presentation of autism in adults

Signs of autism in adults

Main signs of autism.

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
• taking things very literally – for example, you may not understand sarcasm or phrases like "break a leg"
• having the same routine every day and getting very anxious if it changes

Other signs of autism

You may also have other signs, like:

• not understanding social "rules", such as not talking over people
• avoiding eye contact
• getting too close to other people, or getting very upset if someone touches or gets too close to you
• noticing small details, patterns, smells or sounds that others do not
• having a very keen interest in certain subjects or activities
• liking to plan things carefully before doing them

Autism in women

Autistic women may be more likely to:

• have learned to hide signs of autism to 'fit in' - by copying people who do not have autism
• be quieter and hide their feelings
• appear to cope better with social situations
• show fewer signs of repetitive behaviours

This means it can be harder to tell you're autistic if you're a woman.

The National Autistic Society have more information about autistic women and girls

Non-urgent advice: See a GP if:

• you think you may be autistic

If you already see a health professional, such as another doctor or therapist, you could speak to them instead.

Getting diagnosed can help you get any extra support you might need.

Find out how to get diagnosed

Page last reviewed: 11 November 2022 Next review due: 11 November 2025

• Patient Care & Health Information
• Diseases & Conditions
• Autism spectrum disorder

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. The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger's syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term "Asperger's syndrome," which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

Products & Services

• Children’s Book: My Life Beyond Autism

Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they've already acquired. Signs usually are seen by age 2 years.

Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.

Some children with autism spectrum disorder have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence — they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.

Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It's generally based on the level of impairments and how they impact the ability to function.

Below are some common signs shown by people who have autism spectrum disorder.

Social communication and interaction

A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:

• Fails to respond to his or her name or appears not to hear you at times
• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world
• Has poor eye contact and lacks facial expression
• Doesn't speak or has delayed speech, or loses previous ability to say words or sentences
• Can't start a conversation or keep one going, or only starts one to make requests or label items
• Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
• Repeats words or phrases verbatim, but doesn't understand how to use them
• Doesn't appear to understand simple questions or directions
• Doesn't express emotions or feelings and appears unaware of others' feelings
• Doesn't point at or bring objects to share interest
• Inappropriately approaches a social interaction by being passive, aggressive or disruptive
• Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice

Patterns of behavior

A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these signs:

• Performs repetitive movements, such as rocking, spinning or hand flapping
• Performs activities that could cause self-harm, such as biting or head-banging
• Develops specific routines or rituals and becomes disturbed at the slightest change
• Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
• Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the overall purpose or function of the object
• Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
• Doesn't engage in imitative or make-believe play
• Fixates on an object or activity with abnormal intensity or focus
• Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture

As they mature, some children with autism spectrum disorder become more engaged with others and show fewer disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the teen years can bring worse behavioral and emotional problems.

When to see a doctor

Babies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of delayed development before age 2 years.

If you're concerned about your child's development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.

Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:

• Doesn't respond with a smile or happy expression by 6 months
• Doesn't mimic sounds or facial expressions by 9 months
• Doesn't babble or coo by 12 months
• Doesn't gesture — such as point or wave — by 14 months
• Doesn't say single words by 16 months
• Doesn't play "make-believe" or pretend by 18 months
• Doesn't say two-word phrases by 24 months
• Loses language skills or social skills at any age

There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

Error Email field is required

Error Include a valid email address

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Thank you for subscribing!

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Sorry something went wrong with your subscription

Please, try again in a couple of minutes

Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

• Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. 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.

No link between vaccines and autism spectrum disorder

One of the greatest controversies in autism spectrum disorder centers on whether a link exists between the disorder and childhood vaccines. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines. In fact, the original study that ignited the debate years ago has been retracted due to poor design and questionable research methods.

Avoiding childhood vaccinations can place your child and others in danger of catching and spreading serious diseases, including whooping cough (pertussis), measles or mumps.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It's not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child's risk. These may include:

• Your child's sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It's also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents' ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

More Information

• Autism spectrum disorder and digestive symptoms

There's no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don't outgrow autism spectrum disorder symptoms, they may learn to function well.

• Autism spectrum disorder (ASD). Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/facts.html. Accessed April 4, 2017.
• Uno Y, et al. Early exposure to the combined measles-mumps-rubella vaccine and thimerosal-containing vaccines and risk of autism spectrum disorder. Vaccine. 2015;33:2511.
• Taylor LE, et al. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014;32:3623.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Overview of management. https://www.uptodate.com/home. Accessed April 4, 2017.
• Autism spectrum disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed April 4, 2017.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Complementary and alternative therapies. https://www.uptodate.com/home. Accessed April 4, 2017.
• Augustyn M. Autism spectrum disorder: Terminology, epidemiology, and pathogenesis. https://www.uptodate.com/home. Accessed April 4, 2017.
• Bridgemohan C. Autism spectrum disorder: Surveillance and screening in primary care. https://www.uptodate.com/home. Accessed April 4, 2017.
• Levy SE, et al. Complementary and alternative medicine treatments for children with autism spectrum disorder. Child and Adolescent Psychiatric Clinics of North America. 2015;24:117.
• Brondino N, et al. Complementary and alternative therapies for autism spectrum disorder. Evidence-Based Complementary and Alternative Medicine. http://dx.doi.org/10.1155/2015/258589. Accessed April 4, 2017.
• Volkmar F, et al. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2014;53:237.
• Autism spectrum disorder (ASD). Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/autism/Pages/default.aspx. Accessed April 4, 2017.
• American Academy of Pediatrics policy statement: Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129:1186.
• James S, et al. Chelation for autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010766.pub2/abstract;jsessionid=9467860F2028507DFC5B69615F622F78.f04t02. Accessed April 4, 2017.
• Van Schalkwyk GI, et al. Autism spectrum disorders: Challenges and opportunities for transition to adulthood. Child and Adolescent Psychiatric Clinics of North America. 2017;26:329.
• Autism. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 4, 2017.
• Autism: Beware of potentially dangerous therapies and products. U.S. Food and Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm394757.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery. Accessed May 19, 2017.
• Drutz JE. Autism spectrum disorder and chronic disease: No evidence for vaccines or thimerosal as a contributing factor. https://www.uptodate.com/home. Accessed May 19, 2017.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Behavioral and educational interventions. https://www.uptodate.com/home. Accessed May 19, 2017.
• Huebner AR (expert opinion). Mayo Clinic, Rochester, Minn. June 7, 2017.

Associated Procedures

• Cognitive behavioral therapy

News from Mayo Clinic

• 10 significant studies from Mayo Clinic's Center for Individualized Medicine in 2023 Dec. 30, 2023, 12:00 p.m. CDT
• Mayo Clinic 'mini-brain' study reveals possible key link to autism spectrum disorder Aug. 10, 2023, 04:00 p.m. CDT
• Symptoms & causes
• Diagnosis & treatment
• Doctors & departments

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

• Opportunities

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press .

• Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence
• The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book
• Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance
• FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment
• Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book

Let’s celebrate our doctors!

Join us in celebrating and honoring Mayo Clinic physicians on March 30th for National Doctor’s Day.

Autism Spectrum Disorders (ASD)

• Autism at Work: Overcoming Challenges

Adult Autism and Relationships

Autism treatments, interventions, and therapy options, autism behavior problems, does my child have autism, helping your child with autism thrive, learning disabilities and disorders.

• Online Therapy: Is it Right for You?
• Mental Health
• Health & Wellness
• Children & Family
• Relationships

Are you or someone you know in crisis?

• Bipolar Disorder
• Eating Disorders
• Grief & Loss
• Personality Disorders
• PTSD & Trauma
• Schizophrenia
• Therapy & Medication
• Exercise & Fitness
• Healthy Eating
• Well-being & Happiness
• Weight Loss
• Work & Career
• Illness & Disability
• Heart Health
• Childhood Issues
• Learning Disabilities
• Family Caregiving
• Teen Issues
• Communication
• Emotional Intelligence
• Love & Friendship
• Domestic Abuse
• Healthy Aging
• Aging Issues
• Alzheimer’s Disease & Dementia
• Senior Housing
• End of Life
• Meet Our Team

Understanding autism in adults

Signs and symptoms of autism in adults, how gender affects the signs of autism, diagnosis and causes, living with a diagnosis, living with adult autism tip 1: improve communication and relationships, tip 2: manage anxiety and depression, tip 3: better organize your life, treatment for adult autism, autism in adults: recognizing the signs, living with a diagnosis.

Even if you weren’t diagnosed as a child, you may notice the symptoms of high-functioning autism in later life. Here's what to look for and how to deal with a diagnosis.

We all have our quirks. But if you’ve noticed that your way of thinking, feeling, or doing things isn’t quite the norm, you may suspect that you have autism spectrum disorder (ASD), even though you never received a diagnosis as a child.

Perhaps your body language, social skills, interests, behaviors, or general preferences don’t seem to match those around you? Or maybe you have a child who was recently diagnosed with autism and you recognize some of the same issues in your own way of behaving?

In recent years, more people are embracing the idea of neurodiversity—the concept that some people have neurological differences and those differences should be valued rather than “corrected”. Still, a diagnosis of autism as an adult can come as an unwanted surprise. You may even experience denial or anxiety over the diagnosis. On the other hand, if you’ve long suspected that you have ASD or some other condition that sets you apart from your peers, a diagnosis can come as a relief. Suddenly, a lot of your past experiences and interactions make sense and you’re afforded a sense of clarity.

No matter how you feel after a diagnosis, keep in mind that, just like everyone else, you have unique strengths and weaknesses. You can always take further steps to better understand your own thoughts and behaviors and grow as a person.

Why weren’t you diagnosed earlier?

Parents and doctors sometimes miss the symptoms of autism in children who are “high functioning”—meaning they’re able to move through the world without assistance. You may hear this referred to as Asperger’s syndrome, a formal diagnosis that is now categorized under the broader umbrella of ASD.

It’s also common for autism in children to be misdiagnosed as attention deficit hyperactivity disorder (ADHD) since ADHD can also cause difficulty with communication skills and repetitive behavior.

While it’s possible to have both conditions, over the years, experts have become better at distinguishing the symptoms of ADHD from those of ASD.

Autism has a wide range of symptoms, even if you narrow the scope down to “high functioning” autism. Autism symptoms in adults tend to be most prominent in your communication skills, interests, emotional and behavioral patterns, and sensitivity to stimuli, such as noise and touch.

Problems with communication

If you’re an adult with ASD, you might have a hard time reading social cues. This can encompass everything from another person’s facial expressions to their gestures or tone of voice, making it difficult to maintain back-and-forth conversations or tell what another person is feeling. Sarcasm and figures of speech can be especially tricky to detect.

In addition, you might also use a monotone voice or limited facial expressions, which makes it difficult for others to interpret your thoughts and feelings. Eye contact may be another important social cue that you struggle with. Perhaps you’ve been told you look away too often during conversations, or even stare.

Narrow interests

Everyone has their own interests. But adults with ASD often focus on one or two subjects that they find highly fascinating. You may have an encyclopedic knowledge of a historical event or movie series, for example.

While it’s often impressive to others, it may limit the amount you feel you can contribute to conversations beyond your favorite subjects. Trying to relate to people who don’t understand your interests may feel tedious or incredibly challenging. It might even lead you to avoid social interactions.

Repetitive behavior

Maintaining a consistent routine or keeping items organized can help you feel that your life is secure and predictable. You may experience discomfort when your daily routine and rituals are interrupted, such as having to take a new route to work or someone moving your belongings so they’re now out of place. You might feel so upset that you have an outburst of strong emotion such as anger.

Sensory issues

To someone with ASD, certain sensations can be unbearable. You may feel pain if someone taps you on the arm. for example, or certain sounds, smells, or textures may elicit a similar unpleasant reaction. In some cases, you may do everything you can to avoid that discomfort.

Men are about four times as likely to be diagnosed with ASD than women. Some researchers theorize this may be because women in general are better at imitating socially acceptable behavior. Unlike children with ASD, adults with autism (even when undiagnosed) have had plenty of time to practice their social skills. Women especially often learn to “mask” certain behaviors that seem to draw the attention of other people.

It’s also possible that women with ASD have repetitive behavior tendencies and narrow interests that aren’t seen as unusual. For example, a woman with ASD who feels the urge to neatly organize dishes or who is only fascinated with music theory may pass as “neurotypical”.

In some cases, you might only recognize your own ASD symptoms when you have a child diagnosed. Experts haven’t yet decided on standard criteria to diagnose adults who believe they have ASD. However, a clinician may borrow some of the criteria used to diagnose children, such as experiencing problems with social communication, exhibiting restricted, repetitive behaviors, and any sensory issues.

[Read: Autism Spectrum Disorders]

To diagnose ASD as an adult, a clinician will likely talk to you about your interests, emotions, and childhood. They may also want to talk to your family members. This can be especially useful because symptoms—even subtle ones—likely developed when you were a child.

What causes autism?

Scientists aren’t entirely sure yet if autism is the result of biological or environmental factors. But the answer could be both. Some of the possible causes they’re exploring include:

Genetics . Gene mutations might link to specific ASD symptoms, make a person more susceptible to developing ASD, or determine the severity of symptoms.

Environment . Certain environmental factors, such as air pollution or low birth weight, may cause ASD in a child who was already susceptible to it.

Other biological factors . Abnormalities with the immune system, metabolism, or brain development may also play a role.

Feel caught off guard by your adult autism diagnosis? It may help to look at your diagnosis as a path to better understanding yourself. You can gain insight on challenging moments from your childhood or teen years, for example, or any relationship problems you’ve experienced as an adult.

Every adult with ASD has both unique challenges to overcome and unique strengths to draw upon. However, there are some common challenges to address, including difficulty building or maintaining relationships , social isolation, managing mood disorders, and staying organized.

Even if you haven’t received a formal diagnosis, if you suspect you have ASD, you can begin to take steps to improve your life. The following tips and strategies can help.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

If other people have a hard time reading and understanding you—and you them—you’ll likely have difficulty with relationships. But you can still find ways to nurture a healthy social life.

Consider disclosing your diagnosis . Talking about your diagnosis can be difficult and the social stigma attached to ASD may make you shy away from doing so. While disclosure is entirely up to you and your comfort level, it may help improve some relationships. Letting close friends and family know about your diagnosis can help them understand why you have a hard time interpreting their sarcastic comments, for example, or why you’re distressed by sounds that seem normal to everyone else.

Note when you’re experiencing sensory overload . Perhaps you find it difficult to keep up with everything that’s going on in an intense group conversation. Or maybe something as simple as loud traffic or a barking dog is bothering you. Do what you can to minimize distractions. This might involve switching rooms or leaving a larger group for a one-on-one chat.

Look for common ground with the person you’re talking to . Establishing commonalities can lead to more relaxed and enjoyable conversations. If you have similar hobbies, that’s, of course, great news. Otherwise, you can look for other things you both like or dislike. This could be anything from a shared interest in cars to a shared dislike for loud noises.

[Read: Adult Autism and Relationships]

Reach out to other adults with ASD . You might find that talking with others with ASD is less tiring than other interactions. Although every person with ASD is different, you share a common ground and can talk about your experiences. Additionally, neither of you will need to focus on reading or presenting social cues in a way that a neurotypical person might expect.

Support groups for adults with autism

If you feel isolated or feel like your neurotypical friends don’t “get” you, it can help to join a support group for adults with ASD. These may take place either online or in-person with groups of varying sizes.

Support groups can be a great way to meet people who have had similar life experiences. You might meet lifelong friends and become an important part of someone else’s social support network.

Group sessions can also help you gain a better understanding of the neurodiversity movement, which aims to erase the social stigmas associated with autism and neurodivergence in general.

Some people find that anxiety and depression go hand in hand with symptoms of ASD. For example, difficulty relating to others can lead to feelings of anxiety . Increased anxiety can, in turn, make it even harder to communicate. You might even feel so flustered that you can’t form sentences.

Feelings of isolation can also trigger depression . But there are steps you can take to manage your mood and improve how you feel.

Stay active . Exercise is good for the mind and eases stress. Some studies show that vigorous exercise can be especially useful for helping adults with ASD manage aggression. Find an aerobic exercise that fits neatly into your routine and won’t potentially throw your schedule into chaos. It may be something as simple as going for daily walks or runs. Make sure it’s something you enjoy, so you’re more likely to stick to it.

Rely on close friends . Socializing can also be good for your mood, as long as the people you’re with don’t stress you out. Find people who share your interests. Thanks to the Internet, it’s easy to find people in your local area who share your interests. If possible, look for conventions or other gatherings where people who share your hobby come together and interact in person.

Practice relaxation techniques . You might find that techniques such as mindfulness meditation and deep breathing help you manage anxiety symptoms. These are also practices that you can easily incorporate into your daily routine. A 2020 study showed that self-guided mindfulness and cognitive behavioral techniques may be useful in reducing levels of anxiety in people with ASD.

[Read: The Benefits of Mindfulness]

Develop good sleep hygiene . Lack of sleep or poor sleep quality can affect your mood, making you more anxious, unhappy, and irritable. Unfortunately, insomnia is a common problem for adults with ASD. Some steps that might help include following a consistent, relaxing routine before bed each night. You should also consider if environmental issues, such as your bedroom temperature of texture of your blankets, are causing you discomfort.

