Autism spectrum disorder (ASD) is typically diagnosed in childhood. However, many adults are now seeking diagnoses. Getting tested and properly diagnosed is important. An adult autism diagnosis can open doors to support and services that lead to a better quality of life.
This in-depth guide will cover everything you need to know about autism testing and diagnosis as an adult.
What Is Autism Spectrum Disorder?
Autism spectrum disorder (ASD) is a developmental disability. It affects how a person communicates and interacts with others. ASD also involves restricted, repetitive patterns of behaviors, interests, or activities.
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now includes autism under one umbrella diagnosis. In the past, there were separate diagnoses like Asperger’s syndrome, pervasive developmental disorder, and others. Today, these all fall under the diagnosis of ASD.
The current criteria for ASD in the DSM-5 are problems in two main areas:
- Difficulty with social communication and interactions
- Restricted interests and repetitive behaviors
Symptoms are present early in life and limit or impair everyday functioning.
ASD occurs along a spectrum. This means it affects each person differently. Some autistic people need very little support. They are considered to be on the “high-functioning” end of the spectrum. Others require much more substantial support.
How Common Is Autism?
According to the Centers for Disease Control and Prevention (CDC), about 1 in 44 children has been diagnosed with ASD. Boys are diagnosed more often than girls.
Autism statistics also show:
- 1 in 45 white children are diagnosed
- 1 in 54 Hispanic children
- 1 in 25 Black children
While autism is often considered a childhood disorder, it is a lifelong condition. Some key reasons more adults are seeking diagnoses include:
- Greater awareness and understanding of ASD
- The realization that girls and women often go undiagnosed
- Finding out one’s child is on the autism spectrum and recognizing similarities
Recognizing Signs of Autism in Adults
Autistic adults often learn to mask or compensate for their challenges over the years. This makes the signs of ASD less obvious. But there are still many clues that can point to autism in adults.
Social Communication and Interaction
Some examples of social communication and interaction issues in autistic adults include:
- Not understanding the unwritten social “rules” in certain situations
- Struggling to interpret nonverbal cues like body language and facial expressions
- Having monotone speech or using unusual speech patterns without realizing it
- Finding it hard to build rapport or chat with others, especially about “small talk” topics
- Seeming overly formal or stiff in conversations
- Not making consistent eye contact or missing social cues
Restricted, Repetitive Behaviors
Examples of this core autism trait in adults include:
- Needing set routines and becoming anxious if they change
- Having intense interests or hobbies that border on obsessions
- Getting very upset when unable to pursue interests or rituals
- Repeating certain physical movements, sounds, or phrases
- Having sensory issues like extra sensitivity to light, sound, or touch
Emotional Regulation Issues
Many autistic adults also struggle with:
- Anxiety
- Depression
- Managing frustration and controlling reactions during meltdowns
Executive Functioning Difficulties
Problems with executive functioning related to autism might include:
- Trouble starting tasks and staying organized
- Difficulty planning and prioritizing
- Problems focusing and multitasking
- Struggles with working memory
Autism Screening and Diagnostic Tests for Adults
Wondering if you should consider autism testing? There are self-screening tools and professional diagnostic assessments available.
Autism Self-Screening Tests
If you are an adult who suspects you may be on the spectrum, a self-screening test is a good place to start.
Some top autism screening tools for adults include:
- Autism Spectrum Quotient (AQ-10): This 10-question test screens for autism traits. It’s adapted from the longer 50-item Autism Spectrum Quotient test.
- Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): This questionnaire has 80 questions assessing areas like social relatedness, language, sensory issues, and more.
- Adult Repetitive Behaviors Questionnaire-2 (RBQ-2A): The 20 questions in this test screen for restricted, repetitive behaviors related to autism.
- Adult Social Behavior Questionnaire (ASBQ): This tool has 44 items evaluating multiple aspects of social behavior, communication style, and related autism traits.
These autism screening tools for adults are available free online. But they should not be used for self-diagnosis. Professional diagnosis is still required.
Positive results on these questionnaires indicate a need for a complete diagnostic evaluation. An experienced clinician can properly interpret results and make a diagnosis.
Professional Autism Diagnosis
Diagnosing autism spectrum disorder in adults can be challenging. There are no lab tests. A clinical diagnosis is made based on a full evaluation of an individual’s history, symptoms, and functioning.
