Autism in Adults: Diagnosis, Treatment, and Resources (2023)

According to the DSM-5, autism is characterized by:

  • difficulty communicating and interacting with others
  • repetitive behaviors and a narrow set of interests
  • symptoms that affect quality of life and functioning in areas like work and school

No two autistic people have the exact same set of symptoms. Autism spectrum disorder (ASD) is referred to as a spectrum because of the variety of its signs and symptoms, and the different impacts and support needs that people may experience.

Some autistic people experience symptoms that can make daily life difficult without appropriate therapies and supports.

Others who have lower support needs (sometimes referred to “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 autistic adults 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.

Signs of autism with lower support needs in adults

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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 you believe you may be on the spectrum, it’s possible that you may be considered autistic with lower support needs. In the past, this has been referred to as “high-functioning” autism.

Following are signs of autism in adults:

Social communication behaviors

  • 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.
  • You make noises in places where quiet is expected.
  • Building and maintaining close friendships is difficult.

Restrictive and repetitive behaviors

  • You have trouble regulating your emotions and your responses to them.
  • Changes in routines and expectations cause strong feelings that may include 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.

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 successful in one or two challenging academic subject areas. Some autistic people may do very well in some areas while also having great difficulty doing well in others.
  • You are very sensitive to sensory input (like pain, sound, touch, or smell), or you are much less sensitive to these things than other people.
  • You feel like you’re clumsy or have difficulty with coordination.
  • You prefer to work and play by yourself, rather than with others.
  • Others perceive you as eccentric or an academic.
  • You are able to learn complex details and remember them for long periods of time.
  • You learn well visually or by listening.

There are currently no ASD diagnostic criteria specifically for adults. But the current DSM-5 criteria can be adapted and used for this age group.

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 is no 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.

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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.

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 the same as a professional evaluation and should not be viewed as definitive.

Potential benefits of living with an autism diagnosis

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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 impacted.

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.

A better understanding of your own situation can help you find new and inventive ways to work with your strengths and qualities. You can also work with your clinician and your loved ones to seek supports 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.

Note that certain therapies such as applied behavioral analysis (ABA) are controversial in autistic communities. Some advocacy groups such as the Autistic Self-Advocacy Network do not support the use of ABA.

In general, you’ll want to seek out specific support based on the impacts you’re experiencing. This might include anxiety, social isolation, relationship problems, or job difficulties.

Some possibilities include:

Psychiatrist or psychologist

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.

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In some states, other licensed mental health professionals such as social workers may also provide official ASD assessments.

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.


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 play an important role in supporting autistic people. 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 health and medical care.


There are many types of therapy that can be helpful for autistic adults, such as cognitive behavioral therapy (CBT), physical therapy, or occupational therapy.

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 autistic adults have found support through online groups and forums, as well as by connecting in person with other adults on the autism spectrum.

The takeaway

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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.

In some cases, getting a diagnosis can be a step toward positive outcomes such as accessing resources, understanding your own strengths, and building connections with other autistic people.


What questions are asked in an autism assessment for adults? ›

For adults

The assessment team may: ask you to fill in a questionnaire about yourself and any problems you have. speak to someone who knew you as a child to find out about your childhood. read any reports from the GP about other health problems you may have.

What are the diagnostic criteria for autism in adults? ›

(Diagnosis requires person meets all three criteria.) Difficulty initiating or sustaining back and forth conversation; tendency to monologue without attending to listener cues; unusual response to greetings or other social conventions.

Why is diagnosing autism in adults difficult? ›

Because so many behavioral health professionals specialize in autism for children, it can be difficult to find someone who's comfortable with (and skilled in) diagnosing and treating autism in adults.

What is the most accurate autism test for adults? ›

The Adult Repetitive Behavior Questionnaire (RBQ-2)

The Adult Repetitive Behavior Questionnaire was developed by researchers in Wales and is the best-researched tool of its kind.

What is the gold standard assessment for autism? ›

The 2 tests that are considered the gold-standard for diagnosing ASD include the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised.

Can an MRI show autism in adults? ›

Increasingly, studies are showing that there are actual differences in the autistic brain; using MRI, researchers (Sherr et al., 2017) identified structural abnormalities in the brains of individuals with one of the most common genetic causes of autism.

What are the 2 categories to consider when diagnosing autism? ›

into two categories of symptoms
  • Persistent deficits in social communication/interaction and.
  • Restricted, repetitive patterns of behavior.

