Can You Have Both Down syndrome & Autism?
Many families wonder if a child with Down syndrome (DS) can also be diagnosed with autism spectrum disorder (ASD). The answer is yes, and understanding this overlap is key to ensuring your child gets the right support.
How Common Is DS–ASD?
Studies suggest that approximately 16–20% of individuals with Down syndrome also meet the criteria for autism, significantly higher than in the general population. A 2023 study found 13% of DS children had ASD, with some reports even citing rates as high as 39%. [autismspeaks.org], [ndss.org] [link.springer.com], [lumindidsc.org]
What It Looks Like
Children with both diagnoses (sometimes called DS–ASD) typically show:
- More pronounced challenges in social communication (e.g., less eye contact or difficulty engaging)
- Repetitive behaviors like flapping or lining up toys
- Greater delays in expressive language compared to DS alone [autismspeaks.org], [massgeneral.org]
However, diagnosing ASD in a child with DS can be tricky. Some behaviors may overlap, and professionals must rule out medical issues and use thorough evaluations. [ndss.org], [massgeneral.org]
Why It Matters
Identifying autism alongside Down syndrome helps tailor interventions, speech therapy, behavioral strategies, and sensory supports, to your child’s specific needs. Early and accurate diagnosis improves outcomes and support at school and at home. [massgeneral.org], [ndss.org]
What You Can Do
- Monitor development: Pay attention to changes in communication, social interaction, or behavior.
- Seek evaluation: Work with professionals experienced in assessing DS and ASD.
- Customize support: If ASD is diagnosed, integrate strategies like structured routines, visual aids, and therapies that address both learning and social-emotional needs.
Final Thoughts
Yes, Down syndrome and autism can coexist. About 1 in 5 individuals with DS may also have ASD. But this overlap doesn’t define your child, it simply guides the direction of care. With the right tools, understanding, and support, families can help children with DS–ASD thrive.
Sources:
- “Spinazzi, Noemi A., et al. “Co‑Occurring Conditions in Children with Down Syndrome and Autism: A Retrospective Study.” Journal of Neurodevelopmental Disorders, vol. 15, no. 9, 2023, https://doi.org/10.1186/s11689-023-09478-w.
- “Down Syndrome and Autism Spectrum Disorder (DS‑ASD).” Autism Speaks, https://www.autismspeaks.org/down-syndrome-and-autism-spectrum-disorder-ds-asd.
- “Dual Diagnosis of Down Syndrome and Autism.” National Down Syndrome Society, https://ndss.org/resources/dual-diagnosis-syndrome-autism.
- “Down Syndrome and Autism Spectrum Disorder (DS‑ASD): What You Need to Know.” MassGeneral Children’s Hospital, 15 Aug. 2022, https://www.massgeneral.org/children/down-syndrome/down-syndrome-and-autism-spectrum-disorder-what-you-need-to-know.
- Autistic Down Syndrome: Understanding Dual Diagnosis.” NeuroLaunch, 10 Aug. 2025, https://neurolaunch.com/autistic-down-syndrome/.
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