To diagnose ASD, clinicians look for early developmental delays and clear evidence of current autism symptoms that impair function.
The gold standard ASD assessments for adults include:
- Autism Diagnostic Observation Schedule, Second Edition (ADOS-2): This evaluation involves various activities that allow the clinician to observe social and communication behaviors associated with ASD.
- Autism Diagnostic Interview-Revised (ADI-R): The examiner completes this structured interview with a parent or caregiver to gather developmental history and symptoms.
- Developmental, Dimensional and Diagnostic Interview (3Di): This standardized interview collects developmental history and current symptom information from the individual.
Testing is often supplemented with questionnaires like the Social Responsiveness Scale (SRS-2) for adults. A medical exam and psychological testing may also be completed.
Who Can Diagnose Autism in Adults?
It’s best to seek an assessment from a professional who specializes in evaluating ASD in adults. This might be a:
- Neuropsychologist
- Developmental psychologist
- Psychiatrist
- Licensed clinical social worker (LCSW)
Some clinics also have specialized adult autism assessment programs. Resources like the Autism Research Institute can help you find experienced diagnosticians in your area.
Getting Support After an Autism Diagnosis
Receiving an autism diagnosis as an adult can be overwhelming. Some people feel relief at finally understanding their challenges. Others mourn time lost to masking symptoms and not getting needed support.
It is important to be patient with yourself and seek any help you need processing the diagnosis. Connecting with other autistic adults can help you see you are not alone.
An autism diagnosis makes you eligible for services and accommodations. Work with knowledgeable providers to access:
- Job training and placement assistance
- Independent living support
- Social skills training
- Cognitive behavioral therapy (CBT) for anxiety or depression
- Speech therapy for communication issues
- Occupational therapy for sensory-motor struggles
With the right support, many autistic adults can live happy, healthy, independent lives. Early intervention and services are so important to help people reach their full potential.
Signs Your Child May Have Autism
If your child is diagnosed with ASD, pay close attention to your own traits and behaviors. Research shows autism has a strong genetic component. When one family member is diagnosed, others often realize they are also on the spectrum.
Some red flags your child’s autism should prompt your own evaluation include:
- You had speech delays as a child yourself
- You were considered shy, odd or socially awkward as a youth
- You have always hated change and preferred set routines
- You have intense interests that you get very wrapped up in
- Friends and loved ones have suggested you may be “a little autistic”
If you notice similarities between you and your autistic child, consider screening yourself for ASD. Then pursue professional assessment if indicated.
Access World-Class ABA Therapy in Maryland
If your child is diagnosed with autism, don’t delay getting them treatment. Applied behavior analysis (ABA) therapy can make a life-changing difference when started early.
Jade ABA Therapy provides premier ABA services in Maryland. Our passionate team has decades of experience. We offer customized 1:1 ABA for kids on the spectrum from toddlers through teens.
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Conclusion
Autism spectrum disorder is much more common in adults than previously thought. Many older individuals struggle for years without knowing they are on the spectrum.
Seeking testing and diagnosis as an adult can be transformative. It provides answers and opens up access to support services. Everyone deserves the chance to understand their neurology and get help mitigating challenges.
There are reliable screening tools and experienced professionals to guide adults through diagnosis. With an accurate diagnosis, personalized treatment and support, autistic adults can live their best lives.
References
[1] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.
[2] Parish-Morris J, Liberman MY, Cieri C, et al. Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism. 2017;8:48.
[3] Lehnhardt FG, Gawronski A, Volpert K, et al. Clinical assessment of autistic symptoms in women and girls: interview, observation, and diagnostic evaluation. Child and Adolescent Psychiatry and Mental Health. 2020;14(1):46.
[4] Cassidy S, Bradley P, Robinson J, Allison C, McHugh M, Baron-Cohen S. Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: a clinical cohort study. The Lancet Psychiatry. 2014;1(2):142-147.
[5] Spain D, Sin J, Chalder T, Murphy D, Happe F. Cognitive behaviour therapy for adults with autism spectrum disorders and psychiatric co-morbidity: A review. Research in Autism Spectrum Disorders. 2015;9:151-162.
[6] Autism Research Institute. Find A Professional. Accessed February 27, 2023. https://www.autism.org/find-a-professional/