In today’s world, most articles and most stories written about Autism Spectrum Disorder are written about children. While it is true that symptoms of autism appear first in early childhood, before the age of 3 mostly, however, autism is not a pediatric disorder. Instead, it is a neurodevelopmental disorder and it is a lifelong condition that can make the adult years very challenging.
You might be wondering if it is possible to have autism as an adult. Maybe you read something about autism or you watched a program on television. It is true that people live without a diagnosis of autism, they do not need to be fully diagnosed. While many people experience difficulties, they learn to cope with life through their own efforts. They can be married or live with a partner, have families, or have a successful career. Or others may choose to be alone.
It means if a person suspects about themselves or people around them suspect about there is something wrong with that person, they should go to see a professional. Because individuals might get diagnose even after infancy and childhood period.
In this article, I will mention about Autism Spectrum Disorder in adults in general, and then in more detail. After general clarification, I will try to explain how to get diagnosed, what the causes are, and what kind of treatments should be used for adults with autism.
Symptoms of Autism Spectrum Disorder in Adults
Autism is a disorder that actually spread over a very diverse range and has different types. While autism can be diagnosed at very young ages, mostly in toddlers, some types of autism are also observed in adults.
Generally, in the 3 three years of life, the symptoms of autism appear. Early diagnosis is very important for effective treatment. Autism symptoms in adults are similar to those observed in children. However, it can be a confusing process to understand whether the behaviors are autism-related, as they are somehow adapted to adult life.
There is a 22 years old girl who is a performing artist. While she was talking about her childhood, she said that she thought she was an alien. It sounds stupid, but that was the only thing her mind could understand.
People thought she was deaf when she was a baby. But she was not deaf, she just was not paying attention. As a toddler, she always felt like thinking logically and the other kids were just careless according to her.
She was very badly bullied at school. Now, she thinks that people saw her as an easy target and that ruined her. She has always felt that there was some kind of mental retardation or a sort of learning difficulties when she was at school.
When she got her teaching certificate from the university, she decided she needed to find some kind of diagnosis. She knows that there is something wrong with her. She was thinking about finding out what happened to her.
After 22 years of life period with lots of stress and anger, her psychologist said she has Autism Spectrum Disorder. She was 22 when she was finally diagnosed.
The most severe symptom seen in adults is that they cannot perform their daily tasks and activities. This often leads to the need to have cared for someone. Some adults with autism can live with their families at the same house. Some individuals can live together with other people with autism in controlled homes.
Most adults with autism are not inclined to engage in social interaction because they have difficulty in creating and maintaining a task. One of the most important symptoms is that they have a lack of empathy. This causes us to perceive individuals with autism as cold. However, it is useful to remind that this is a sign of autism.
It is also observed that most adults with autism have an obsession with an object or a situation, as children with autism do. When this pattern is altered or impaired, an individual with autism may be upset or irritable.
Asperger syndrome, another form of Autism Spectrum Disorder, can be diagnosed at school-age periods or in adolescence. The symptoms are much less obvious. Asperger syndrome is a life-long condition, but progress is also possible. Adults with Asperger’s symptoms could be more successful in developing their abilities. They can also improve themselves to be more aware of social cues such as body language and gestures.
Adults with Asperger syndrome may not tend to prefer to live alone. Most of them get married and have children. Contrary to being distracted easily in autism, individuals with Asperger syndrome can be focused for a long time and are very careful about details.
The longer focus times and attention to detail can help them achieve a very successful career. They even have a great tendency to progress on difficult topics such as engineering, science, and technology. Early diagnosis for autism is very important for the treatment of autism. Thus, further, development can be achieved more easily.
Autism Spectrum Disorder is a life-long condition, though early diagnosis and treatment can make a huge difference. There are some common symptoms of autism in adults. For example;
- They have difficulties to interpret what others thinking or feeling
- They have incapability of empathy
- They have difficulties regulating their emotion
- They have troubles keeping up a conversation, mostly back-and-forth conversation.
- They have mostly inflection which does not reflect their feelings.
- They have a proneness to monologues on a favorite subject, want to talk about their favorite subject non-stop.
- They use flat, monotone, or robotic speaking patterns that don’t communicate what they are feeling.
- They invent their own descriptive words and phrases.
- They find it difficult to understand figures of speech and turns of phrase.
- They do not like to look at someone’s eyes when talking to them.
- They talk in the same patterns and tone whether they are at home, with friends, or at work.
- They have a tendency to engage in repetitive behaviors.
- They may be obsessed with routine activities.
- They only participate in a restricted range of activities.
- They are strictly consistent with daily routines.
- They may have outbursts when changes occur in their daily routines.
- When something unexpected happens, they respond with an emotional meltdown.
