autism
Even if you weren’t diagnosed as a child, you may notice the symptoms of high-functioning autism in later life. Here's what to look for and how to deal with a diagnosis.
Understanding autism in adults
We all have our quirks. But if you've noticed that your way of thinking, feeling, or doing things isn't quite the norm, you may suspect that you have autism spectrum disorder (ASD), even though you never received a diagnosis as a child.
Perhaps your body language, social skills, interests, behaviors, or general preferences don't seem to match those around you? Or maybe you have a child who was recently diagnosed with autism and you recognize some of the same issues in your own way of behaving?
In recent years, more people are embracing the idea of neurodiversity—the concept that some people have neurological differences and those differences should be valued rather than “corrected”. Still, a diagnosis of autism as an adult can come as an unwanted surprise. You may even experience denial or anxiety over the diagnosis. On the other hand, if you’ve long suspected that you have ASD or some other condition that sets you apart from your peers, a diagnosis can come as a relief. Suddenly, a lot of your past experiences and interactions make sense and you’re afforded a sense of clarity.
No matter how you feel after a diagnosis, keep in mind that, just like everyone else, you have unique strengths and weaknesses. You can always take further steps to better understand your own thoughts and behaviors and grow as a person.
Why weren’t you diagnosed earlier?
Parents and doctors sometimes miss the symptoms of autism in children who are “high functioning”—meaning they're able to move through the world without assistance. You may hear this referred to as Asperger’s syndrome, a formal diagnosis that is now categorized under the broader umbrella of ASD.
It’s also common for autism in children to be misdiagnosed as attention deficit hyperactivity disorder (ADHD) since ADHD can also cause difficulty with communication skills and repetitive behavior.
While it’s possible to have both conditions, over the years, experts have become better at distinguishing the symptoms of ADHD from those of ASD.
Signs and symptoms of autism in adults
Autism has a wide range of symptoms, even if you narrow the scope down to “high functioning” autism. Autism symptoms in adults tend to be most prominent in your communication skills, interests, emotional and behavioral patterns, and sensitivity to stimuli, such as noise and touch.
Problems with communication
If you’re an adult with ASD, you might have a hard time reading social cues. This can encompass everything from another person’s facial expressions to their gestures or tone of voice, making it difficult to maintain back-and-forth conversations or tell what another person is feeling. Sarcasm and figures of speech can be especially tricky to detect.
In addition, you might also use a monotone voice or limited facial expressions, which makes it difficult for others to interpret your thoughts and feelings. Eye contact may be another important social cue that you struggle with. Perhaps you’ve been told you look away too often during conversations, or even stare.
Narrow interests
Everyone has their own interests. But adults with ASD often focus on one or two subjects that they find highly fascinating. You may have an encyclopedic knowledge of a historical event or movie series, for example.
While it’s often impressive to others, it may limit the amount you feel you can contribute to conversations beyond your favorite subjects. Trying to relate to people who don’t understand your interests may feel tedious or incredibly challenging. It might even lead you to avoid social interactions.
Repetitive behavior
Maintaining a consistent routine or keeping items organized can help you feel that your life is secure and predictable. You may experience discomfort when your daily routine and rituals are interrupted, such as having to take a new route to work or someone moving your belongings so they’re now out of place. You might feel so upset that you have an outburst of strong emotion such as anger.
Sensory issues
To someone with ASD, certain sensations can be unbearable. You may feel pain if someone taps you on the arm. for example, or certain sounds, smells, or textures may elicit a similar unpleasant reaction. In some cases, you may do everything you can to avoid that discomfort.
How gender affects the signs of autism
Males are about four times as likely to be diagnosed with ASD than women. Some researchers theorize this may be because women in general are better at imitating socially acceptable behavior. Unlike children with ASD, adults with ASD (even when undiagnosed) have had plenty of time to practice their social skills. Women especially often learn to “mask” certain behaviors that seem to draw the attention of other people.
It’s also possible that women with ASD have repetitive behavior tendencies and narrow interests that aren’t seen as unusual. For example, a woman with ASD who feels the urge to neatly organize dishes or who is only fascinated with music theory may pass as “neurotypical”.
Diagnosis and causes
In some cases, you might only recognize your own ASD symptoms when you have a child diagnosed. Experts haven't yet decided on standard criteria to diagnose adults who believe they have ASD. However, a clinician may borrow some of the criteria used to diagnose children, such as experiencing problems with social communication, exhibiting restricted, repetitive behaviors, and any sensory issues.