While many adults with ASD are extremely organized, others may become so fixated on certain interests that other aspects of their lives become disorganized. If this is a challenge you face, these tips can help you stay organized:

Use a timer to stay on track . This can be especially useful when you’re working on a hobby that you’re intensely passionate about. Once the timer goes off, you know it’s time to switch to an activity that is less intriguing, but nonetheless important, such as paying bills or grocery shopping.

Use a list or day planner . If remembering appointments and other responsibilities is a challenge, use a paper planner or an organizational app for your cell phone. You could also use anything from spreadsheets to a whiteboard to help you organize daily tasks.

Automate certain aspects of your life . For example, use online banking to track spending and automatic payment options to manage your bills. This can also help you avoid the clutter that tends to build up when you receive paper billing statements in the mail.

Although treatment is often recommended for children with ASD, adults with ASD may also find certain types of treatment to be beneficial. It’s important to understand that these treatments don’t aim to cure ASD. Instead, they help you address issues such as anxiety, rigid thinking, or depression.

As mentioned before, self-guided mindfulness and CBT can help adults with ASD. However, you can also visit a therapist for professional guidance. Prioritize finding one who specializes in ASD.

[Read: Finding a Therapist Who Can Help You Heal]

A therapist can offer personalized sessions that help you address specific issues. Perhaps you’re having trouble communicating your feelings in a relationship or frustrated with a coworker who refuses to accommodate your needs. Your therapist will help assess stressors in your life and develop adaptive solutions, such as reframing your thoughts and building more effective communication skills .

Vocational rehabilitation

Vocational rehab is intended to help you address workplace-related difficulties. You may have specific challenges, such as discomfort with noise, that make it hard to work in a traditional setting.

[Read: Autism at Work]

Vocational rehab can help you find work that is accommodating and aligns with your interests and strengths. This can help to provide an opportunity to work to your fullest potential and enjoy a rewarding, successful career .

Helplines and support

Call the  Autism Society  National Helpline at 1-800-328-8476, find support groups at the  Asperger/Autism Network (AANE) , or find  vocational rehabilitation services  near you.

Find help and support at  The National Autistic Society .

Find support and programs at  Autism Canada  or call 1-800-983-1795.

Find adult community services at  Autism Spectrum Australia .

More Information

• Neurodevelopmental Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
• Milner, Victoria, Hollie McIntosh, Emma Colvert, and Francesca Happé. “A Qualitative Exploration of the Female Experience of Autism Spectrum Disorder (ASD).” Journal of Autism and Developmental Disorders 49, no. 6 (2019): 2389–2402. Link
• Cummins, Clare, Elizabeth Pellicano, and Laura Crane. “Autistic Adults’ Views of Their Communication Skills and Needs.” International Journal of Language & Communication Disorders 55, no. 5 (2020): 678–89. Link
• Kentrou, Vasiliki, Danielle MJ de Veld, Kawita JK Mataw, and Sander Begeer. “Delayed Autism Spectrum Disorder Recognition in Children and Adolescents Previously Diagnosed with Attention-Deficit/Hyperactivity Disorder.” Autism 23, no. 4 (May 2019): 1065–72. Link
• CDC. “Diagnostic Criteria | Autism Spectrum Disorder (ASD) | NCBDDD | CDC.” Centers for Disease Control and Prevention, June 29, 2020. Link
• Sasson, Noah J, and Kerrianne E Morrison. “First Impressions of Adults with Autism Improve with Diagnostic Disclosure and Increased Autism Knowledge of Peers.” Autism 23, no. 1 (January 1, 2019): 50–59. Link
• Hohn, Vanessa D., Danielle M. J. de Veld, Kawita J. S. Mataw, Eus J. W. van Someren, and Sander Begeer. “Insomnia Severity in Adults with Autism Spectrum Disorder Is Associated with Sensory Hyper-Reactivity and Social Skill Impairment.” Journal of Autism and Developmental Disorders 49, no. 5 (2019): 2146–55. Link
• Gaigg, Sebastian B, Paul E Flaxman, Gracie McLaven, Ritika Shah, Dermot M Bowler, Brenda Meyer, Amanda Roestorf, Corinna Haenschel, Jacqui Rodgers, and Mikle South. “Self-Guided Mindfulness and Cognitive Behavioural Practices Reduce Anxiety in Autistic Adults: A Pilot 8-Month Waitlist-Controlled Trial of Widely Available Online Tools.” Autism 24, no. 4 (May 1, 2020): 867–83. Link
• Im, David S. “Treatment of Aggression in Adults with Autism Spectrum Disorder: A Review.” Harvard Review of Psychiatry 29, no. 1 (February 2021): 35–80. Link
• Landrigan, Philip J. “What Causes Autism? Exploring the Environmental Contribution.” Current Opinion in Pediatrics 22, no. 2 (April 2010): 219–25. Link

More in Autism

A parent’s guide to symptoms and diagnosis on the Autism spectrum

Autism at Work

Overcoming challenges and finding success in the workplace

Dealing with challenges and building a partnership together

Understanding your child’s options

What’s triggering your child’s outbursts?

Recognizing the early signs and symptoms of Autism

Parenting tips, treatments, and services that can help

The different types of learning disorders and their signs

Professional therapy, done online

BetterHelp makes starting therapy easy. Take the assessment and get matched with a professional, licensed therapist.

Help us help others

Millions of readers rely on HelpGuide.org for free, evidence-based resources to understand and navigate mental health challenges. Please donate today to help us save, support, and change lives.

• Bipolar Disorder
• Therapy Center
• When To See a Therapist
• Types of Therapy
• Best Online Therapy
• Best Couples Therapy
• Best Family Therapy
• Managing Stress
• Sleep and Dreaming
• Understanding Emotions
• Self-Improvement
• Healthy Relationships
• Student Resources
• Personality Types
• Verywell Mind Insights
• 2023 Verywell Mind 25
• Mental Health in the Classroom
• Editorial Process
• Meet Our Review Board
• Crisis Support

What To Know About Diagnosing Autism In Adults

Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

Fjordalisa / Getty Images

Language note: Although individual preferences exist, surveys of the autistic community consistently show that autistic people prefer identity-first language rather than person-first language (i.e., “autistic person” rather than “person with autism”). This article reflects that community language preference.

Although autism is a lifelong neurodevelopmental difference, it is often seen as a childhood diagnosis. Many people are not diagnosed in childhood, however, and may seek an evaluation as adults. This article discusses what an autism evaluation can look like for adults.

Signs of Autism in Adults

Even though autism is lifelong, and autistic people do not “grow out of” autism or stop being autistic, much of the existing autism assessment research focuses on the presentation and experiences of young children.

Specifically, research highlights the presentation of cisgender , white boys, and as a result, other populations (cisgender girls and women, nonbinary individuals, transgender individuals, and BIPOC individuals) are typically diagnosed later in life.

• Special interests: Autistic adults might find that their interests and hobbies are not similar to those of their peers. They may experience sensory issues, such as being more bothered by light or sound, that other adults seem not to notice.
• Stimming Autistic adults can engage in repetitive behaviors (known as stims ), though they have often learned to stim in a way that the people around them will not notice. This can include thinking of a phrase repeatedly, listening to the same song over and over, making repeat noises , or using fidget items like spinners or cubes.
• Consistent needs: Sensory, social, and behavioral needs tend to remain consistent for autistic people throughout their lifetime even if presentation changes somewhat due to masking.
• High risk for mental illness: Autistic adults are at higher risk than neurotypical people for various mental health issues as well. This occurs as a result of the stress of being held to neurotypical standards for behavior when this does not come naturally to the autistic person. This stress can lead to mood disorders, substance use disorders, and even suicide.

Types of Autism Evaluations for Adults

Many existing autism assessments focus on the experience of young children, and limited options are available for adults. However, providers can evaluate for autism in adults using certain measures, including:

• Autism Diagnostic Observation Schedule, Second Edition (ADOS-2): This measure involves presenting an individual with tasks and observing whether their behavior and responses are similar to autistic individuals. Some subtests on the ADOS-2 can be administered to adults.
• Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2): This guided interview queries for communication style, relationships, emotional responses, and sensory sensitivity to determine whether the individual’s symptoms meet criteria for autism.
• Personality Assessments: An evaluator may use personality measures to gather information about how an individual perceives the world around them, approaches social relationships, or exhibits symptoms of a mental illness that may be comorbid with autism.
• Diagnostic Interview : The evaluator can conduct a thorough interview of the individual’s symptoms and history, including information about early childhood and development.
• Collateral Interviews: Some providers may ask to interview a parent or family member for information about the client’s early development and behaviors. This particular component is not always used, as some people might not be able to have a parent participate in their assessment.

How to Get an Autism Evaluation as an Adult

If you think you might be autistic, you may decide to pursue an evaluation. It can be difficult to know where to start. Many therapist directories allow users to filter by service and expertise, so you can filter results and find someone who is qualified to diagnose autism.

You can also speak to your primary doctor or general practitioner, who likely has information about providers they can refer you to. Usually, a provider needs specific credentials and training to be able to assess for and diagnose autism. Often psychologists or psychiatrists have the qualifications to diagnose autism, but not every provider has the necessary training.

If you are reaching out to providers to get an autism evaluation, ask if this is a service they provide. Be specific that you want to be evaluated for autism. Many clinics can provide a referral if they are unable to provide the service you need.

Risks of Getting Evaluated for Autism as an Adult

An autism evaluation can help you better understand how your brain works, communicate your needs, and access appropriate support. Many adults pursue autism evaluations for these reasons.

However, there are also drawbacks to seeking an evaluation. Some insurance plans will not cover the cost of an evaluation, and even when insurance allows for testing, many providers do not accept insurance. An autism evaluation can cost thousands of dollars, which is not affordable for many.

In addition to the high cost of testing, many autistic people are misdiagnosed or told that they do not meet criteria even though they are later identified as autistic. One study showed that as many as two-thirds of autistic people are initially misdiagnosed before receiving their autism diagnosis.

This occurs because the diagnostic criteria for autism does not fully encompass the varied experience of autistic people and does not account for masking that might cause an autistic person to appear neurotypical in an evaluation. This means that the individual has possibly spent a significant amount of money and is still not diagnosed.

Even if someone is accurately diagnosed with autism, they might experience discrimination as a result of their diagnosis. Twitter user GummiPies conducted an informal survey of autistic people’s experience of discrimination post-diagnosis.

Users reported discrimination in healthcare, including being involuntarily given Do Not Resuscitate orders at hospitals, being denied care because they were not considered competent to make their own medical decisions, or being denied organ transplants. They also reported being denied applications to foster, adopt, or immigrate to other countries.

Because of these risks, many adults choose to self-identify rather than seek a formal diagnosis.

Support for Autistic Adults

Whether you have self-identified autistic traits or been formally evaluated, community support can help you better understand and advocate for your needs. These organizations are run by and for autistic people:

• The Autistic Self-Advocacy Network
• Autistic Women & Nonbinary Network
• NeuroClastic

If you think an evaluation is right for you, you can find a diagnostician in your area. These directories offer neurodiversity-affirming care:

• Asperger/Autism Network
• Neurodivergent Therapists

Jo H, Schieve LA, Rice CE, et al. Age at autism spectrum disorder (Asd) diagnosis by race, ethnicity, and primary household language among children with special health care needs, united states, 2009–2010. Matern Child Health J. 2015;19(8):1687-1697.

Simonoff E, Kent R, Stringer D, et al. Trajectories in symptoms of autism and cognitive ability in autism from childhood to adult life: findings from a longitudinal epidemiological cohort .  Journal of the American Academy of Child & Adolescent Psychiatry . 2020;59(12):1342-1352.

Dell’Osso L, Carpita B, Muti D, et al. Mood symptoms and suicidality across the autism spectrum .  Comprehensive Psychiatry . 2019;91:34-38.

Fusar-Poli L, Brondino N, Politi P, Aguglia E. Missed diagnoses and misdiagnoses of adults with autism spectrum disorder .  Eur Arch Psychiatry Clin Neurosci . 2022;272(2):187-198.

By Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

Discover SPARK Share this: Twitter X Facebook

Getting an autism diagnosis in adulthood.

Marina Sarris

Date Published: November 14, 2023

In elementary school, Ariel sat alone at a desk in the closet. She could see the class through a two-way mirror, but no one could see her.

She doesn’t remember if it was a punishment, but she preferred it. She could work alone, away from the social stresses that caused emotional meltdowns or nausea in the classroom. “I was just weird,” she says now, three decades later.

What she really was ─ she learned two years ago ─ was autistic. She is among a number of autistic adults over age 35 who came of age before autism was widely recognized and diagnosed. They often struggled without extra help in school or understanding in their communities. Many were bullied, sometimes relentlessly, by classmates who sensed their differences.

Sometimes they believed the names they were called on the playgrounds and in the hallways. “I still call myself an idiot from time to time. I had this inner voice that said I was worthless, I wasn’t capable, I wasn’t likeable, I wasn’t worth anybody’s time,” says Diana, 59, who was diagnosed nine years ago.

“I Didn’t Start Living Until I Got the Autism Diagnosis”

For Diana and others like her, getting an autism diagnosis in adulthood led to a new understanding of themselves, ending the confusion or self-doubt they felt growing up.

“It was a huge relief that there’s a name for it, and it encompassed all of my traits,” says Diana, who works for the military.

The diagnosis changed the life of artist Vonda Burris, too. “I didn’t start living until I got the autism diagnosis,” explains Burris, 36, who was diagnosed three years ago.

After receiving a professional diagnosis, Burris and others interviewed joined SPARK, the largest study of autism . They are among about 22,000 autistic adults and 102,000 children, in addition to their family members, who participate in SPARK.

About half of the autistic adults were diagnosed when they were older than 17, some in their 30s, 40s, and 50s. Some, like Ariel, sought a diagnosis for themselves after their child was diagnosed with autism. Other adults benefited from a public awareness of autism that did not exist when they were growing up.

Diana read a book about girls with a milder form of autism. She recognized herself in those pages, “So much of what I read mirrored my experiences as a child and young adult,” she recalls.

What Did Autism Explain?

The autism diagnosis explained so much that had previously puzzled them, several adults say. At its core, autism causes differences in how people respond and communicate in social situations. Other important signs are repetitive behaviors; over- or under-active responses to hearing, touch, and other senses; and a need for sameness.

Autism, Diana learned, was why she would stay awake late into the night, when everything was quiet. It was why she would abruptly leave a social gathering when she felt overwhelmed and exhausted.

Autism was why Ariel did not absorb the unwritten rules of friendship as a child. Like the time another girl announced she would not eat her lunch because she was “fat.” What that girl really meant was that she wanted everyone to tell her that she was thin. But Ariel did not know that, and she asked if she could have the rejected lunch. The reaction was swift: “I was ostracized and called ‘mean’ and ‘not cool,’” Ariel recalls. “I was always a step behind in catching up to the girls’ social interaction.”

The Journey to an Adult Autism Diagnosis

While autism helped to explain aspects of their lives, some adults say, the ease and process of getting a diagnosis varied widely. Some say that their insurance companies helped them find the right doctor or psychologist to evaluate them. Others, however, say that they had problems with insurance, cost, or finding a healthcare provider who was experienced with adult autism.

Autism appears in early childhood, when it’s usually diagnosed, and many autism specialists only see children and teens. Some psychologists and psychiatrists who just see adults may not be experienced in diagnosing autism.

And autism may look different in adults. They may no longer have the “red flags” of childhood autism, such as poor eye contact and problems having a conversation, said psychologist Vanessa Bal, Ph.D., during a webinar for SPARK .

That may be because their social communication skills have developed over time, she said. Also, some adults have learned to camouflage, or hide their autism traits, in order to fit in during social situations, Bal said. Camouflaging makes a person’s autism appear less visible to others. 1, 2

“For autistic adults, the presentation of autism, what autism ‘looks like,’ may look quite different from what people in the general public might expect, and even professionals who are more familiar with autism in children,” Bal said.

Vonda Burris understands how misunderstandings about adult autism may affect an evaluation. During her first attempt at getting a diagnosis, a doctor asked her why she thought she was autistic. After they spoke for 45 minutes, the doctor told her, “I don’t think you have autism.” His reasons? “‘You went to college, you’re a mother, you can communicate,'” she recalls him saying.

Burris was frustrated that her ability to camouflage or mask her autism may have made it harder to be diagnosed. “I lived thinking I was neurotypical for 33 years. I perfected my mask,” she says.

Burris did not give up. She eventually found a hospital clinic that gave her psychological tests and surveys that measured autism traits, among other things. Only then did she get an autism spectrum diagnosis.

What Might an Assessment for Autism Include?

What happens during an autism assessment may vary, depending on the type of healthcare provider conducting it, the reasons for the evaluation, and whether it is the first time a person has been assessed.

Bal, the psychologist, outlined the typical parts of many autism assessments in her webinar. The provider will observe the person’s social and communication skills, administer language or cognitive tests, and ask about developmental, school, job, and mental health histories. The provider also will ask about their interests, self-care habits, relationships, strengths, and challenges. Relatives, friends, and partners may also be asked questions about them, she said.

