Autism Spectrum Disorder in Adults: When to get tested for ASD

Have you ever wondered if you had autism? While symptoms of autism often appear early in childhood, many adults go years or even decades without diagnosis! While not talked about or studied as much as childhood autism, there are many adults who also have autism spectrum disorder. It is important to remember that it is never too late to get tested! 

Autism Spectrum Disorder was officially added to the Diagnostic and Statistical Manual in 2013, combining four previously defined categories and changing the way that autism would be diagnosed (University of Oregon, 2019). Despite being a controversial change, the addition of ASD increased awareness of the disorder and the broadness of the diagnostic criteria allowed more children and adults to be diagnosed. 

Autism Spectrum Disorder is a condition related to brain development that impacts how a person perceives and socializes with others. Symptoms are often split into two categories– problems in social interaction and limited and repetitive patterns of behavior (Mayo Clinic, 2018). As stated in the name, Autism Spectrum Disorder is assessed on a spectrum! Some people may have very mild symptoms, while others are more severe, however all ASD symptoms may impact how one functions in society. 

While autism may not be diagnosed until adulthood, it begins in early childhood. Many children begin to show symptoms within the first year (Mayo Clinic, 2018), however there are also many who slip through the cracks and go decades without diagnosis. It is estimated that 2.21% of adults in the US have ASD according to a 2017 study (CDC, 2017), many of whom have gone through life not recognizing their symptoms. Recognizing symptoms of autism in adults is important as it can lead adults to seek a diagnosis which can result in positive changes in one’s life.

Signs of Autism in Adults 

Symptoms of autism in adults are similar to those in children, however many adults learn to hide or mask their symptoms, making diagnosis more difficult. Here are some of the common symptoms of ASD in adults (NHS, 2022):

1. Difficulty understanding the emotion

2. Difficulty making friends and increased anxiety in social situations

3. Seeming blunt, rude, or disinterested without intending to

4. Difficulty expressing emotions 

5. Having the same daily routine and becoming uncomfortable and anxious when it changes

Overtime, symptoms may change and evolve. Specifically, symptoms may worsen during stressful times or major life changes (Harvard Health Publishing, 2024). 

Masking 

Masking is a behavior often displayed by autistic adults where one hides symptoms of autism when around other people. Many chose to mask symptoms because they want to be accepted by others and avoid negative attention in social situations. Oftentimes adults with autism mask their symptoms without even realizing it! While masking can help one avoid bullying, it has been shown to have negative effects on mental health. Many find it exhausting and draining, and others discover that it makes them feel isolated and misunderstood (Autism Speaks). 

Diagnosis and Treatment

To receive an accurate ASD diagnosis, you should speak to a specialist! A neuropsychologist, psychologist, or psychiatrist can help you start the journey to diagnosis. As with many disorders, there is no single test for autism. When speaking to a specialist and receiving your diagnosis, here’s what you can expect (Harvard Health Publishing, 2024): 

1. Provide a thorough medical history: Your doctor will most likely ask you for a thorough medical history, which will include detailed questions about both your childhood and the present!

2. ASD Assessment: Your doctor will most likely perform a variety of cognitive tests as well as an ASD assessment. The most common ASD assessment for adults is the Autism Diagnostic Observation Schedule, which consists of an hour long interview where the administrator will observe your behavior and responses. 

   
   

Getting a proper autism diagnosis can be extremely beneficial for adults, however there are several challenges to be aware of. First, not as many clinicians are available to diagnose and treat autism in adults as are available for children. Due to this it may take months or even a year to receive an appointment. Another factor is cost. Autism evaluations can be expensive, and are not always covered by insurance. Lastly, while receiving diagnosis can be very beneficial, it also presents a challenge to your identity! It can change the perception of who you are, which can be difficult to cope with (Harvard Health Publishing, 2024). 

Despite the challenges associated with receiving a diagnosis, there are many positive effects! Once diagnosed with Autism Spectrum Disorder, adults can connect with therapists who specialize in helping manage symptoms of ASD. While autism has no treatment, certain supplements and prescription medications may help manage symptoms associated with ASD. Lastly, receiving a diagnosis allows adults to find a community of others who have been dealing with similar things, receive support from peers, and can enhance self acceptance!