What is adult autism?

Adult autism refers to autism that is diagnosed in adulthood. You might hear clinicians describe autism as a neurodevelopmental condition, meaning it is present from birth and persists throughout life. I prefer to think of autism as a divergent neurotype. While autistic individuals are all different, they share common characteristics. These include differences in social experiences and behaviours. It is important to note that autism is not a mental illness, although individuals with autism may have mental health needs.

Autism is the term currently preferred by the majority of autistic individuals. However, diagnostic manuals often use "Autism Spectrum Disorder" (ASD). Some prefer the term "Autism Spectrum Condition" (ASC) to avoid framing autism as a disorder. Previously, terms like "Asperger Syndrome" and "High Functioning Autism” were used. You're encouraged to use whichever language you feel most comfortable with.

How common is autism?

Autism is estimated to affect 1 in 100 people, making it a relatively common neurotype. Both males and females can be autistic, but the prevalence is higher in males. However, there is growing recognition that autistic females may present differently, which highlights the importance of understanding and recognising autism across all genders.

What are the signs of adult autism?

Signs of autism include:

• Differences navigating conversations

• Challenges articulating feelings to others (“alexithymia”)

• Preference for literal language

• Preference to rely on scripted language in social interactions

• Differences in eye contact, gesturing, or facial expressions

• Engaging in masking behaviours to fit in, leading to exhaustion and burnout

• Unique experiences with friendships and relationships, including when initiating or maintaining them

• Engagement in stimming movements (e.g., rocking, spinning, tip-toeing, flapping)

• Strong distress in response to unexpected changes

• Preference for routines and rituals

• Specific rules around food and eating

• Intense focus on passions, often spending significant time thinking about, talking about, or engaging in them

• Sensory sensitivities, such as discomfort with loud noises, bright lights, certain textures, and variations in pain or temperature.
  

How do you diagnose adult autism?

Diagnosing autism involves a clinical judgment made by a qualified and experienced psychiatrist, psychologist, or other professional. The gold standard for diagnosis is an in-person assessment. There are no specific diagnostic tests for autism. Established tools like the Autism Diagnostic Observation Schedule (ADOS) are used to observe behaviour and gather information. Therefore, it's crucial to be assessed by a clinician who can accurately interpret your presentation.

In adults, a key component of the diagnostic process is a thorough clinical interview, which involves a structured exploration of your life experiences. These experiences are then compared against the official diagnostic criteria outlined in either the DSM-5 or ICD-11. Possible outcomes of the assessment include:

• A new diagnosis of autism

• Displaying some features but not meeting the full criteria for autism

• Identifying another explanation for your differences

An adult autism assessment should also be "neuroaffirmative," meaning it acknowledges and celebrates your strengths alongside your differences. Your assessor should inquire about your preferred communication methods, respect your chosen terminology and gender identity, and accommodate any adjustments you may require throughout the assessment process.

Is it worth having an adult autism assessment?

There are numerous reasons why seeking an adult autism assessment can be beneficial. Often, individuals either recognise or have been informed that they exhibit certain characteristics and seek clarity to understand and validate their experiences. A diagnosis of autism can be empowering, providing a sense of identity and improving self-esteem. Additionally, many find that increased understanding can enhance their relationships with close individuals.

For some an autism diagnosis is essential for accessing appropriate support or "reasonable adjustments" at universities or in workplaces, in accordance with the Equality Act 2010 and Autism Act 2009. An official diagnosis can better enable healthcare professionals to address both physical and mental health needs throughout your lifespan.