Medically reviewed by Timothy J. Legg, PhD, PsyD
Written by Jayne Leonard
The symptoms of autism in adults can differ from those in children, and many adults have learned to live with their symptoms over the years.
Autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders. In most cases, people receive an autism diagnosis in childhood, usually after the age of 4 years.
However, some adults live with undiagnosed ASD. Even people with more severe symptoms may not have received the correct diagnosis.
There are some similarities between ASD and certain other disorders, including attention deficit hyperactivity disorder (ADHD).
Receiving an ASD diagnosis later in life can be helpful for many reasons, but particularly because it can provide people with better access to services and support. Read on to learn more about autism in adults.
Signs and symptoms of adult autism
Autistic people typically find aspects of communication and social interaction challenging. They may have difficulty relating to other people and understanding the emotions of others.
Autistic people may also have inflexible thought patterns and behavior, and they often carry out repetitive actions.
Adults with mild symptoms of ASD may not get a diagnosis until later in life, if ever.
Common signs and symptoms of ASD in adults can include:
- difficulty making conversation
- difficulty making or maintaining close friendships
- discomfort during eye contact
- challenges with regulating emotions
- extreme interest in one particular topic, such as a specific period of history
- frequent monologues on the same subject or subjects
- hypersensitivity to sounds or smells that do not seem to bother others
- involuntary noises, such as repetitive throat clearing
- issues understanding sarcasm or idioms
- lack of inflection when speaking
- only having an interest in a few activities
- preference for solitary activities
- problems reading the emotions of others
- trouble understanding facial expressions and body language
- reliance on daily routines and difficulty dealing with changes to routine
- repetitive behaviors
- social anxiety
- superior abilities in mathematics and related disciplines, in some cases
- the need to arrange items in a specific order
Autistic people will not usually have all of the above signs and symptoms, and they may experience others that are not on the list. Signs and symptoms vary from person to person.
Also, the symptoms can differ between men and women.
Autistic women may be quieter and appear to cope better with social situations than autistic men. As a result, it can be more challenging to diagnose ASD in women.
According to some research, autistic people may have higher rates of co-occurring conditions, such as anxiety or depression, than those in the general population.
Seeking an autism diagnosis as an adult can be challenging for several reasons:
- Firstly, people who did not receive a diagnosis in their younger years may have milder symptoms, which can be more difficult for a doctor to recognize.
- Secondly, if people have been living with ASD for some time, they may be better at disguising or managing the signs and symptoms.
- Thirdly, there is currently no established method of diagnosing ASD in adults, although this is likely to change in the future.
Individuals may wish to begin with a self-assessment test for adults. While these tests cannot confirm a diagnosis, they are a good starting point and provide material to discuss with a healthcare professional.
Alternatively, those who suspect that they or their loved one has ASD can speak directly to a doctor. A doctor will try to determine whether ASD may be present by:
- enquiring about symptoms, both current and during childhood
- observing and interacting with the person
- speaking to loved ones (with permission)
- checking for other physical or mental health conditions that may be causing symptoms
If no underlying physical condition appears to be responsible for the symptoms, the doctor may then refer the person to a psychiatrist or a psychologist to make a diagnosis.
If symptoms are not present in childhood but begin in adolescence or adulthood, this may indicate a cognitive or mental health condition other than ASD.
Currently, it is challenging to find a specialist who can diagnose and treat ASD in adults. A good starting point is to contact a local autism center, such as an Autism Speaks Autism Treatment Network location.
Others may find it helpful to speak to a developmental pediatrician or child psychiatrist who has experience and is willing to see adult clients.
Benefits of diagnosis
While getting a diagnosis of ASD in adulthood can be tricky, it offers several advantages.
- The diagnosis may provide relief and an explanation for the challenges that an individual has experienced throughout their life.
- It may give family members, friends, and colleagues a better understanding of living with ASD.
- It may open up access to useful services and benefits, including in the workplace or at university.
- It may replace an incorrect diagnosis, such as ADHD.
On the other hand, not every adult with undiagnosed ASD may want or need a diagnosis. It is important to respect the needs and wishes of the individual.
Living with autism
Living with ASD can be challenging, but receiving a diagnosis can provide access to certain autism supports and services.
It can also provide a different perspective on a person’s childhood and the way that they relate to others and the world.
There is no “cure” for ASD, but for many people, ASD is an essential part of their identity and does not require treatment.
Doctors and therapists can help people manage their symptoms and deal with challenges specific to ASD, such as sensory overload and social situations.
Symptom management options for autistic adults differ from those for children. They include:
Learning about autism can give individuals and their loved ones a greater understanding of the condition.
It can help a person feel validated and find solutions that work for them. Friends and family can help reduce stress and be more compassionate when they know more about ASD.
It may be helpful to see a therapist for a range of issues, including anxiety, work stresses, or feeling isolated.
Therapy for autistic people may take place either individually or in a group or family setting.
Vocational rehabilitation can help autistic people cope with career-related challenges.
It allows people to explore the possibility of further education, volunteering, or career changes.
Some workplaces can be uncomfortable because they are too noisy, too bright, or require a long commute.
Employers can take steps to support neurodiversity in the workplace, for example, making appropriate accommodations for autistic employees. Many resources are available, including from the Employer Assistance and Resource Network on Disability Inclusion.
Autistic people can thrive in the right workplace and with adequate support.
Some autistic people find it helpful to connect with others with ASD. They can do this through online groups and forums or at face-to-face support meetings.
Sometimes, prescription medications may alleviate co-occurring symptoms, such as depression and anxiety.
Receiving an autism diagnosis as an adult can provide relief, validation, and access to services for those who require them.
As awareness of ASD increases, finding a doctor who can recognize the signs and symptoms and help a person find the right resources should also become easier.
Adults who suspect that they may be autistic should speak to their doctor, who can provide advice and guidance on the next steps.