Autism spectrum disorder (ASD), or autism, is a developmental disability that can present with a variety of symptoms. It typically affects social skills and communication. While many of the clinical signs of autism in adults are similar to those in children, some adults may mask their symptoms socially. This can make it more difficult to be diagnosed as an adult.
Many adults with autism find it challenging to relate to and communicate with others in a way that is considered “typical” in society. Symptoms related to social interactions and relationships may include:
- Difficulty with friendships
- Difficulty reading social cues, such as facial expressions or tone of voice
- Challenges expressing emotions
- Speaking in a “flat” tone
- Difficulty listening to others
- Lack of eye contact
- Social anxiety
- Trouble understanding social norms or nonverbal communication
- Taking words and phrases literally (for example, not understanding sarcasm)
Adults with autism often have repetitive or restricted behaviors that can affect their physical movements, speech, interests, and daily routines. These may include:
- Being more interested in objects than people
- Difficulty shifting focus
- Echolalia (repeating words or phrases)
- Following a strict routine and feeling stressed by change
- Limited, narrow, or obsessive interests
- Repetitive movements (sometimes called “stimming”), such as flapping hands and rocking back and forth
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:
- Avoiding physical touch
- Hypo- or hypersensitivity to stimuli such as lights or sounds
- Hypersensitivity to or strong dislike of certain foods
- Eating only certain foods
- Being overstimulated by lights, crowds, and noise
- Feeling less or more startled than usual by noises
- Low or high pain tolerance
- Sensitivity to heat and/or cold
Other challenges associated with ASD may include:
- Cognitive challenges, including learning disabilities, difficulty concentrating, and difficulty imagining
- Emotional challenges, including high fear/anxiety or fearlessness, unusual moods, and irritability
- Gastrointestinal problems
- Difficulty sleeping
- Hyperactivity
- Impulsivity
Note: Up to 30% of autistic children will develop epilepsy, a seizure disorder, at some point during their lifetime.
Diagnosing autism in adults can be extra challenging because some adults, consciously or not, may “mask” or camouflage their symptoms in social situations. This coping mechanism can help adults with autism to “fit in.”
However, it can be emotionally and physically draining to act in ways that feel uncomfortable. For example, a person may look people in the eye during a conversation despite an aversion to doing so. Research indicates that masking can be harmful to a person’s mental health.
Signs of autism usually appear before the age of two. Children are often screened for autism by a pediatrician. However, many people aren’t diagnosed until much later.
You can’t determine whether you are autistic without an assessment from a healthcare provider. Getting a diagnosis can help you advocate for yourself. Many resources are available, from peer support groups to treatment options.
Reaching out to a healthcare provider may help if your symptoms cause distress or negatively affect your quality of life. These symptoms may include:
- Becoming extremely distressed if your daily routine changes
- Difficulty reading, understanding, and/or responding to social and emotional cues
- Challenges communicating in ways that others understand
- Feeling overstimulated by sensory input, such as loud noises or bright lights
- Difficulty making and keeping friends
- Intense focus on specific interests
