of co-occurring conditions
What are co-occurring conditions?
You might have heard that it’s very common for autistic people to have one or more co-occurring conditions - but what does that mean, and what are some examples of co-occurring conditions?
Put simply, a co-occurring condition is any stand-alone condition you have, in addition to being autistic. These range from the commonly diagnosed, such as ADHD and dyslexia, to lesser-known conditions such as alexithymia, echolalia and dysgraphia.
While not all of these conditions can be found in diagnostic manuals, and some are simply considered by professionals to be part of an autistic person’s profile, it is important to recognise the impact they may have on the lives of an individual, as well as those around them.
So to help raise awareness and understanding, we’ve pulled together this comprehensive A to Z of co-occurring conditions.
ADHD
Around three in 10 autistic children and adults also have ADHD, which stands for attention deficit hyperactivity disorder. ADHD can present as difficulty focusing, having a short attention span, being unable to sit still, losing or forgetting things, and acting without thinking.
Alexithymia
This affects around one in five autistic people. It means having trouble with immediately identifying, understanding or finding words to describe emotions. Someone with alexithymia can also have difficulty feeling emotions that are deemed socially appropriate.
Anorexia
Autistic women are more likely to develop this severe eating disorder than nonautistic women. This might be linked to high anxiety, rule-bound behaviour, difficulty feeling hunger or sensory problems with food. Symptoms include a very low body weight, missing meals and excessive exercising.
Anxiety
Two in five autistic children and adults are diagnosed with an anxiety disorder. Common triggers are a change in routine, sensory overload, social situations, and specific fears like dogs. It can lead to meltdowns, overthinking, self-soothing behaviour and seeking reassurance.
Aphantasia
Aphantasia – sometimes referred to as mind blindness – is when someone can’t visualise a person or an object in their mind. It affects around 2% of the general population but more than 5% of autistic people, research has suggested.
Apraxia
A neurological condition that leads to difficulty with motor skills for movement or speech. Someone with speech apraxia finds it hard to speak clearly and consistently – they might distort sounds and make mistakes – even if they understand language at the appropriate level.
ARFID
Stands for avoidant and restrictive food intake disorder, where someone has a limited diet in range and quantity, often because of sensory issues linked to the taste, texture, smell or appearance of certain types of food.
Auditory processing difficulties
People with auditory processing difficulties usually have normal hearing but struggle to interpret the sounds they hear. This can make it difficult to understand speech when background noise is present, to recognise slight differences between sounds in words, or to follow verbal directions.
BBipolar disorder
A mental health condition which usually involves extreme mood swings including mania and depression. It can lead to difficulties with sleeping and eating, risky behaviour and apparent changes in personality. It usually develops in the late teens and can be treated with therapy and medication.
Body dysmorphia
A mental health condition that affects men and women, where they spend a lot of time worrying about perceived flaws in their appearance. It can lead to depression and self-harm and is treated with either therapy or anti-depressant medication or both.
Borderline personality disorder
Also known as emotionally unstable personality disorder, BPD can mean difficulties with relationships and sense of identity, intense emotions, feeling empty and insecure, and acting impulsively. Some people feel they were misdiagnosed with BPD before they got their autism diagnosis.
Clinical depression
CAround half of all autistic adults have experienced depression at some point in their lives. Depression is a mental health condition that leads to continuous low mood, feeling hopeless, lack of energy, social withdrawal and an increased risk of suicidal thoughts.
DDown’s syndrome
People with Down’s syndrome have been born with an extra chromosome, affecting the way their brain and body develop. Up to 20% of people with Down’s syndrome screen positive for autism.
Dyscalculia
Difficulty in understanding numbers which can affect people whatever their age or abilities. It can involve a lack of an intuitive understanding of numbers, simple number concepts, how numbers relate to each other and patterns.
Dyslexia
A life-long learning difficulty which affects information processing, reading and writing skills. It can also lead to difficulties with organisation, sequencing, memory and time perception.
Dyspraxia
A neurological condition that affects movement and physical coordination. It can present as clumsiness, poor spatial awareness, and difficulties with organisation and planning. Verbal dyspraxia can mean difficulty keeping up with conversations.
