AuDHD Assessment in Adults: When ADHD and Autism Overlap (Particularly for Midlife Women)
- Ryan Burns
- 18 hours ago
- 7 min read
Last reviewed: 02/26/2026
Reviewed by: Dr. Kiesa Kelly
If you’re looking into an AuDHD assessment, you’re probably not trying to collect labels. You’re trying to make sense of patterns like: “Why is work doable some days and impossible on others?” “Why do social situations drain me?” “Why do I crave novelty and also need predictability?”
In this article, you’ll learn:
What “AuDHD” means and why ADHD and autism can coexist
The overlap clinicians untangle in an ADHD and autism assessment
Why midlife can intensify traits that were easier to manage before
What a combined evaluation can clarify (and what it can’t)
How to choose a provider for an AuDHD assessment in Tennessee
🧭 Key takeaway: A good evaluation is about understanding your support needs, not defining your identity.
What AuDHD means (without making it your whole identity)
“AuDHD” is an informal term many adults use to describe co-occurring autism and ADHD. Clinically, ADHD and autism are diagnosed separately, but they commonly show up together. Reviews and meta-analyses consistently find elevated rates of overlap, although estimates vary depending on the sample and method. [1,2]
Think of AuDHD as a profile: a mix of traits that can affect attention, energy, sensory load, communication style, and stress tolerance. It doesn’t replace your personality, values, or strengths.
Why both can coexist
Autism and ADHD are both neurodevelopmental conditions, and it’s now widely recognized that a person can meet criteria for both. [1,3] DSM-5 (2013) also removed the earlier restriction against dual diagnosis. [3]
Why the combo can look “inconsistent”
With co-occurrence, outward behavior often shifts by context. You might look “together” at work but fall apart at home, or you might be socially skilled but deeply depleted afterward. That doesn’t mean you’re faking; it often means different demands (attention, novelty, sensory/social load) are pulling in different directions. [1]
🧩 Key takeaway: “Inconsistent” can be data. It can point to what drains you and what supports you.
Overlap vs differences: what clinicians try to untangle
A combined ADHD and autism assessment usually focuses on three questions:
Which traits have been present since childhood (even if they were masked)?
Where is the day-to-day impairment right now?
What explanations fit best, and what explanations don’t?
Because anxiety, depression, trauma, sleep disorders, and burnout can mimic or amplify attention and social challenges, a careful differential diagnosis matters. [11,12]
If you’re exploring options, it can help to review what a thorough evaluation typically includes on a psychological assessments page: interview, history, multiple data sources, and clear recommendations.
Executive function vs sensory/social load
“Executive function” is a cluster of skills like planning, starting tasks, shifting gears, and working memory.
In ADHD, executive challenges often show up as difficulty starting, organizing, prioritizing, and sustaining effort.
In autism, challenges can show up as higher cognitive and sensory load in social or unpredictable situations, plus difficulty shifting when the situation changes.
Research suggests different patterns of executive function across ADHD, autism, and the combined profile. [1,2]
Practical example: You can run a meeting because it’s structured, but afterwards you’re wiped out from sensory and social processing. Or you can hyperfocus on a passion project but can’t start the “simple” email that carries uncertainty or social nuance.
Novelty-seeking vs need for sameness (and why both can be true)
This is one of the most common AuDHD “paradoxes.”
ADHD traits can drive novelty-seeking and interest-based attention.
Autistic traits can drive a need for predictability and fewer surprises.
Many AuDHD adults do best with “structured flexibility”: predictable anchors (sleep, meals, routines) plus planned novelty (new learning, creative projects, travel with buffers).
🧠 Key takeaway: Wanting both novelty and sameness isn’t contradictory. It can be your brain trying to balance stimulation and safety.
Why midlife can amplify the AuDHD picture
A lot of women say: “I managed for decades… and then everything got harder.”
That doesn’t mean you were “fine” before. It can mean your coping system finally hit its limit, or the environment changed (more responsibility, less recovery time).
Sleep disruption, stress, hormonal shifts
Midlife often brings layered stressors: parenting, elder care, leadership roles, health changes, and chronic time pressure. Sleep disruption alone can worsen attention, emotion regulation, and sensory tolerance.
There’s also growing research on the menopausal transition and ADHD-related symptoms. In a large cohort study, women with ADHD reported higher perimenopausal symptom burden than women without ADHD, including cognitive and psychological symptoms. [9]
If insomnia is part of the picture, evidence-based care like CBT for insomnia can be an important piece of the plan.
Burnout from decades of compensating
Many adults, especially women, spend years compensating: over-preparing, copying social scripts, and “being the reliable one.” Autistic camouflaging is well described in the research literature and is reported more often by autistic women. [6,7]
Autistic burnout has also been described by autistic adults as a prolonged state of exhaustion and loss of function related to chronic stress and insufficient supports. [8]
🫶 Key takeaway: Burnout is not a character flaw. It’s often a mismatch between demands and supports.
What a combined AuDHD assessment can clarify
A thoughtful AuDHD evaluation can help you move from “What’s wrong with me?” to “What actually fits, and what do I need?”