[Read: Autism Spectrum Disorders]
To diagnose ASD as an adult, a clinician will likely talk to you about your interests, emotions, and childhood. They may also want to talk to your family members. This can be especially useful because symptoms—even subtle ones—likely developed when you were a child.
What causes autism?
Scientists aren’t entirely sure yet if autism is the result of biological or environmental factors. But the answer could be both. Some of the possible causes they’re exploring include:
Genetics. Gene mutations might link to specific ASD symptoms, make a person more susceptible to developing ASD, or determine the severity of symptoms.
Environment. Certain environmental factors, such as air pollution or low birth weight, may cause ASD in a child who was already susceptible to it.
Other biological factors. Abnormalities with the immune system, metabolism, or brain development may also play a role.
Living with a diagnosis
Feel caught off guard by your adult autism diagnosis? It may help to look at your diagnosis as a path to better understanding yourself. You can gain insight on challenging moments from your childhood or teen years, for example, or any relationship problems you’ve experienced as an adult.
Every adult with ASD has both unique challenges to overcome and unique strengths to draw upon. However, there are some common challenges to address, including difficulty building or maintaining relationships, social isolation, managing mood disorders, and staying organized.
Even if you haven’t received a formal diagnosis, if you suspect you have ASD, you can begin to take steps to improve your life. The following tips and strategies can help.
Living with adult autism tip 1: Improve communication and relationships
If other people have a hard time reading and understanding you—and you them—you’ll likely have difficulty with relationships. But you can still find ways to nurture a healthy social life.
Consider disclosing your diagnosis. Talking about your diagnosis can be difficult and the social stigma attached to ASD may make you shy away from doing so. While disclosure is entirely up to you and your comfort level, it may help improve some relationships. Letting close friends and family know about your diagnosis can help them understand why you have a hard time interpreting their sarcastic comments, for example, or why you’re distressed by sounds that seem normal to everyone else.
Note when you’re experiencing sensory overload. Perhaps you find it difficult to keep up with everything that’s going on in an intense group conversation. Or maybe something as simple as loud traffic or a barking dog is bothering you. Do what you can to minimize distractions. This might involve switching rooms or leaving a larger group for a one-on-one chat.
Look for common ground with the person you’re talking to. Establishing commonalities can lead to more relaxed and enjoyable conversations. If you have similar hobbies, that’s, of course, great news. Otherwise, you can look for other things you both like or dislike. This could be anything from a shared interest in cars to a shared dislike for loud noises.
[Read: Adult Autism and Relationships]
Reach out to other adults with ASD. You might find that talking with others with ASD is less tiring than other interactions. Although every person with ASD is different, you share a common ground and can talk about your experiences. Additionally, neither of you will need to focus on reading or presenting social cues in a way that a neurotypical person might expect.
Support groups for adults with autism
If you feel isolated or feel like your neurotypical friends don’t “get” you, it can help to join a support group for adults with ASD. These may take place either online or in-person with groups of varying sizes.
Support groups can be a great way to meet people who have had similar life experiences. You might meet lifelong friends and become an important part of someone else’s social support network.
Group sessions can also help you gain a better understanding of the neurodiversity movement, which aims to erase the social stigmas associated with autism and neurodivergence in general.
Tip 2: Manage anxiety and depression
Some people find that anxiety and depression go hand in hand with symptoms of ASD. For example, difficulty relating to others can lead to feelings of anxiety. Increased anxiety can, in turn, make it even harder to communicate. You might even feel so flustered that you can't form sentences.
Feelings of isolation can also trigger depression. But there are steps you can take to manage your mood and improve how you feel.
Stay active. Exercise is good for the mind and eases stress. Some studies show that vigorous exercise can be especially useful for helping adults with ASD manage aggression. Find an aerobic exercise that fits neatly into your routine and won't potentially throw your schedule into chaos. It may be something as simple as going for daily walks or runs. Make sure it’s something you enjoy, so you’re more likely to stick to it.
Rely on close friends. Socializing can also be good for your mood, as long as the people you’re with don’t stress you out. Find people who share your interests. Thanks to the Internet, it’s easy to find people in your local area who share your interests. If possible, look for conventions or other gatherings where people who share your hobby come together and interact in person.
Practice relaxation techniques. You might find that techniques such as mindfulness meditation and deep breathing help you manage anxiety symptoms. These are also practices that you can easily incorporate into your daily routine. A 2020 study showed that self-guided mindfulness and cognitive behavioral techniques may be useful in reducing levels of anxiety in people with ASD.
