Natasha Nelson, a 35-year old entrepreneur in Stone Mountain, in the US state of Georgia, does not have an innate sense of social norms. She did not know why people meeting for the first time would choose to engage in small talk instead of deep conversations, or why people like to make their beds.
Then, a few years ago, she was diagnosed with autism , just after her youngest daughter received the same diagnosis.
"If your entire life seems disorganized and chaotic, leaving you feeling uncomfortable and unfulfilled—like you’re merely enduring each day without truly thriving—what do you really have to lose?" asks Nelson, urging individuals in this situation to consider getting diagnosed.
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Typical indicators of autism involve difficulties in social communication and an intense focus on specific habits or subjects—Nelson mentions “individuals have turned into my particular fascination nowadays”—and these might not be easily spotted during early years.
But it can be costly and difficult to obtain an autism diagnosis later in life due to a shortage of medical professionals trained to work specifically with adults.
Here is more information on what you should know about adult autism diagnoses.
What is autism and when is it usually diagnosed?
Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn and behave. It presents in different ways, including rigidly following routines, having fixed or obsessive interests, having diverse sensory responses, and struggling to hold eye contact or understand non-verbal communication.
Autism is typically diagnosed during childhood The American Academy of Pediatrics suggests that all children undergo screening starting at 18 months.
What explains the rise in adult diagnoses of autism?
A greater number of grown-ups have pursued understanding about themselves. neurodiversity Over the last ten years—frequently following their children’s diagnosis or upon encountering social media posts—a study released in 2024 in JAMA Network Open highlighted a dramatic 452 percent rise in autism spectrum disorder (ASD) cases among adults between 26 and 34 years old from 2011 to 2022.
Certain characteristics might remain hidden until one reaches adulthood, particularly when faced with fresh social expectations. Others could have acquired skills to conceal particular behaviors, a phenomenon referred to as masking.
"As individuals mature, they develop coping mechanisms,” explains Whitney Ence, a psychologist at the University of California San Francisco specializing in adult autism. “They might realize ‘It’s not appropriate for me to show this publicly, so I engage in those behaviors privately.’”
There is also an overlap of symptoms between various disorders such as attention deficit hyperactivity disorder (ADHD ) and obsessive compulsive disorder (OCD Those factors can make diagnosing autism more complex, because of comparable challenges with understanding unspoken social signals or managing tasks related to executive functioning such as maintaining focus, retaining information, and resolving issues.
What are the signs of autism in grown-ups?
Symptoms can vary greatly from person to person. Many characteristics are also commonly found in individuals who do not have autism, such as appreciating structured activities or delving deeply into detailed topics.
According to Dr. Arthur Westover, a psychiatrist specializing in autism at the University of Texas Southwestern Medical Center, for an individual to be diagnosed with autism, their symptoms must lead to considerable functional challenges.
As humans, we typically enjoy routines... finding joy and comfort in them doesn’t imply you have autism," Westover states. "There’s more to it than that.
Russell Lehmann, who is 34 years old, has been living with ASD for over two decades and shared the highs and lows of his experience in his book. On the Outside Looking In: My Life on the Autism Spectrum . A motivational speaker, he has routines that he describes as both comfortable and stressful.
Eating the same food and buying the same groceries brings him comfort, he says. But if he skips going to the gym for an hour and a half every day, he becomes overwhelmed with feelings of depression and failure.
"It's like no gym, no day," he says. "My routine is an incredibly existential burden, because every night I go to bed knowing I have to do a routine I do not like simply to function."
How does a diagnosis work?
There are various online screening tools, but autism is a complex diagnosis, so experts recommend talking to your doctor for a psychiatry referral.
A psychiatrist might want to interview people who were present in your early childhood, like family and friends, who can attest to symptoms being present at that time.
Some psychiatrists may refer you to a psychologist, who can give you a standard diagnostic autism test or use their own clinical judgment. There is no brain scan or blood test for autism.
Getting an autism diagnosis as an adult can be costly and take time. Westover says there is a major shortage of specialists who work with autistic adults. Nelson's diagnosis took three years and she paid more than US$3,000 (HK$23,000).
In Hong Kong, amid a shortage of mental health professionals and a long wait for services in the public sector, local Non-governmental organizations have intervened to provide free or affordable services. , and assist in locating the required resources.
Ence recommends asking yourself several questions before opting for a professional evaluation, and being aware that you might encounter a waitlist.
"What is guiding me towards considering whether I require a professional evaluation? Is it necessary for me to have access to certain services? Could there be services unavailable to me?" she implies.
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