What fits best and why
A combined assessment often includes:
A detailed clinical interview (developmental history, school/work patterns, relationships, sensory profile)
Rating scales and screeners for adult ADHD and autistic traits
Review of prior records when available
Screening for common look-alikes (anxiety, depression, OCD, trauma, sleep)
Screeners can be a helpful starting point, but they are not diagnoses. For example, the Adult ADHD Self-Report Scale (ASRS) and brief autism screeners like the AQ-10 are designed to flag who may benefit from a full diagnostic evaluation. [13,14]
Misconception #1: “If I made good grades, I can’t have ADHD.”Many girls and women compensate through effort, anxiety, or perfectionism, and inattentive symptoms can be overlooked. [4,5]
Misconception #2: “If I’m empathetic, I can’t be autistic.”Autism is not a lack of caring. Many autistic adults feel deeply; differences are more about processing and load. [12]
Misconception #3: “An online ADHD or autism test will tell me for sure.”Online tools can support self-reflection, but diagnostic conclusions require clinical history and functional impact over time. [11,12]
Support recommendations that match the pattern
A combined report is most useful when it translates findings into practical support. Depending on your goals, recommendations might include:
Systems for task initiation, planning, and prioritizing
Sensory and environment adjustments (noise, lighting, recovery time)
Medication consultation for ADHD symptoms when appropriate
Therapy that is neurodiversity-affirming and adapted to your processing style
Communication and boundary tools to reduce demand load
For some people, targeted executive function coaching is a practical next step once the pattern is clear.
✅ Key takeaway: The goal of assessment is usable guidance, not a perfect label.
How to choose a provider for combined evaluation
Whether you’re searching “adult autism test,” “adult ADHD assessment,” or “AuDHD assessment Tennessee,” provider fit matters as much as the test battery.
Experience with adults + masking + women
Look for someone who:
Routinely evaluates adults (not only children)
Understands masking/camouflaging and late identification in women [6,7]
Can discuss differential diagnoses and explain “meets criteria” in plain language [11,12]
Practical example: If your coping looks like “high achievement + high anxiety,” ask how the clinician separates compensatory strategies from true symptom absence. Women can be missed when impairment shows up as exhaustion, overwhelm, or relationship strain rather than obvious external disruption. [4,5]
Documentation needs (work/meds/accommodations)
If you need documentation for work, school, or medication management, ask in advance what the report will cover and what collateral information they may need (records, prior diagnoses, performance history). Quality standards emphasize clear rationale, evidence sources, and actionable recommendations. [10]
📝 Key takeaway: A strong evaluation answers “why” and “now what,” not just “yes/no.”
Next steps
How to start a combined ADHD/autism evaluation
Write down your top 3 goals (clarity, meds guidance, accommodations, self-understanding).
Gather a few data points: old report cards, prior evaluations, a timeline of major stressors.
Complete brief screeners as a starting point, like the ASRS and the AQ-10.
Choose a provider who evaluates adults and understands masking in women.
Schedule an intake and bring your questions.
If you’d like to talk with our team about assessment options, you can reach us through our contact page and we’ll help you identify the best next step for your situation.
🌿 Key takeaway: The right assessment can turn confusion into a plan.
About the Author
Dr. Kiesa Kelly is a clinical psychologist with a concentration in neuropsychology and more than 20 years of experience in psychological assessment. Her training includes an NIH-funded postdoctoral fellowship with research and clinical focus on ADHD, along with extensive neuropsychological assessment experience across academic medical centers.
At ScienceWorks Behavioral Healthcare, Dr. Kelly provides neurodiversity-affirming assessment and therapy for adults and teens, with specialized work in OCD, trauma, insomnia, and ADHD/autism overlap.
References
Hours C, et al. ASD and ADHD Comorbidity: What Are We Talking About? Front Psychiatry. 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC8918663/
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Leitner Y. The Co-Occurrence of Autism and Attention Deficit Hyperactivity Disorder in Children. J Atten Disord. 2014. https://pmc.ncbi.nlm.nih.gov/articles/PMC4010758/
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Smári UJ, et al. Perimenopausal symptoms in women with and without ADHD: A population-based cohort study. Eur Psychiatry. 2025. https://pubmed.ncbi.nlm.nih.gov/40903825/
Adamou M, et al. The adult ADHD assessment quality assurance standard. BJPsych Open. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11327143/
National Institute for Health and Care Excellence (NICE). Attention deficit hyperactivity disorder: diagnosis and management (NG87). Updated 2025. https://www.nice.org.uk/guidance/ng87
National Institute for Health and Care Excellence (NICE). Autism spectrum disorder in adults: diagnosis and management (CG142). 2012. https://www.nice.org.uk/guidance/cg142
Kessler RC, et al. Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener. Psychol Med. 2007. https://pubmed.ncbi.nlm.nih.gov/17623385/
Allison C, et al. Toward brief “Red Flags” for autism screening: The Short Autism Spectrum Quotient (AQ-10). Psychol Med. 2012. https://pubmed.ncbi.nlm.nih.gov/22265366/
Disclaimer
This article is for informational purposes only and is not a substitute for professional diagnosis, treatment, or medical advice. If you are in crisis or concerned about immediate safety, call 911 or your local emergency number.