Autism in Adults

D'Amore Autism in Adults

Autism spectrum disorder (ASD) is a developmental disorder that affects how someone communicates and behaves. Autism is considered a spectrum disorder because there are many different levels of severity of symptoms that those with autism experience. 1

Autism can be diagnosed at any age; however, symptoms of severe autism are usually observed in the first two years of someone’s life. 1 Individuals with high-functioning autism may not be diagnosed until much later in life. 2

  • Symptoms of ASD occur within the following areas: 2
  • Social interactions
  • Verbal and nonverbal communication
  • Restricted interests and repetitive behaviors

Adults who experience high-functioning autism may show mild symptoms that might be mistaken for signs of attention deficit hyperactivity disorder (ADHD), while others can have more severe symptoms. Symptoms of ASD manifest differently for everyone but usually interfere with daily functioning to some extent. 2

Undiagnosed Adult Autism

Many adults who show signs and characteristics of autism can go undiagnosed for several reasons, including: 3

  • Some reasons include:
  • Social interactions
  • Verbal and nonverbal communication
  • Restricted interests and repetitive behaviors

Many adults who demonstrate behaviors associated with autism and who have not gotten a formal diagnosis can develop meaningful relationships, function well in a career, and live a satisfying life. 3

Other adults with undiagnosed autism might experience difficulties functioning, isolation from others, or struggle in some areas of their life. They may want meaningful relationships or a satisfying career but can have problems achieving them. These challenges can ultimately affect their mental health, physical health, and overall well-being. 3 Fortunately, there are resources available for adults who struggle in these ways. 

Symptoms of Autism in Adults

Symptoms of autism generally manifest in the communication and behavior of an individual, including adults.3


  • Symptoms of adult autism associated with communication include: 3
  • Difficulty joining a conversation
  • Speaking in a flat, monotone voice
  • Issues relating to other peoples thoughts or emotions
  • Using repetitive language
  • Difficulty reading body language and emotions
  • Experiencing feelings that are difficult for others to understand
  • Dominating conversations
  • Talking “at” people instead of engaging in a back and forth conversation
  • Issues reading social cues
  • Difficulty engaging in “small talk”
  • Talking things literally
  • Having a blunt assessment of people and things
  • Issues maintaining eye contact when speaking with someone
  • Using unique phrases and descriptive words
  • Difficulty building and maintaining close friendships
  • Making unusual faces
  • Making gestures when talking with others


  • Behavioral symptoms of adult autism include: 3
  • Enjoying consistent routine and schedules
  • Getting upset or anxious when routine or schedule is changed
  • Getting upset when something unexpected happens
  • Difficulty regulating emotional responses
  • Being bothered when things are moved or rearranged by someone else
  • Engaging in repetitive rituals and behaviors daily
  • Making noise in quiet places
  • Having particular interests or hobbies that are time-consuming
  • Issues with multi-tasking
  • Having a strong reaction or no reaction to sensory stimuli like textures, sounds, smells, and taste
  • A preference for working and playing alone


  • These characteristics can sometimes positively impact life and can manifest in outcomes including: 3
  • Excelling in a chosen career path or area of study
  • Noticing environmental details that others do not
  • Experiencing increased empathy or care for people or animals
  • Finding enjoyment in working independently

High Functioning Autism in Adults

High-functioning autism is not an official term or diagnosis. This term informally refers to individuals with an autism spectrum disorder who possess essential life skills and can live independently.4

The term “high-functioning” autism may describe someone with ASD when they are someone who: 5

  • Received their diagnosis as an adult
  • Functions well in school and at work
  • Does not display any noticeable language differences or developmental delays
  • Has the ability to live on their own

Symptoms of High-Functioning Autism in Adults

  • Common symptoms of high-functioning autism in adults include: 6
  • Emotional sensitivity: They might struggle to control emotions and often have intense emotional reactions. For example, a small coffee spill on their shirt can ruin the rest of the day.
  • Fixation on a particular idea or subject: They may discuss the same topic repeatedly, play the same song over and over again, or read obsessively about a specific topic.
  • Linguistic oddities: They often have an eccentric way of speaking and a diverse vocabulary. They may also interrupt or focus on specific topics during conversations.
  • Social challenges: Peer interaction can be challenging and may manifest as having a small social circle or difficulties performing group work.
  • Issues processing physical sensations: Certain tastes, noises, smells, or feelings might cause distress. These triggers can include large crowds, loud noises, unwanted touch, and uncomfortable clothing.
  • Devotion to routine: They typically love routine, and any deviation from that routine may cause frustration and anxiety. The necessity to engage in specific routines can sometimes create a deficit in sleep, exercise, self-care, work, or homework.
  • Restrictive or repetitive habits: Repetitive habits, such as turning the lights on and off before leaving the house, may become a part of their routine and can ultimately interfere with responsibilities. Repetitive habits, such as never wearing anything but flip-flops, can cause daily functioning and self-care issues.
  • Focus on self and lack of empathy: Conversationally, this can manifest as excessively speaking about themselves, interrupting when others are speaking, and changing the focus back onto themselves. It can also manifest as other unintentionally selfish behaviors. These conversational and behavioral tendencies can cause issues with developing deep social connections.
  • Dislike of change: Disruptions or life changes, such as friends moving, family passing away, or the redesign of their favorite brand’s logo, can create frustration, anxiety, and even anger.
  • Unusual movement patterns: This can include things like toe walking and other uncommon forms of movement.

