19 Sep Adult ADHD and Autism
Brooklyn Letters
1139 Prospect Avenue, Brooklyn
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We would highly recommend Ally! Our son always asks about her, so very thankful to Brooklyn Letters for introducing us.
~ Emily, mom of Brooklyn 2 year old -
Nicole has been an amazing therapist!! She played a tremendous role in our daughter’s speech progress and overall development. She has come such a long way and we are so happy with the therapy she received!
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I cannot express how grateful and rewarding my experience with Brooklyn Letters has been. Her tutor Ms. Daria is so knowledgeable, amazing, kind and awesome. My daughter has made so much progress in Literacy and Math and it's all … More thanks to Ms. Daria. I know my daughter is sad that she can no longer work with Ms. Daria, as she looked forward to their sessions every week. Thank you again!
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Excellent services, caring therapists.
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Christina was absolutely wonderful. She went out of her way to win my son over and it worked. He looked forward to her visits and his speech improved so much under her care. She was super flexible and it’s clear she truly cares. We adore … More Christina and we’re going to miss her. Almost sad he improved so much! She’s simply amazing and we can’t say enough how great she is. I would recommend her services to anyone and everyone, without hesitation. Thank you so much for connecting us with her!
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We could not be happier with the services Valerie provided! She is very thoughtful and knowledgeable and provided significant guidance to support our daughter's speech development outside of our scheduled sessions. She established … More a great working relationship with her, and she will definitely be missed! Your business model is amazing and it was an absolute pleasure working with Valerie. I've referred your organization and Valerie to the Executive Director of our daughter's school and friends/colleagues who are in need of speech therapy services.
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We cannot say enough good things about Effie, the ASL teacher, who was so engaged and effective with our 2 year old daughter from the very first session! Effie gladly included our whole family in the sessions! Her expertise and fantastic … More personality gave our daughter a way to communicate that she was so desperately seeking. The coordinators at Brooklyn Letters were so helpful and communicative…I would highly recommend their services!
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The company is great with outstanding customer service. They keep my horses protected. I have recommended them to other horses trainers as well that are going to get service early next year. Very professional an honest too. Respectfully … More submitted Christopher
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Ron and Ken did a fantastic job with our security system today. Installed everything very quick. Both of them were very polite and asked us throughout if the installation met our needs. Simply fantastic!
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I called Cornerstone Protection to get a Security system at a relatives out of state property, within a week it was installed! The installers worked with the client to help understand her new system and she was happy! Our relative said … More they were courteous, professional and patient! I highly recommend Cornerstone Protection for all of your security needs!
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Had blink cameras; Car was broken into multiple times so I called CornerStone & they were able to install multiple cameras very quickly & for a reasonable price. I am so happy with the app & getting alerts that are not superfluous, … More like they were with Blink. Highly recommend CornerStone & the tech Ronnie.
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Ron and Ken are great guys to work with.
Both were very knowledgeable and got our system back up and running.
Thanks to both for a job well done... -
Samantha Dalmas was fantastic! We saw her for a feeding therapy evaluation and while she doesn’t think my daughter needs more feeding therapy sessions at this time, but she gave me lots of tips to try. If my daughter's doctors want … More to see more progress at her next appointment, I wouldn’t hesitate to reach out to Samantha again.
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Amazing assistance provided by Shannon today on my security system. I’m so grateful for your prompt, efficient, professional, and courteous service. Put me down as a customer for life!
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One of the most painless experiences I've had. They came on time and was over the moon professional with still keeping a level of personability to it. The gentleman also went out of his way to say that my husband and Mines business … More was appreciated. Which is actually rare to be appreciated by such a great company. So thank you and we look forward to continuing services with this company.
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I am so happy we decided to go with cornerstone. They were quick and efficient. Shannon and the installer we very friendly. We got a lot of equipment and it was still within our budget. 10/10 would definitely recommend! Thank you
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Love the customer service and Shanon and his team go above and beyond for my restaurant. Couldn't of asked for a better security system and level of service that his team provides.
