i will still be considered rude, i will still be called stupid and useless by people. Sometimes i think I should just use the words other people will use because very few people will give you the benefit of the doubt in life. I was once told you’re at least two people, who you think you are and who other’s think you are. the only one that counts is who others think u are as they hold the keys to getting along in life.

Say I offend someone, then i spot it afterwards, which is often the case. What do i say then? No no no you don’t understand i said that thoughtless insensitive thing coz autism. They still won’t want to spend time with me 🤷‍♂️ Anyway great talk!

[ashmoleproductions]

AS: " Autism speaks, and thats a problem."
This whole webinar was basically, "Sorry we have nothing. Keep looking." The anger this inspires cannot be understated.
Of course there is more than one kind of autism, that has been readily apparent for decades just from reading a couple of the studies. Are clinicians really so unaware or too lazy to find out about the developments in their fields? You all keep searching for a panacea for Autism when it has been readily apparent there is none for decades. There is no one size fits all. So many promising treatments that could have helped a population of autism sufferers disregarded because it did not help another. How wastelful, how evil. Then you have the gal to mention a CBT type for adults then say "wait five years" Disgusting. We have lives, they are finite you cannot just stop the timer for bureaucracy. We need something now not later. I wish I could get my time back.

[pollystyrene]

@its just beth made an important observation in that as a young person females learn to mask, stifle their irritation and anger to be socially acceptable, so many of us are undiagnosed. The medical profession has failed us. Here's a little of my story, I imagine there's many of us undiagnosed spectrum folk who can relate: The social aspect of school was painfully intolerable so I dropped out and I never fit in anyway. Despite this, I did very well in my early career, I was identified as top management calibre for an international bank in my late twenties, by early 30's I was head of the canadian division. I was invited to be a partner by another firm. But I was struggling to mask my social anxiety and a raft of things that others seemed to have no problem with. Masking is exhausting, I started to crack in my 40's, venting irritation instead of masking and trying to please. Eventually i shutdown. Experienced job and relationship issues in my 40s-50's-60's. My 40's were a nightmare, I cracked amidst a storm of personal and professional challenges. I lost my partnership as I stopped wanting to leash my irritation and intolerance of people and bad systems. I was too tired to mask and this non-conformity put a target on my back. Looking back I wish someone had put me forward for a diagnosis, but in my day the "bell mental health' supports weren't a thing, but firing outliers was. Now I'm 60 and unlikely I'll get a job again.

[avgirlaustintx]

I found the title to be misleading because 90% of the talk was about Autism and then he just threw ADHD there at the end.

[UnburiedTalents]

I'm a THERAPIST ON THE SPECTRUM, late diagnosed at 43, now 48. I'm looking to connect with other therapists who are late-diagnosed autistic. Autism became my specialty, real quick! I got my license in 2005 before the DSM 5 came out. Wow, was my education about autism and Asperger's minimal! I don't recall spending even one hour discussing autism in ANY class, on the college or graduate level. At that same time, I got diagnosed with dysthymia (remember that one?) and recurrent depression. My father (also autistic) was believed by mom's therapist to have symptoms of schizoaffective disorder and narcissism (his mindblindness is strong). My self-diagnosis in Honors Psych 101 was Avoidant Personality Disorder. It wasn't until my brother, seeking help for his social issues at work (nuclear medicine), started trying suggestions from a book about Asperger's in the workplace, that the seed of exploration was planted for me. It's all over our family for 4 generations that we know of.

[Synchrodipity]

This contained some useful information -- However, he virtually dismissed personality disorder comorbidity and all those people who have been misdiagnosed -- and it's the 'either or' approach here that fails a lot of people.

I have ADHD, Dyspraxia and in the middle of a second-opinion ASD assessment, and really would not want this man to be assessing me.

[bookbeing]

Sensory overload is enough to drive a person mad. Sounds, smells, textures can be overwhelming, like someone turned up the volume past 10.

[jonathanberry]

🎯 Key Takeaways for quick navigation:

00:00 🧩 *Overview of Autism Spectrum Disorder Diagnosis*
- The diagnostic criteria for Autism Spectrum Disorder (ASD) include two major domains: Social Communication and Interaction and Repetitive Behaviors.
- In the Social Communication and Interaction domain, behaviors like reciprocity, nonverbal communication, and relationship development are evaluated.
- The Repetitive Behaviors domain covers repetitive movements, speech, object use, and the need for sameness.
08:41 📊 *Prevalence and Other Considerations*
- The prevalence of autism is estimated at one in 54 individuals.
- There has been progress in reducing racial disparities in diagnosis, but Hispanic youth are still less likely to receive a diagnosis.
- About 75-80% of children with autism also have a diagnosis of ADHD.
16:46 🤝 *Intersection of Autism and ADHD*
- Rates of co-occurrence of autism and ADHD vary depending on the study, but they can range from 20% to 65% in adults.
- The diagnostic criteria for both conditions can sometimes overlap, making it challenging to distinguish them.
- Social components of ADHD symptoms can resemble features of autism, creating complexity in diagnosis.
21:42 🔍 *Assessment Challenges and Lack of Gold Standard*
- There is currently no gold standard diagnostic practice for distinguishing between autism and ADHD in adulthood.
- Clinicians may face challenges in differentiating symptoms due to the lack of clear guidelines.
- Assessment practices for ASD and ADHD in adulthood are still evolving.
21:56 📋 *Diagnosing Autism and ADHD*
- Autism and ADHD diagnoses are based on behaviors that develop over time.
- The challenge is piecing together a person's history to understand their challenges.
- There are gold standard tools for evaluation, including developmental history and screening questionnaires.
24:00 🧩 *Autism Screening Tools*
- Autism screening tools like the Social Communication Questionnaire and Autism Quotient are used.
- These tools help assess social communication skills and traits related to autism.
- The Autism Diagnostic Observation Schedule (ADOS) is considered a gold standard for childhood evaluations.
26:17 🌟 *Adaptive Behavior Assessment*
- Adaptive behavior assessments measure daily living skills, socialization, and coping skills.
- These assessments help understand an individual's independence and how they function in their daily life.
- They are essential for evaluating autism in adulthood.
28:07 🧠 *Psychiatric Assessment and Differential Diagnosis*
- Psychiatric assessments consider various differential diagnoses, including social anxiety, generalized anxiety, and ADHD.
- Distinguishing between autism-related behaviors and other conditions is crucial.
- It's important to rule out other psychiatric conditions when diagnosing autism.
30:02 🧒 *ADHD and Autism in Childhood*
- ADHD symptoms in children with autism can impact adaptive behaviors.
- ADHD may add complexity to supporting children with autism.
- Research has shown that ADHD symptoms can affect independence and quality of life in children with autism.
32:07 🧑 *ADHD and Autism in Adulthood*
- ADHD symptoms continue to impact daily functioning and quality of life in adults with autism.
- Addressing ADHD symptoms in adulthood may improve independence and overall well-being.
- This research highlights the need for tailored interventions for adults with both conditions.
42:54 📋 *Diagnosis and Treatment in Adults*
- The importance of finding the right treatment for ADHD in adults.
- Emphasizing clear goals and outcomes in ADHD treatment.
44:01 🧩 *Seeking a Diagnosis for ASD in Adults*
- Challenges in finding qualified providers for autism diagnosis in adults.
- The value of starting with a psychologist for autism evaluations.
- Looking for credentials and training related to autism in potential providers.
45:10 🏥 *Professional Organizations and Resources*
- Mention of Autism Speaks as a resource for finding autism providers.
- The Autism Roadmap website as a helpful resource for autism-related questions.
- Suggestions for looking for autism centers at major universities with medical centers.
50:18 🚺 *Diagnosis Challenges for Women with Autism*
- The delayed diagnosis of autism in females.
- The concept of masking and how it affects diagnosis in women.
- The ongoing debate about the lower autism diagnosis rate in females.
53:20 🧬 *Genetic Component of Autism*
- Confirmation of a genetic component in autism.
- Discussion of genetic overlap between different neurodevelopmental disorders.
- The role of numerous genes with small effects in contributing to autism.
55:01 🧩 *Outgrowing Autism in Adulthood*
- The possibility of individuals outgrowing their autism diagnosis.
- How coping mechanisms and life experiences can impact diagnosis.
- The challenges for clinicians when diagnosing adults who have adapted to their traits.

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[kindische.kaiserin]

.. made me laugh when he apologized for speaking fast since I'm watching this at 1.5x speed. wouldn't be able to focus/process at a lower speed. anyone else?

[innovationsanonymous]

"I apologize if I'm talking fast." It's ok. I'm listening at 2x speed

[oreradovanovi]

It's scary as hell that there is no research on adults, that there's no training for basic understanding of Asperger's.

[astrammd]

Going to a provider who can do goldstanded diagnostic assessments, like the ADOS2, may also be important when considering insurance coverage for ASD related services or treatments later on.

[brandonlee]

It's all starting to make sense now now. I realise why this is all been miss leading from the very start, since I was back in 1986 being born after hours cut for my mum's Billy umbilical cord.It is all making sense so I remember being wrapped around the tree, 🌳 in the 90s because the car was aride off, then 6 other car crashes followed then all the hard times at school primary school high school teachers putting me down the road I'll never have a future and kids buying me then in 2020 fast forward a bit and I'm in hospital in recovering from an infection on my lower and now still going through the hurdles of life hard ways of the yin and yang, then I thought I was dead, so I finished myself. My nephew was in the car 🚗 I'm not sure I think my mum was in shock, I was definitely in shock I couldn't remember a lot of things because I'm tails & mum is cancer like sonic, my nephew was knuckles like Capricorn so he wouldn't have felt any pain, the tails was already dead in Sonic 2 on the Sega Master, it happened so quickly but still and I'm pretty sure I have ADHD autism and at my mind is running 88 miles an hour so I'm so I'm just leash you I'm going to have it till the day I die and people cut understand my difficulty hard some people even tell me I'm intimidating but yeah I don't care🤷🏻‍♂️. I'm me and I'm only always be me I can't be anybody else like all the zodiac signs of the astrologist company of the shin Garuda code💭. And as for my older sister she passed away on a thing called dialysis which I'm pretty sure is caused by smoking but yet alone I could be wrong because most of the time a lot of people can die from natural causes as well✌️👋🏼.

[brendascally]

I think doctors are missing the mark with those that have Aspbergers and ADHD. Level of interest and longevity while helpful is too narrow a descriptor. Those with ADHD will have been distracted and moved on, so seemingly, a great number of interests suddenly precludes one from an ASD diagnosis. This isnt being talked about enough and is not serving us well.