Some wonder whether all those components are necessary, she said. Those steps help the healthcare provider to recommend supports and accommodations that are based on someone’s individual needs, she said. “It doesn’t tell us much of anything to know that someone has autism, in and of itself,” she explained.

What Comes After an Autism Diagnosis?

An autism diagnosis in middle age may bring relief for some, but it usually does not result in the services and supports that often follow a diagnosis made in childhood. Some adults say finding doctors, therapists, and organizations that can help them is challenging.

Emma Goldman-Sherman, a playwright, says she was on her own after her autism diagnosis at age 55. “When I was diagnosed, the doctor said that obviously I had low support needs and was doing just fine, but clearly this is not the case,” she says. “Since I am a published author, the doctor just assumed I was fine.”

The therapists she found were expensive and had a long wait list for new clients, she says. “I am trying to maintain health and cognitive gains and ability to empathize, etc., in a kind of a vacuum. I would love some guidance, direction, signs, anything!”

Finding Community With Other Autistic Adults

One source of help, at least for some, is connecting to other autistic adults. Burris, for one, found community and information online. As her knowledge of autism grew, she stopped feeling bad about her social differences. “There was trauma from not understanding your own idiosyncrasies and your own behavior, and hating yourself for not being like others all the time,” she says.

“Learning about autism and getting a diagnosis was like getting the instruction manual on how to be human,” she adds. “Once I read about autism and understood it and became part of these autism communities, it gave me the ability to say ‘I’m OK the way I am.’ It allowed me to embrace myself and love myself.”

Learn more about autism in adulthood and SPARK research. Interested in joining SPARK? Here’s what you should know .

Photo credit: Getty Images

• Hull L. et al. J. Autism. Dev. Disord . 47 , 2519-2534 (2017) PubMed
• Bradley L. et al. Autism Adulthood 3 , 320-329 (2021) PubMed

Read more about:

• Advocacy and acceptance
• Diagnosing autism
• SPARK study

• Search the site GO Please fill out this field.
• Newsletters
• Health Conditions A-Z
• Neurological Disorders

Signs and Symptoms of Autism in Adults

Maskot / Getty Images

Autism spectrum disorder (ASD), often known simply as autism, is a developmental disability that can present with a variety of symptoms, often affecting social skills as well as both verbal and nonverbal communication. Typically, symptoms of autism spectrum disorder appear before the age of three. Infants and young children are often screened for autism. It can be more challenging to be diagnosed with autism as an adult.  

Many of the clinical signs of autism in adults are similar to those in children. Examples include challenges with reading and responding to social cues, difficulty communicating in ways that others understand, repetitive behaviors, and restricted interests.  

Autism Is a Spectrum

As the name autism spectrum disorder implies, autism is a spectrum . This means that it is experienced differently by each autistic person, so symptoms can be difficult to explain and quantify. That said, this article will discuss some of the clinically identified symptoms and how they may present in autistic people.

Social Symptoms

Many adults with autism find it challenging to relate to and communicate with others in a way that is considered "typical" in society. Symptoms of autism related to social interactions, relationships, and communication may include:

• Not making eye contact
• Having trouble listening while others speak
• Finding it hard to express emotions, whether through words, body language, or facial expressions 
• Low presentation of empathy
• Difficulty making and keeping friends
• Having trouble understanding nonverbal communication
• Finding it difficult to read social cues in others, such as facial expressions or tone of voice
• Not understanding social norms, such as unspoken “rules of etiquette”
• Having a “flat” tone when speaking
• Taking words and phrases literally (for example, someone with autism may struggle to understand sarcasm)
• Not adapting or difficulty adapting to different social situations
• Social anxiety

Restricted and Repetitive Behaviors

Adults with autism often engage in repetitive and/or restricted behaviors. These may affect their physical movements, speech, interests, and daily habits. 

Symptoms of autism related to repetition and restriction may include:

• Echolalia (repeating words or phrases)
• Difficulty shifting focus from one topic or activity to another
• Limited, narrow, or obsessive interests
• Repetitive movements (sometimes called “ stimming ”), such as flapping hands and rocking back and forth
• Being more interested in objects than people
• Following a strict routine and feeling stressed when it changes

Sensory Symptoms

Some adults with autism experience and respond to sensory input (i.e., touch, tastes, smells, sounds, and sights) in atypical ways. Sensory symptoms associated with ASD include:

• A low or high pain tolerance
• Being hypo- or hypersensitive to sensory stimuli such as lights or sounds
• Being overstimulated by lights, crowds, and/or noise
• Sensitivity to heat and/or cold
• Avoiding physical touch
• Feeling less or more startled than usual by noises 
• Food aversions (intense dislike of specific foods)
• Eating only certain foods
• Being more sensitive to the tastes, smells, and textures of particular foods

Other Symptoms

ASD can present in many different ways and to different extents. Some adults with autism show nearly all of the clinically “typical” symptoms, while others have only a few. 

In addition to sensory symptoms, restricted and/or repetitive behaviors, and social and communication challenges, other symptoms of ASD may include:

• Difficulty sleeping
• Irritability
• Gastrointestinal problems, such as constipation  
• Cognitive difficulties and/or a learning disability
• Impulsivity
• Difficulty concentrating
• Hyperactivity
• Unusual moods 
• Being either very fearful or unusually fearless
• Difficulties with imagination

Also, a disproportionate number of ASD experience seizures. Up to 30% of autistic children will develop epilepsy , a seizure disorder, at some point during their lifetime.

When to Contact a Healthcare Provider

While signs of autism often first appear in early childhood, many people with autism aren’t diagnosed until their adolescent or adult years. There are many resources available for adults with autism, from peer support groups to treatment options, if necessary. Not everyone with autism wants or needs treatment, and that's ok. Getting and having a diagnosis is helpful information to have about yourself so you can better advocate for yourself and your individual needs.

Some people may find it helpful to reach out to a healthcare provider about autism symptoms, especially if symptoms are causing distress or reducing your quality of life. These symptoms may include:

• Have trouble reading, understanding, and/or responding to social and emotional cues
• Have trouble communicating in ways that others understand
• Find it hard to make and keep friends
• Feel overstimulated by sensory input , such as loud noises or bright lights
• Tend to focus intensely on specific interests
• Become extremely distressed if your daily routine changes

A Quick Review

Clinically, symptoms of autism spectrum disorder in adults may include challenges with social interactions and communication, repetitive and/or restricted behaviors, and sensory sensitivities. Adults with autism may also have difficulties with eating, sleeping, and managing anxiety. However, autism is a spectrum and symptoms can significantly vary from person to person.

Autism is a lifelong condition and there is not a cure. However, there are lifestyle adjustments and accommodations that can be made to improve your overall quality of life, if you would like. If you think you may have ASD and want to discuss diagnosis and management options, reach out to a healthcare provider. They can refer you to a specialist like a neuropsychologist or a psychiatrist to perform a thorough assessment and connect you with appropriate resources.

Frequently Asked Questions

Signs of autism may include repetitive movements, sensitivity to certain sensory stimuli, hyperfixating on particular interests, and difficulties with reading body language and social cues. You may also experience challenges with making and keeping friends. However, you can’t definitively determine whether or not you are autistic without an assessment from a healthcare provider.

There are several symptoms that people with attention-deficit hyperactivity disorder (ADHD) and autism may have in common, such as fidgeting and restlessness.

Also, autism and ADHD can occur together. However, people with ASD are more likely to have trouble shifting their focus from one thing to another rather than being easily distracted and hyperactive in general. Autism is also more likely to be associated with difficulties with social situations and communication.

There are several different mental health diagnoses that can be mistaken for autism. Examples include ADHD, anxiety disorders, and obsessive-compulsive disorder (OCD). Symptoms of other developmental disorders may also overlap with those of autism.

The exact process for screening for autism in adults is still being developed. Usually, a specialist such as a neuropsychologist, psychiatrist, or neurologist will diagnose an adult with ASD. They may use the criteria for ASD in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition ( DSM-5 ) as well as behavioral observations to make a diagnosis.

MedlinePlus. Autism spectrum disorder .

National Institute of Mental Health. Autism spectrum disorder .

Spain D, Zıvralı Yarar E, Happé F. Social anxiety in adults with autism: A qualitative study . Int J Qual Stud Health Well-being . 2020;15(1):1803669. doi:10.1080/17482631.2020.1803669

Kalandadze T, Norbury C, Nærland T, Næss KB. Figurative language comprehension in individuals with autism spectrum disorder: A meta-analytic review .  Autism . 2018;22(2):99-117. doi:10.1177/1362361316668652

U.S. Centers for Disease Control and Prevention. Signs and symptoms of autism spectrum disorder .

National Institute of Neurological Disorders and Stroke. Autism spectrum disorder .

Eunice Kennedy Shriver National Institute of Child Health and Human Development. How do health care providers diagnose autism? .

Hours C, Recasens C, Baleyte JM. ASD and ADHD comorbidity: What are we talking about? . Front Psychiatry . 2022;13:837424. doi:10.3389/fpsyt.2022.837424

Related Articles

Signs and Symptoms of Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. It is important to note that some people without ASD might also have some of these symptoms. But for people with ASD, these characteristics can make life very challenging.

Learn more about ASD

Social Communication and Interaction Skills

Social communication and interaction skills can be challenging for people with ASD.

Examples of social communication and social interaction characteristics related to ASD can include

• Avoids or does not keep eye contact
• Does not respond to name by 9 months of age
• Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
• Does not play simple interactive games like pat-a-cake by 12 months of age
• Uses few or no gestures by 12 months of age (for example, does not wave goodbye)
• Does not share interests with others by 15 months of age (for example, shows you an object that they like)
• Does not point to show you something interesting by 18 months of age
• Does not notice when others are hurt or upset by 24 months of age
• Does not notice other children and join them in play by 36 months of age
• Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
• Does not sing, dance, or act for you by 60 months of age

Restricted or Repetitive Behaviors or Interests

People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by problems with social communication and interaction only.

Examples of restricted or repetitive behaviors and interests related to ASD can include

• Lines up toys or other objects and gets upset when order is changed
• Repeats words or phrases over and over (called echolalia)
• Plays with toys the same way every time
• Is focused on parts of objects (for example, wheels)
• Gets upset by minor changes
• Has obsessive interests
• Must follow certain routines
• Flaps hands, rocks body, or spins self in circles
• Has unusual reactions to the way things sound, smell, taste, look, or feel

Other Characteristics

Most people with ASD have other related characteristics. These might include

• Delayed language skills
• Delayed movement skills
• Delayed cognitive or learning skills
• Hyperactive, impulsive, and/or inattentive behavior
• Epilepsy or seizure disorder
• Unusual eating and sleeping habits
• Gastrointestinal issues (for example, constipation)
• Unusual mood or emotional reactions
• Anxiety, stress, or excessive worry
• Lack of fear or more fear than expected

It is important to note that children with ASD may not have all or any of the behaviors listed as examples here.

Learn more about screening and diagnosis of ASD

Learn more about treating the symptoms of ASD

Exit Notification / Disclaimer Policy

• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
• You will be subject to the destination website's privacy policy when you follow the link.
• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

• Current Issue
• Back Issues
• Article Topics
• ASN Events Calendar
• 2023 Leadership Awards Reception
• Editorial Calendar
• Submit an Article
• Sign Up For E-Newsletter

Presentation of Autism Spectrum Disorder in Females: Diagnostic Complexities and Implications for Clinicians

• By: Jessica Scher Lisa, PsyD Harry Voulgarakis, PhD, BCBA St. Joseph’s College
• April 1st, 2020
• assessment , behaviors , diagnosis , females , research , Spring 2020 Issue
• 9646    0

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by pervasive deficits in social communication and patterns of restricted, repetitive, stereotyped behaviors and interests (American Psychiatric Association, 2013). Beyond the […]

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by pervasive deficits in social communication and patterns of restricted, repetitive, stereotyped behaviors and interests (American Psychiatric Association, 2013). Beyond the main diagnostic criteria, however, there is considerable heterogeneity in the symptom presentations that is demonstrated by people with ASD, including severity, language, cognitive skills, and related deficits (Evans et al, 2018). Regarding sex differences, it has been well established that ASD is diagnosed more often in males than in females, with recent estimates suggesting a 3:3:1 ratio (Hull & Mandy, 2017). Despite the fact that this is well known, there is considerable uncertainty about the nature of this sex discrepancy and how it relates to the ASD diagnostic assessment practice (Evans et al, 2018). Additionally, it has been widely accepted that males and females with ASD present differently, which has implications for the sex discrepancy in diagnostic practices, thus females are generally under-identified (Evans et al, 2018).

The fact that females with ASD are under-identified and often overlooked can be due to a number of factors. First, they often don’t fit the “classic” presentation that is most often associated with the ASD diagnosis; specifically, there is a distinct ASD female phenotype that looks dissimilar to the typical ASD male presentation. Females with ASD tend to present with less restricted interests and repetitive behaviors (RRBs) (Supekar and Menon, 2015), thus standing out less both in society, as well as on screening and diagnostic measures. Fewer RRBs makes ASD appear in a different way, often more subtle, than what is considered to be the norm. It is also important to note that evidence suggests that even when females with ASD are identified, they receive their diagnosis (and related support) later than equivalent males with ASD (Giarelli et al, 2010). The implications for under- or late-identification are enormous and deserve empirical attention in an effort to improve diagnostic methods for ASD in females.

Harry Voulgarakis, PhD, BCBA

Jessica Scher Lisa, PsyD

While no consistent, reliable differences have been found between sex and core ASD symptoms (e.g. Bolte et al, 2011; Holzmann et al, 2007; Mandy et al, 2012), it has been well documented that compared to males, females with ASD that are undiagnosed or are diagnosed at a later age generally present with less severe ASD symptoms and more intact language and cognitive skills (Begeer et al, 2013; Giarelli et al, 2010; Rutherford et al, 2016). Research has also noted that females with ASD may be better able to compensate for symptoms despite having core deficits associated with ASD (Livingston & Happe, 2017; Hull et al, 2017). There has been some suggestion that females must exhibit more severe symptoms, impairment, or co-occurring problems in order to receive diagnoses of ASD (Evans et al, 2018). This finding is due to an analysis of previous research that demonstrates the following: females with ASD perform better on measures of nonverbal communication (which may mask other symptoms), females with ASD face more social, friendship, and language demands than males with ASD, and that females with ASD can exhibit patters of restricted interests and repetitive behaviors, as well as social and communicative problems that are deemed more socially acceptable as compared to the patterns seen in males with ASD (Lai et al, 2015; Rynkiewicz et al, 2016; Dean et al, 2014). This theory also accounts for the findings that females with ASD in general present with more severe behavioral, emotional, and cognitive problems compared to males (Frazier, et al, 2014; Holtmann et al, 2007; Horiuchi et al, 2014; Stacy et al, 2014). Further, Hiller and colleagues (2014) found that females were more likely to show an ability to integrate non-verbal and verbal behaviors, and initiate friendships, and exhibited less restricted interests. Teachers reported fewer concerns for females with ASD than for males, including concerns about behaviors and social skills. These data support the idea that that females with ASD may “look” different from the considerable “classic” presentation of ASD and may also present as less impaired in an academic setting.

The vast differences associated with gender presentation in ASD require that clinicians involved in diagnostic work become more cognizant of these broader phenotypes and adjust their assessment practices accordingly to better detect females presenting with atypical symptoms that still fall on the autism spectrum. Notably, many common diagnostic tools lack sensitivity to such a presentation. To that end, it is important to recognize that generally speaking, the evidence base, and hence the diagnostic criteria for ASD in itself comes from research among male-predominant samples (e.g. Edwards et al, 2012; Watkins et al, 2014). Therefore, while the efforts to study this area further are prominent, it is important to be mindful of the fact that existing assessment tools and diagnostic criteria likely contain sex/gender bias (Evans et al, 2018). Without addressing the neurological and diagnostic challenges pertaining to these sex/gender issues, any research in this area will be influenced by the underlying problem of not knowing how ASD should be defined and diagnosed in males as compared to females (Lai et al, 2015).

Currently, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is arguably the most commonly relied upon diagnostic instrument for ASD. The ADOS-2 is a semi-structured observational assessment designed to evaluate aspects of communication, social interaction, and stereotyped behaviors and restricted interests (Lord et al, 2000; 2012). In contrast to what has been documented with regard to the strong differences in the prevalence of ASD, differences between the sexes in the phenotypic presentation of ASD have been found to be much smaller in size, with inconsistencies in the findings with regard to severity level of the core symptoms, as well as age and general level of functioning. For example, some studies have found no significant differences between sexes with regard to the behavioral presentation of ASD on the ADOS (e.g. Lord et al., 2000; Lord et al., 2012, Ratto et al, 2017), while others have reported some differences (e.g. Lai et al., 2015).

