What actually happens during an AuDHD assessment?

AuDHD is an informal term used to describe people who are both Autistic and ADHD. It’s not a separate diagnosis in diagnostic manuals, but it is a very real and increasingly recognised neurotype. Autism and ADHD frequently co-occur; research shows that, on average, about 38.5% of individuals with autism also meet criteria for ADHD, based on a meta-analysis of 63 studies (Rong et al., 2021). 

A good assessment looks at both profiles together, rather than treating them as isolated conditions. An AuDHD assessment is about understanding what is happening and using that understanding to inform the sorts of accommodations or changes which might help a person achieve what they want to; whether it be at home, school or work. This begins with the sense of why might the person think they have autism, or ADHD, or both, building in the assessors’ conception of this and examining what is going on for that person in a number of ways such as asking questions about the range of things that make up Autism and ADHD, observing how a person behaves in different situations and asking questions of those that know them how they have behaved and understood things across their lives.

At Autism Positive, we start with a conversation about you, to find out more about what led you to us.

We then follow the process below:

Step 2 (in more detail): Developmental History 

A developmental history will be taken, whereby clinicians are looking for lifelong patterns, not just current struggles. You may be asked for information about:

• Early childhood behaviour
• Play, friendships, and social communication
• Sensory sensitivities
• Attention, impulsivity, and hyperfocus
• School experiences
• Emotional regulation

Step 4 & 5 (in more detail): Interview / Assessment with Client and Significant Others

The core of the assessment is usually one or more structured or semi‑structured interviews /assessments.

Don’t worry! These are not tests that you can fail. One of our assessors will guide you through the conversation carefully. You might talk about:

• How you experience social interaction
• Communication style
• Executive functioning (planning, time, organisation)
• Sensory processing
• Emotional intensity or shutdowns
• Masking and burnout

For autism, tools like the ADI‑R or ADOS‑2 may be used.

For ADHD, interviews focus on:

• Inattention
• Hyperactivity (including internalised restlessness)
• Impulsivity

Step 6: Multi-disciplinary Meeting

A big part of an AuDHD assessment is differential diagnosis. At Autism Positive, our team of professionals come together to analyse all the collected evidence and ask some very important questions. Such as:

• Which traits are best explained by autism?
• Which fit the criteria for ADHD?
• Which may overlap or interact?
• Are there other factors to consider (trauma, anxiety, learning differences)?

Step 7: What happens after the diagnosis?  

After the diagnosis, the team would talk through the findings, explaining where our narratives about Autism and ADHD meet, or where they diverge (at times when we are not offering a diagnosis). This then develops into how the understanding we have reached can inform the goals and needs deriving from the assessment.

This is an opportunity to ask questions and reflect on the process and consider what changes or support might be helpful in the future.

For ADHD, the question of medication is also relevant after the diagnosis. ADHD medication has been found to be very effective and the majority of people find a medication which suits them; offering tolerable side effects and noticeable benefits. The question of medication is a very personal one however, with many concerned about the effects of taking tablets. This is to be respected and spoken through with medical professionals.

If you are considering an AuDHD assessment for yourself or supporting someone who is, feel free to get in touch with us via our contact form on the website https://autismpositive.co.uk/contact-us/ or email us at autism@talktherapyuk.com

We’d be happy to answer your questions and guide you through our comprehensive AuDHD assessment. 

References:

Rong, Z., Wang, Z., Zheng, Y., Song, J., Lai, Y., & Zhou, Y. (2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83, Article 101759. https://doi.org/10.1016/j.rasd.2021.101759