Everything You Need to Know About Autism in Adults

No two autistic people have the exact same set of symptoms. Autism spectrum disorder (ASD) is referred to as a spectrum because of the variety of its signs and symptoms, and the different impacts and support needs that people may experience.

According to the DSM-5, autism is characterized by :

• difficulty communicating and interacting with others
• repetitive behaviors and a narrow set of interests
• symptoms that affect quality of life and functioning in areas like work and school

Some people with autism experience symptoms that can make daily life difficult without appropriate therapies and supports.

Others who have lower support needs (sometimes referred to “high-functioning”) may simply feel like something is “different” about them. They might have felt that way since childhood but haven’t been able to pinpoint exactly why.

Similarly, they may not notice that they feel or behave differently, but others around them may notice that they behave or act differently.

While autism is most often diagnosed in toddlers, it’s possible for autistic adults to go undiagnosed.

If you think you may be on the autism spectrum, this article will explain common traits associated with ASD, as well as diagnosis and support options.

Most of the time, prominent symptoms of ASD are diagnosed in young children around toddler age.

If you’re an adult who hasn’t been diagnosed with autism, but you believe you may be on the spectrum, it’s possible that you may be considered autistic with lower support needs. In the past, this has been referred to as “high-functioning” autism.

Following are signs of autism in adults:

Social communication behaviors

• You have trouble reading social cues.
• Participating in conversation is difficult.
• You have trouble relating to others’ thoughts or feelings.
• You’re unable to read body language and facial expressions well. (You might not be able to tell whether someone is pleased or unhappy with you.)
• You use flat, monotone, or robotic speaking patterns that don’t communicate what you’re feeling.
• You invent your own descriptive words and phrases.
• Understanding figures of speech and turns of phrase (like “The early bird catches the worm” or “Don’t look a gift horse in the mouth”) is difficult.
• You don’t like to look at someone’s eyes when talking to them.
• You talk in the same patterns and tone whether you’re at home, with friends, or at work.
• You talk a lot about one or two favorite topics.
• You make noises in places where quiet is expected.
• Building and maintaining close friendships is difficult.

Restrictive and repetitive behaviors

• You have trouble regulating your emotions and your responses to them.
• Changes in routines and expectations cause strong feelings that may include outbursts or meltdowns.
• When something unexpected happens, you respond with an emotional meltdown.
• You get upset when your things are moved or rearranged.
• You have rigid routines, schedules, and daily patterns that must be maintained no matter what.
• You have repetitive behaviors and rituals.

Other signs

• You care deeply and are knowledgeable about a few specific areas of interest (like a historical period, book series, film, industry, hobby, or field of study).
• You are very successful in one or two challenging academic subject areas. Some autistic people may do very well in some areas while also having great difficulty doing well in others.
• You are very sensitive to sensory input (like pain, sound, touch, or smell), or you are much less sensitive to these things than other people.
• You feel like you’re clumsy or have difficulty with coordination.
• You prefer to work and play by yourself, rather than with others.
• Others perceive you as eccentric or an academic.
• You are able to learn complex details and remember them for long periods of time.
• You learn well visually or by listening.

There are currently no ASD diagnostic criteria specifically for adults. But the current DSM-5 criteria can be adapted and used for this age group.

Clinicians primarily diagnose adults with ASD through a series of in-person observations and interactions. They also take into consideration any symptoms the person reports experiencing.

If you’re interested in being evaluated for ASD, begin with your family doctor, who will evaluate you to be certain that there is no underlying physical illness accounting for your behaviors. Your doctor may then refer you to a psychiatrist or psychologist for an in-depth assessment.

Reporting issues

The clinician will want to speak with you about any issues you have regarding communication, emotions, behavioral patterns, range of interests, and more.

You’ll answer questions about your childhood, and your clinician might request to speak with your parents or other older family members to gain their perspectives about your lifelong behavior patterns.

If the diagnostic criteria for children are being used for reference, your clinician can ask your parent questions from that list, relying on their memories of you as a child for further information.

Potential factors

If your clinician determines that you didn’t display symptoms of ASD in childhood, but instead began experiencing symptoms as a teen or adult, you may be evaluated for other possible mental health or affective disorders.

Because most autism diagnoses are made in children, it could be a challenge to find a healthcare professional who will diagnose adults.

Is there a test for adult autism?

There are no medical tests for ASD, no matter your age. This means that ASD can’t be detected using methods like blood tests or imaging tests.

Instead, a doctor will review behaviors to make an ASD diagnosis. For adults, this usually means an in-person visit where the doctor asks questions and evaluates how you respond. They will also consider self-reported symptoms.

Many psychologists use the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) , a diagnostic assessment when assessing adults.

Self-administered ASD questionnaires for adults are available online. These tests include the Autism Spectrum Quotient (AQ) and derivatives like the AQ-10, AQ-20, and AQ-S, among others. These tests are not the same as a professional evaluation and should not be viewed as definitive.

Receiving an ASD diagnosis as an adult could mean a greater understanding of yourself and how you relate to the world. And it can help you learn how to better work with your strengths and strengthen areas of your life that are impacted.

Getting diagnosed can help you gain a different perspective on your childhood. It can also help those around you to understand and empathize more with your unique characteristics.

A better understanding of your own situation can help you find new and inventive ways to work with your strengths and qualities. You can also work with your clinician and your loved ones to seek supports that may be right for you.

Adults aren’t generally given the same support as children with ASD. Sometimes adults with ASD may be treated with cognitive, verbal, and applied behavioral therapy.

Note that certain therapies such as applied behavioral analysis (ABA) are controversial in autistic communities. Some advocacy groups such as the Autistic Self-Advocacy Network do not support the use of ABA.

In general, you’ll want to seek out specific support based on the impacts you’re experiencing. This might include anxiety, social isolation, relationship problems, or job difficulties.

Some possibilities include:

Psychiatrist or psychologist

A psychiatrist is a doctor and is qualified to make an official medical diagnosis of ASD. There are some psychiatrists that even specialize in ASD. Licensed psychologists (PhD) are also qualified to make these diagnoses, and may be more affordable in some areas.

In some states, other licensed mental health professionals such as social workers may also provide official ASD assessments.

An official diagnosis may be required to cover related expenses such as therapy through your health insurance provider. It may also help to qualify you for governmental protections and programs, though these can vary by state.

Medication

A psychiatrist may also prescribe you medication. This could help to alleviate symptoms of disorders like anxiety or depression, which sometimes occur alongside ASD.

Social worker

Social workers can play an important role in supporting autistic people. They may be familiar with local resources and self-advocacy groups. Some social workers can provide support as case managers, helping to facilitate appropriate mental health and medical care.

Therapy

There are many types of therapy that can be helpful for autistic adults, such as cognitive behavioral therapy (CBT), physical therapy, or occupational therapy.

A psychologist can provide general counseling or therapy either individually or in a group setting.

Vocational rehabilitation

A vocational rehabilitation (VR) counselor can help evaluate your specific strengths and needs when it comes to working. They can then assist you in finding or retaining employment. This is a governmental service that varies by state.

Support groups

Many autistic adults have found support through online groups and forums, as well as by connecting in person with other adults on the autism spectrum.

If you’re diagnosed with ASD, it’s possible to seek support that helps improve your quality of life and outlook moving forward. While it’s not as common for adults to be diagnosed with ASD as children, more adults are asking to be evaluated for autism.

In some cases, getting a diagnosis can be a step toward positive outcomes such as accessing resources, understanding your own strengths, and building connections with other autistic people.

Last medically reviewed on July 12, 2022