In order to examine these inconclusive findings further, Tillman et al (2018) looked at data containing 2684 individuals with ASD from over 100 different sites across 37 countries. Children and adults were administered one of four ADOS modules (modules are determined by expressive language level). The Autism Diagnostic Interview, Revised (ADI-R) was also administered as well as a general intellectual ability instrument, such as the Wechsler Intelligence Scale for Children, or a different measure depending on age and verbal capabilities. Effects of sex were determined after excluding non-verbal IQ as a predictor. No main effect of sex was found for ADOS symptom severity, or on the specific ADOS subscales. Females showed lower scores on the RRB scale with increasing age. This result is similar to previous meta-analytic research on small-scale studies as well as large-scale studies (Van Wijngaarden-Cremers et al, 2014; Mandy et al, 2012, Supekar & Menon, 2015; Wilson et al, 2016; Charman et al., 2017). The researchers concluded that this adds to the current body of literature that supports the notion that females with ASD show lower levels of RRBs than males, but exhibit a more similar autistic phenotype to boys in relation to social communication deficits across ages (Tillman et al, 2018). Thus, it is possible to surmise that females with ASD are being under-identified as a result of exhibiting fewer RRBs. Notably, research has found that clinicians are hesitant to diagnose ASD without the presence of RRB (Mandy et al, 2012), as the diagnosis of ASD in the DSM-5 requires at least two types of RRBs. Lai et al. (2015) made the case that females with ASD may simply be exhibiting different RRBs rather than fewer, and it is possible that these less common forms of RRBs are being missed during diagnostic assessments.

Understanding the phenotypic differences in the presentation of autism is critical for diagnosticians for several reasons. It is crucial to understand that aspects of the diagnostic criteria for ASD may present on other ways in females though not be elevated on standard measure scales. As a result, those who do not receive an appropriate diagnosis will subsequently not receive an appropriate intervention. Beyond the obvious concern associated with females on the autism spectrum not receiving intervention associated with their autism symptomatology, there are a range of other mental health concerns that may dually go unaddressed. Higher functioning adolescents with ASD, which is often the presentation consistent with females that get “missed” in the diagnostic process, are at greater risk for developing depression (Greenlee et al, 2016) and anxiety (Steensel, Bogels, & Dirksen, 2012). Adults with high-functioning ASD are also at increased risk for suicidality (Hedley et al, 2017). More recent, emerging research suggests that while those with ASD may be able to mask their symptoms the majority of the day and thus not reach the diagnostic threshold in scandalized measures, doing so causes them significant distress and puts them at increased risks for such co-occurring mental health concerns.

The under-diagnosis of ASD in females with ASD lends itself to a population of women who end up wondering “what is wrong” with them. Females who do not have the opportunity to understand themselves in the context of neurodiversity tend to waste time and efforts on imitating and trying to fit-in (Bargiela et al, 2016). They are at far greater risk of bullying, as well as being taken advantage of socially, with subtle difficulties in perceiving and responding appropriately to social cues rendering them inept in certain situations that require a degree of social assimilation. These females have missed out on the benefits of early intervention, most often in the social realm, and can be plagued with identity issues later in life as they try to play catch-up in light of a new diagnosis. The timely identification of ASD can mitigate some of these risks and problems by improving the quality of life, increasing access to services, reducing self-criticism, and helping to foster a positive sense of identity. As such, diagnostic experts have a responsibility to continue to stay abreast of research developing in this area and adjusting their assessment practices accordingly.

Drs. Scher Lisa and Voulgarakis are Assistant Professors in the Department of Child Study at Saint Joseph’s College, New York. They are both also clinicians in private practice. You can find more information about their respective practices at www.drjessicascherlisa.com and www.drharryv.com .

Bölte, S., Duketis, E., Poustka, F., & Holtmann, M. (2011). Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders. Autism, 15(4), 497–511. doi: 10.1177/1362361310391116

Charman, T., Loth, E., Tillman, J., Crawley, D., Wooldridge, C., Goyard, D. et al (2017). The EU-AIMS Longitudinal European Autism Project (LEAP): Clinical characterization. Molecular Autism, 8(1), 27.

Evans, S. C., Boan, A. D., Bradley, C., & Carpenter, L. A. (2018). Sex/Gender Differences in Screening for Autism Spectrum Disorder: Implications for Evidence-Based Assessment. Journal of Clinical Child & Adolescent Psychology, 48(6), 840–854. doi: 10.1080/15374416.2018.1437734

Giarelli, E., Wiggins, L.D., Rice, C. E., Levy, S. E., Kirby, R. S., Pinto-Martin, J., et al. (2010). Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disability and Health Journal , 3 (2), 107-116. doi:10.1016/jdhjo.2009.07.001.

Hiller, R. M., Young, R. L., & Weber, N. (2014). Sex Differences in Autism Spectrum Disorder based on DSM-5 Criteria: Evidence from Clinician and Teacher Reporting. Journal of Abnormal Child Psychology, 42(8), 1381–1393. doi: 10.1007/s10802-014-9881-x

Holtmann, M., Bolte, S., & Poustka, F. (2007). Autism spectrum disorders: Sex differences in autistic behavior domains and coexisting psychopathology. Developmental Medicine & Child Neurology, 49, 361-366. doi: 10.1111/dmcn.2007.49.issue-5

Horiuchi, F., Oka, Y., Uno, H., Kawabe, K., Okada, F., Saito, I., Ueno, S. I. (2014). Age-and sex-related emotional and behavioral problems in children with autism spectrum disorders: Comparison with control children. Psychiatry and Clinical Neurosciences, 68, 542-550. doi:10.1111/psc.12164

Hull, L., Petrides, K.V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47, 2519-2534. doi:10.1007/s10803-017-3166-5

Lai, M.C., Lombardo, M., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: Setting the scene for future research. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 11-24.

Livingston, L.A., & Happe, F. (2017). Conceptualizing compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder. Neuroscience & Behavioral Reviews, 80, 729-742. doi: 10.1016/j. neubiorev.2017.06.005

Lord, C., Risi, S., Lambrecht, L., Cook, E.H., Leventhal, B.L., DiLavore, P.C. et al (2000). The autism diagnostic observation schedule – generic: A standard measure of social communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205-223.

Lord, C., Rutter, M., DiLavore, P.C., Risi, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule, Second edition (ADOS-2) Manual (Part I): Modules 1-4. Torrance: CA: western Psychological Services.

Mandy, W. P., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2012). Sex differences in autism spectrum disorder: Evidence from a large sample of children and adolescents. Journal of Autism and Developmental Disorders, 42, 1304-1313. doi: 1007/s10803-011-1356-0

Ratto, A.B., Kenworthy, L. Yerys, B.E., Bascom, J., Wieckowski, A.T., White, S., et al (2017). What about the girls? Sex-based differences in autistic traits and adaptive skills. Journal of Autism and Developmental Disorders, 48, 1698-1711.

Rutherford, M., McKenzie, K., Johnson, T., Catchpole, C., O’Hare, A., McClure, I., Murray, A. (2016). Gender ratio in a clinical population sample, age of diagnosis and duration of assessment in children and adults with autism spectrum disorder. Autism, 20, 628-634. doi10.1177/1362361315617879

Supekar, K., Menon, V. (2015). Sex differences in structural organization of motor systems and their dissociable links with repetitive/restricted behaviors in children with autism. Super and Menon Molecular Autism, 6, 50 doi: 10.1186/s13229-015-0042-z.

Tillman, J., Ashwood, K., Absoud, M., olte, S., Bonnet-Brilhalut, F., Buitelaar, J.K. et al (2018). Evaluation sex and age differences in ADI-R and ADOS scores in a large European Multi-site sample of individuals with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(7), 2490-2505.

Van Wijngaarden-Cremers, P.J., van Eeten, E., Groen, W.B., Van Deurzen, P.A., Oosterling, I.J., & Van der Gaag, R.J. (2014). Gender and age differences in the core triad of impariments in autism spectrum disorders: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 44(3), 627-635.

Wilson, C.E., Murphy, C.M., McAlonan, G., Robertson, D.M., Spain, D., Haywayrd, H. et al (2016) Does sex influence the diagnostic evaluation of autism spectrum disorder in adults? autism, 20(7), 808-819.

Related Articles

Genetics, diagnosis, and the male-female gender gap in autism.

I hesitated to write this article. What business does a psychologist like me have writing about genetics and the gender gap in autism? I am not a geneticist. At most, […]

Your Child Has Just Been Diagnosed with Autism – Now What?

Every family has their own personal journey towards an autism diagnosis for their child. Whether it brings the confirmation of what may have been suspected or the news of something […]

Beyond the Autism Diagnosis: Understanding the Multifaceted Needs of Parents

As the number of children diagnosed with autism spectrum disorder (ASD) increases, so does the number of parents trying to navigate the complexities that accompany an autism diagnosis. Raising an […]

Bridging the Gap: Empowering Families Awaiting an Autism Diagnosis

The prevalence of autism spectrum disorder (ASD) continues to rise. According to the CDC, 1 in 36 children are diagnosed with autism by the age 81 and as a result, […]

A Mother’s Journey Advocating for Her Child’s Autism Diagnosis and What Fellow Educators Can Learn

As a registered occupational therapist (OTR) and Director of Portfolio Management and Delivery at Pearson Clinical Assessment, I have extensive experience working with students who have been diagnosed with a […]

Have a Question?

Have a comment.

You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

Individuals, Families, and Service Providers

View our extensive library of over 1,500 articles for vital autism education, information, support, advocacy, and quality resources

Reach an Engaged Autism Readership Over the past year, the ASN website has had 550,000 pageviews and 400,000 unique readers. ASN has over 55,000 social media followers

View the Current Issue

ASN Winter 2024 Issue "Understanding and Accommodating Varying Sensory Profiles"

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Transl Pediatr
• v.9(Suppl 1); 2020 Feb

Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation

Holly hodges.

1 Department of Pediatrics, Baylor College of Medicine and Meyer Center for Developmental Pediatrics, Texas Children’s Hospital, Houston, TX, USA;

Casey Fealko

2 Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA;

Neelkamal Soares

3 Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors. There have been recent concerns about increased prevalence, and this article seeks to elaborate on factors that may influence prevalence rates, including recent changes to the diagnostic criteria. The authors review evidence that ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain, and enumerate factors that correlate with ASD risk. Finally, the article describes how clinical evaluation begins with developmental screening, followed by referral for a definitive diagnosis, and provides guidance on screening for comorbid conditions.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors ( 1 ). In 2013, the Diagnostic and Statistical Manual of Mental Disorders —5 th edition (DSM-5) was published, updating the diagnostic criteria for ASD from the previous 4 th edition (DSM-IV) ( Table 1 ) ( 1 , 2 ).

ASD, autism spectrum disorder; SPCD, social (pragmatic) communication disorder.

In DSM-5, the concept of a “spectrum” ASD diagnosis was created, combining the DSM-IV’s separate pervasive developmental disorder (PDD) diagnoses: autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS), into one. Rett syndrome is no longer included under ASD in DSM-5 as it is considered a discrete neurological disorder. A separate social (pragmatic) communication disorder (SPCD) was established for those with disabilities in social communication, but lacking repetitive, restricted behaviors. Additionally, severity level descriptors were added to help categorize the level of support needed by an individual with ASD.

This new definition is intended to be more accurate and works toward diagnosing ASD at an earlier age ( 3 ). However, studies estimating the potential impact of moving from the DSM-IV to the DSM-5 have predicted a decrease in ASD prevalence ( 4 , 5 ) and there has been concern that children with a previous PDD-NOS diagnosis would not meet criteria for ASD diagnosis ( 5 - 7 ). There are varying reports estimating the extent of and effects of this change. One study found that with parental report of ASD symptoms alone, the DSM-5 criteria identified 91% of children with clinical DSM-IV PDD diagnoses ( 8 ). However, a systematic review suggests only 50% to 75% of individuals maintain diagnoses ( 9 ) and other studies have also suggested a decreased rate of diagnosis of individuals with ASD under the DSM-5 criteria ( 10 ). Often those who did not meet the requirements were previously classified as high functioning Asperger’s syndrome and PDD-NOS ( 11 , 12 ). Overall, most studies suggest that the DSM-5 provides increased specificity and decreased sensitivity compared to the DSM-IV ( 5 , 13 ); so while those diagnosed with ASD are more likely to have the condition, there is a higher number of children whose ASD diagnosis is missed, particularly older children, adolescents, adults, or those with a former diagnosis of Asperger’s disorder or PDD-NOS ( 14 ). Nevertheless, the number of people who would be diagnosed under the DSM-IV, but not under the new DSM-5 appears to be declining over time, likely due to increased awareness and better documentation of behaviors ( 4 ).

It has yet to be determined how the new diagnosis of SPCD will impact the prevalence of ASD. One study found the new SPCD diagnosis encompasses those individuals who possess subthreshold autistic traits and do not qualify for a diagnosis of ASD, but who still have substantial needs ( 15 ). Furthermore, children who previously met criteria for PDD-NOS under the DSM-IV might now be diagnosed with SPCD.

Epidemiology

The World Health Organization (WHO) estimates the international prevalence of ASD at 0.76%; however, this only accounts for approximately 16% of the global child population ( 16 ). The Centers for Disease Control and Prevention (CDC) estimates about 1.68% of United States (US) children aged 8 years (or 1 in 59 children) are diagnosed with ASD ( 6 , 17 ). In the US, parent-reported ASD diagnoses in 2016 averaged slightly higher at 2.5% ( 18 ). The prevalence of ASD in the US more than doubled between 2000–2002 and 2010–2012 according to Autism and Developmental Disabilities Monitoring Network (ADDM) estimates ( 6 ). Although it may be too early to comment on trends, in the US, the prevalence of ASD has appeared to stabilize with no statistically significant increase from 2014 to 2016 ( 19 ). Changing diagnostic criteria may impact prevalence and the full impact of the DSM-5 diagnostic criteria has yet to be seen ( 17 ).

Insurance mandates requiring commercial plans to cover services for ASD along with improved awareness have likely contributed to the increase in ASD prevalence estimates as well as the increased diagnosis of milder cases of ASD in the US ( 6 , 20 , 21 ). While there was only a modest increase in prevalence immediately after the mandates, there have been additional increases later as health care professionals better understood the regulatory and reimbursement process. The increase in prevalence may also be due to changes in reporting practices. One study in Denmark found the majority of increase in ASD prevalence from 1980–1991 was based on changes of diagnostic criteria and inclusion of outpatient data, rather than a true increase in ASD prevalence ( 21 ).

ASD occurs in all racial, ethnic, and socioeconomic groups, but its diagnosis is far from uniform across these groups. Caucasian children are consistently identified with ASD more often than black or Hispanic children ( 6 ). While the differences appear to be decreasing, the continued discrepancy may be due to stigma, lack of access to healthcare services, and a patient’s primary language being one other than English.

ASD is more common in males ( 22 , 23 ) but in a recent meta-analysis ( 24 ), true male-to-female ratio is closer to 3:1 than the previously reported 4:1, though this study was not done using the DSM-5 criteria. This study also suggested that girls who meet criteria for ASD are at higher risk of not receiving a clinical diagnosis. The female autism phenotype may play a role in girls being misdiagnosed, diagnosed later, or overlooked. Not only are females less likely to present with overt symptoms, they are more likely to mask their social deficits through a process called “camouflaging”, further hindering a timely diagnosis ( 25 ). Likewise, gender biases and stereotypes of ASD as a male disorder could also hamper diagnoses in girls ( 26 ).

Several genetic diagnoses have an increased rate of co-occurring ASD compared to the average population, including fragile X, tuberous sclerosis, Down syndrome, Rett syndrome, among others; however, these known genetic disorders account for a very small amount of overall ASD cases ( 27 - 30 ). Studies of children with sex chromosome aneuploidy describe a specific social functioning profile in males that suggests more vulnerability to autism ( 22 , 23 , 31 , 32 ). With the increased use of chromosomal microarray, several sites (chromosome X, 2, 3, 7, 15, 16, 17, and 22 in particular) have proven to be associated with increased ASD risk ( 28 ).

Other risk factors for ASD include increased parental age and prematurity ( 33 - 35 ). This could be due to the theory that older gametes have a higher probability of carrying mutations which could result in additional obstetrical complications, including prematurity ( 36 ).

ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain. Ongoing research continues to deepen our understanding of potential etiologic mechanisms in ASD, but currently no single unifying cause has been elucidated.

Neuropathologic studies are limited, but have revealed differences in cerebellar architecture and connectivity, limbic system abnormalities, and frontal and temporal lobe cortical alterations, along with other subtle malformations ( 28 , 37 , 38 ). A small explorative study of neocortical architecture from young children revealed focal disruption of cortical laminar architecture in the majority of subjects, suggesting problems with cortical layer formation and neuronal differentiation ( 39 ). Brain overgrowth both in terms of cortical size and additionally in terms of increased extra-axial fluid have been described in children with ASD and are areas of ongoing study both in terms of furthering our understanding of its etiology, but also as a potential biomarker ( 40 , 41 ).

Genetic factors play a role in ASD susceptibility, with siblings of patients with ASD carrying an increased risk of diagnosis when compared to population norms, and a much higher, although not absolute, concordance of autism diagnosis in monozygotic twins ( 42 - 44 ).

