Autism is characterized primarily by social and behavioral challenges, including:

  • differences in how people perceive their environments and those around them
  • communication barriers due to how people both process and verbalize information
  • the need to maintain rigid — and sometimes repetitive — patterns and rituals that can interfere with social interactions and quality of life
  • difficulty controlling movement, ranging from fine motor skills to speech volume

No two people with autism spectrum disorder (ASD) have the exact same set of symptoms. ASD is referred to as a spectrum because of the variety of its signs and symptoms, and their differences in severity.

Some people with ASD experience symptoms that make daily life difficult. Others who are considered “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 adults with autism spectrum disorder 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 believe you may have ASD, you may be considered to have high-functioning autism.

Following are signs of autism in adults:

Communication challenges

  • 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.
  • Building and maintaining close friendships is difficult.

Emotional and behavioral difficulties

  • You have trouble regulating your emotions and your responses to them.
  • Changes in routines and expectations cause 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.
  • You make noises in places where quiet is expected.

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 smart in one or two challenging academic subject areas, but have great difficulty doing well in others.
  • You experience hypersensitivity or impaired sensitivity to sensory input (like pain, sound, touch, or smell).
  • You feel like you’re clumsy and have difficulty with coordination.
  • You prefer to work and play by yourself, rather than with others.
  • Others perceive you as eccentric or an academic.

There are currently no standard diagnostic criteria for adults with suspected ASD, but they are in development.

In the meantime, 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 isn’t an 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.

While a medical diagnosis may be desired for some, it might not be necessary for everyone. 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 as reliable 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 challenging.

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.

Better understanding the set of challenges you face can help you find new and inventive ways to work with or around those challenges. You can also work with your clinician and your family to seek support 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. More often, you’ll need to seek out specific support based on the challenges you’re experiencing (like anxiety, social isolation, relationship problems, or job difficulties).

Some possibilities include:

Psychiatrist

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.

Some adults may be content with a self-diagnosis, and there’s nothing wrong with that. 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’t diagnose ASD, but they can play an important role in helping to manage it. 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 and medical care.

Therapy

There are many types of therapy that can be helpful adults with ASD, including applied behavior analysis (ABA) and cognitive behavioral therapy (CBT).

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 adults with autism 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.

As awareness of ASD continues to grow and more detailed diagnostic criteria for adults are put into place, new resources and support will also continue to become available.