What is 299.00 autism spectrum disorder? ›

Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

What does high functioning autism look like in adults? ›

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.

What happens if autism goes untreated? ›

Untreated autism causes changes in brain function that make it more difficult for the person to control impulsive behavior or think rationally about their actions before they act on them. This can lead to situations where ASD adults are unable to live alone and take care of themselves without assistance.

What are the signs of high functioning autism 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.
  • seeming blunt, rude or not interested in others without meaning to.
  • finding it hard to say how you feel.

How do psychologists test for autism in adults? ›

The Social Communication Questionnaire, Autism Spectrum Quotient, Adaptive Behavior Questionnaire, Autism Diagnostic Interview-Revised (ADI-R), and Autism Diagnostic Observation Schedule-2 (ADOS) are commonly used. The latter two are the most comprehensive measures available.

How long is autism testing for adults? ›

Each of the diagnostic tests (ADOS, CSBS) usually last between 30-60 minutes, and depending on the results and observations of a clinician, there will be moderate follow up. Make sure to communicate with any potential autism assessment providers about their anticipated process before committing to a full evaluation.

How valid are online autism tests? ›

Online tests are not an accurate way to determine if someone has autism or any other mental health condition. Even though they may ask questions related to characteristics associated with certain diagnoses, they cannot accurately diagnose a person.

What are the diagnostic procedures for autism? ›

Diagnosing autism spectrum disorder (ASD) can be difficult because there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child's developmental history and behavior to make a diagnosis. ASD can sometimes be detected at 18 months of age or younger.

What tests do psychologists use to diagnose autism? ›

The ADOS is an assessment used for autism. The ADOS consists of structured and semi-structured subtests that involve different components of social interactions and communication. The assessment has five modules. The module is chosen based on the individual's developmental level.

What is the autism diagnostic observation schedule for adults? ›

The Autism Diagnostic Observation Schedule-2 (ADOS-2) is considered the “gold standard” in diagnosing ASD. It consists of a semi-structured, standardized assessment of social interaction, play, and imaginative use of material for individuals suspected of having ASDs from 12 months old to adults.

Who is the best professional to diagnose autism? ›

Developmental pediatricians are medical doctors who possess the training and experience to diagnose autism and other developmental difficulties. These professionals consider the medical and psychosocial elements of children's behavior problems and provide counsel and treatment accordingly.

What is a score for autism? ›

Total scores can range from a low of 15 to a high of 60; scores below 30 indicate that the individual is in the non-autistic range, scores between 30 and 36.5 indicate mild to moderate autism, and scores from 37 to 60 indicate severe autism (Schopler et al.

How does neurologist diagnose autism? ›

Neurologists typically carry out an evaluation of symptoms associated with the ASD triad, as defined by the DSM criteria. “The DSM criteria is the baseline for ASD diagnosis. Furthermore, insurance companies often require standardized testing such as the autism diagnostic and observation scale (ADOS).

Does an autistic brain look different on a scan? ›

Which brain regions are known to be structurally different between autistic and non-autistic people? Studies that make use of a brain-scanning technique called magnetic resonance imaging (MRI) have highlighted a few brain regions that are structurally distinct in people with autism.

What is a highly functioning autistic? ›

“High-functioning autism” isn't an official medical term or diagnosis. It's an informal one some people use when they talk about people with an autism spectrum disorder who can speak, read, write, and handle basic life skills like eating and getting dressed.

Can EEG detect autism in adults? ›

Quantitative electroencephalography (QEEG) during wakefulness has been extensively used to characterize brain functioning and its relation to autistic symptoms in ASD children and adolescents (4). However, given the age-specific physiopathology of brain atypicalities in ASD, these results may not apply to adults.

What is level 1 autistic adults? ›

Level 1 Autism

Someone who would fall into this level of autism is capable of interacting with other people. However, they might still struggle and need coaching and assistance. For example, in some of the following areas: Problems with starting a conversation.

How long does a diagnosis for autism take? ›

If you are referred for an assessment, it should start within 3 months and be done by a team of people who are specialists in autism.

What is a Level 3 autism diagnosis? ›

ASD level 3 is characterized by severe challenges in social communication as well as extremely inflexible behavior. Children with level 3 autism will be nonverbal or have the use of only a few words of intelligible speech. Initiation of social interaction is very limited, as well as response to others.