[Read: The Benefits of Mindfulness]
Develop good sleep hygiene. Lack of sleep or poor sleep quality can affect your mood, making you more anxious, unhappy, and irritable. Unfortunately, insomnia is a common problem for adults with ASD. Some steps that might help include following a consistent, relaxing routine before bed each night. You should also consider if environmental issues, such as your bedroom temperature of texture of your blankets, are causing you discomfort.
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Tip 3: Better organize your life
While many adults with ASD are extremely organized, others may become so fixated on certain interests that other aspects of their lives become disorganized. If this is a challenge you face, these tips can help you stay organized:
Use a timer to stay on track. This can be especially useful when you're working on a hobby that you're intensely passionate about. Once the timer goes off, you know it’s time to switch to an activity that is less intriguing, but nonetheless important, such as paying bills or grocery shopping.
Use a list or day planner. If remembering appointments and other responsibilities is a challenge, use a paper planner or an organizational app for your cell phone. You could also use anything from spreadsheets to a whiteboard to help you organize daily tasks.
Automate certain aspects of your life. For example, use online banking to track spending and automatic payment options to manage your bills. This can also help you avoid the clutter that tends to build up when you receive paper billing statements in the mail.
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Treatment for adult autism
Although treatment is often recommended for children with ASD, adults with ASD may also find certain types of treatment to be beneficial. It’s important to understand that these treatments don’t aim to cure ASD. Instead, they help you address issues such as anxiety, rigid thinking, or depression.
Therapy
As mentioned before, self-guided mindfulness and CBT can help adults with ASD. However, you can also visit a therapist for professional guidance. Prioritize finding one who specializes in ASD.
[Read: Finding a Therapist Who Can Help You Heal]
A therapist can offer personalized sessions that help you address specific issues. Perhaps you’re having trouble communicating your feelings in a relationship or frustrated with a coworker who refuses to accommodate your needs. Your therapist will help assess stressors in your life and develop adaptive solutions, such as reframing your thoughts and building more effective communication skills.
Vocational rehabilitation
Vocational rehab is intended to help you address workplace-related difficulties. You may have specific challenges, such as discomfort with noise, that make it hard to work in a traditional setting.
[Read: Autism at Work]
Vocational rehab can help you find work that is accommodating and aligns with your interests and strengths. This can help to provide an opportunity to work to your fullest potential and enjoy a rewarding, successful career.
Authors: Sheldon Reid.
- References
Neurodevelopmental Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425787.x01_Neurodevelopmental_Disorders
Milner, Victoria, Hollie McIntosh, Emma Colvert, and Francesca Happé. “A Qualitative Exploration of the Female Experience of Autism Spectrum Disorder (ASD).” Journal of Autism and Developmental Disorders 49, no. 6 (2019): 2389–2402. https://doi.org/10.1007/s10803-019-03906-4
Cummins, Clare, Elizabeth Pellicano, and Laura Crane. “Autistic Adults’ Views of Their Communication Skills and Needs.” International Journal of Language & Communication Disorders 55, no. 5 (2020): 678–89. https://doi.org/10.1111/1460-6984.12552
(Video) Autism Spectrum Disorder Help Guide for ParentsKentrou, Vasiliki, Danielle MJ de Veld, Kawita JK Mataw, and Sander Begeer. “Delayed Autism Spectrum Disorder Recognition in Children and Adolescents Previously Diagnosed with Attention-Deficit/Hyperactivity Disorder.” Autism 23, no. 4 (May 2019): 1065–72. https://doi.org/10.1177/1362361318785171
CDC. “Diagnostic Criteria | Autism Spectrum Disorder (ASD) | NCBDDD | CDC.” Centers for Disease Control and Prevention, June 29, 2020. https://www.cdc.gov/ncbddd/autism/hcp-dsm.html
Sasson, Noah J, and Kerrianne E Morrison. “First Impressions of Adults with Autism Improve with Diagnostic Disclosure and Increased Autism Knowledge of Peers.” Autism 23, no. 1 (January 1, 2019): 50–59. https://doi.org/10.1177/1362361317729526
Hohn, Vanessa D., Danielle M. J. de Veld, Kawita J. S. Mataw, Eus J. W. van Someren, and Sander Begeer. “Insomnia Severity in Adults with Autism Spectrum Disorder Is Associated with Sensory Hyper-Reactivity and Social Skill Impairment.” Journal of Autism and Developmental Disorders 49, no. 5 (2019): 2146–55. https://doi.org/10.1007/s10803-019-03891-8
