Adult Autism Evaluations

While many individuals show neurodiverse indicators for autism earlier in life across their social communication, social interaction, sensory management, and behavioral patterns and preferences, several go undiagnosed and “fly under the radar”. This may be for a number of reasons; however, one important factor may be that we, as the psychological and medical field, have only recently learned more about the subtler presentations of an autism development. In fact, this year (2023) the Centers for Disease Control and Prevention (CDC) released updated prevalence rates for autism in the general population. Specifically, in 2018 it was estimated that 1 in 44 individuals fall on the autism spectrum. Currently, the prevalence rate increased to 1 and 36! As such, many neurodivergent adults now find themselves on a pathway to figuring out if they fall on the autism spectrum.

What are the signs of autism in adults? Oftentimes, individuals who have reached adulthood without an autism diagnosis have learned and developed savvy social strategies (i.e., masking behaviors) that have allowed them to operate and navigate their social world. However, many adults still experience notable (often internal) difficulties with social interactions. Please note, everyone on the autism spectrum can present with differing areas of strength and struggle, and as clinicians, we view all types of social-behavioral development on a continuum. Below is a list of potential experiences that many adults on the spectrum report; however, this list is not exhaustive.

Are social interactions particularly exhausting for you? Do you often require prolonged periods of time to “recover” from such interactions?
Are you consciously aware of what your face and body are doing during conversations, meetings, etc.?
Is “small talk” harder for you than deeper conversations? Do you ever feel like you “dominate” a conversation?
Do you prepare for upcoming social interactions? For example, planning a list of topics ahead of time and talk about, having a “favorite” joke you know consistently gets laughs, or bringing a friend or partner you know will help “carry” a conversation for you.
Do you ever feel internally overwhelmed or stressed by the effort required to maintain a socially acceptable “façade” while at work, in the community, or other social spheres?
Do you have a desire for connections and relationships; however, struggle with the “how” of establishing, sustaining, navigating, and understanding these connections?
Do you struggle to intuitively understand others’ emotions, behaviors, and/or reactions? Conversely, do you sometimes feel overly attuned to others and easily become “swept up” in their emotions?
Are there any sensory experiences that you absolutely love or hate? Do these ever interfere with hygiene routines, relationships, limit your engagement in activities or outings?
Do others tell you that you talk too much about an interest? Do you, or have you historically, spent a copious amount of time researching, engaging in, or thinking about a particular topic or interest?
Do you enjoy engaging in repetitive movements and/or tasks? These can be for self-stimulation when bored, as a self-calming/self-soothing strategy, or simply when on “autopilot”.
Are you very particular about certain routine, task, or other activities? If these unexpectedly change, do you find it hard to adjust?
Do you do better with structure? For example, is it difficult for you to manage unpredictable schedules or changes in your daily life?
Do you notice details in your surroundings that others typically miss?

An adult autism diagnosis can not only clarify a medical diagnostic presentation (which can be useful to determine eligibility for services in the community) but can also provide a lens for insight and personal understanding. Information gleaned through an adult autism evaluation can also help guide current therapeutic treatments and goals, help adults become connected with resources (e.g., social skill support), as well as become connected with the larger autism community (offering a sense of belonging and connecting with others).