EEating disorders
Mental health conditions that involve using food and eating to cope with difficult emotions or situations. They can lead to eating too much or too little, or becoming obsessed with weight. Some research suggests that up to 23% of people with an eating disorder are also autistic.
Echolalia
The repetition of others’ words or sentences. It can be immediately after someone says something, or it can be delayed – for example, a line from a favourite film or a phrase heard from a specific situation in the past. It can be a way of stimming or a means to communicate.
Ehlers-Danlos syndromes
A group of genetic conditions affecting connective tissue that can cause loose, unstable joints, hypermobility, joint pain, fragile or stretchy skin, dizziness and extreme tiredness. They can also lead to digestive problems and dizziness after standing up.
Epilepsy
Around 12% of autistic people have epilepsy compared to 1% of the general population, with most having their first seizure as a teenager. Epileptic seizures can involve temporary confusion, uncontrollable jerking movements and loss of consciousness.
FFragile X syndrome
A genetic condition that can lead to learning, communication and social difficulties, as well as emotional and behavioural problems. Up to half of males and 15% of females with Fragile X also have a dual autism diagnosis.
Fibromyalgia
A long-term condition that causes pain all over the body, increased sensitivity, stiffness, sleep difficulties, headaches and problems with concentration and memory. The cause is unclear but it appears to be triggered by physical or emotional stress.
GGender dysphoria
Discomfort or distress that someone feels when their assigned sex is different from the gender they identify with. Research suggests that autistic people are more likely than the general population to have gender dysphoria, though there is no evidence as to why.
Gut problems
Gastrointestinal problems such as constipation, diarrhoea and a bloated stomach are more common in autistic people than the general population. Opinion is divided on whether this is a genetic, sensory, food allergy or stressrelated issue.
HHyperacusis
This is increased sensitivity to noise, meaning that everyday sounds seem much louder than they should – even to the extent that they are painful. This could include sounds like a barking dog or someone chewing.
Hyperlexia
An intense fascination with numbers or letters, which can cause a child to have a reading ability well advanced for their age. Despite this, people with hyperlexia have difficulty understanding spoken language and initiating conversations.
Hyperverbalism
This can present as verbal fluency and sophisticated vocabulary. Despite this, a hyperverbal person can still have difficulty understanding context, figurative language or social communication.
Hypomania
A milder version of mania that typically lasts for a shorter period, leading to a period of over-active and high energy behaviour. Symptoms can include feeling happy, excited, agitated or easily distracted, and talking a lot, sleeping less and taking risks. It can leave people feeling tired, ashamed or depressed.
IInsomnia
Autistic people can often have sleep problems, caused by irregular melatonin levels, sensory distractions or difficulties winding down. On average, adults should be getting 7-9 hours of sleep, children need 9-13 hours and toddlers and babies need 12-17 hours.
Irlen syndrome
An issue with the way the brain processes visual information. It can lead to light sensitivity, sensory overload, problem with depth perception and print or environmental distortion. Sometimes treated by coloured lenses.
J K
Joint hypermobility syndrome
Very flexible joints, which causes pain. Symptoms can include tiredness, joint pain, frequent dislocation of the joints, poor balance, thin, stretchy skin and bladder or bowel problems. Part of a range of hypermobility disorders which includes Ehlers-Danlos (above).
KBG syndrome
A rare genetic condition characterised by distinctive facial features and learning disability. Symptoms can include large teeth, widely spaced eyes, hearing loss and curvature of the spine.
Learning disability
LAlthough autism is not a learning disability, around four in 10 autistic people have a learning disability. Learning disability affects intellect – that’s why it’s sometimes known as intellectual disability – and is separate from specific learning difficulties, such as dyslexia.
MMast cell activation syndrome
Mast cells are part of our immune system, and create the symptoms of an allergic reaction. When they act abnormally, they can cause itching, a rash, eye irritation, wheezing and pain. Triggers can include alcohol, heat, insect bites and some medications.