What is the difference between autism and autism spectrum disorder ASD? ›

They are one and the same. The Autism Spectrum Disorder (ASD) is the clinical definition for autism. Some people chose to be referred to as “an autistic person”, while others prefer to be referred to “a person with autism”.

What are idiosyncratic phrases? ›

When we're talking about spoken language, idiosyncrasies are when someone uses normal words or phrases in an abnormal way—the word will be a real word in the speaker's native language, but it won't actually be associated with whatever he/she is referring to.

What is ICD-9 for autism disorder? ›

ICD-9 code 299.00 for Autistic disorder, current or active state is a medical classification as listed by WHO under the range -OTHER PSYCHOSES (295-299).

What therapy is used for high functioning autism? ›

Treatment for high-functioning autism

Occupational therapy, physical therapy, and talk therapy are all alternatives for autism treatment. However, Applied Behavior Analysis (ABA) is commonly regarded as the "gold standard" of autism therapy.

Can autism get worse in adulthood? ›

Autism does not change or worsen as someone gets older, and there's no cure. Autism isn't like a pair of shoes that needs to be broken in for complete comfort. This is because no matter what you've heard, the notion that you'll wake up one day no longer autistic is, was, and will forever be untrue.

What is the mildest form of autism? ›

Asperger's Syndrome is the mildest form of autism and is closely associated with level one of ASD.

What are the benefits of being diagnosed with autism? ›

Benefits of a diagnosis
  • It may help you (and your family, partner, employer, colleagues and friends) to understand why you may experience certain difficulties and what you can do about them.
  • It may correct a previous misdiagnosis (such as schizophrenia) and mean that any mental health problems can be better addressed.
Aug 13, 2020

Can you drive if autistic? ›

It is very possible for autistic people to drive. When you're learning to drive with autism, there is lots of support out there for you. There are driving instructors who specialise in teaching people with disabilities.

What causes autism in adults? ›

Some genetic mutations seem to be inherited, while others occur spontaneously. Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

Can you develop autism from trauma? ›

While autism is never caused by trauma, there may be something about living with autism that is inherently traumatic.

How do you communicate with high functioning autistic adults? ›

How to Talk to Someone with “High-Functioning” Autism
  1. Focus on Individuals Strengths. ...
  2. Understand the Impact of Negative Labels. ...
  3. Appropriate Social Inclusion. ...
  4. Speak Clearly and Literally. ...
  5. Ask Questions and Facilitate Successful Dialogue. ...
  6. Initiate Conversation and Identify Commonalities. ...
  7. Avoid Distracting Environments.
Apr 26, 2022

How hard is it to diagnose autism in adults? ›

The problem is, there's no established procedure for diagnosing ASD in adults. So, adult autism specialists are hard to find. It might be best to ask your primary care doctor or psychologist for a referral. If your area has an autism center, that would be an excellent place to start.

Who can diagnose autism in adults in the US? ›

Any professional with the credentials and expertise to diagnose any other condition may also make a diagnosis of ASD. Such professionals may be social workers (MSW), master's level psychologists (MA), or other mental health professionals. Neuropsychological testing is not required to get a “formal” diagnosis.

What does a psychiatrist do for autism? ›

These professionals will learn treatment approaches tailored to individuals with autism, including applied behavioral analysis, communication interventions and occupational therapy. This is in addition to standard psychiatric treatment approaches such as psychopharmacology and psychotherapy.

Where is the best place for autism evaluation? ›

In general, a developmental pediatrician or psychologist is the best qualified to make a diagnosis. However with training, other medical providers can competently conduct the evaluation. It should involve direct interaction between the provider and your child.

Why is it so hard to get an autism assessment? ›

There are a number of reasons why early screenings don't always catch autism. Doctors often hesitate to diagnose autism if it might be something else. They want to see how the child's development goes first. Sometimes, kids who have both ADHD and autism just get diagnosed with severe ADHD.

Should you self diagnose autism? ›

There are actually many valid reasons to seek a medical diagnosis for autism spectrum disorder, but there may also be a case for self diagnosis; especially for those who simply cannot afford a formal medical diagnosis, or find an appropriately trained doctor willing to diagnose adults who suspect they may be on the ...

Which autism spectrum test is most accurate? ›

The Adult Repetitive Behavior Questionnaire was developed by researchers in Wales and is the best-researched tool of its kind.

