ATLANTA — Natasha Nelson, a 35-year-old business owner from Stone Mountain, Georgia, struggled to grasp certain societal norms. She often questioned why people opted for small talk rather than meaningful discussions when meeting someone for the first time, or why making the bed was a common practice. However, a few years back, she received an autism diagnosis, coinciding with her youngest daughter’s diagnosis.
“If your life has always felt chaotic and you don’t find comfort or a sense of thriving, but rather feel as though you are merely surviving, then what do you have to lose?” Nelson remarked, urging others to pursue a diagnosis.
Identifying signs of autism in adults might be challenging, especially if you didn’t experience noticeable indicators during childhood. Symptoms often include difficulties in social communication, a strong attraction to specific routines or topics—Nelson mentions that “people have become my special interest now”—and these traits can evade detection for years. Obtaining an autism diagnosis later in life can prove to be expensive and complicated, particularly due to a deficit of medical professionals adept at addressing adult cases.
Autism spectrum disorder encompasses a variety of intellectual, social, and communicative challenges. Common characteristics include strict adherence to routines, fixated interests, and difficulties with nonverbal communication, such as maintaining eye contact. Traditionally, autism evaluations are conducted during childhood, with pediatricians recommending screenings starting at 18 months of age.
In recent years, there has been a marked increase in adults seeking diagnoses related to autism, with many prompted by their children’s diagnoses or exposure to information shared on social media. A study published last year detailed a staggering 452% rise in autism diagnoses among adults aged 26 to 34 from 2011 to 2022.
Some traits associated with autism can remain unnoticed until adulthood when social expectations become heightened. Others may have developed coping mechanisms to mask their behaviors in public settings, leading to the phenomenon known as masking. Whitney Ence, a psychologist at the University of California, San Francisco, states, “Adults have learned to compensate over time. They may feel they have to hide certain behaviors when they are around others.”
Complications can arise in the diagnostic process, as disorders like ADHD and OCD share overlapping symptoms with autism. This can create difficulties concerning the interpretation of nonverbal cues and executive functioning.
Symptoms of autism can manifest in diverse ways, with several traits being commonplace in individuals not diagnosed with autism. For instance, enjoying routines or deep dives into specific subjects is a shared trait among many. However, to qualify for an autism diagnosis, the symptoms must lead to significant impairment in daily life. Dr. Arthur Westover, a psychiatrist specializing in autism at the University of Texas Southwestern Medical Center, emphasizes, “Having a fondness for routines doesn’t automatically mean you’re autistic. It goes deeper than enjoyment.”
Russell Lehmann, a motivational speaker who has lived with autism for over 20 years, describes his routines as both comforting and overwhelming. He finds solace in maintaining consistent eating habits and shopping patterns, but skipping his gym sessions leaves him feeling anxious and depressed. “If I don’t go to the gym, then I struggle with my day,” he explained. “The pressure to adhere to a routine that I find burdensome can sometimes be existential.”
Navigating the diagnosis process can be complicated. Experts suggest opting for a conversation with a primary care physician for a potential referral to a psychiatrist. A specialist may conduct interviews with family and friends who knew you as a child to document symptoms that were present early on. Diagnosing autism isn’t streamlined through brain scans or blood tests but relies on clinical assessments.
Seeking an autism diagnosis as an adult may entail considerable costs and lengthy waits, as there is a significant shortage of professionals available to assist this demographic. Nelson, for example, waited three years before receiving her diagnosis, with expenses surpassing $3,000 out-of-pocket. Ence further advises prospective patients to reflect on their motivations for seeking a formal diagnosis: “Ask yourself what factors are prompting this pursuit. Do you need access to specific services that are currently unavailable?”