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I have been using Cornerstone Protection service for over 5 years and I'm really happy with the service and state-of-the-art equipments and it's futures are so much in advance and friendly, I highly recommend Cornerstone Protection … More Service any and all business that need a security protection days and nights specially after business hours(Cornerstone Protection is perfect solution for your business). Owner of Cornerstone Protection is proactive with their customers and their equipments. Good experienced with Cornerstone Protection!!!
Kanu Patel -
We had a very positive experience with Alissa as a tutor for our pod of 5th grade boys from January - June 2020. She cared a lot about the boys and worked hard to create meaningful activities for them. The pod experience was invaluable … More for all of our families during a difficult year and we were so grateful to have found this partnership! We also want to appreciate Craig for helping to match us with a tutor on very short notice after we had cycled through a few folks who were not able to see the commitment through. Thanks for sticking with us!
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Dusty was the exact person we needed to help our child finish out the school year. So grateful to him for the way he steadily encouraged her and helped her stay on track and organized. He is flexible, responsive to our needs/schedule as … More a family, and a delight to be with. We are also thankful that Craig at Themba Tutors really "gets it" and partnered us with such a wonderful tutor who was a great fit for our girl.
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My child worked with Gillian D virtually for math enrichment. She is an excellent teacher. She took time to understand my child's specific learning style and provided tools that would be engaging. She was kind and empathetic- really … More made it her goal to connect with my child and build trust and rapport. My child started the school year with confidence and without the typically "brain-drain" that occurs over the summer, thanks to Gillian.
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I am going into my second year as a Themba tutor. I have met so many great individuals while working for this company. Craig and the rest of the Themba team do such an excellent job picking and choosing Themba tutors that suit each client's … More individual needs! I look forward to meeting new tutors and clients in the 2021-2022 school year!
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Our son started in a new high school, 100% remote, and was really struggling with Latin and Physics. I found Themba Tudors online and had an initial call with Craig, who was very knowledgeable, responsive, and found 2 amazing tutors for … More us. Both the Latin and the physics tutors were fantastic, connected with my son really well and helped him go from 'failing' grade to 'honors'! I will for sure continue using (and recommending!) Themba Tutors. Thank you, C, K, and W!
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Brian is a fantastic executive functioning coach. Super helpful, flexible with hours, and tailored the experience to our needs.
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Giulia Mercuri is a great Italian tutor! She was very responsive and accessible. Giulia put a ton of effort into preparing for each session and really helped our son with test preparation and projects. We are grateful that she was able … More to help, especially since our son did not receive any live teaching during COVID. We are happy that she was referred to us!
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As an adult student diagnosed with a learning disability during grad school, I knew I needed help dealing with my Master's program's demanding workload. I was seriously considering dropping out when I was referred to Themba Tutors. … More I was paired up with a wonderful tutor, Julie, who was a total lifesaver. I learned many techniques that I can utilize in the future as I embark on the next phase of my career.
I can wholeheartedly say after working with Themba for two years that I would not have finished my program without this organization. And I am so thankful I selected them. -
We were introduced to a wonderful tutor: Mcedwyn. He and our son, a freshman in college, worked well together. As a result, our son’s grades significantly improved. The tutor taught our son subject content and various methods to effectively … More study for quizzes and exams. Our son was also taught time management and organization. My son’s experience with the tutor made the first year of college a less intimidating experience.
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We have been with our tutor, Cailin Schiller, for two years, from 5th - 7th grade. She started as an executive functioning tutor with my daughter. From the start, she demonstrated a depth of expertise and a selective use of techniques skillfully … More adapted to my daughter’s ADHD and Math disability. Cailin made Math accessible and understandable to her in a way that even her teachers had not been able to do. She differentiated reading, writing and math tasks and assignments to tailor them to my daughter’s unique learning differences. Not only did it have an effect on her grades and her work efficiency, but she finally could do her work with less anxiety. Even my daughter’s teachers used Cailin’s guidance to modify their work with her. But most importantly, she became my daughter’s favorite resource. I can’t say how invaluable Cailin has been to my daughter’s progress and well-being. I’d recommend her a million times over. She is a gem.