Why Signs of High-Functioning Autism are Often Overlooked

The signs of high-functioning autism are often entirely overlooked, primarily when autism affects adults, adolescents, or teenagers. More severe forms of autism are usually identified when someone is very young. Additionally, individuals with high-functioning autism are generally extremely intelligent or gifted.7

Throughout their life, adults with autism spectrum disorder learned how to hide their struggles related to autism. The mechanisms autistic adults use to mask their difficulties include forcing themselves to engage in eye contact or attending social gatherings that a child with autism may avoid. These efforts are often effective and convincing to the point where it is difficult or near impossible for others to recognize the challenges they face.7

Pursuing an Autism Diagnosis in Adulthood

It can be challenging for adults to seek an autism diagnosis because .5

  • They usually have milder and less apparent symptoms, which may be difficult for a doctor to recognize
  • They may have become highly successful in hiding or disguising their signs and symptoms after living with autism for a long time
  • There is not currently any method for diagnosing autism in adults

Some adults with more severe symptoms of autism spectrum disorder may have had a misdiagnosis as a child. There are many cases in which a professional misdiagnoses autism spectrum disorder as attention deficit disorder, obsessive-compulsive disorder, or another mental condition.8

A good starting point for adults seeking an autism diagnosis can be performing a self-assessment test specifically for adults. While self-assessments cannot provide a formal diagnosis, they can provide material to discuss with a healthcare professional. 9

How to Seek a Diagnosis

An adult who wishes to obtain a formal diagnosis can speak directly with a doctor who will determine the presence of autism by. 9

  • Discussing current symptoms as well as symptoms that were only present during childhood
  • Observing and interacting with the individual
  • Speaking with loved ones about the individual seeking a diagnosis
  • Speaking with loved ones about the individual seeking a diagnosis

If the doctor does not conclude that a different condition is responsible for the symptoms, they will refer the individual to a psychologist who will make the diagnosis. It is currently challenging to find a specialist who diagnoses and treats autism in adults. 9

Benefits of Receiving a Diagnosis as an Adult

If an adult is questioning whether they have autism spectrum disorder, obtaining a professional diagnosis can create understanding for the individual regarding how they relate to the outside world. A diagnosis might also help the individual find their strengths, work on their weaknesses, and gain a new ability to understand and empathize with others.10

Having an autism spectrum diagnosis as an adult can also help the adult create a new perspective on their lives and childhood. Perhaps they had difficulty with social interactions and had trouble fitting in. A diagnosis can provide this person with an understanding of why they struggled in the ways they did and a resulting sense of relief. 10

Resources for Adults with Autism

There are many resources available for adults with autism spectrum disorder, no matter where they fall on the spectrum. These can include autism therapy, autism education, and peer support. These resources can make living with autism easier for the individual. 10

Autism Therapy

Many therapies are used on their own and often together for people with autism. Adults with autism often engage in different treatment methods than children with autism. For example, applied behavioral therapy is a common and effective therapy and treatment for autistic adults. Cognitive and verbal therapy is also helpful for adults with autism.10

Autistic adults might be interested in seeking out a psychiatrist who specializes in treating autism. They might also work with a social worker or a local autism center and participate in group and individual therapies designed for adults with autism. 10

The type of therapy that is right for an individual adult with autism spectrum disorder depends on the challenges they experience personally. For instance, an autistic adult might experience anxiety, social isolation, or difficulties at work. These challenges are often treated with a combination of methods specific to the needs of each autistic adult patient. 10

Regular counseling is often a beneficial form of therapy for autistic adults who wish to overcome daily challenges, including job-related difficulties. Adults with autism who experience symptoms like anxiety and depression may benefit from taking prescription medication. 10

Autism Education

Learning about autism spectrum disorder is often beneficial for adults who were not diagnosed until later in life or have not yet had a formal diagnosis. This type of education can help them understand the struggles they experience regularly and help them find solutions. 10

Loved ones may also find autism education to be beneficial in relating to and understanding the autistic adult. This understanding is helpful for loved ones, as it cultivates a new sense of compassion within them. It can also generate relief for autistic adults by helping them feel validated. 10

Peer Support

Creating connections with other adults with autism spectrum disorder can be a helpful tool for adults on the spectrum. Online support groups offer a platform through which autistic adults can easily share ideas and help each other through challenges associated with autism. There are also in-person support groups led by professionals that may offer additional support. 10


1. Autism Spectrum Disorder. (n.d.). Retrieved from

2. Janice Rodden Medically reviewed by ADDitude’s ADHD Medical Review Panel on March 19, Rodden, J., & Panel, A. A. (2021, March 19). What Does Autism Spectrum Disorder Look Like in Adults? Retrieved from

3. Grandin, — T. (2019, November 26). Autism signs and characteristics checklist for adults. Retrieved from

4. High-Functioning Autism: What is it and How is it Diagnosed? (n.d.). Retrieved from

5. High functioning autism: Symptoms, diagnosis, and treatment. (n.d.). Retrieved from

6. Iprovadmin. (2020, February 04). Signs and Symptoms of High Functioning Autism. Retrieved from

7. High Functioning Autism Symptoms: Key Questions Answered. (n.d.). Retrieved from

8. Can Adults Get Diagnosed on the Autism Spectrum? (n.d.). Retrieved from

9. Autism in adults: Signs, symptoms, and diagnosis. (n.d.). Retrieved from

10. Diagnosis of Autism Spectrum Disorder in Adults. (2020, August 10). Retrieved from

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