Gaigg, Sebastian B, Paul E Flaxman, Gracie McLaven, Ritika Shah, Dermot M Bowler, Brenda Meyer, Amanda Roestorf, Corinna Haenschel, Jacqui Rodgers, and Mikle South. “Self-Guided Mindfulness and Cognitive Behavioural Practices Reduce Anxiety in Autistic Adults: A Pilot 8-Month Waitlist-Controlled Trial of Widely Available Online Tools.” Autism 24, no. 4 (May 1, 2020): 867–83. https://doi.org/10.1177/1362361320909184
Im, David S. “Treatment of Aggression in Adults with Autism Spectrum Disorder: A Review.” Harvard Review of Psychiatry 29, no. 1 (February 2021): 35–80. https://doi.org/10.1097/HRP.0000000000000282
Landrigan, Philip J. “What Causes Autism? Exploring the Environmental Contribution.” Current Opinion in Pediatrics 22, no. 2 (April 2010): 219–25. https://doi.org/10.1097/MOP.0b013e328336eb9a
Helplines and support
In the U.S.: Call the Autism Society National Helpline at 1-800-328-8476, find support groups at the Asperger/Autism Network (AANE), or find vocational rehabilitation services near you.
UK: Find help and support at The National Autistic Society.
Canada: Find support and programs at Autism Canada or call 1-800-983-1795.
Australia: Find adult community services at Autism Spectrum Australia.
Lawrence Robinson
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Last updated: October 17, 2022
FAQs
What does autism feel like in adults? ›
Common signs of autism in adults include: finding it hard to understand what others are thinking or feeling. getting very anxious about social situations. finding it hard to make friends or preferring to be on your own.
How do you treat high functioning autism in adults? ›Treatment for adult high-functioning autism involves therapy, which helps people gain the skills and strategies needed to better manage the condition. Sometimes, drugs may be prescribed as part of an overall treatment plan. Seeking care may also lead to better access to services for people with autism.
What is the autism spectrum screening questionnaire for adults? ›The Autism-Spectrum Quotient Test (abbreviated to AQ ) is a diagnostic questionnaire designed to measure the expression of Autism-Spectrum traits in an individual, by his or her own subjective self-assessment.
How do you deal with mild autism in adults? ›Create a calm environment by removing distractions, clutter, and loud noise. Relaxation techniques—such as counting to 10, deep breathing, or exercise—can also help calm someone with autism in a moment of stress. Also consider using calming apps to help control anxiety and other powerful emotions.
What are the signs of high functioning autism in adults? ›- Emotional Sensitivity.
- Fixation on Particular Subjects or Ideas.
- Linguistic Oddities.
- Social Difficulties.
- Problems Processing Physical Sensations.
- Devotion to Routines.
- Development of Repetitive or Restrictive Habits.
- Dislike of Change.
Difficulty Communicating and Awkward Communication
– Difficulty reading social cues and participating in conversations. – Difficulty empathizing with other people's thoughts and feelings. – Struggling to read people's body language or facial expressions.
Total AQ50 scores therefore range from 0 to 50, with higher scores indicating more autistic traits. The published cut-off value for the AQ10 is ⩾6, i.e. scores of 6 or above are considered positive for ASD (Allison et al. 2012).
What is the average AQ score? ›Data for gender related norms are provided for the sample of adults with autism and the community sample (Baron-Cohen et al., 2001). Men with autism have an average score of 35.1 (SD = 6.9), while the mean score for women with autism is 38.1 (SD = 4.4).
What does an AQ score of 35 mean? ›11 – 21 is the average score for most of the population. 22 – 25 Indicates that one has slightly higher than average autistic traits. 26 – 31 Is a borderline score. 86% of people with this score have can be correctly classified as having Aspergers Syndrome. 32+ Is the official criteria for having Aspergers Syndrome.
Is there medication for autism in adults? ›Some newer antipsychotic medications may help with aggression, self-harm, and behavioral problems in both children and adults with autism. The FDA recently approved the use of risperidone (Risperdal) and apripiprazole (Abilify) to treat symptoms of autism.
What medications are good for autism? ›
- Selective serotonin re-uptake inhibitors (SSRIs) This group of antidepressants treats some problems that result from imbalances in the body's chemical systems. ...
- Tricyclics. ...
- Psychoactive or anti-psychotic medications. ...