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Victoria is a superb tutor. She helped my high school age daughter with her writing. Victoria's skills as a tutor, as well as her sense of humor and her engaging personality went a long way with my daughter.
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Themba Tutors provided a leaning specialist that was a perfect fit for my daughter. I told them what we were looking for and they delivered. Our tutor is responsive and flexible and makes it easy for my daughter to reach out to her own … More her own, which gives her an added sense of responsibility over her learning. As a therapist myself, I now regularly recommend Themba to my patients. A much needed and well provided service to the community!!
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The tutors at Themba are fantastic! Caitlyn McNeill helped our son academically, but also with getting organized in every subject, which he so desperately needed. She offered great advice and useful strategies that helped our son become … More a more successful student. We are using Themba tutors again this year for our daughter. We're so happy to have been referred to them!
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I'm so glad we were referred to Themba Tutors. After a great initial conversation to learn our needs, we were connected with an excellent tutor, Felicia, who is helping our high school daughter learn better organizational and executive … More skills. Highly recommended.
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We had a wonderful experience with our tutor Micaela. She helped our son not only academically but at every level. We will be forever grateful to have her in our lives.
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The tutors at Themba are fantastic! Caitlyn McNeill helped our son academically, but also with getting organized in every subject, which he so desperately needed. She offered great advice and useful strategies that helped our son become … More a more successful student. We are using Themba tutors again this year for our daughter. We're so happy to have been referred to them!
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Paul Smith at Themba has been an exceptional tutor for my son, both in terms of teaching the subject matter and teaching how best to approach the process of learning math and executing assignments. We feel very fortunate to be working with … More Paul.
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We were very lucky to have found Edwouine Swift, my son's therapist through Themba Tutors. Thomas is 12 years old, and it is extremely difficult to get him to write. Edwouine just works her magic with him, he adores her and is so … More eager to follow her guidance. I have no doubt she will be a positive driving force in his academic future.
Adult ADHD and Autism: Accurate Diagnosis and Treatment in NYC
Introduction: Why ADHD and Autism Are Often Missed or Misdiagnosed
Many successful adults come to me after years of therapy and psychiatric treatment for anxiety, depression, or burnout yet still feel something does not add up. Some were bright students who struggled with organization. Others had few friends as children but excelled academically. Many had seen multiple therapists and psychiatrists without clarity or resolution.
When I conduct an evaluation, I often uncover long-standing ADHD, autism, or both conditions. Often, people who I see were diagnosed with depression or social anxiety and treated with antidepressants. Proper diagnosis transforms treatment and, most importantly, quality of life.
This article explains how ADHD and autism overlap, differ, and are best diagnosed in adults. It also illustrates how careful, comprehensive assessments and individualized treatment lead to meaningful change.
Similarities and Differences in ADHD and Autism
Adults with ADHD and autism often share difficulties such as disorganization, strained social interactions, and high rates of anxiety or depression. Yet the conditions differ in important ways. ADHD is often marked by inattention, distractibility, impulsivity, inconsistent performance, and time blindness. Autism is more often defined by restricted interests, sensory sensitivities, rigidity in routines, and challenges with reciprocal social interaction.
Despite these distinctions, the overlap is significant. Both conditions can result in underachievement, strained relationships, and frustration despite intelligence and motivation. In fact, research has shown that about 20 to 30 percent of adults with ADHD also meet criteria for autism (Lai et al., 2019). This makes an accurate evaluation essential.
My Diagnostic Approach
Most of my patients come to me after standard checklists or short office visits have failed to capture the complexity of their history. My approach is designed to be more thorough and comprehensive. The complete assessment including speaking with the individual, testing, review past documents and assessments, and speaking with previous and current providers and family members can often take four to five hours. It can be very challenging to truly understand the person as a unique individual and not a diagnosis in order to provide a personalized and effective treatment plan.
