A few weeks ago, I wrote an article on Hidden Autism Spectrum in Young Adults. In the article, I talked about the increasing number of college students with both ADHD (Attention Deficit Hyperactivity Disorder) and ASD (Autism Spectrum Disorder) that we find ourselves coaching. Let’s look at a few statistics that might explain this increasingly common occurrence.
Prevalence of ADHD, Other Disorders, and ASD
- Roughly two-thirds of young people with ADHD have a least one co-existing disorder.
- The chance of having a co-existing disorder is six times as great for a person with ADHD as for a person who does not have ADHD.
- Some studies suggest that half of children with ASD also have ADHD.
What is ADHD?
People with ADHD have issues with inattention, hyperactivity, and/or impulsivity. It is primarily a disorder of self-regulation and executive function. ADDers have challenges with “brain management,” including regulating their daily activities.
College presents a major challenge for many young adults with ADHD. Almost overnight, they are “adults.” As adults, society expects them to self-regulate. Yale professor and researcher Thomas Brown uses the term “ADD Syndrome” to describe ADHD. That’s because the symptoms of ADHD overlap with what neuropsychologists call “Executive Functions”:
Not all adults with ADHD experience challenges in every area of Executive Functioning. For example, approximately 70% of our adult ADHD clients typically have below average, low, or very low working memory and processing speed. Yet, some of our adult ADHD clients have higher than average working memory and processing speed.
What is ASD?
ASD is a very different disorder than ADHD. It is a continuum of developmental conditions in which there are problems with social interactions, communication, repetitive behaviors, and/or restricted interests. However, each individual with autism is unique.
For example, a person with ASD can be highly intelligent and verbal with odd social interactions and restricted interests. Or a person with ASD can be moderately intelligent and socially aloof with mildly repetitive behaviors.
This chart demonstrates the very diverse ways in which ASD presents:
Even though a large percentage of adults with ASD have ADHD, parents, mental health professionals, teachers, and others often do not recognize ASD traits. Therefore, it’s important for ADHD coaches to be aware of the diverse ways in which autism can present.
Co-Existing ADHD and High Functioning Autism
The college students that we coach have mild to severe ADHD symptoms. However, since they are in college, they fall into what is sometimes referred to as the “High Functioning Autism” range. In fact, many of them are intellectually gifted. Their high intellect helps to offset some of the academic challenges that other college students often have.
When a parent of a young adult child with both ADHD and High Functioning Autism initially contacts us, they may or may not know that the young adult is on the autism spectrum. They typically describe their child something like this:
“My son’s ADHD is what’s getting in the way of his success at college. He has trouble keeping up with his assignments. My son procrastinates and when he finally gets started on a paper, it’s late. Then he gets anxious and that just makes things worse. He has a few problems with social issues, but you won’t be able to tell when you first meet him. He’s very personable and polite. He really wants friends. It’s just that he’s not always aware of what he needs to do to make friends. And sometimes he says things that are inappropriate. His sister and I try to help him recognize when he does that.”
If the college student has not been assessed for ASD, we ask the parent additional questions to determine the extent of autism spectrum behaviors. We sometimes recommend that the college student have a formal evaluation to determine if the student has ASD. It’s not that a formal assessment is always necessary. It’s just that the more we know about a student, the more effective coaching can be.
What Does ADHD and ASD Coaching Focus On?
The coach’s responsibility is to coach to the student’s identified goal and desired outcome. An effective coach uses a comprehensive set of tools to address issues that can be complex and overlapping.
College students who have both ADHD and ASD usually have challenges meeting their goals. The coach’s job is to discern if an executive function or developmental building block is broken or missing – in a particular moment! Coaching is interactive and dynamic, so a young adult’s issues may vary considerably from day to day or even moment to moment.
As an example, a student with both ADHD and ASD might have a goal to get homework done before the last minute. Yet the student might also have a goal of making one or two friends on campus. He finds himself lonely because of limited social interactions. To compensate, the student engages in Internet “fan fiction” or video games several hours a day to get his social and emotional needs met. That results in him not getting his homework done in time. The student may start feeling unable to catch up. Sometimes he just gives up.
In this situation, the coach’s job is to intervene as early as possible to help the student:
- Become aware of the amount of time he is spending on the Internet.
- Recognize that time spent on the internet is taking away from developing real world social relationships.
- Determine if he needs to work with a therapist about excessive internet usage.
- Think about and plan activities in which he can make social connections and form friendships.
- Decide how much time he needs to study and build study time into his weekly calendar.
- Review upcoming assignments and make a plan for when to work on the assignments.
ADHD and ASD are both complex conditions. When a young adult has both, he or she almost certainly will need more assistance than many colleges can provide.
If your young adult child is struggling to manage both ADHD and High Functioning Autism, click on our contact form today to schedule a free 30-minute consultation.