What questions should I ask at an autism evaluation? ›

Here are a few questions to take with you to the appointment:
  • What does the diagnosis mean? ...
  • What does that term mean? ...
  • If autism is a spectrum, where is my child? ...
  • What benefits are there to receiving a diagnosis? ...
  • What type of therapy or other services does my child need?

What are some common questions about autism? ›

Frequently Asked Questions About Autism
  • I think I/my child may have autism but I'm not sure. ...
  • How is autism diagnosed? ...
  • How can I find out what caused my child's autism? ...
  • How can I find out if my/my child's case is genetic? ...
  • If there is no autism epidemic, why do the autism statistics just keep climbing?
Apr 22, 2014

What questionnaire is used for autism? ›

The ASSQ (Autism Spectrum Screening Questionnaire) is a screening questionnaire for autism.

How long does an autism evaluation take for adults? ›

Each of the diagnostic tests (ADOS, CSBS) usually last between 30-60 minutes, and depending on the results and observations of a clinician, there will be moderate follow up. Make sure to communicate with any potential autism assessment providers about their anticipated process before committing to a full evaluation.

What is done during an autism evaluation? ›

The specialist may observe the child give the child a structured test, ask the parents or caregivers questions, or ask them to fill out questionnaires. The results of this formal evaluation highlight your child's strengths and challenges and can inform whether they meet criteria for a developmental diagnosis.

How long does an autism evaluation take? ›

What to expect during your child's autism evaluation. Your child will be evaluated by either a developmental pediatrician, a psychologist or with a team of professionals. Evaluations can range from one-and-a-half hours to four hours or longer, and may be done in one day or over a few visits.

Do autistic adults ask a lot of questions? ›

However, autistic people will ask questions more often and, in more depth, than their neurotypical counterparts because multi-part questions serve a very specific purpose for the autistic brain.

What are the three main impairments in autism? ›

These are known as 'the triad of impairments', or 'the three impairments':
  • Social Interaction. ...
  • Social Communication. ...
  • Rigidity of Thinking and Difficulties with Social Imagination.

What does autism mainly affect? ›

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior.

How do I know if I am masking? ›

Signs you or someone you support may be masking include:
  • Mirroring others' facial expressions or social behaviors.
  • Rehearsing or preparing scripted responses to comments.
  • Imitating gestures such as handshakes or initiating eye contact.
  • Noticeable difficulty with disguising autistic traits in unfamiliar environments.
Apr 19, 2022

What is masking autism traits? ›

Masking may involve suppressing certain behaviours we find soothing but that others think are 'weird', such as stimming or intense interests. It can also mean mimicking the behaviour of those around us, such as copying non-verbal behaviours, and developing complex social scripts to get by in social situations.

How does a neurologist diagnose autism? ›

Neurologists: Neurologists can play a role in diagnosing autism by ruling out neurological disorders that may be causing the symptoms of autism. They perform neurological testing and developmental motor tests. Autism—its cause as well as its treatment—is still not clearly understood.

What do I need to know after being diagnosed with autism? ›

Children with autism tend to have difficulty in social situations, such as making eye contact, reading facial expressions, and having conversations (4). They may be rigid and have difficulty being flexible or accepting changes in routine. They may exhibit repetitive behavior, such as hand flapping or spinning.

What are the good things about autism? ›

  • Autism: the positives. Understanding, embracing and celebrating different ways of thinking and doing can release the true power of the autistic mind. ...
  • Remember. Harriet Cannon. ...
  • Attention to detail. • Thoroughness. ...
  • Deep focus. • Concentration. ...
  • Observational skills. ...
  • Absorb and retain facts. ...
  • Visual skills. ...
  • Expertise.

Should I disclose my autism in a job interview? ›

The most common question surrounding autism and job interviews is whether or not you must disclose the fact that you have autism. The short answer is no. Disclosing autism, or any disability is a personal decision that people should make based on their own needs, beliefs, and comfort level.


1. Why are so many autistic adults undiagnosed? | Kip Chow | TEDxSFU
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2. Step-by-Step Adult Autism Diagnostic Process ✏️📊 PLUS The #1 Thing to Do Before You Test
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3. The Importance of Stimming in Late Diagnosed Autistic Adults
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4. How to Get an Adult Autism Diagnosis
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5. How to not miss the diagnosis of autism spectrum disorder in adults
6. Diagnosis of Autism in Adults I Presented by Claire Schutte, Psy-D, BCBA-D


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