The process begins with extended clinical interviews, often across several sessions, that cover childhood development, academic performance, and social history. I also use structured self-report measures such as the ASRS, CAARS, AQ, and RAADS-R, but I supplement them with customized questionnaires I have developed for my practice. This help identify subtle executive function challenges and interpersonal struggles that standard tools often miss.
Family input is a critical part of the evaluation. I frequently speak with parents or siblings and request childhood records, including grades, teacher reports, and in some cases early intervention plans (EIP), which provide valuable details about early learning and behavior.
To strengthen diagnostic accuracy, I use validated neuropsychological testing, particularly CANTAB (Cambridge Neuropsychological Test Automated Battery). CANTAB is widely regarded as a gold standard computerized assessment tool and has been validated in ADHD and autism research. Studies confirm that it can reliably identify executive function and memory deficits (Wild & Musser, 2014). This layered approach helps ensure accuracy and avoids the misdiagnoses that often persist for years. Also, often, it is vital to speak with previous therapists, specialists and psychiatrists to get past history and information.
Case Study 1: Charlie*, 49-Year-Old Financial Manager
Charlie* came to me after years of treatment for depression, anxiety, and social anxiety. He is a 49-year-old married, financial manager. He had worked with multiple therapists and psychiatrists but never felt fully understood. Professionally, he excelled at technical analysis at his financial firm but avoided leadership roles. Personally, he struggled in relationships and often felt isolated.
Through discussions with his parents, I learned of early difficulties with focus and friendships. Teacher reports from ages five and eleven documented inattention, fidgeting, and social withdrawal, and he had been placed in a special program for additional classroom support. CANTAB testing confirmed deficits in sustained attention and working memory.
The final diagnosis was combined-type ADHD with high-functioning autism. Treatment began with ADHD medication, carefully titrated to minimize side effects. Antidepressants and anti-anxiety medications that had been prescribed in the past were discontinued, as they were not addressing the root issue. Charlie also joined a social skills group designed for adults with ADHD and autism and worked with a dating coach and an autism-informed therapist.
Within a year, his work performance improved significantly, his confidence grew, and he built new friendships. Most importantly, he met a woman who had autism but not ADHD, and together they developed a thriving relationship based on mutual understanding.
Case Study 2: David*, Senior Tech Executive
David*, a senior manager at a global technology firm, had already been diagnosed with ADHD and prescribed medication. Despite this, he continued to struggle with procrastination, emotional regulation, and communication in high-stakes meetings.
During his evaluation, customized executive function questionnaires revealed persistent difficulties with task initiation and follow-through. CANTAB testing showed challenges with set-shifting and planning.
I implemented a treatment plan that combined Cognitive Behavioral Therapy focused on perfectionism and fear of failure with executive coaching that emphasized concrete productivity systems and accountability in team communication. Over time, David reduced procrastination, became more effective in delegation, and strengthened his leadership. Within months, he moved toward a higher executive role.
Case Study 3: Anna*, 42-Year-Old CEO
Anna*, the CEO of an international firm, came to me exhausted, anxious, and on the verge of burnout. She was intelligent and capable but often felt out of place in social situations and overwhelmed by sensory input.
Her childhood reports revealed no ADHD symptoms but early challenges with peer relationships. CANTAB confirmed intact attention but highlighted subtle deficits in emotion recognition. She also had a long history of masking her symptoms, a coping strategy especially common among women with autism.
The final diagnosis was autism spectrum disorder without ADHD. For Anna, medication was not required. Instead, treatment centered on autism-informed coaching, sensory management strategies in the workplace, and tailored support for navigating board dynamics and executive communication. With these changes, she built a sustainable leadership style, avoided burnout, and strengthened her executive presence.