- They may have deep knowledge of one particular topic such as a specific branch of history or science.
- They have an extreme interest in particular topics and this may border on obsession.
- They make noises in places where quiet is expected.
- They feel like they are clumsy and have difficulty with coordination.
- They prefer to work and play for themselves, rather than with others.
- Other people perceive them as eccentric or an academic.
Obviously, some of these symptoms are shared with other conditions, including dementia, Alzheimer’s disease, attention deficit hyperactivity disorder, and many other mental disorders. When trying to determine the cause of behaviors, it is essential to consider whether behaviors are new or have always been present but might be exacerbated by recent experiences.
If the person is curious about the potential of autism in himself/ herself, a partner, parent, sibling, or a loved one, it can help to start with own research, but that person definitely wants to consult a doctor about concerns.
Misdiagnosed Symptoms of Autism Spectrum Disorder in Adults
Before diagnosis, many adults are misdiagnosed with a variety of conditions. Though it is true that people may show the same symptoms at the same time, it is a high probability of comorbidity, these diagnoses are not always relevant or helpful, as many symptoms are better explained by the diagnosis of ASD. There are some symptoms of that disorder commonly or mistakenly attributed to other conditions or disorders. For example;
- They have difficulties with social interactions and communication, which is one hallmark symptom of autism, might be attributed to shyness, social anxiety disorder or avoidant personality disorder.
- Individuals with autism, especially in their adolescence or adulthood period, are 5 times more likely to be picky eaters with narrow food preferences and more likely to have ritualistic eating behaviors. These preferences may be attributed to an eating disorder.
- Adults with autism might have a hard time in order to connect and relate to other people or they can find it difficult to see things and events from another person’s perspective which means they may have incapability of empathy. This characteristic may be misconstrued as a personality disorder.
- Exhibiting repetitive or ritualistic behaviors, such as rocking back and forth and eating only certain foods, are the main symptoms of autism. However, if these symptoms are observed in adults, it might be seen as a symptom of obsessive-compulsive disorder (OCD). Sometimes these ritualistic behaviors, especially when occurs in public, are seen as eccentric or awkward. Moreover, the person with autism may be mislabeled as schizophrenic.
- Because of having difficulties with self-expression both verbally and nonverbally and having difficulties with quick processing and understanding what other people are saying, adults with autism can be misdiagnosed as a language-based learning disability.
- Some people with autism have a strong preference for being alone, especially when become adults, this preference is getting stronger. They may find social interactions draining and spend time pursuing solitary activities. Moreover, they may have difficulties with social interactions and that is why they can find it easier to be alone. However, many people and professionals do not understand the preference for staying alone and see it as a mood disorder instead of autism.
- When adults with autism become irritable of tense during transitions or if there is a change in daily routines, they may be misdiagnosed as a generalized anxiety disorder.
- Autism spectrum Disorder and Attention- Deficit Hyperactivity Disorder (ADHD) share plenty of symptoms. For example problems with executive functioning, hyperactivity, and impulsiveness. Time to time, individuals with autism are misdiagnosed with attention- deficit hyperactivity disorder.
- Hypersensitivity is one of the common features of autism. When adults with autism are hypersensitive, for example refusing to eat certain foods because of the texture, becoming irritable in high stimulus conditions or bristling when touched, these behaviors could be misdiagnosed as a sensory processing disorder.
- Adults with autism might continue to have problems to manage their emotions, as in their childhood or adolescence period. They may have a sudden outburst of anger, have aggression or become withdrawn when overwhelmed. In common sense, these emotional reactions are normal for those with autism. However, for adults who did not get diagnosed with autism, these reactions might be seen as psychosis, borderline personality disorder or another mental disorder. Outside of a medical diagnosis, there behaviors and reactions might also be misinterpreted as selfishness or immaturity.
Autism Spectrum Disorder symptoms can vary from mild to severe. It is diagnosed based on behaviors. Each individual experiences symptoms differently. Because of this reason, it is difficult to diagnose in adults. On the other hand, many professionals are familiar with autism symptoms in children, that is another reason in order to get diagnosed in adulthood.
There was a teacher who did not have real friends or if she called a friend, they were people working together or met online. She did not like people coming to her house. On the contrary, her husband was very friendly and extrovert. And she has 2 children with autism. Her daughter got diagnosed at 15 and her son got diagnosed at 4 years old.
She read about Asperger when she taught a child with autism at school. She realized that they had something similar to what happened in her son. The child in the book was reprimanded at school and staring at another – not looking at people. The teachers did not think he was listening, but he listened to them all.
She felt synonymous with him in time. She really understands his thoughts and thought that maybe she has Asperger syndrome too. She was misinterpreting things in primary school. she was making mistakes for not able to understand. She really sinks like a stone.