Genome wide association studies and whole exome sequencing methods have broadened our understanding of ASD susceptibility genes, and learning more regarding the function of these genes can shed light on potential biologic mechanisms ( 45 ). For example candidate genes in ASD include those that play a role in brain development or neurotransmitter function, or genes that affect neuronal excitability ( 46 , 47 ). Many of the genetic defects associated with ASD encode proteins that are relevant at the neuronal synapse or that are involved in activity-dependent changes in neurons, including regulatory proteins such as transcription factors ( 42 , 48 ). Potential “networks” of ASD genetic risk convergence include pathways involved in neurotransmission and neuroinflammation ( 49 ). Transcriptional and splicing dysregulation or alterations in epigenetic mechanisms such as DNA methylation or histone acetylation and modification may play a role ( 42 , 49 - 51 ). A recent study describes 16 newly identified genes associated with ASD that raise new potential mechanisms including cellular cytoskeletal structure and ion transport ( 52 ). Ultimately, ASD remains one of the most genetically heterogeneous neuropsychiatric disorders with rarer de novo and inherited variants in over 700 genes ( 53 ).

While genetics clearly play a role in ASD’s etiology, phenotypic expression of genetic susceptibility remains extremely variable within ASD ( 54 ). Genetic risk may be modulated by prenatal, perinatal, and postnatal environmental factors in some patients ( 35 ). Prenatal exposure to thalidomide and valproic acid have been reported to increase risk, while studies suggest that prenatal supplements of folic acid in patients exposed to antiepileptic drugs may reduce risk ( 55 - 57 ). Research has not confirmed if a small positive trial of folinic acid in autism can be used to recommend supplementation more broadly ( 58 ). Advanced maternal and paternal age have both been shown to have an increased risk of having a child with ASD ( 59 ). Maternal history of autoimmune disease, such as diabetes, thyroid disease, or psoriasis has been postulated, but study results remain mixed ( 60 , 61 ). Maternal infection or immune activation during pregnancy is another area of interest and may be a potential risk factor according to recent investigations ( 62 - 65 ). Both shorter and longer inter-pregnancy intervals have also been reported to increase ASD risk ( 66 ). Infants born prematurely have been demonstrated to carry a higher risk for ASD in addition to other neurodevelopmental disorders ( 34 ). In a prior epidemiologic review, obstetric factors including uterine bleeding, caesarian delivery, low birthweight, preterm delivery, and low Apgar scores were reported to be the few factors more consistently associated with autism ( 67 ). A recent meta-analysis reported several pre, peri and postnatal risk factors that resulted in an elevated relative risk of ASD in offspring ( 35 ), but also revealed significant heterogeneity, resulting in an inability to make true determination regarding the importance of these factors.

Despite the hysteria surrounding the now retracted Lancet article first published in 1998, there is no evidence that vaccines, thimerosal, or mercury is associated with ASD ( 68 - 70 ). In the largest single study to date, there was not an increased risk after measles/mumps/rubella (MMR) vaccination in a nationwide cohort study of Danish children ( 70 ).

Ultimately, research continues to reveal factors that correlate with ASD risk, but no causal determinations have been made. This leaves much room for discovery with investigators continuing to elucidate new variants conveying genetic risk, or new environmental correlates that require further study ( 52 ).

Evaluation in ASD begins with screening of the general pediatric population to identify children at-risk or demonstrating signs suggestive of ASD, following which a diagnostic evaluation is recommended. The American Academy of Pediatrics (AAP) guidelines recommend developmental surveillance at 9, 15 and 30 months well child visits and autism specific screening at 18 months and again at 24 or 30 months ( 28 , 71 ). Early red flags for ASD include poor eye contact, poor response to name, lack of showing and sharing, no gesturing by 12 months, and loss of language or social skills. Screening tools for ASD in this population include the Modified Checklist for Autism in Toddlers, Revised, with Follow-up (M-CHAT-R/F) and Survey of Wellbeing of Young Children (SWYC) ( 72 , 73 ). Red flags in preschoolers may include limited pretend play, odd or intensely focused interests, and rigidity. School age children may demonstrate concrete or literal thinking, have trouble understanding emotions, and may even show an interest in peers but lack conversational skills or appropriate social approach. If there is suspicion of ASD in these groups, screening tools available include the Social Communication Questionnaire (SCQ), Social Responsiveness Scale (SRS), and Autism Spectrum Screening Questionnaire (ASSQ) ( 74 - 76 ).

If concerns are raised at screening, primary care clinicians are recommended to refer the child to early intervention if less than 3 years of age or to the public school system for psychoeducational evaluation in order to establish an individual education program (IEP) if the child is three years of age or older. Clinicians should additionally refer the child to a specialist (pediatric neurologist, developmental-behavioral pediatrician, child psychiatrist, licensed child psychologist) for a definitive diagnosis and comprehensive assessment ( 71 ). A comprehensive assessment should include a complete physical exam, including assessment for dysmorphic features, a full neurologic examination with head circumference, and a Wood’s lamp examination of the skin. A parent interview, collection of any outside informant observations, and a direct clinician observation of the child’s current cognitive, language, and adaptive functioning by a clinician experienced with ASD should be components of this comprehensive assessment. ( 28 , 71 , 77 , 78 ).

Additionally, primary care clinicians need to be aware of (and evaluate for) potential co-occurring conditions in children with ASD. According to a surveillance study of over 2,000 children with ASD, 83% had an additional developmental diagnosis, 10% had at least one psychiatric diagnosis, and 16% at least one neurologic diagnosis ( 79 ). In the past, rates of co-morbid intellectual disability (ID) in patients with ASD were reported from 50% to 70%, with the most recent CDC estimate reported at 31.0% (26.7% to 39.4%) with ID defined as intelligence quotient (IQ) ≤70 ( 6 , 80 ). Other common co-occurring medical conditions include gastrointestinal (GI) disorders, including dietary restrictions and food selectivity, sleep disorders, obesity, and seizures ( 81 - 84 ). Studies using electronic health record (EHR) analysis revealed prevalence of epilepsy ~20% and GI disorders [without inflammatory bowel disease (IBD)] at 10–12% ( 82 ). Epilepsy has been shown to have higher prevalence rates in ASD with comorbid ID and medical disorders of increased risk such as tuberous sclerosis complex (TSC) ( 85 - 87 ). GI disorders or GI symptomatology, including diarrhea, constipation, restrictive eating, or reflux, have been shown to be prominent in ASD across multiple studies ( 81 , 82 , 88 , 89 ). Sleep problems have been reported to occur in anywhere from 50% to 73% of patients with ASD with variation in prevalence dependent on the definition of sleep symptoms or the measurement tool used ( 90 - 92 ). Rates of overweight and obesity in ASD are reported to be roughly 33% and 18% respectively, higher than rates in typically developing children ( 81 - 84 , 93 ).

Other behavioral or psychiatric co-occurring conditions in ASD include anxiety, attention deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder, and mood disorders or other disruptive behavior disorders ( 81 ). Rates of co-occurring ADHD are reported anywhere from 25% to 81% ( 81 , 94 ). A recent meta-analysis of 30 studies measuring rates of anxiety and 29 studies measuring rates of depression reported a high degree of heterogeneity from the current literature, but stated pooled lifetime prevalence for adults with ASD to be 42% for any anxiety disorder and 37% for any depressive disorder, though the use of self-report measures and the presence of ID could influence estimates ( 95 ). In children with ASD seeking treatment, the rate of any anxiety disorder was found to be similar at 42% and in addition this study reported co-morbid oppositional defiant disorder at a rate of 46% and mood disorders at 8%, with 66% of the sample of over 600 patients having more than one co-occurring condition ( 94 ).

Currently no clear ASD biomarkers or diagnostic measures exist, and the diagnosis is made based on fulfillment of descriptive criteria. In light of a relatively high yield in patients with ASD, clinical genetic testing is recommended and can provide information regarding medical interventions or work up that might be necessary and help with family planning ( 96 ). The American College of Medical Genetics and Genomics (ACMGG) guidelines currently recommend chromosomal microarray for all children, fragile X testing in males, and additional gene sequencing, including PTEN and MECP2 , in certain patients as first tier genetic testing in the work up of ASD ( 97 ). High resolution G-banded karyotype, once recommended for all patients with ASD, is no longer routinely indicated based on recent consensus recommendations, but might still be performed in patients with a family or reproductive history suggestive of chromosomal rearrangements or specific syndromes such as sex chromosome anomalies or Trisomy 21 ( 96 - 98 ). Several professional societies recommend genetic testing for ASD, including the American Academy of Neurology, the AAP, ACMGG, and the American Academy of Child and Adolescent Psychiatry, and a child may require further referral to a geneticist and/or genetic counselor, depending on results of testing ( 25 , 28 , 97 , 99 ). As the field of genetics continues to advance rapidly, recent publications suggest whole exome sequencing may become the preferred method for clinical genetic testing in individuals with ASD ( 100 , 101 ).

Aside from genetic testing, no other laboratory work up is routinely recommended for every patient with a diagnosis of ASD. However, further evaluation may be appropriate for patients with particular findings or risk factors. Metabolic work-up should be considered in patients with any of the following concerning symptoms or signs: a history of clear developmental regression including loss or plateau of motor skills; hypotonia; recurrent episodes of vomiting, lethargy or hypoglycemia; microcephaly or poor growth; concern for other organ involvement; coarse features; or concern for seizures or ataxia. Based on the patient’s history and presentation, components of a metabolic laboratory evaluation could include complete blood count (CBC), liver and renal function tests, lactate, pyruvate, carnitine, amino acids, an acylcarnitine profile, urine organic acids and/or urine glycosaminoglycans ( 97 , 102 ). Children with a history of pica should have a lead level measured ( 28 , 103 ). In a child with significantly restricted food intake, one should consider a laboratory evaluation of nutritional status. Sleep symptoms may warrant a referral for a possible sleep study, and if restless sleep symptoms are present, an evaluation for iron deficiency is not unreasonable, particularly if dietary rigidity limits iron intake ( 104 ).

Neuroimaging is not routinely recommended for every patient with ASD ( 28 , 99 ), but may be appropriate in patients with a suspicion for TSC or other neurocutaneous disorders, microcephaly, or an abnormal neurologic exam (spasticity, severe hypotonia, unilateral findings). Patients with suspected seizures should have an electroencephalography (EEG) obtained ( 102 ). If accessible, it might be appropriate to immediately refer children with concern for further genetic, metabolic or neurologic conditions to a specialist who can then obtain and interpret the aforementioned testing. At this time there is inadequate evidence to recommend routine testing for celiac disease, immunologic or neurochemical markers, mitochondrial disorders, allergy testing, hair analysis, intestinal permeability studies, erythrocyte glutathione peroxidase studies, stool analysis, urinary peptides or vitamin and mineral deficiencies without a history of severe food selectivity.

ASD is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors. Recent changes to the diagnostic criteria occurred with the transition to the new diagnostic manual (DSM-5) and will likely impact prevalence, which currently stands at 1 in 59 children in the US. ASD is a neurobiological disorder influenced by both genetic and environmental factors affecting the developing brain. Research continues to reveal factors that correlate with ASD risk and these findings may guide further etiologic investigation, but no final causal pathway has been elucidated. Clinical evaluation begins with developmental screening of the general pediatric population to identify at-risk children, followed by referral to a specialist for a definitive diagnosis and comprehensive neuropsychological assessment. Children with ASD should also be screened for common co-morbid diagnoses. While no clear biomarkers or diagnostic measures exist, clinical genetic testing is recommended as part of the initial medical evaluation. Further medical work up or subspecialist referrals may be pursued based on specific patient characteristics.

Acknowledgments

Funding: None.

Ethical Statement : The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Conflicts of Interest : The authors have no conflicts of interest to declare.

Home / Getting a diagnosis / Autism characteristics: checklist for adults

Autism characteristics: checklist for adults

If you think you may be autistic; or you know, love, or work with an adult who you feel might be on the autism spectrum, the following information may help you to better understand the common characteristics relating to adults with Autism Spectrum Disorder (ASD).

You may demonstrate the characteristics of autism, but may not have been assessed or diagnosed for a number of reasons, these could include:

• The characteristics are not obvious to you or those around you.
• People around you are not aware of the characteristics of autism so don’t point them out to you.
• The characteristics do not have a significant impact on you, or limit your everyday life.
• You have learnt coping strategies to support your challenges including masking or camouflaging.
• The financial and emotional cost of an assessment.
• Another diagnosis that could account for some of the characteristics demonstrated
• You self-identify as autistic, but don’t see the benefits of having a formal assessment
• You do not want a formal diagnosis.

Many adults who demonstrate the behaviours of autism, and are not formally diagnosed, live life perfectly well. They might develop meaningful relationships, have satisfying careers, or live an excellent quality of life that satisfies them.

However, many adults that demonstrate the behaviours of autism, and are not formally diagnosed, may also find life difficult, isolating, or a bit of a struggle in some areas.

Individuals may develop the feeling that “everyone else is different” and may find it hard to form meaningful relationships, or have satisfying careers, despite wanting these things. This can have an impact on a persons mental health, physical health, and wellbeing.

Characteristics checklist

If you’re reading this page, you may be thinking that you, your partner, or someone you know or love is showing some of the characteristics of autism.

These signs cover a range of human behaviour; from social communication and social interaction, to restricted, repetitive and sensory processing.

Note that the information below is just a list of some of the common characteristics of autism.

It is unlikely that an adult, you will display all of these characteristics, and it’s important to remember, only a qualified professional can carry out an assessment for autism.

Some of the characteristics that autistic adults commonly report, include:

Communication

• Find joining in conversation difficult .
• Speaking in a way that is not expected in the context of the conversation e.g. very formally or very informally, in a monotone, in an accent, etc.
• Difficulties in using and responding to tone of voice or non-verbal social cues such as facial expressions and body language in social interactions.
• Find it hard to read someone’s body language and emotions.
• Find that others don’t understand how you are feeling and say that “it is hard to know what you are thinking”.
• Like to lead conversations and provide extensive information on the specific topics you are interested in.
• Find it easier to talk ‘at’ people , rather than engaging in a two-way conversation.
• Find ‘small talk’ such as talking about the weather and what others are doing difficult .
• Differences in natural communication styles , preferring more literal language use rather than the use of non-literal language like sarcasm or metaphor, which may be more challenging to understand in context.
• Be blunt in your assessment of people and things.
• Prefer to make little or no eye contact when you are talking to someone.
• Have your own unique phrases and descriptive words.
• Find building and maintaining close friendships and relationships difficult in a range of environments .
• You may use facial expressions and make gestures when speaking with people that others find unusual.
• You enjoy consistent routine and schedules and get upset or anxious should that routine or schedule be changed.
• You find it upsetting when something happens that you did not expect to happen, even if it is positive.
• Have trouble regulating your emotional responses .
• Are bothered if your things are moved or rearranged by someone.
• Have a series of repetitive rituals or behaviours that you follow on a daily basis.
• You make noises in places where you are expected to be quiet.
• Preference for highly specific interests or hobbies that you spend a lot of time on.
• Have difficulty multi-tasking .
• Have a very strong reaction or no reaction at all to sensory stimuli , such as textures, sounds, smells and taste.
• Like operating solo – both at work and play.

How do these characteristics play out in adult life? Sometimes well, and sometimes not so well.

For some people, the characteristics of autism will impact life positively.

This might include:

• Excelling in a chosen area of study, or a chosen career.
• Noticing details in the environment that others miss.
• Having increased empathy or immense care for people or animals.
• Enjoying working independently.

What would happen if the autism gene was eliminated from the gene pool? You would have a bunch of people standing around in a cave, chatting and socializing and not getting anything done. — Temple Grandin, The Way I See It: A Personal Look at Autism & Asperger's

On the other hand, according to the National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia , autistic adults may find they have:

• Problems in obtaining, regularly attending or sustaining employment or education.
• Difficulties in initiating or sustaining social relationships .
• Previous or current contact with mental health or learning disability services.
• A history of a neuro-developmental conditions (including learning disabilities and attention deficit hyperactivity disorder) or psychiatric difficulties.

It’s important to note that each person’s experience of autism is different – and no two autistic people will have exactly the same set of characteristics.

Some autistic adults will experience characteristics that result in challenges in everyday life. Others may simply feel like something is different about them from a non-autistic person. Chances are, they may have felt that way since childhood but haven’t been able to pinpoint exactly why. Or, they may not notice that they feel or behave differently than others, that are not autistic.

Should an adult pursue an autism diagnosis?

If you think you have some of the characteristics of autism, you might question why you would consider getting assessed at this stage in your life? At the end of the day, there is no right or wrong answer to this question, it is a personal question.

What are some of the benefits of getting a diagnosis?

• Getting a professional diagnosis may help you to receive any appropriate funding, support and help you might need or desire.
• Your family, friends and work colleagues (if you choose to tell them) may have a better understanding of you and your needs – and it may allow them to support you more effectively.
• You may have a greater sense of self-identify if you understand yourself – and the spectrum – better.
• You may have a better understanding of your experiences as a child or adolescent.
• You may have increased confidence knowing you are part of a larger group of adults that may be like-minded.

Some adults find that by having a better understanding of the challenges associated with autism, they can use their strengths and develop strategies to support these.

Fast fact: Did you know that autistic people commonly show character strengths such as loyalty, kindness, honesty and a lack of judgement?

Seeking a diagnostic assessment

Getting started.

You’ve decided to seek an assessment to determine if you or an adult you love is autistic, so, what are the next steps?

Assessments for adults involve appropriately qualified health professionals gathering and considering a range of developmental, historical and current information against the criteria for autism.