- Stimulants. ...
- Anti-anxiety medications. ...
- Anticonvulsants.
Every person living with autism is unique; some may struggle with empathy while others may feel completely overwhelmed by other people's feelings, and then there is everyone in between. It seems that autistic expression of empathy may be atypical.
Do people with autism have empathy? ›Yes. Despite the stereotype, people with autism can be empathetic. In fact, some experience a type of empathy known as affective empathy, which is based on instincts and involuntary responses to the emotions of others.
What can mimic high-functioning autism? ›- Avoidant personality disorder.
- Obsessive compulsive disorder (OCD)
- Reactive attachment disorder.
- Social (pragmatic) communication disorder.
- Schizophrenia, which rarely happens in children.
- Delayed language skills.
- Delayed movement skills.
- Delayed cognitive or learning skills.
- Hyperactive, impulsive, and/or inattentive behavior.
- Epilepsy or seizure disorder.
- Unusual eating and sleeping habits.
- Gastrointestinal issues (for example, constipation)
- Unusual mood or emotional reactions.
- Medical Laboratory Technologist.
- Computer Programmer.
- Reference Librarian.
- Taxi Driver.
- Telemarketer.
- Artist/Designer.
- Information Technology.
- Lines up toys or other objects and gets upset when order is changed.
- Repeats words or phrases over and over (called echolalia)
- Plays with toys the same way every time.
- Is focused on parts of objects (for example, wheels)
- Gets upset by minor changes.
- Has obsessive interests.
Autistic people may act in a different way to other people
find it hard to understand how other people think or feel. find things like bright lights or loud noises overwhelming, stressful or uncomfortable. get anxious or upset about unfamiliar situations and social events. take longer to understand information.
While autism is most often diagnosed in toddlers, it's possible for autistic adults to go undiagnosed.
How can you tell if someone is on the spectrum? ›- Avoiding eye contact.
- Delayed speech and communication skills.
- Reliance on rules and routines.
- Being upset by relatively minor changes.
- Unexpected reactions to sounds, tastes, sights, touch and smells.
- Difficulty understanding other people's emotions.
What are the signs of mild autism in adults? ›
- Difficulty interpreting what others are thinking or feeling.
- Trouble interpreting facial expressions, body language, or social cues.
- Difficulty regulating emotion.
- Trouble keeping up a conversation.
- Inflection that does not reflect feelings.
If someone in your family has autism spectrum disorder (ASD), you may be more likely to have a child with ASD. ASD can look very different from person to person, so taking a careful family health history can be important for early diagnosis.
Can you get autism later in life? ›Age Limit for Autism Development
Older children, teens, and adults do not develop autism. In fact, to qualify for an autism spectrum diagnosis, you must have symptoms that appear during early childhood (i.e., before age 3).
Every person living with autism is unique; some may struggle with empathy while others may feel completely overwhelmed by other people's feelings, and then there is everyone in between. It seems that autistic expression of empathy may be atypical.
What are autistic people good at? ›Autistic people may display a range of strengths and abilities that can be directly related to their diagnosis, including: Learning to read at a very early age (known as hyperlexia). Memorising and learning information quickly. Thinking and learning in a visual way.
Which parent carries autism gene? ›Due to its lower prevalence in females, autism was always thought to have a maternal inheritance component. However, research also suggests that the rarer variants associated with autism are mostly inherited from the father.
What can mimic high functioning autism? ›- Avoidant personality disorder.
- Obsessive compulsive disorder (OCD)
- Reactive attachment disorder.
- Social (pragmatic) communication disorder.
- Schizophrenia, which rarely happens in children.
But emerging research suggests that autistic adults are at high risk of a broad array of physical and mental health conditions, including diabetes, depression and heart disease. They are also about 2.5 times as likely as their neurotypical peers to die early.
Is autism overdiagnosed in adults? ›Thomas Frazier, PhD, the chief science officer at Autism Speaks, told Healthline: “Autism is not being overdiagnosed.” “The core features of autism — social communication and inflexible, repetitive behavior — have remained the same since the beginning,” said Frazier.
Why is autism increasing? ›The global increase in autism prevalence reflects major improvements in public awareness and public health response to autism. Children are now more likely to be diagnosed earlier, and even underrepresented regions like Africa and the Middle East have been advancing their ability to measure autism prevalence.
What is the most mild form of autism? ›
Asperger's Syndrome is the mildest form of autism and is closely associated with level one of ASD.