How to Identify Autism Spectrum Disorders in Adults

Autism spectrum disorders, also called autism or ASD, are becoming increasingly common. According to the Centers for Disease Control and Prevention, approximately 1% of the world’s population – or 75,000 people – has ASD. Even more surprisingly, an estimated 5.4 million (or 2.2%) American adults have ASD. This number may seem high, but ASDs have a wide range of symptoms and levels of severity.

“Autism spectrum disorders occur in all age, racial, ethnic, and socioeconomic groups,” says Lisa Neitzke, PhD, BCBA, a Nebraska-certified medical psychologist and assistant professor of psychology at UNMC/Munroe- Meyer Institute. “Although not everyone is diagnosed at an early age, early detection is key to improving outcomes later in life.”

Below, we outline five common questions (and answers) about ASDs in adults.

1. Can adults be diagnosed with Autism Spectrum Disorder?

Adults can be diagnosed with an ASD. Most symptoms usually present before the age of 18, but others may not fully manifest until later in life, when social demands exceed individual capabilities.

2. What are the signs of ASD in adults?

Some adults with ASD have symptoms that resemble attention deficit hyperactivity disorder or ADHD. Other symptoms may include:

  • Difficulty interpreting what others are thinking or feeling
  • Difficulty interpreting facial expressions, body language, or social cues
  • Difficulty regulating emotions
  • Difficulty maintaining a conversation
  • Inflection that does not reflect feelings
  • Difficulty maintaining the natural back-and-forth of a conversation
  • Tendency to engage in repetitive or routine behaviors
  • Participating in only a limited range of activities
  • Strict consistency with daily routines or blasts when changes occur
  • Demonstrate special and strong interests

3. How is autism diagnosed?

A multifactorial assessment is the best tool for diagnosing ASD in adults. The assessment should include an in-person assessment as well as a thorough evaluation of your developmental history by a parent or caregiver who knew you as a child. Sometimes it can be difficult to find an informant like this. If so, a spouse, partner, or close friend can help you with the necessary screenings by reporting your current behavior.

If you’re considering requesting an autism assessment, ASD’s online assessments can be a good place to start. However, most online rating scales lack sufficient reliability and validity to provide accurate diagnoses, and they don’t take your developmental history into account. Therefore, clinical expertise is required to correctly interpret your results and make an appropriate diagnosis.

4. Who can diagnose ASD in adults?

If you suspect an ASD, you should talk to your primary care provider. Your doctor may refer you to a behavioral health specialist, such as a licensed psychologist, who is licensed to perform psychological testing. It is important to find a health care provider with specific knowledge of ASD developmental disabilities and assessment methods suitable for adults, as these are different from those for children or adolescents. (Some clinicians experienced in assessing children and adolescents may not have experience in assessing adults.)

5. Is an autism diagnosis covered by insurance?

Although ASD assessments are increasingly recognized as medical necessities, insurance coverage often differs between providers. Check with your insurance provider to see what they will cover.

The bottom line: ASDs can manifest differently and are often a lifelong condition, but early diagnosis and treatment can make a significant difference.

If you or your loved one are having difficulty, call 800.922.0000 make an appointment with a behavioral health specialist.

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