To seek an assessment for autism, you have a couple of options:

• Contact your state or territory autism association for information about assessments.
• Talk to a qualified health professional with experience in the assessment and diagnosis of autism.
• Make an appointment with your GP to discuss and possibly to refer you to a qualified health professional with experience in the assessment and diagnosis of autism.
• Refer yourself for an assessment.

There are a number of government-funded services that specialise in the assessment and diagnosis of autism. You can contact these teams directly, but you may need a referral from your GP or paediatrician.

There are also private practitioners and organisations that conduct assessments on a fee-paying basis. These services can be accessed via a referral from a health care professional, or can be referred to directly.

You can learn more at Getting a diagnosis for adults (over 18) .

Autism & Me

Members of the autism community and their families share lived experience on their autism journeys. Video Transcription

Autism Community

One of the main things I like to explain is that people with autism have varied abilities and character traits, there’s not one single experience of autism.

— Zoran Bekric

I have Asperger’s syndrome and that means I’m sometimes a bit different from the norm. And - given the right circumstances - being different is a superpower.

— Greta Thunberg

I would play with numbers in a way that other kids would play with their friends.

— Daniel Tammet

People on the spectrum experience the neurotypical world as relentlessly unpredictable and chaotic, perpetually turned up too loud, and full of people who have little respect for personal space.

— Steve Silberman

Everyone has a mountain to climb and autism has not been my mountain, it has been my opportunity for victory.

— Rachel Barcellona

Although people with autism look like other people physically, we are in fact very different in many ways. We are more like travellers from the distant, distant past. And if, by being here, we could help the people of the world remember what truly matters for the Earth, that would give us a quiet pleasure.

— Naoki Higashida

PLEASE NOTE:

The Spectrum has not been designed for Internet Explorer and may not display or function as expected, we recommend you consider using an alternate browser..

• Type 2 Diabetes
• Heart Disease
• Digestive Health
• Multiple Sclerosis
• COVID-19 Vaccines
• Occupational Therapy
• Healthy Aging
• Health Insurance
• Public Health
• Patient Rights
• Caregivers & Loved Ones
• End of Life Concerns
• Health News
• Thyroid Test Analyzer
• Doctor Discussion Guides
• Hemoglobin A1c Test Analyzer
• Lipid Test Analyzer
• Complete Blood Count (CBC) Analyzer
• What to Buy
• Editorial Process
• Meet Our Medical Expert Board

Mild Autism in Adults and Children

Signs are subtle and often missed in early childhood

• Symptoms in Kids
• Symptoms in Adults
• Delayed Diagnosis
• Confirming Autism

Mild autism is an unofficial term commonly used to refer to a diagnosis of autism spectrum disorder level 1. Mildly autistic people have less noticeable traits (that they often mask) and have low support needs. However, challenges can include social interaction, reading social cues, understanding body language, and deciphering facial expressions.

Because these traits can be subtle, mild autism is often missed during early intervention screenings in childhood. As a result, people with the condition tend to be diagnosed at an older age, possibly adulthood.

This article discusses mild autism in adults and children. It describes traits of autism with low support needs, how they are often overlooked, and how they may eventually be diagnosed.

What Are Traits of Mild Autism?

The term "mild autism" can be confusing unless you know that autism is a spectrum disorder with traits that range from the least to most intense .

Autistic people with mild traits, those with intense challenges, and autistic people in between are all diagnosed with ASD. However, their diagnoses are further classified by level. There are three, each of which is defined by the amount of support a person may need.

Level 1 autism describes people who need the least support for the activities of daily life. This is what some call mild autism.

In general, people with ASD have challenges with social communication, usually resist changes in their routine, and can be hypersensitive to noise, smell, touch, and other sensory experiences.

Autistic people with low support needs may have advanced academic abilities, but struggle with social skills , sensory challenges , or organization. Children and adults can exhibit different signs.

Support needed for a person with level 1 autism might include:

• Building self-control
• Controlling emotions
• Being flexible
• Developing back-and-forth communications skills
• Understanding non-verbal communication
• Reducing anxiety

How much support autistic people with mild traits need depends on many factors and varies from person to person, even though they have the same level-1 diagnosis.

Also Known As

Mild autism is also sometimes called:

• High-functioning autism (HFA)
• Asperger's syndrome
• Being "slightly autistic"
• Being "mildly autistic"
• Being "a little autistic"

These terms are not used by the medical community and are considered offensive to some. Many people prefer "autism with low support needs" to describe their diagnosis.

Mild Autism Traits in Children

Autistic children with low support needs can have many neurotypical behaviors. When traits do appear, they can be slight and easy to overlook, or considered simple differences in personality or temperament.

• Doesn't make eye contact: Autistic kids may seem very shy and look away from people when speaking or being spoken to, either often or consistently.
• Seems distant: They can sometimes seem to be "in their own world" and may not seem to hear people who are speaking to them.
• Attached to routine: A specific way of doing things often brings feelings of security. Any change to this routine can cause them to react in an emotional way.
• Limits in adapting to change: Age-appropriate schoolwork or tasks may not be problematic, but a child may have a hard time changing activities or trying new ways of doing something.
• Difficulty seeing another's perspective: It may be hard for an autistic child to understand what other people are thinking or feeling.
• Challenges adjusting to different social situations: Autistic children might become upset in new social situations and not understand social "rules" and expectations.
• Trouble developing and maintaining relationships: Autistic children often struggle with imaginative play, making friends, or sharing interests.
• Repeating the same actions, activities, movements, or words: Autistic children may line up objects or do other activities over and over again, even if there is no obvious reason for doing so.
• Limited range of interests, but in-depth knowledge: An autistic child might only care about a few things, but they'll know everything there is to know about them.
• Extremely sensitive or indifferent to sensations: An autistic person can be extremely sensitive (hyperreactive) to the feel of material on their skin, be unable to stand loud noises, or have strong reactions to other sensory experiences. Others may not notice changes in sensation (hyporeactive), such as extreme heat or cold.

Some of these traits may be more obvious than others. It's also important to consider that autism traits and their expression can be affected by the child's location (e.g., at home or school), as well as who is with them (e.g., friends and family or strangers).

Autism traits may become more obvious as a child gets older. For example, an autistic preteen might be unable to keep up socially with their peers. This isn't always the case, however.

Mild Autism Traits in Adults

Autistic people with low support needs may not receive a diagnosis until they become adults—or at all. Signs of autism in adults may be difficult to see because autistic people with mild traits often adopt coping skills to suppress these traits, making them less obvious.

Some autism traits in adults include:

• Difficulty relating to others: You may have a hard time putting yourself in "other people's shoes."
• Difficulty making and maintaining friendships: Autistic adults have trouble understanding and following social rules, and can sometimes be seen as "rude" or inconsiderate. This can make it difficult to establish and maintain friendships.
• Challenges with back-and-forth communication: An autistic person can find it hard to hold a conversation and use or understand body language, eye contact, and facial expressions.
• Trouble expressing yourself verbally: You may say things that seem blunt, or have trouble describing what you are thinking or feeling.
• Strong need for planning and routine: Autistic adults like structure and may have a rigid routine. They may have a need to plan out the details of everything they do.
• Disliking change: Change can make an autistic adult feel very uncomfortable or emotional.
• Experiencing anxiety in social situations: You might have difficulty adjusting to a new social situation or to situations where there is a lot of sensory input, such as a crowded store.
• Having intense interests in very specific subjects: Autistic adults can become "hyperfixated" on certain subjects or activities.

Can an Autistic Person Have a "Normal" Life?

Whether an autistic person can live a "normal" life depends on the level of their diagnosis. Those with mild autism traits are typically able to live independently, get an education, hold a job, and so on. This is not to say that autism with low support needs won't come with some challenges, but ensuring proper support can set an autistic person up for success.

Why Mild Autism Traits May Go Undiagnosed

Autistic people with low support needs are more likely to fly under the radar and not be diagnosed until they are older. There are several reasons for this, some of which include their sex, how they adopt masking strategies, the difficulty with diagnosis, and more.

Assigned females are more likely to have mild autism traits that go undiagnosed until they are older. Autistic girls are less likely to engage in repetitive behaviors and don't act out as much as autistic boys.

They're also more likely to be seen as shy and withdrawn. If caregivers and teachers consider these behaviors "expected" for girls, it can contribute to the delay in autism diagnosis.

Masking and Coping Skills

Masking is when someone suppresses or covers up autism traits in order to "fit in" better with those around them. Examples of this include imitating the way others speak or carry themselves, and practicing statements before saying them.

Autistic people with low support needs are often better able to mask their autism traits than those with intense traits and high support needs. They can be successful in their efforts, though this usually ends up causing distress.  

Autistic people with low support needs also tend to adopt coping skills to help them in settings like school and work. For example, a child may fidget with something under their desk throughout the day to feed their need for stimulation. This may go unnoticed or not be paid much mind if it is.

Difficulty With Diagnosis

Autism with low support needs can be hard to diagnose in anyone. But since children typically have several grown-ups monitoring them (caregivers, teachers, coaches, healthcare practitioners, and so on), getting to the point where an evaluation is actually done may be harder for autistic adults.

Usually, a person will need to see a psychologist or psychiatrist who specializes in adult autism. This might not happen if someone is unaware they are exhibiting signs or they do not want to acknowledge them.

Misdiagnosis

Sometimes an autistic person with mild traits may get a diagnosis—just not an autism diagnosis.

Autistic adults with low support needs may have been previously misdiagnosed with:

• Depression 
• Obsessive-compulsive disorder 
• Personality disorders
• Other neurodevelopmental disorders 

These mental health diagnoses in adults with undiagnosed autism may actually be a sign of autistic burnout.

What Is Autistic Burnout?

Autistic burnout is a non-medical term for a state of exhaustion autistic people can experience. Autistic adults say it is caused by the stress of masking and living in an unaccommodating "neurotypical" world. Signs of autistic burnout look a lot like depression and include:

• Decreased ability to suppress autistic traits (mask)
• Problems with focus and concentration 
• Reduced daily living skills
• Social withdrawal

How Mild Autism Is Diagnosed

Pediatricians, school staff, and parents may notice mild autism traits in a child that prompt an evaluation. This is done by an ASD specialist such as a child psychologist, child psychiatrist, pediatric neurologist, or developmental pediatrician.

Adults who may have autism must be evaluated by a psychologist or psychiatrist, but this requires them to take the initiative to make that appointment.

Diagnosing Mild Autism Traits in Children 

The specialist will go over your child's medical and developmental history. Your child's intelligence, behavior patterns, and social and communication skills can be tested.

Tests used to help diagnose autism can include:

• An  IQ test
• Autism Diagnostic Interview (ADI)-Revised
• The  Autism Diagnosis Observation Schedule (ADOS)

Before the fifth and most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the handbook that guides clinicians' diagnosis of these conditions, a child had to show delays in social interaction and communication before age 3 to be diagnosed with autism. Now, there's a little more flexibility—the autism traits just have to be present from an "early age."

If your child is in school, you can also inquire about having your child evaluated through the school district. 

Diagnosing Mild Autism Traits in Adults

The process of getting an autism diagnosis as an adult can be difficult and may vary from provider to provider.

Your healthcare provider will likely assess you based on:

• Their observations about your autism traits
• Your own observations about your autism traits
• Screening questionnaires such as the Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS–R)

Support services for autistic adults can be lacking, and many people have strong emotions after being diagnosed.

A Word From Verywell

As with any other condition, a timely diagnosis is key to getting the support you or your child may need and developing a better understanding of how to navigate life with level 1 autism spectrum disorder. The diagnosis can be more difficult to establish than most because of how subtle the signs are, so be sure to advocate for yourself or your child if you suspect ASD.

Mild Autism and Treatment

The recommended treatment for autistic people with low support needs usually depends on age. Autistic children and teens need support that differs from what autistic adults need.

As with any level of ASD, the most helpful treatments for autistic people with low support needs often involve a variety of therapies. The type of support that's needed, as well as how much is needed, may change over time.

Treatments for Children

Autistic children often need a very structured routine . Their caregivers can work with a team of professionals to ensure their child has the support they need at school and at home.

An education plan that's tailored to an autistic child's needs is also necessary. They may also benefit from:

• Social-skills training
• Mental health counseling
• A special diet
• Therapy to help build motor skills

Possible treatments for autism with low support needs include:

• Behavioral therapy : This type of therapy uses rewards to teach autistic children expected or preferred behaviors.
• Play or developmental therapy : This therapy uses play-based activities to build an autistic child's emotional and communication skills.
• Speech therapy : Speech therapy for autistic children with low support needs is usually focused on conversation skills and learning to understand body language.
• Occupational therapy : Occupational therapy is often helpful for sensory challenges that many autistic children face.
• Physical therapy : Many autistic children have low muscle tone and struggle with physical activities.
• Specific condition treatment: Autistic kids also need to be treated for any other physical or mental health conditions they have. For example, seizures, gastrointestinal disorders, sleep disorders, anxiety, and obsessive-compulsive disorder commonly co-occur with autism.

Treatments for Adults

Structure and predictability are also important for autistic adults. Examples of what this might include are:

• Accommodations at work, such as scheduled breaks, written (rather than verbal) instructions, and earplugs or headphones to reduce sensory overload.
• Cognitive behavioral therapy  (CBT) to develop coping skills, which in turn helps them manage relationships and deal with frustrations at work and in life.
• Occupational therapy that focuses on problem-solving skills, building self-esteem, managing sensory challenges, and taking charge of home and finances.
• Speech therapy to help build communication skills and the ability to interpret body language.

As with autistic children, autistic adults also need treatment and support for any other conditions they have—for example, going to therapy or taking medication to help them cope with anxiety.

Mild autism is diagnosed as level 1 autism spectrum disorder. It means a person does not have intense autism traits and needs a lower level of support than other autistic people often do.

Autistic people with low support needs still have a hard time communicating and interacting with others. They can also find it difficult to change their routine and can be sensitive to sounds, pain, tastes, or other sensations. But generally, they are able to carry out the tasks of daily living well.

There's no separate diagnosis for mild autism, but providers may develop a treatment plan to align with level 1 autism traits and support needs.

National Institute of Mental Health. Autism spectrum disorder .

Neggers YH. Increasing prevalence, changes in diagnostic criteria, and nutritional risk factors for autism spectrum disorders. ISRN Nutr . 2014;2014:514026. doi:10.1155/2014/514026

Weitlauf AS, Gotham KO, Vehorn AC, Warren ZE. Brief report: DSM-5 "levels of support:" a comment on discrepant conceptualizations of severity in ASD. J Autism Dev Disord. 2014;44(2):471-6. doi:10.1007/s10803-013-1882-z

Faras H, Al ateeqi N, Tidmarsh L. Autism spectrum disorders. Ann Saudi Med. 2010;30(4):295-300. doi:10.4103/0256-4947.65261

Hull L, Petrides KV, Allison C, et al. "Putting on my best normal": social camouflaging in adults with autism spectrum conditions . J Autism Dev Disord . 2017;47(8):2519-2534. doi:10.1007/s10803-017-3166-5

Atherton G, Edisbury E, Piovesan A, Cross L. Autism through the ages: a mixed methods approach to understanding how age and age of diagnosis affect quality of life . J Autism Dev Disord . 2022;52(8):3639–54. doi:10.1007/s10803-021-05235-x

Lai MC, Szatmari P. Sex and gender impacts on the behavioural presentation and recognition of autism . Curr Opin Psychiatry . 2020;33(2):117–23. doi:10.1097/YCO.0000000000000575

Cook J, Hull L, Crane L, Mandy W. Camouflaging in autism: A systematic review . Clin Psychol Rev . 2021;89:102080. doi:10.1016/j.cpr.2021.102080

Lai MC, Baron-Cohen S. Identifying the lost generation of adults with autism spectrum conditions . Lancet Psychiatry. 2015;2(11):1013-27. doi:10.1016/S2215-0366(15)00277-1

Arnold SR, Higgins JM, Weise J, Desai A, Pellicano E, Trollor JN. Confirming the nature of autistic burnout . Autism . 2023:13623613221147410. doi:10.1177/13623613221147410

Higgins JM, Arnold SR, Weise J, Pellicano E, Trollor JN. Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout . Autism . 2021;25(8):2356–69. doi:10.1177/13623613211019858

Jones SL, Johnson M, Alty B, Adamou M.  The Effectiveness of RAADS-R as a Screening Tool for Adult ASD Populations .  Autism Res Treat . 2021;2021:9974791. doi:10.1155/2021/9974791.

Huang Y, Arnold SR, Foley KR, Trollor JN. Diagnosis of autism in adulthood: A scoping review . Autism . 2020;24(6):1311–27. doi:10.1177/1362361320903128

Defilippis M, Wagner KD. Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacol Bull. 2016;46(2):18-41.

Eunice Kennedy Shriver National Institute of Child Health and Human Development. Speech-language therapy for autism.

Bodison SC, Parham LD. Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: a systematic review . Am J Occup Ther . 2018;72(1):7201190040p1-7201190040p11. doi:10.5014/ajot.2018.029413

Eunice Kennedy Shriver National Institute of Child Health and Human Development. Physical therapy for autism .

