9 min · Autism
August 10, 2020

Diagnosis of Autism Spectrum Disorder in Adults

Can Adults Have Autism Spectrum Disorder

CDC states that autism spectrum disorder can occur in all age, racial, ethnic, and socioeconomic groups.

The spectrum disorder is generally characterized by social and communication difficulties.

Usually, severe forms of autism spectrum disorder are diagnosed within the first two years of a child’s life.

Yet, sometimes when an individual is on the high-functioning side of the spectrum, they may not be diagnosed until later in their lives.

There are other reasons why a child with ASD is not diagnosed early in life. Sometimes lack of information or access to resources by parents and caregivers could delay diagnosis.

What Does Autism Look Like in Adults?

Autism spectrum disorder is primarily characterized by social and behavioral challenges. This is also the case for adults with autism.

Adults who have autism experience their environment and the people around them differently.

They may find it difficult to communicate as they process and verbalize information.

Autism spectrum disorder looks different on everyone. No two people have the same set of symptoms.

Some adults with ASD could have symptoms that may heavily impact their daily life, while others could have mild symptoms.

This is considered as “high-functioning” adults with autism.

Severity of the symptoms could be different on everyone. High-functioning adults with autism may feel like something is slightly different about them.

They may not be able to exactly say what is wrong. They may not even notice they feel or behave differently.

Since autism is often diagnosed in toddlers, it may be possible for adults on the autism spectrum to be undiagnosed as well.

Sometimes adults with autism who are high functioning may have mild symptoms that they can be mistaken for having ADHD.

Recent decades have allowed us to be more knowledgeable about how autism presents. So more and more adults can now be diagnosed with autism.

Symptoms of ASD in Adults

As we have discussed before, symptoms of autism spectrum disorder could be different for each individual.

Here are some of the most common symptoms seen in adults with autism spectrum disorder:

Difficulty interpreting facial expressions or body language

  • Not understanding social cues
  • Trouble regulating emotions
  • Being prone to engaging in repetitive and restricted behaviors
  • Having deep knowledge in specific topics of interest
  • Restricted interests
  • Participating in only certain activities
  • Difficulty maintaining conversation
  • Being prone to monologues on favorite topics
  • Strict adherence to daily routines
  • Interests bordering on obsessions

Evaluation of an Adult for Autism

There is no standard diagnostic criteria for adults who are suspected to have autism.

But because of the increased awareness and advancement of technology, more and more adults are now being diagnosed.

Clinicians primarily diagnose adults with autism through observations and interactions in-person.

The person also states their symptoms if they are experiencing any.

The first step to take in this evaluation is to consult your family doctor.

Your family doctor will evaluate you to rule out any other underlying physical illness that may be causing the behaviors.

If they find anything relating to autism, they will refer you to a psychiatrist or a psychologist to conduct an in-depth assessment.

The clinician will be asking the adult about their communication, behavioral patterns, interests, emotions, routines and more.

They will also ask the patient about their childhood and experiences. The clinician will also talk to the parents and other family members to get a clearer idea of the behaviors.

It could be a challenge to find a professional who will diagnose adults since most diagnoses are made in children.

However, there are resources you can access if you suspect that you may be on the autism spectrum, like going to an autism center in your area.

Who Diagnoses ASD in Adults

For adults who think they may be on the spectrum, the first step could be to consult their primary care physician. They can refer you to a specialist if need be.

There are a couple of professionals that can diagnose adults with ASD:

  • Psychiatrists or other medical doctors who are experienced in ASD,
  • psychologists and neuropsychologists,
  • licensed clinical social workers can diagnose autism in adults.

If none are available, developmental pediatricians, child psychiatrists or pediatric neurologists who are both experienced in evaluating children with autism and open to seeing adults could be an option.

They may also have colleagues that they can refer the patient to.

Another option to get a diagnosis could be contacting an established autism center in the area.

This way the adult with ASD could have access to information and referrals to clinicians who are familiar with adults with ASD.

Signs of High-Functioning Autism in Adults

Here are some signs of autism seen in high-functioning adults:

  • Having trouble participating in conversations
  • Difficulty with social cues
  • Not being able to relate to or understand other people’s feelings or thoughts
  • Not being able to read facial expressions
  • Talking or monologuing about favorite topic
  • Lack of eye contact during conversation
  • Not being able to adjust the tone of the speech to the setting
  • Difficulty understanding figures of speech
  • Difficulty in making friends
  • Being prone to having emotional meltdowns at the face of unexpected things
  • Strict adherence to routines, schedules, etc.
  • Restricted and repetitive behaviors
  • Meltdowns or outbursts when changes happen to routines
  • Deep knowledge in specific areas of interest
  • Difficulty in academic subjects other than those that are interesting to the individual
  • Hyper- or hypo-sensitivity to certain sensory stimuli like sound, textures, temperatures, ets.

Different Types of Autism in Adults

Since Autism is a spectrum disorder, this means that there is a wide range of symptoms that people may experience.

Throughout the years, the definition of autism in the Diagnostic and Statistical Manual of Mental Disorders has changed.

