Introduction
In Explaining AuDHD, Dr Khurram Sadiq offers a timely and accessible exploration of the intersection between Autism Spectrum Condition (ASC) and Attention Deficit Hyperactivity Disorder (ADHD), bringing clarity to a domain often characterised by diagnostic ambiguity, professional inconsistency, and experiential invisibility. This book emerges from both clinical experience and personal reflection, bridging autobiographical narrative and structured analysis to provide what the author terms a "framework aimed at helping others" understand themselves or those they care for (Sadiq, 2025, p. 2). Comprising seven chapters, the text journeys from definitions and history to the contested territory of diagnostic boundaries, culminating in a passionate call for better understanding and support for those with co-occurring conditions. The result is a highly readable yet conceptually rich contribution that deserves attention across disciplines.
Chapter 1: Introducing the Basics of Autism and AuDHD
This opening chapter grounds the book in a deeply personal grief narrative -- Sadiq's reflections following the death of his father -- and uses it as a lens to introduce the concept of AuDHD. He candidly describes a familial and professional "revelation" where traits once interpreted as idiosyncrasies reveal themselves as undiagnosed neurodevelopmental differences: "It was during my work -- conducting assessments that look for both Autism and ADHD -- that I saw how different these conditions can appear when they intersect, compared to when they are diagnosed separately" (Sadiq, 2025, pp. 1-2). The chapter situates AuDHD not only as a clinical overlap but as a lived experience that may defy binary thinking and resist standard categories.
Here, Sadiq introduces the term 'AuDHD', noting that it is "not a formal nomenclature, but how the neurodiversity community and support groups like to refer to those with co-occurring Autism and ADHD" (Sadiq, 2025, p. 5). By weaving anecdotal case studies with broad epidemiological observations -- citing research showing "the co-occurrence of Autism Spectrum Condition (ASC) and Attention Deficit Hyperactivity Disorder (ADHD) is estimated to be between 50-70 per cent" (Sadiq, 2025, p. 5) -- this chapter effectively establishes the rationale for a book-length treatment.
Importantly, Sadiq also engages with the neurodiversity paradigm, highlighting its evolutionary and sociocultural roots. He acknowledges Judy Singer's contributions and invokes Jim Sinclair's (1993) "Don't Mourn for Us" as a pivotal text that "stands as a cornerstone in the Autism movement" (Sadiq, 2025, p. 9). This sets the tone for a text that is both scientifically literate and socially responsive, though the rapid transitions between personal narrative, historical overview, and theoretical frameworks occasionally feel disjointed.
Chapter 2: Autism
Chapter 2 explores Autism in detail, offering an integrated account of its behavioural, emotional, cognitive, and social dimensions. The descriptions are vivid yet rooted in diagnostic criteria, with the author drawing on DSM-5 and ICD-11 while still retaining the preference for the term Autism Spectrum Condition (ASC), as aligned with the neurodiversity paradigm. Sadiq notes that "within the Neurodiversity Paradigm, the term Autism Spectrum Condition (ASC), or simply Autism, is preferred" (Sadiq, 2025, p. 18). Through striking clinical vignettes -- such as the autistic teenager interpreting "It's raining cats and dogs" as an unjust omission: "That's not fair, where are the chipmunks?" (Sadiq, 2025, p. 17) -- Sadiq illustrates how literalism, sensory sensitivities, and emotional regulation challenges coalesce in unique ways for each individual.
The chapter excels in tracing historical shifts -- from Bleuler's early use of the term in 1911, through Kanner and Asperger's contributions in the 1940s, to the reframing of Autism as a spectrum in DSM-5 (Sadiq, 2025, pp. 19-21). The section on myths and misconceptions is especially valuable in correcting persistent falsehoods, such as the MMR vaccine myth, drawing on robust studies like the Danish Cohort Study which "encompassed all children born in the country between 1991 and 1998, totalling over 537,000 participants" (Sadiq, 2025, p. 26). Moreover, Sadiq deftly introduces the "double empathy problem" to challenge unidirectional models of social difficulty, explaining that "misunderstandings in communication and empathy do not only happen because people with Autism struggle to understand non-autistic people, but also because non-autistic people often have difficulty understanding those with Autism" (Sadiq, 2025, p. 30).
However, the chapter's treatment of gender differences feels cursory, with only brief mention that "the actual male-to-female ratio might be closer to 3:1 or even 2:1" (Sadiq, 2025, p. 24), a topic deserving more substantial exploration given its significance for diagnostic accuracy.
Chapter 3: ADHD
This chapter provides a sharp yet compassionate analysis of ADHD as a neurodevelopmental condition affecting executive function, attention, impulse control, and emotional regulation. Sadiq presents a typology of ADHD using DSM-5 categories -- Predominantly Inattentive, Hyperactive-Impulsive, and Combined Type (Sadiq, 2025, p. 44). His attention to real-world manifestations is notable: the "floordrobe" as a symptom of disorganisation (Sadiq, 2025, p. 41) and "the ADHD tax" as a reference to misplaced essential items (Sadiq, 2025, p. 42) bring texture and relatability to clinical abstraction.
The chapter's strength lies in its capacity to capture ADHD's nuances without reducing the condition to clichés. Sadiq describes ADHD as characterised by "a constant need for stimulation" largely due to "an imbalance in the brain's neurotransmitters, specifically dopamine and norepinephrine" (Sadiq, 2025, pp. 43-44). The author's defence against dismissing ADHD as merely a "TikTok diagnosis" is particularly compelling: "Labelling ADHD as a 'TikTok diagnosis' undermines the genuine struggles and experiences of those affected by the condition" (Sadiq, 2025, p. 53). This argument for digital literacy across generations is both timely and necessary.