Cohen S, Conduit R, Lockley SW, Rajaratnam SM, Cornish KM. The relationship between sleep and behavior in autism spectrum disorder (ASD): a review. J Neurodev Disord. 2014;6(1):44. doi:10.1186/1866-1955-6-44

Stratton E, Glozier N, Woolard A, et al. Understanding the vocational functioning of autistic employees: the role of disability and mental health . Disabil Rehabil . 2022:1-9. doi:10.1080/09638288.2022.2066207 

Cooper K, Loades ME, Russell AJ. Adapting psychological therapies for autism - therapist experience, skills and confidence . Res Autism Spectr Disord . 2018;45:43-50. doi:10.1016/j.rasd.2017.11.002 

Lin LY, Huang PC. Quality of life and its related factors for adults with autism spectrum disorder . Disabil Rehabil . 2019;41(8):896-903. doi:10.1080/09638288.2017.1414887 

Santhanam SP, Bellon-Harn ML. Speech-language pathologist's role in understanding and promoting self-advocacy in autistic adults . Am J Speech Lang Pathol . 2022;31(2):649–63. doi:10.1044/2021_AJSLP-21-00223

Hazen EP, Stornelli JL, O'Rourke JA, Koesterer K, McDougle CJ. Sensory symptoms in autism spectrum disorders . Harv Rev Psychiatry . 2014 Mar-Apr;22(2):112-24. doi:10.1097/01.HRP.0000445143.08773.58. PMID: 24614766.

Reaven J. The treatment of anxiety symptoms in youth with high-functioning autism spectrum disorders: developmental considerations for parents . B rain Res . 2011 Mar 22;1380:255-63. doi:10.1016/j.brainres.2010.09.075. Epub 2010 Sep 25. PMID: 20875799.

By Lisa Jo Rudy Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.

10 Signs of Autism in Women

Sensory sensitivity, camouflaging, and more..

Posted April 29, 2021 | Reviewed by Devon Frye

• What Is Autism?
• Find counselling to help with autism
• Male and female autism share some similarities, but overall, women tend to present differently than men.
• Symptoms that may present differently in women include social struggles and the nature of intense interests.
• Understanding that autism can manifest differently in women may lead to better quality of life.

Women with autism tend to present differently than men, a fact which has often led to misdiagnosis and under-diagnosis. As a result, women who have autism and don’t receive a diagnosis tend to judge themselves harshly for finding life difficult; what's more, mental health issues are common in women with autism.

In contrast, women who do receive a diagnosis often find that it has a positive impact on their confidence and self-esteem 1 ; they may even become advocates or mentors for other women with autism. Receiving a diagnosis can also help ensure that they receive the right kind of support and access any resources available.

Any woman who has reached the point of wondering whether or not she has autism may find it hard to find definitive information, given the fact that autism has predominantly been viewed as a male condition. If she's experiencing many of these symptoms, however, it might point towards a diagnosis of autism. In my book, I explore the difficulties in securing a diagnosis and coming to terms with having autism.

1. Social difficulties. One of the main reasons women begin to wonder whether they have autism is a lifetime of social difficulties. Autism spectrum disorder is a developmental disorder, which means that people are born with autism (although it may not be obvious until later in life).

Women with autism often find it difficult to read and respond to social cues. Many women navigate this difficulty by creating a social “checklist” and learning how to respond to people in socially appropriate ways. They often feel socially anxious, ruminate on their social interactions, and may end up feeling left out and lonely —despite their best efforts to be sociable. While autistic women may interact well in one-to-one situations, they often find it very hard to be in groups and may feel exhausted after too much social interaction.

2. Sensory sensitivity. People with autism experience the world in a different way than neurotypical people, and many women with autism experience intense sensory sensitivity. They may have a heightened sense of awareness when it comes to smells, light, sounds, and touch.

For someone with autism, it’s not just a matter of “not liking” certain things; it’s a sense of being unable to tolerate them. My clients have described being unable to sleep if people are breathing in the same room, having to leave a rail carriage because someone is eating, being unable to cross roads or drive due to sensory overload, and being unable to go to shopping malls because of the lights, sounds, and crowds.

3. Executive function . Many women with autism experience problems with executive function, 2 a set of skills that involves working memory , flexible thinking, and self-control. People with executive function problems might find it hard to organise themselves, finish tasks, and maintain emotional control. Whether in the workplace or at home, it can be hard for women to complete tasks such as completing tasks at work which are deemed less interesting, keeping a clean house, maintaining healthy habits, or carrying out daily tasks such as showering and eating breakfast.

4. Obsessive interests. Both men and women with autism tend to have specialised, intense interests. People with autism display “what if-then” thinking and often want to get to the bottom of how something works. They may want to know every single fact about their interest.

While boys’ and men’s interests often focus on specific objects or things, women often display an intense interest in a wider range of subjects—including how the mind works or people (particularly romantic partners, “crushes,” or celebrities). Many women with autism are skilled researchers, and may gravitate toward careers or hobbies which require a high level of intense focus.

5. Camouflaging . Autistic women tend to have a greater desire to be sociable than autistic men and spend a considerable amount of time and energy in masking, or camouflaging, their differences in order to pass as “normal.” Although neurotypicals of both genders and autistic men also camouflage, women with autism tend to do so to a far higher degree. 3

6. Sleep issues. Many women with autism experience difficulty sleeping . Often, this is caused by sensory issues, including a high sensitivity to noise at night and problems feeling comfortable. The presence of another person can exacerbate sleep issues.

7. Difficulties with eye contact. Making eye contact can be extremely challenging for people with autism. Women, in particular, often become skilled at forcing themselves to make eye contact; if they do this enough, it may start to feel more natural to them. Thus, a woman with autism may be OK at making eye contact because she's learned to so—but if it feels unnatural or hard, it could potentially be a sign of autism.

8. Emotional regulation issues and meltdowns. Women with autism often have problems with emotional regulation. Research has shown that there is a poor connection between the frontal cortex and the amygdala in people with autism. 4 Put simply, the amygdala can be thought of as an “ emotion centre” in our brain, as it's part of our limbic system and our mammalian brain. The frontal cortex can be thought of as our “thinking brain,” the more rational part of our brain which makes judgments.

Because of the poor connection between the two areas, women with autism may find it hard to rationalise situations and stay in control. Many describe having meltdowns: extreme emotional reactions to situations that might result in losing their temper, crying, or going into shutdown mode.

9. Stimming . Stimming (short for self-stimulating behaviour) refers to repetitive behaviours. The most obvious behaviours we associate with autism are rocking, hand flapping, repetition of words or phrases, and rocking or spinning. However, women with autism may display other stimming behaviours such as skin picking, feet rubbing, pacing, or hair twirling. People with autism tend to stim more than other people and may not be aware of their behaviours. It is thought that stimming is a self-regulation tool.

10. Anxiety and depression . Anxiety and depression are not universal symptoms of autism. But because life is difficult for many women with autism, it is common for them to experience mental health issues like anxiety, depression, or problems with addiction . There is also a far higher than average rate of suicidality in women with autism, which appears to be related to the degree of camouflaging they engage in. 5 Though their autism goes undiagnosed, it is more likely that they will receive a formal diagnosis for anxiety, depression or another mental health issue.

Anyone who identified with the above symptoms should seek out professional help. Autism displays similar symptoms to other conditions and a formal diagnosis can help establish whether or not autism may be at play.

To find a therapist near you, visit the Psychology Today Therapy Directory.

Facebook image: Dmitry Sedakov/Shutterstock

1. Leedham, A, Thompson, A, Smith, R, Freeth, M (2020) ‘“I was exhausted trying to figure it out”: The experiences of females receiving an autism diagnosis in middle to late adulthood’, Autism, 24, p135-146

2. White, SW, Elias, R, Capriola-Hall, NN, Smith, IC, Conner, CM, Asselin, SB, Howling, P, Getzel, EE & Mazefsky, CA (2017) ‘Development of a college transition and support program for students with autism spectrum disorder’, Journal of Autism and Developmental Disorders, 47(10), p3072-3078

3. Hull, L, Lai, M-C, Baron-Cohen, S, Allison, C, Smith, P, Petrides, KV, Mandy, W (2020) ‘Gender differences in self-reported camouflaging in autistic and non-autistic adults’, Autism, 24, p352-363

4. Richney, JA, Damiano, CR, Sabatino, A, Rittenberg, A, Petty, C, Bizzell, J, Voyvodic, J, Heller, AS, Coffman, MC, Smoski, M, Davidson, RJ, Dichter, GS (2015) ‘Neural mechanisms of emotion regulation in Autism Spectrum Disorder’, Journal of Autism Developmental Disorder, 45(11), p3409-23

5. Cassidy, S, Bradley, L, Shaw, R, Baron-Cohen, S (2018) ‘Risk markers for suicidality in autistic adults’, Molecular Autism, 9(1), Article 42

Claire Jack, Ph.D. , is a hypnotherapist, life coach, researcher, and training provider who specialises in working with women with autism spectrum disorder (ASD). She was herself diagnosed with ASD in her forties.

• Find a Therapist
• Find a Treatment Centre
• Find Online Therapy
• Calgary, AB
• Edmonton, AB
• Hamilton, ON
• Montréal, QC
• Toronto, ON
• Vancouver, BC
• Winnipeg, MB
• Mississauga, ON
• Oakville, ON
• Asperger's
• Bipolar Disorder
• Chronic Pain
• Eating Disorders
• Passive Aggression
• Personality
• Goal Setting
• Positive Psychology
• Stopping Smoking
• Low Sexual Desire
• Relationships
• Child Development
• Therapy Center NEW
• Diagnosis Dictionary
• Types of Therapy

Understanding what emotional intelligence looks like and the steps needed to improve it could light a path to a more emotionally adept world.

• Coronavirus Disease 2019
• Affective Forecasting
• Neuroscience

Your Internet Explorer 11 browser is not supported by this site. Please upgrade to a recent browser for the best experience.

What is autism?

Autism is a lifelong developmental disability which affects how people communicate and interact with the world. More than one in 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK. 

Find out more about autism by watching our film narrated by Alan Gardner, the Autistic Gardener

Being autistic

Autism is a spectrum condition and affects people in different ways. Like all people, autistic people have their own strengths and weaknesses. Below is a list of difficulties autistic people may share, including the two key difficulties required for a diagnosis. Click on the plus sign for more information.

Social communication and social interaction challenges

Social communication

Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Some autistic people are unable to speak or have limited speech while other autistic people have very good language skills but struggle to understand sarcasm or tone of voice. Other challenges include:

• taking things literally and not understanding abstract concepts
• needing extra time to process information or answer questions
• repeating what others say to them (this is called echolalia)

Social interaction

Autistic people often have difficulty 'reading' other people - recognising or understanding others' feelings and intentions - and expressing their own emotions. This can make it very hard to navigate the social world. Autistic people may:

• appear to be insensitive
• seek out time alone when overloaded by other people
• not seek comfort from other people
• appear to behave 'strangely' or in a way thought to be socially inappropriate
• find it hard to form friendships.

Read more about  social communication and social interaction challenges here

Repetitive and restrictive behaviour

With its unwritten rules, the world can seem a very unpredictable and confusing place to autistic people. This is why they often prefer to have routines so that they know what is going to happen. They may want to travel the same way to and from school or work, wear the same clothes or eat exactly the same food for breakfast. 

Autistic people may also repeat movements such as hand flapping, rocking or the repetitive use of an object such as twirling a pen or opening and closing a door. Autistic people often engage in these behaviours to help calm themselves when they are stressed or anxious, but many autistic people do it because they find it enjoyable. 

Change to routine can also be very distressing for autistic people and make them very anxious. It could be having to adjust to big events like Christmas or changing schools, facing uncertainty at work, or something simpler like a bus detour that can trigger their anxiety. 

Read more about repetitive behaviours and dealing with change here

Over- or under-sensitivity to light, sound, taste or touch

Autistic people may experience over- or under-sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain. For example, they may find certain background sounds like music in a restaurant, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Many autistic people prefer not to hug due to discomfort, which can be misinterpreted as being cold and aloof.

Many autistic people avoid everyday situations because of their sensitivity issues. Schools, workplaces and shopping centres can be particularly overwhelming and cause sensory overload. There are many simple adjustments that can be made to make environments more autism-friendly. 

Read more about sensory differences here

Highly focused interests or hobbies

Many autistic people have intense and highly focused interests, often from a fairly young age. These can change over time or be lifelong. Autistic people can become experts in their special interests and often like to share their knowledge. A stereotypical example is trains but that is one of many. Greta Thunberg's intense interest, for example, is protecting the environment.

Like all people, autistic people gain huge amounts of pleasure from pursuing their interests and see them as fundamental to their wellbeing and happiness.

Being highly focused helps many autistic people do well academically and in the workplace but they can also become so engrossed in particular topics or activities that they neglect other aspects of their lives. 

Take a look at the Spectrum magazine, written for and by autistic people

Extreme anxiety

Anxiety is a real difficulty for many autistic adults, particularly in social situations or when facing change. It can affect a person psychologically and physically and impact quality of life for autistic people and their families.  

It is very important that autistic people learn to recognise their triggers and find coping mechanisms to help reduce their anxiety. However, many autistic people have difficulty recognising and regulating their emotions. Over one third of autistic people have serious mental health issues and too many autistic people are being failed by mental health services. 

Read more about anxiety and mental health

Meltdowns and shutdowns

When everything becomes too much for an autistic person, they can go into meltdown or shutdown. These are very intense and exhausting experiences. A meltdown happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioural control.  This loss of control can be verbal (eg shouting, screaming, crying) or physical (eg kicking, lashing out, biting) or both. Meltdowns in children are often mistaken for temper tantrums and parents and their autistic children often experience hurtful comments and judgmental stares from less understanding members of the public.  A shutdown appears less intense to the outside world but can be equally debilitating. Shutdowns are also a response to being overwhelmed, but may appear more passive - eg an autistic person going quiet or 'switching off'. One autistic woman described having a shutdown as: 'just as frustrating as a meltdown, because of not being able to figure out how to react how I want to, or not being able to react at all; there isn’t any ‘figuring out’ because the mind feels like it is past a state of being able to interpret.'

Get advice and guidance on meltdowns and shutdowns

"The greatest discomfort for autistic people can be the social one. For me, I was confused by the way people behaved." Chris Packham, CBE and National Autistic Society Ambassador

Think you or someone you know could be autistic?

Ever-changing definition .

The definition of autism has changed over the decades and could change in future years as we understand more. Some people feel the spectrum is too broad, arguing an autistic person with 24/7 support needs cannot be compared with a person who finds supermarket lights too bright. We often find that autistic people and their families with different support needs share many of the same challenges, whether that’s getting enough support from mental health, education and social care services or being misunderstood by people close to them. We will continue to fight to make society work for autistic people.

How many people are autistic

It is important to know how many autistic people there are for several reasons, including helping to provide support, as well as showing the sheer number and diversity of autistic people. This is also called “autism prevalence”. It is an estimate of how many autistic people there are in the UK. It is not the same as the number of autistic people who have a diagnosis and many autistic people might not have been identified or even know yet themselves. As autism understanding has grown, the estimated prevalence has also changed. 

Government prevalence surveys last estimated that around one in 100 people are autistic. However, because these are estimates this is not definite. Other surveys and international estimates have come up with different prevalence estimates. Most of them suggest autism prevalence is higher. The National Autistic Society thinks the UK governments should do more research into autism prevalence to find an updated figure. Until that research is done, we believe that more than one in 100 people are autistic, which means more than 700,000 people in the UK.

Having an accurate prevalence figure is vital. We all need to know this to improve support and understanding, and to create a society that works for autistic people.

More about autism

Varying support needs

Autistic people have varying and complex needs from 24-hour care to simply needing clearer communication and a little longer to do things.

Autistic women and girls

More men and boys are currently diagnosed with autism than women and girls. The most up-to-date ratio is 3:1. There are various theories to explain this.

Autism and BAME people

Our 2014 report, Diverse Perspectives, suggests it can be even harder for people from Black, Asian and minority ethnic groups to get a diagnosis and support.

Autism and gender identity

We look at the connection between autism and gender identity, and hear stories from non-binary and transgender autistic people.

The causes of autism

There is strong evidence to suggest that autism can be caused by a variety of physical factors that affect brain development and genetic factors.

The history of autism

It is more than 40 years since Lorna Wing and Judith Gould coined the term autism spectrum and introduced the idea of the triad of impairments.

Ways to get involved

Help us support as many autistic people and their families as possible.

Campaign with us

Join us and help create a society that works for autistic people. 

Was this page helpful?

Cookies on this site.

Our site uses cookies for key functions and to give you the best experience. Use cookie settings to control which cookies are allowed or click on Allow Optional Cookies to allow all cookies. For more detailed information please see our cookie policy .

Please wait while we check your current settings

• Set Your Location
• Learn the signs
• Symptoms of autism
• What causes autism?
• Asperger syndrome
• Autism statistics and facts
• Learn about screening
• Screening questionnaire
• First Concern to Action
• Autism diagnosis criteria: DSM-5
• Newly diagnosed
• Associated conditions
• Sensory issues
• Interventions
• Access services
• Caregiver Skills Training (CST)
• Information by topic
• Resource Guide
• Autism Response Team
• Our mission
• Our grantmaking
• Research programs
• Autism by the Numbers
• Fundraising & events
• World Autism Month
• Social fundraising
• Ways to give
• Memorial & tributes
• Workplace giving
• Corporate partnership
• Become a partner
• Ways to engage
• Meet our Partners
• Deteccion de autismo
• Deteccion temprana
• My Autism Guide
• Select Your Location

Please enter your location to help us display the correct information for your area.