In 2013, Asperger’s syndrome, childhood disintegrative syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS), autistic disorder, and Rett syndrome have been included under the umbrella term of Autism Spectrum Disorder.

These terms are not diagnosis now. They are used as descriptions. They help clinicians and parents better understand the status of their loved one with autism.

The terms may cause confusion as they are difficult to define. Practitioners selected different diagnoses for the same patients.

Therefore, certain terms like “severe autism”, “mild autism” and “high functioning autism” are used to clarify the diagnosis.

How to Deal with Autism in Adults

Adults with ASD have certain traits which make life difficult for them. They are different.

Which makes it challenging for them to get through their daily life without struggles. But there are ways to work with adults with autism to ensure they receive the best treatment possible.

If you are working with an adult with autism, the first thing to do is to learn and educate yourself about ASD. This will eliminate conflicts in the work environment by minimizing misunderstandings.

Autism causes issues in the individual’s communication. Adults with autism who are high-functioning can speak fluently with high level of vocabulary.

But those on the lower part of the spectrum may be non-verbal or may only use sounds to communicate. Make sure that you give these adults sufficient amount of time to communicate and don’t force the communication.

Autistic adults may not be able to understand nuances or wordplays while communicating. Try to avoid sarcasm and keep your sentences short and concise.

Sensory overload is a huge problem for individuals with autism. They get overwhelmed with the stimuli in their environment. You may find the situation you are in comfortable, while they get extremely overwhelmed. They do not enjoy certain common physical gestures like hugging or pats on the back. Try to respect and understand their desire for personal space.

Another thing to note is that change can cause struggle for autistic adults. Individuals with autism like regular schedules, they like to be prepared for and know what’s coming next. Try not to disturb their routines unnecessarily. They like sticking to their daily routines and if disturbed, they may be really upset. Consistency is key.

If an adult with autism feels panicked, upset, or feel anxious, it is important to create a calm environment for them. They would not like increased voices and tension at such times. You can allow them some space to calm themselves down. If you have to speak, speak softly.

At a workplace, a designated manager could be assigned to the employee with autism. This way they can help the adult with autism if need be and give feedback too. This manager could also prepare new tasks for the individual, notify them of any future changes to reduce stress.

Autism Therapy

There many types of therapies, often used in concert for autism. However, adults with autism do not generally receive the same treatments as children with autism.

Autistic adults could get treatment and therapy with applied behavioural therapy. This therapy method is widely used and proven to be effective. They could also receive cognitive and verbal therapy as well.

Therapy for autistic adults depends on the challenges the individual experiences. They may be experiencing anxiety, social isolation, or even job problems.

The professional handling the therapy of the autistic adult will use or combine therapy methods to address the difficulties individual is experiencing in their lives.

Adults with autism could consult a psychiatrist who is experienced in treatment for autism via medical evaluation.

The individual could also see a social worker or a local autism center for group and individual therapies suitable for the autistic adult.

Counselling on a continuous basis could be really beneficial in terms of therapy. Adults with autism could benefit from counselling in overcoming their daily obstacles. They could also receive vocational rehabilitation for job-related difficulties.

Some of the symptoms that come along with autism like anxiety and depression can be managed by taking prescription medication. These should be taken by consulting the person’s primary healthcare provider.

Another option could be to find support through online groups. There are many forums and groups online focusing on sharing information and first hand experiences.

Connecting with other adults with autism could shed a light on some of the problems the autistic adult faces in life.

Autism Education

Autism education could go both ways. An adult with autism may not know that they have been on the spectrum until later in their life. Learning about autism spectrum disorder could help them understand their struggles in their live.

On the other hand, loved ones of autistic adults could also benefit from learning about autism.

Understanding this condition could provide a great deal of relief for both the loved ones and the autistic adult.

Educating oneself about autism could help the autistic adult feel validated.

This could mean that they find solutions for the difficulties they face in life. Their stress level could decrease.

Once the loved ones learn more about ASD, they can be more compassionate for the autistic adults.

Peer Support

We have touched on this before when we talked about therapy methods for autistic adults. Peer support could be a great help in terms of connecting with others who are on the spectrum.

The adult with autism can find online groups where other adults with autism spectrum disorder discuss and share ideas with each other, offering help for the struggles in life.

There are also face-to-face support groups and meetings. In these, the individual could get support in real life from both their peers and professionals.

Living with Autism

Autism diagnosis could provide a great deal of understanding for the person.

Diagnosis of autism could help the autistic adult understand how they relate to the world.

It could help individual learn how to find their strengths and use these in their advantage. They can also find out what their weaknesses are and work on them.

Anita, who was diagnosed when she was 50 years old, stated that getting a diagnosis of Asperger’s has been the greatest gift she had ever received, as she was finally able to know the answers to the mystery of her life.

A diagnosis allows the individual to gain a different perspective on their lives. They will look at their childhood in a different way.

They will be able to understand and empathize with others more.

Those who were diagnosed later in their adult life felt a sense of relief.

They found social interactions difficult when they were little and felt like they never fit in. Once they were diagnosed, they finally understood the reason of their struggles.

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