Chapter 4: When Autism and ADHD Overlap
This chapter articulates the core of the book's argument -- that the co-occurrence of Autism and ADHD is both common and distinct, requiring more than the sum of its diagnostic parts. Drawing on layered case examples -- such as "a woman in her mid-fifties who sought an ADHD assessment" after "delay[ing] this assessment for nearly three decades" (Sadiq, 2025, p. 5) and a patient whose hypervigilance to a dropped charger indicated underlying sensory processing difficulties (Sadiq, 2025, pp. 6-7) -- Sadiq demonstrates how symptoms of one condition may mask or mimic the other.
Although Autism and ADHD have "distinct and separate diagnostic criteria," Sadiq notes that professionals often struggle to distinguish between them, leading to diagnostic confusion and missed overlaps (Sadiq, 2025, p. 61). The chapter's systematic examination of overlapping features through seven paired comparisons (such as "Inattention vs Indifference" and "Hyperfocus vs Preoccupations") provides valuable clinical insight, though the binary presentation occasionally oversimplifies the spectrum nature of these conditions.
Chapter 5: The Rise of AuDHD
Here, Sadiq charts the cultural, clinical, and diagnostic ascendance of AuDHD as a framework. He argues that the increasing use of this label reflects not diagnostic creep, but epistemological correction. The author notes that "individuals with AuDHD describe their experience as akin to having split personalities, reminiscent of Dr Jekyll and Mr Hyde" (Sadiq, 2025, p. 103), capturing the internal conflict many experience.
Sadiq identifies multiple pressures driving the rise: improved adult assessment pathways, growing self-advocacy, social media connectivity, and the crucial fact that "until 2013, it wasn't possible to diagnose someone with both Autism and ADHD at the same time" (Sadiq, 2025, p. 102). The discussion is enriched by an evolutionary lens -- linking the Hunter-Farmer Hypothesis to a mismatch between neurodevelopmental traits and modern environments, suggesting that "what were once essential traits for survival and innovation can now be perceived as challenges or disorders" (Sadiq, 2025, p. 11).
Chapter 6: Is AuDHD a Separate Diagnosis?
In one of the most intellectually charged chapters, Sadiq confronts the epistemological and taxonomical tension surrounding AuDHD. He acknowledges that "AuDHD is not officially recognised as a distinct diagnosis within the major diagnostic manuals" (Sadiq, 2025, p. 141), yet defends its clinical utility. The chapter presents balanced arguments for viewing AuDHD either as part of a neurodevelopmental spectrum or as a distinct entity, noting that "the intersection of Autism and ADHD is a complex and often misunderstood space" (Sadiq, 2025, p. 177).
His personal narrative about his own AuDHD diagnosis adds authenticity: "Now I understand that my Autism is where I draw my perseverance and my grit... At the same time, my ADHD is where my creativity comes from" (Sadiq, 2025, p. 159). While this risks essentialising these conditions, it provides valuable phenomenological insight.
Chapter 7: Towards a Better Understanding of AuDHD
The final chapter returns to a tone of hopeful advocacy. Sadiq reiterates that recognition, not reductionism, should guide practice. He outlines a manifesto of sorts: greater training for professionals, deeper engagement with neurodivergent narratives, and a wholesale shift toward compassion-driven care. Sadiq underscores that acknowledging AuDHD serves as an important form of validation, noting that "when people feel recognised, it can have a profound impact on their self-esteem and mental health" (Sadiq, 2025, p. 191).
The chapter addresses practical implications, noting that "traditional treatments for Autism and ADHD have evolved separately" but for individuals with AuDHD, "these separate treatment pathways are often insufficient" (Sadiq, 2025, pp. 192-193). His concluding assertion that "the work we do today to recognise and support individuals with AuDHD will lay the foundation for a future where neurodiversity is not just accepted but embraced" (Sadiq, 2025, p. 203) provides an aspirational vision, though the chapter could benefit from more specific, actionable research questions.
Critical Assessment
Explaining AuDHD is a rare achievement: it is accessible without being reductive, passionate without losing rigour, and scholarly without alienating its lay readership. The book's key strength lies in its integrative approach -- drawing from psychiatry, social theory, evolutionary psychology, and the neurodiversity movement -- to reframe what it means to live with, assess, and support those with Autism and ADHD. Sadiq's dual perspective as clinician and person with lived experience provides unique insights, particularly in describing the phenomenology of AuDHD.
However, several limitations warrant attention. The oscillation between clinical text and personal memoir sometimes compromises analytical rigour. Greater engagement with empirical studies beyond anecdotal and historical reference points would strengthen its academic foundation. The absence of critical discussion on racialised or culturally variant presentations of neurodevelopment is a missed opportunity. Similarly, the treatment of gender differences remains underdeveloped, despite acknowledgement that "AuDHD is often underdiagnosed in girls and women" (Sadiq, 2025, pp. 149-150).
Conclusion
Explaining AuDHD represents a valuable contribution to neurodevelopmental literature, particularly in raising awareness of this increasingly recognised dual diagnosis. Sadiq has produced a work that is both timely and necessary. For clinicians, it offers a practice-changing lens through detailed phenomenological descriptions and practical guidance. For neurodivergent readers, it offers language, legitimacy, and validation of their experiences. For the field, it offers a robust, compassionate intervention in an ongoing diagnostic debate.
While the book may not resolve fundamental questions about the nature of AuDHD or its place in psychiatric nosology, it succeeds in putting this important clinical phenomenon firmly on the map. The practical implications of recognising AuDHD are profound, changing approaches to treatment, education, and workplace accommodations. Ultimately, Sadiq's work challenges readers -- especially clinicians and educators -- to re-evaluate their assumptions and approaches, contributing to a future where neurodiversity is truly understood and embraced.