• Autism screening
• What is autism?
• What causes autism
• Early signs of autism
• Signs of autism in adults
• Signs of autism in women and girls
• Autism diagnosis criteria
• Autism severity levels
• Child diagnosis
• Adult diagnosis

There is no medical autism test, like a blood test, to diagnose autism spectrum disorder (ASD). Instead, experienced medical professionals examine a person’s developmental history and behavior, interview and observe the person and their loved ones, and use professional  screening and diagnostic tools  to make a diagnosis.

While an autism diagnosis can only be given by a health care professional, there are several screening tools that can alert parents, caregivers and autistic people to potential autism symptoms. Early screening for autism can impact access to services and supports, which in turn can influence future outcomes for autistic individuals.

The screening tools below are designed to help identify children and adults who might have ASD. This list is not exhaustive and other tests are available.  Please note that a positive result on a screening tool is NOT a diagnosis.  A positive screening result should be followed by a thorough assessment by a health care professional.

Autism screening tools

Modified checklist for autism in toddlers, revised (m-chat-r), for ages 16 to 30 months.

The M-CHAT-R is a free parent-completed questionnaire that will ask a series of 20 questions about your child’s behavior. You can use the results of the screener to discuss any concerns that you may have with your child’s healthcare provider.  Take the 2-minute screening questionnaire.

Take the M-CHAT-R

Social Attention and Communication Surveillance, Revised (SACS-R) and SACS-Preschool (SACS-PR) Tools

For ages 12 to 60 months.

The SACS-R and SACS-PR are autism screening tools developed by La Trobe University and designed to identify behaviors that are characteristic of children on the spectrum from as young as 12 months old through preschool. This tool is meant to be administered by a trained psychologist, early childhood educator, allied health professional or other professional.

Social Challenges Screening Questionnaire (SCSQ)

For school-aged children.

Developed to be taken by parents, educators and medical professionals, Southwest Autism Research & Resource Center’s (SARRC) 15-question Social Challenges Screening Questionnaire can identify children who may have symptoms that were once characterized as Asperger syndrome , now level 1 ASD.

Take the Social Challenges Screening Questionnaire

Autism Spectrum Quotient (AQ) Test

For ages 16+ years.

The Autism Spectrum Quotient Test is a self-administered 50-question questionnaire used to measure autistic traits in adolescents and adults aged 16+. The questionnaire is suitable for people with an IQ over 80.

Take the Autism Spectrum Quotient Test

Need more information or support?

Autism Speaks'  Autism Response Team (ART) can help you with information, resources and opportunities.

• In English:  888-288-4762 |  [email protected]
• En Español:  888-772-9050 |  [email protected]

Find local providers and services in your area with the Autism Speaks Resource Guide .

The 9 Biggest Signs Of Autism In Adulthood

Y ou may have seen videos on social media where people detail the signs that made them realize they’re autistic. Viewers are finding them enlightening and comforting as many people  — mainly women — are undiagnosed as they reach adulthood.

According to Dr. Megan Anna Neff , a clinical psychologist based in Oregon, a recent study found that 80% of women with autism are still undiagnosed at age 18.

There are many reasons for this: For starters, people learn to adjust their behavior to fit in with society. Additionally,the autism diagnostic tools used today were developed exclusively on white boys from high socioeconomic status, said  Stephanie Gardner-Wright , a licensed master social worker and certified autism clinical specialist in Michigan.

There is also a huge focus on the external signs and not so much the internal symptoms of autism, Gardner-Wright said. And those internal symptoms are very different from person to person.

“There are so many ways that autism can show up and present,” Neff added. “I think there’s more diversity within autism than there is between autism and allistic.” (Allistic people are folks who aren’t on the autism spectrum.)

That said,  there are a number of signs or thought patterns that undiagnosed autistic people may be able to relate to.  HuffPost spoke with mental health professionals, including some people who are neurodivergent themselves, about the signs of autism in adulthood:

A Feeling Of Being ‘Different’ From Others

All four experts shared that it’s common for autistic people to feel different. Brandon Tessers , the director of Effective Artistry, a therapy group that supports neurodivergent people, said some folks will describe it as “ feeling like an alien sometimes,” while  Dr. Vanessa Bal , the director of the Center for Adult Autism Services Psychological Services Clinic at Rutgers University in New Jersey said folks describe it as “a  lifetime experience of feeling different.”

The difference between this feeling and the occasional outsider feeling everyone deals with from time to time is that for autistic folks, this feeling does not come and go and is not only during one specific period, like middle school, Bal told HuffPost.

Gardner-Wright added that this is a big indicator and an internal experience at that — you cannot look at a person and know if they feel like an outsider. The feeling could be overpowering or could be more subtle, it depends on the person, she said.

But, it’s important to know that autistic people don’t necessarily feel like outsiders all the time, Bal noted. They may find settings that are more inclusive for neurodivergent people. Additionally, some adults also say they feel more comfortable with who they are and worry less about differences, sometimes seeing them as strengths, as they get older, Bal said.

Difficulty With Social Cues

Social cues are also another sign. Someone with undiagnosed autism may find they have trouble deciphering how much eye contact is appropriate or when they should stop smiling during a conversation, Gardner-Wright said. They may be able to mask these uncertainties by learning how much is appropriate, but it’s not an innate sense as it is with someone who is allistic, she added.

A Confusing Relationship History — Both Romantically Or Platonically

According to Neff, many undiagnosed autistic adults have a confusing and complicated social relationship history. Additionally, romantic relationships may feel tough to navigate.

“There might be relationships that have that kind of suddenly burst apart but the autistic person doesn’t understand why,” she said. When it comes to the reason behind this complicated relationship history, it’s likely that the person with autism doesn’t know why their relationships fail when other people’s don’t.

Sensory Differences

Sensitivity to sensory input — like noise and sight — is another potential sign of autism, said Gardner-Wright, who added that this can mean being hyper-aware of a sound or totally unaware.

People who are not autistic tend to be more or less responsive to sensory stimuli, she said.

For example, an autistic person may find that they’re constantly aware of a ticking clock at a friend’s house or really sensitive to the sound of a loud siren, Gardner-Wright noted.

A Desire For Routine

Many people with autism thrive on consistency. “ The world we occupy is much more uncertain and unpredict able. So we go to routine as a way of self-soothing,” Neff said.  When a routine is disrupted, strong emotions may present, including intense irritability or anxiety.

Gardner-Wright added that the routine doesn’t need to be super strict, either; it’s a common misconception when people think about people with autism’s day-to-day schedule. Instead, it could be a strong preference for a certain mug every morning. Routine looks different for different people.

Additionally, big changes can be hard, too. “If  they move [homes] or they move careers, this could create a season of insomnia or anxiety,” Neff said.

Routine can extend to certain behaviors as well. It also includes repetitive body movements, which is known as stimming, Neff added. According to the Children’s Hospital of Pennsylvania’s Research Institute , stimming behaviors can include body rocking, hand flapping, spinning, rubbing a specific surface and squealing.

A Need For Solitude 

Another common sign? “Needing solitude to recharge after social situations or really overstimulating situations — and overstimulating could be different for everyone — but that is a very typical hallmark of [autism],” Gardner-Wright said.  This could mean feeling totally exhausted after a work presentation or a family party.

Bal said this exhaustion comes from a term known as “camouflaging” or “masking.” “This is the idea that you have to really hide different facets of yourself or different behaviors in order to fit in what you think the expectations around you are.”

And while we all do this at times, the degree that autistic people have to camouflage aspects of themselves may results in a feeling of total drainage where afterward they report spending long periods of time alone or in dark and quiet places to recover, Bal said.

Tessers added that, from the outside, people have no idea when someone is camouflaging. “T hey’re doing what everybody wants or expects of them to some successful degree.” This could look like behaving as you “should” at work but going home and crashing and dreading the idea of having to do this camouflaging all over again tomorrow, Tessers noted.

More Intense Interests

A deep curiosity and passion for one particular activity  or subject can also develop. “Our brains tend to gravitate with a lot of passion towards our area of interest and we become very invested in them and it’s also a way we self-soothe,” Neff said.  This could mean building a career around a specific interest or knowing everything about a specific hobby.

And while everyone has interests — and many people have strong interests — Neff said autistic folks likely find a way to relate everything to their specific interest. For example, this could look like finding a way to talk about a favorite TV show even when the conversation revolves around current events.

“Allistic people can have a special interest but then it doesn’t become their lens for their whole world,” Neff said.

A Dislike Of Small Talk

Most people don’t love small talk, but for people with autism, small talk can feel totally exhausting or something that shouldn’t have to happen.

“They typically don’t enjoy small talk and perhaps found ways to avoid it,” Neff said. “Maybe they structured their life or their career in a way that they don’t have to do a lot of that allistic communication.”

Gardner-Wright added that people who are on the spectrum tend to prefer deep, meaningful conversations.

A Desire For Direct Communication

People with autism thrive on straightforwardness, with  “really honest, clear communication being a strong preference,” Gardner-Wright said.

Neff said autistic people tend to be pretty literal. For example, when you say the phrase “it’s raining cats and dogs,” she said autistic people may picture literal cats and dogs falling from the sky in their mind, but then realize the person speaking is referring to rain.

“So, actually, I think it’s perhaps more precise to say we’re visual in our communication style versus literal, but it often shows up as being literal,” Neff said.  Additionally, the communication style can be described as direct and honest. “W hat we say, we tend to say at face value,” Neff added. 

If you think you have these signs, look to autistic voices for guidance.

Both Gardner-Wright and Neff recommend exploring the hashtag #actuallyaustic  on social media to listen to lived experiences and hear from people in your specific community about how this exists for them.

“Discovering that you’re autistic as an adult can be really validating,” Gardner-Wright said. It can help you more fully understand yourself and your life. “But there can also be a grieving process for that,” she said, where you may wish you had this information when you were a kid so certain situations could have been different.

“Feeling a mix of grief and also excitement is very, very normal,” Gardner-Wright said.

Additionally,  embrace-autism.com  is a helpful resource for free screening tools and tests to help you understand if you are autistic — though it is not diagnostic, they’re simply online guides to help arm you with information, Gardner-Wright noted.

You can reach out to mental health professionals, too.

Neff said it can be helpful to connect with a therapist to talk about this new discovery, but she stressed that it’s important to find one who is neurodivergent-affirming or -informed.

Bal agreed and said “we have a long way to go with respect to training medical professionals and mental health professionals about autism. I worry there’s a lot of misinformation and misconceptions out there.”

Bal added that you can also look up autism centers near you for diagnosis or treatment, but noted that many have a yearslong waitlist and may focus only on children. If they can’t fit you in, Bal said, you can ask if they have resources they recommend, or look for community autism organizations to see if they have any resources.

Additionally, a community of supportive people can be helpful as well, which is where the #actuallyaustic hashtag — or other online communities — can be helpful.

• I'm A Woman Who Was Diagnosed With Autism At 44
• 10 Adult ADHD Signs You May Not Realize Are Actually Symptoms
• 6 Personality Traits That May Secretly Be ADHD

Transforming the understanding and treatment of mental illnesses.

Información en español

Celebrating 75 Years! Learn More >>

• Stakeholder Engagement
• Connect with NIMH
• Digital Shareables
• Science Education
• Upcoming Observances and Related Events

Digital Toolkit for National Autism Acceptance Month

During National Autism Acceptance Month, help the National Institute of Mental Health (NIMH) raise awareness and acceptance about autism spectrum disorder by sharing our informational materials based on the latest research.

Campaign date : April 1-30, 2024

Hashtags : #AutismAcceptanceMonth, #AutismAcceptance, #shareNIMH

Digital shareables:   nimh.nih.gov/shareNIMH/autism

Sample messages

During April, help @NIMHgov increase awareness and acceptance of autism spectrum disorder by sharing information and resources based on the latest research. https://go.nih.gov/AtPorEd  . #shareNIMH #AutismAcceptanceMonth 

ALT text : Health care provider talking with a parent who is holding a toddler with the text “Let’s Talk About Autism.” The link points to nimh.nih.gov/shareNIMH.

Autism occurs in all ethnic, racial, sex and gender, and economic groups. This April, learn more about supporting people on the autism spectrum via @NIMHgov: https://go.nih.gov/GLdoK1Q  . #AutismAcceptanceMonth 

ALT text : Health care provider talking with a parent who is holding a toddler with the text “Autism occurs in all ethnic, racial, sex and gender, and economic groups. This April, learn more about supporting people on the autism spectrum.” The link points to nimh.nih.gov/autism.

Adults on the autism spectrum can benefit from services and supports that improve health and well-being across the lifespan. Visit https://go.nih.gov/GLdoK1Q  to learn more about autism. #AutismAcceptanceMonth 

Alt text : A young adult working on a computer gear with the text “Adults on the autism spectrum can benefit from services and supports that improve health and well-being across the lifespan.” The link points to nimh.nih.gov/autism.

It's recommended that all children should be screened for developmental delays beginning at their 9-month well-child visit and specifically for autism at their 18- and 24-month visits. Learn more at https://go.nih.gov/GLdoK1Q  . #AutismAcceptanceMonth 

ALT text : Health care provider talking with a toddler with the text “It's recommended that all children should be screened for developmental delays beginning at their 9-month well-child visit and specifically for autism at their 18- and 24-month visits.” The link points to nimh.nih.gov/autism. 

Many people are not diagnosed with autism until later childhood or adolescence. To read more about autism identification, visit https://go.nih.gov/GLdoK1Q  . #AutismAcceptanceMonth

ALT text : A   Teenager looking out a window with the text “Many people are not diagnosed with autism until later childhood or adolescence.” The link points to nimh.nih.gov/autism.

Facebook  

During April, help the @National Institute of Mental Health (NIMH) increase awareness and acceptance of autism spectrum disorder by sharing information and resources based on the latest research. https://go.nih.gov/5YKv9kt  . #shareNIMH #AutismAcceptanceMonth 

Autism occurs in all ethnic, racial, sex and gender, and economic groups. This April, learn more about supporting people on the autism spectrum via the @National Institute of Mental Health (NIMH): https://go.nih.gov/aSY2mES  . #AutismAcceptanceMonth

It's recommended that all children should be screened for developmental delays beginning at their 9-month well-child visit and specifically for autism at their 18- and 24-month visits. Learn more at https://go.nih.gov/aSY2mES  . #AutismAcceptanceMonth

Many people are not diagnosed with autism until later childhood or adolescence. To read more about autism identification, visit https://go.nih.gov/aSY2mES  . #AutismAcceptanceMonth 

ALT text : A   Teenager looking out a window with the text “Many people are not diagnosed with autism until later childhood or adolescence.” The link points to nimh.nih.gov/autism. 

Instagram  

During April, help @NIMHgov increase awareness and acceptance of autism spectrum disorder by sharing information and resources based on the latest research. Learn more at nimh.nih.gov/shareNIMH/autism. #shareNIMH #AutismAcceptanceMonth 

Autism occurs in all ethnic, racial, sex and gender, and economic groups. This April, learn more about supporting people on the autism spectrum via @NIMHgov: nimh.nih.gov/autism. #AutismAcceptanceMonth 

Adults on the autism spectrum can benefit from services and supports that improve health and well-being across the lifespan. Visit nimh.nih.gov/autism via @NIMHgov to learn more about autism.  #AutismAcceptanceMonth 

ALT text : A young adult working on a computer gear with the text “Adults on the autism spectrum can benefit from services and supports that improve health and well-being across the lifespan.” The link points to nimh.nih.gov/autism.

It's recommended that all children should be screened for developmental delays beginning at their 9-month well-child visit and specifically for autism at their 18- and 24-month visits. Learn more at nimh.nih.gov/autism via @NIMHgov. #AutismAcceptanceMonth 

Many people are not diagnosed with autism until later childhood or adolescence. To read more about autism identification, visit nimh.nih.gov/autism via @NIMHgov. #AutismAcceptanceMonth  

LinkedIn  

During April, help the @National Institute of Mental Health (NIMH) increase awareness and acceptance of autism spectrum disorder by sharing information and resources based on the latest research. https://go.nih.gov/VO1CCKg  . #shareNIMH #AutismAcceptanceMonth 

Autism occurs in all ethnic, racial, sex and gender, and economic groups. This April, learn more about supporting people on the autism spectrum via the @National Institute of Mental Health (NIMH): https://go.nih.gov/qnjCz9N  . #AutismAcceptanceMonth

Adults on the autism spectrum can benefit from services and supports that improve health and well-being across the lifespan. Visit https://go.nih.gov/qnjCz9N  to learn more about autism. #AutismAcceptanceMonth 

Email Content  

Subject: Let's Talk About Autism

During National Autism Acceptance Month in April, help the National Institute of Mental Health (NIMH) increase awareness and acceptance of autism spectrum disorder (ASD) by  sharing information and resources based on the latest research . 

To learn more about the signs of ASD, diagnosis in different age groups, available interventions, and additional resources, visit NIMH’s  health topic page  or download NIMH’s  brochure .