Beyond Words: Supporting people with ADHD and Autism

Speech pathologists work with individuals who have autism, ADHD, and sometimes both. While there are many similarities, there are also specific differences that speech pathologists are trained to address. We love Dr. Megan Anna Neff’s Venn Diagram from Neurodivergent Insights that highlights some of these traits.

Source: Neurodivergent Insights

How can a speech pathologist help?

Novelty-Seekers	Routine-Seekers
People with ADHD tend to desire new experiences and stimuli to maintain interest. Speech therapy goals may be based around fun and interactive games. Activities may be frequently changed, to keep clients attentive. We may introduce new toys, fidgets or movement breaks as a ‘new experience’.	Autistic people often prefer structured, repetitive patterns in activities and behaviours. Speech pathologists can plan and create visual timetables with clients, so they know what to expect. We may start sessions the same way each time or follow a familiar routine. We can use checklists and sticker charts to help clients develop a routine.
Varied Interests	Monotropic Focus
Individuals with ADHD often have multiple, fluctuating interests and desires for change. A speech pathologist can adjust therapy activities to incorporate a client’s changing interests (e.g. writing or speaking about a newly acquired hobby). We may offer clients a variety of activities that ultimately target the same goal. Increased choice equals more engagement.	Individuals with Autism may have intense, focused interests around specific topics. We can use one interest to target multiple language goals (e.g. an interest in music to improve vocabulary, sentences and following directions). We may use characters related to an interest area (e.g. Roblox, Ninjago) to practice social skills such as perspective taking.
Difficulty with social awareness and responses	Preference for direct communication
Some individuals with ADHD may interrupt, talk a lot, or miss social cues due to impulsivity or inattention. We may support a client to develop their awareness of what others are thinking or feeling in a moment. We can teach strategies for conversation turn-taking or waiting to speak. Role play and modelling can help support social understanding.	Autistic people may not always understand implied messages, sarcasm or body language. They may communicate in direct ways, which is not a problem! Speech pathologists can teach both clients and others in their life about the value of direct, honest communication. We can also help autistic clients decode sarcasm or hidden meaning, if they want support in that area. Social stories or visuals can help build understanding of common social experiences.

If you think you might need support in any of these areas, reach out to us.

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Jenkinson, R., Milne, E., & Thompson, A. (2020). The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis. Autism, 24(8), https://doi.org/10.1177/1362361320932437

Martinez, S., Stoyanov, K., & Carcache, L. (2024). Unraveling the spectrum: overlap, distinctions, and nuances of ADHD and ASD in children. Frontiers in Psychiatry, 15. https://doi.org/10.3389/fpsyt.2024.1387179

Davis, N. O., & Kollins, S. H. (2012). Treatment for Co-Occurring Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder. Neurotherapeutics, 9(3), 518–530. https://doi.org/10.1007/s13311-012-0126-9

Poole, D., Gowen, E., Poliakoff, E., & Jones, L. A. (2021). “No idea of time”: Parents report differences in autistic children’s behaviour relating to time in a mixed-methods study. Autism, 25(6). https://doi.org/10.1177/13623613211010014

Roberts, Julie. “Why Perspective-Taking and Neurodiversity Acceptance?” Therapist Neurodiversity Collective, 15 Feb. 2020.
https://therapistndc.org/why-teach-perspective-taking-neurodiversity-acceptance/

Cardillo, R., Crisci, G., Seregni, S., & Mammarella, I. C. (2023). Social perception in children and adolescents with ADHD: The role of higher-order cognitive skills. Research in Developmental Disabilities, 135, 104440.
https://doi.org/10.1016/j.ridd.2023.104440