Treatment Principles: Tailoring Care for Adults
The treatment of ADHD and autism in adults requires a tailored approach. For ADHD, evidence-based care often involves medication combined with Cognitive Behavioral Therapy, schema-focused therapy, and executive coaching. For autism, social skills groups, structured coaching, and workplace accommodations can make a significant difference. When ADHD and autism co-occur, the most effective strategies usually involve a combination of careful medication management and therapies that address both executive functioning and social cognition.
FAQs
Can ADHD and autism really occur together?
Yes. Research shows overlap in up to one-third of cases.
How do you distinguish between them?
The key is a comprehensive evaluation that includes developmental history, collateral family reports, neuropsychological testing, and a focus on whether difficulties arise more from attentional challenges or social reciprocity differences.
Why are women often missed?
Women are more likely to mask their symptoms, especially in autism, which can delay diagnosis.
What role does neuropsychological testing play?
Testing tools such as CANTAB provide objective measures of attention, planning, and flexibility that strengthen diagnostic accuracy.
Conclusion: Taking the Next Step
ADHD and autism in adults are often misunderstood, overlooked, or mistaken for anxiety and depression. Yet with a thorough evaluation, careful history gathering, validated tools, and nuanced clinical judgment, the right diagnosis can transform lives. Accurate assessment not only clarifies years of confusion but also opens the door to treatments that work — from personalized medication management to executive function coaching and autism-informed therapy.
I have seen professionals, executives, and leaders regain confidence, rebuild relationships, and achieve new levels of success once their challenges were properly understood. If you suspect you may be living with ADHD, autism, or both, know that clarity and effective support are possible.
As a Harvard-trained psychiatrist, I provide comprehensive diagnostic evaluations and integrative treatment plans designed for ambitious adults who want to thrive in their work and personal lives. The first step is simply reaching out.
References
Antshel, K. M., & Russo, N. (2019). Comorbidity of ADHD and autism spectrum disorder: Diagnostic and treatment challenges. Current Psychiatry Reports, 21(5), 34. https://doi.org/10.1007/s11920-019-1020-5
Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., Spencer, T., Ustun, T. B., Walters, E. E., & Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry, 163(4), 716–723. https://doi.org/10.1176/ajp.2006.163.4.716
Lai, M. C., Kassee, C., Besney, R., Bonato, S., Hull, L., Mandy, W., Szatmari, P., & Ameis, S. H. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. The Lancet Psychiatry, 6(10), 819–829. https://doi.org/10.1016/S2215-0366(19)30289-5
Lever, A. G., & Geurts, H. M. (2016). DSM-5 criteria for autism spectrum disorder: Sensitivity and specificity in adults. Journal of Autism and Developmental Disorders, 46(8), 2743–2754. https://doi.org/10.1007/s10803-016-2816-2
Robbins, T. W., Gillan, C. M., Smith, D. G., de Wit, S., & Ersche, K. D. (2012). Neurocognitive endophenotypes of impulsivity and compulsivity: Towards dimensional psychiatry. Biological Psychiatry, 69(12), 1100–1108. https://doi.org/10.1016/j.biopsych.2010.12.021
Wild, K. V., & Musser, E. D. (2014). The Cambridge Neuropsychological Test Automated Battery in the assessment of executive functioning. In S. Goldstein & J. A. Naglieri (Eds.), Handbook of executive functioning (pp. 171–190). Springer Science + Business Media. https://link.springer.com/chapter/10.1007/978-1-4614-8106-5_11
About Dr. Scott Shapiro, MD
Scott Shapiro, MD is a Harvard-trained psychiatrist specializing in adult ADHD and a Performance and Productivity Executive Coach. He completed his residency at Massachusetts General Hospital and McLean Hospital, Harvard Medical School’s top teaching hospitals.
He practices in New York City and New Jersey, providing comprehensive assessments and treatment for executives, professionals, and leaders.
Website: www.scottshapiromd.com
Email: [email protected]
Phone: 212-631-8010
Disclaimer: Case examples are composites of real clinical experiences. Identifying details have been changed, and names are pseudonyms. All examples are used solely for educational purposes to illustrate the benefits of accurate diagnosis and treatment.
Craig Selinger
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