Why Does ADHD Often Get Diagnosed BEFORE Autism?

Jun 27
3 min read

Updated: Jul 15

It’s a question more and more people are starting to ask—especially adults who received an ADHD diagnosis and later began to wonder if there might be more to the story.

Many people (especially women, AFAB individuals, and adults) are diagnosed with ADHD first, only to later uncover that they’re also autistic.

And no, it’s not because ADHD always shows up first.

It’s because ADHD is often more visible and socially accepted, while autism is more easily masked or misunderstood.

ADHD & Autism: Co-Occurrence Is Common

Studies show that 50–70% of individuals with ASD also have ADHD. [Source] The overlap is real and significant, yet so many adults go undiagnosed.

It’s because ADHD symptoms tend to be more externally visible, more socially accepted, and more likely to be recognized by teachers, parents, and professionals earlier.

ADHD Is Easier to Spot (Especially in School)

ADHD symptoms like:

Hyperactivity
Impulsivity
Distractibility
Trouble sitting still or waiting their turn

…tend to stand out in structured environments like school or at home during childhood.

Teachers, parents, and pediatricians are more likely to recognize these behaviors early on, especially if they’re disruptive or noticeable in a group setting.

By contrast, autistic traits like:

Deep special interests
Sensory sensitivities
Social confusion or avoidance
Monotone speech or flat affect
Need for routine or repetitive behavior

…often get misread as personality quirks, shyness, or anxiety—especially in individuals who’ve learned to mask those traits well.

A cute woman shyly hides her face. Her social troubles and sensory sensitivities still linger behind her.

Masking: Autism Can Hide in Plain Sight

Many autistic people (especially women and AFAB folks) learn to mask from an early age. This means:

Forcing eye contact even when it feels unnatural
Mimicking facial expressions or tone
Rehearsing social scripts
Pushing through sensory discomfort without showing it

Masking can make autism symptoms almost invisible to teachers, parents, and even professionals.

On the other hand, executive function struggles like forgetfulness, disorganization, and impulsivity (hallmarks of ADHD) are much harder to hide.

"ADHD First" Diagnostic Bias

Mental health and educational systems are often trained to recognize ADHD when someone struggles with focus, behavior, or motivation.

Autism, especially when it doesn’t present with stereotypical traits, is often overlooked unless someone is actively looking for it.

In many cases, people are diagnosed with ADHD, begin treatment, and then later notice:

“Huh... I’m still struggling with social exhaustion, sensory overload, and feeling different in ways ADHD doesn’t fully explain.”

Once the fog of executive dysfunction begins to lift (through ADHD meds or strategies), underlying autistic traits can become clearer.

Wondering if It Might Be Both?

If your ADHD diagnosis doesn’t explain everything… Trust that instinct. Many ADHDers later uncover that they’re neurodivergent in more than one way.

Here are some signs it might be autism too:

You feel like you have to force emotions or words to “perform” socially
You have repetitive stims like tapping, humming, rubbing, or repeating words/sounds
Even small changes in plans or environment often feels disruptive and dysregulating
Sensory sensitivities (sound, light, fabric, textures) feel physically painful
Social interactions are confusing, exhausting, or leave you feeling like you’re performing instead of connecting

Being curious about whether autism might be part of your neurodivergent experience doesn’t mean your ADHD diagnosis was wrong, it means you’re growing in your understanding of yourself.

Both ADHD and autism are deeply nuanced and highly individual. You deserve to understand your brain, your needs, and your experiences more fully; not because you need to “fit” into a diagnosis perfectly, but because you deserve to feel seen.

So if something about your current diagnosis feels incomplete…