Mental health issues
Everyone can suffer mental health issues but they are more common in autistic people. Almost eight in 10 autistic adults have a mental health condition, four in 10 suffer depression at some point in their lives, and six in 10 have had suicidal thoughts.
Neurofibromatosis type 1
NA genetic condition that causes benign tumours to grow along the nerves. In most cases it affects the skin, causing brown birthmarks, clusters of freckles in unusual places and soft tumours on or under the skin. It is also associated with learning disabilities.
OCD
OObsessive compulsive disorder (OCD) is a mental health condition, causing a person to have obsessive thoughts and compulsive behaviours. It can affect anyone - with symptoms often appearing during puberty and early adulthoodhowever some research suggests that autistic people may be more likely to experience OCD.
ODD
Oppositional defiant disorder (ODD) is characterised by negative behaviourssuch as a young person losing their temper or defying requests - towards authority figures such as parents or teachers. ODD is commonly seen in 50% of children with ADHD (above).
PTSD
PPost-traumatic stress disorder (PTSD) is an anxiety disorder (see above) caused by very stressful, frightening or distressing events. Symptoms are often severe and can have a significant impact on an individual’s dayto-day life.
Personality disorders
A person with a personality disorder thinks, feels, behaves or relates to others very differently from the average person. There are several different types of personality disorder - such as borderline personality disorder and antisocial personality disorder - and symptoms vary.
Prosopagnosia
Also known as face blindness, prosopagnosia is a neurological disorder characterised by the inability to recognise faces. Some people may not be able to tell the difference between strangers or people they do not know well. Others may not recognise the faces of friends and family, or even their own face.
Photophobia
A heightened sensitivity to light, which may be caused by an underlying eye condition such as cataracts or glaucoma.
Prader-Willi syndrome
A rare genetic syndrome that causes a wide range of physical symptoms, learning difficulties and behavioural challenges. Typical symptoms include: excessive appetite and overeating, weak muscles, restricted growth and learning difficulties.
PoTS
Postural tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down. The most common symptoms are feeling lightheaded or dizzy, palpitations (being aware of your heartbeat) and fatigue.
Panic attacks
Panic disorder is an anxiety disorder (above) where you regularly have sudden attacks of panic or fear. This happens regularly, at any time, and often for no apparent reason. Symptoms of a panic attack include: racing heartbeat, feeling faint and dizzy, sweating, shortness of breath and a feeling of dread, among others.
Pathological demand avoidance
Some autistic people may present with a demand avoidant profile, which may have been highlighted as part of their autism assessment. A person with this profile may display responses such as: difficulty responding to demands and requests, a strong need to be in control, differences in controlling and regulating emotions.
Pica
This is the medical term for children eating non-edible items. It occurs more frequently in children with learning difficulties and is associated with autism.
QQ deletion syndromes
Otherwise known as DiGeorge syndrome, it is a condition present from birth that can cause a range of lifelong problems, including heart defects, mental health problems and learning difficulties. It occurs when a small piece of genetic material is missing from a person’s DNA.
RRestriction of diet
Restricted eating is common among autistic children and is not simply ‘fussy eating’. While a child should never be forced to eat, a restricted diet can lead to further health issues, such as vitamin deficiencies (below).
(School) Refusal
The term school refusal has been replaced with ‘emotionally-based school avoidance’ which refers to reduced or nonattendance at school by a child or young person. EBSA recognises that this avoidance has its root in emotional, mental health or wellbeing issues. It is believed that, due to the anxieties they experience, autistic children may be more at risk of EBSA.
Synesthesia
Synesthesia is a neurological condition in which stimulation of one sensory or cognitive pathway (for example, hearing) leads to experiences in a second sensory or cognitive pathway (such as vision). Put simply, this could be seeing shapes or colours when you hear music.
Seizures
These are sudden bursts of electrical activity in the brain that temporarily affect how it works. Seizures can affect people when they’re awake or asleep, and can affect people in different ways. Some may cause the body to jerk (commonly known as ‘a fit’), while others cause problems like a loss of awareness. Seizures are a common symptom of epilepsy (see above).