That is the time when she decided to do an autism assessment. The diagnosis was made in 2012 and she was relieved because she thought there is nothing wrong with her, she has only autism. Since then, she has been able to understand why she has difficulties in social issues and why she was not able to make friends. she started accepting herself as she was because she hadn’t done that until then.
In addition to those, misdiagnosed cases are more common among women with Autism Spectrum Disorder. There is an inability to diagnose women with autism. Autism symptoms cannot be detected in women as early as men. And after a certain age, parents do not care about even they observe the symptoms with their daughters.
Diagnosis Autism Spectrum Disorder in Adults
It could be hard to find a service or professional with experience of diagnosing autism spectrum disorder in adults. Also, there are currently no standard diagnostic criteria for adults with suspected ASD, but they are in development.
If the person is suspected of autism, they should begin with the family doctor which is a general practitioner. That professional can evaluate the person and underlying at least where there are physical illnesses accounting for behaviors, if there is any organic-based disorder. The doctor may then refer that person to a psychiatrist or psychologist for an in-depth assessment.
The formal identification of Autism Spectrum Disorder which is diagnosis is best made by a multidisciplinary diagnostic team. Some professionals accept self-referrals. But in general, they need a referral from a general practitioner. General practitioner (GP) is a doctor based in the community who treats patients with minor or chronic illnesses and refers to those with serious conditions to a hospital. Also, if those adults are seeing different health professionals for other reasons, they should ask them for a referral instead.
Firstly, if there is a suspicion about having autism, that person or family members of that person should speak to the general practitioner. These adults make sure that their own diagnosis about autism is the only thing they are seeing general practitioners about. If they mention autism-related symptoms during a consultation about other disabilities, the general practitioner may be confused about addressing it fully.
Secondly, a person who has suspicion should present a case to the general practitioner. Because GP needs a reason in order to refer to that person for diagnosis. So he/she has to explain why thinking that having autism and how a diagnosis would benefit him/her. If the person thinks that he/she needs or wants help with this, he/she should ask someone in order to come with him/her.
While explaining the person who has a suspicion about having autism’s situations, he/she could clarify everything experiences or difficulties people on the autism spectrum can face. He/she would like to see a formal assessment to be certain. For clarification, also that person should GP some examples of difficulties and problems.
These examples could be related to communication, social interaction, sensory difficulties, friendship, need for and insistent on routine both in childhood period and adulthood period. Moreover, this person should tell how much he/she thinks these affect the different areas of life.
Besides a person with autism’s responsibilities, there are some responsibilities belong to the general practitioner. Not all GPs have a deep knowledge of autism spectrum disorder, so it is important to explain things clearly. Because GP will diagnose in order to take proper treatment and it is an important and vital decision for someone’s life quality.
Thirdly, after GP agrees to refer that person, the person with autism should tell about local services that have experience of diagnosis of autism spectrum disorder in adults. That individual can take a referral from a psychiatrist, clinical psychologist, or related professional. This will mean that person more likely to be accurately assessed and it will lead the person to have proper treatment and support.
Fourthly, for diagnostic assessment, the person with autism should go to see a doctor with a parent or siblings. Because they may give important information about the childhood period which he/she does not remember. There is no need for physical examination and samples such as blood. Diagnostic tools will be used instead. The tool involves a series of questions about developmental history mostly.
Fifthly, when the person learns whether he/she has autism or not, what would be the next step? If the person could not get autism diagnosis and is not happy with this result, he/she can go another practitioner for second opinion org o other professionals for another possibility of having different mental disorders.
If a person gets diagnosed, they will have lots of questions. In order to get answers, the person needs to meet other people on the spectrum and needs to get help from autism support services. Because support after diagnosis is very important. On the other hand, it doesn’t mean that everyone has to feel in same way. Everyone may not feel they need further support. For some people, simply getting a diagnosis seems to be enough.
Treatment for Adults with Autism Spectrum Disorder
Adults don’t follow the same steps as children do in treatments. Adults with autism mostly can be treated with cognitive, verbal, and applied behavioral therapy. More often than that, those people will need to seek out specific treatments based on the challenges they are experiencing. These challenges could be anxiety, social isolation, problems in relationships, and communication or job difficulties.
There are some methods using for treatments. For example;
- They can see an experienced psychiatrist in autism and autism-related treatment for medical evaluation.
- They can need consultation from a social worker or psychologist for the group and individual therapy.
- They can get counseling on and support for an ongoing basis.
- They can get vocational rehabilitation for job-related difficulties and challenges.
- They can take prescription medication for symptoms which are results of autism such as anxiety, depression, and behavioral issues that may occur alongside autism.
- They can found support through online groups and forums, as well as by connecting in person with other adults with autism.