Sensory processing disorder
Commonly linked to autism, sensory processing disorder is a neurological condition in children that can affect the way the brain processes information from the senses. People can be hyposensitive (reduced sensitivity) or hypersensitive (easily stimulated).
Situational mutism
Also called selective mutism, this is an anxiety-based mental health disorder which usually affects people in early childhood. Those affected may speak fluently in some situations, but remain completely silent in others.
Social communication disorder
A condition which makes it difficult to communicate with other people. It’s more about processing language, rather than a speech impediment. People with social communication disorder may not follow the unwritten rules of language, often not understanding sarcasm or non-literal language.
TTrauma
When we experience something that is very stressful, frightening or distressing, this can be described as trauma. Traumatic events can happen at any age and, as trauma is deeply personal, everyone is affected differently. Research indicates that autistic people may be more likely to experience traumatic life events.
Tinnitus
Tinnitus is the name for hearing noises that do not come from an outside source, and can typically sound like a buzzing or ringing. While there is no definite cause for tinnitus, it is often linked to hearing loss, Meniere’s disease, anxiety or depression (above) or certain medications.
Tuberous sclerosis
A rare genetic disease that causes the development of mainly benign (non-cancerous) tumours, which most commonly affect the brain, skin, kidneys, heart, eyes and lungs.
Tourette’s syndrome
Tourette’s syndrome causes a person to make involuntary sounds and movements, called tics. There is no cure for Tourette’s, but treatment can help manage symptoms. People with Tourette’s syndrome may also have OCD, ADHD or learning difficulties.
Urophobia & coprophobia
UThose with urophobia will be unable to or have serious difficulty urinating when they are away from home. While coprophobia is an excessive fear of bowel waste, which can cause anxiety or avoidance behaviour. Around 40% of autistic people are diagnosed with anxiety disorders (above).
VVisual impairments
Visual impairment is the term used to describe a loss of sight that cannot be corrected using glasses or contact lenses. The leading cause of visual impairment in adults is age-related macular degeneration, while other causes include glaucoma and cataracts.
Vitamin deficiency
A varied, balanced diet usually provides all the vitamins we need, however some autistic people may have a restricted diet which could result in a deficiency. Common symptoms include: shortness of breath, tiredness, raised heart rate, brittle hair/nails, hair loss and mouth ulcers.
Vestibular neuritis
Vestibular neuritis is an inner ear disorder that causes symptoms such as sudden, severe vertigo, dizziness, balance problems, nausea and vomiting.
Williams syndrome
A rare genetic condition, Williams syndrome occurs randomly and affects 1 in 18,000 people in the UK. It affects everyone in different ways, but many of those with Williams Syndrome will have a learning disability and often share distinctive facial characteristics including a wide mouth with a pronounced bottom lip, slightly high and rounded cheeks, and widely-spaced teeth.
Wilson’s disease
An inherited genetic disorder, in which the liver stores extra copper, rather than getting rid of it within bile. While the body needs small amounts of copper to stay healthy, excessive amounts can be toxic and damage the liver, brain and other organs.
XXXY syndrome
Also known as Klinefelter syndrome, XXY is where male babies are born with an extra X chromosome. while it can cause health problems, such as infertility, and may require treatment, many of those with XXY will often not realise they have this extra X chromosome and live healthy lives.
Young people’s mental health
YResearch shows that autistic children and adolescents are more likely to have mental health issues than non-autistic youngsters. Anxiety disorders are the most common, affecting 42% of autistic children compared to 3% of nonautistic children.
ZZinc deficiency
Zinc is an essential mineral that helps with the creation of new cells, as well as helping the body to process fat, protein and carbohydrate. Typically, we should get all the zinc we need from our diet, however autistic individuals may have a restricted diet and may therefore need to take supplements.
Zellweger syndrome
Zellweger syndrome is a very rare, genetic disorder found in newborn babies. It causes serious problems with nerves and metabolism soon after birth and affects the brain, liver and kidneys. Tragically, babies born with Zellweger syndrome don’t often live past their first year of life.
Tuberous
People with auditory processing difficulties usually have normal hearing but struggle to interpret the sounds they hear. This can make it difficult