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8 signs of autism in adults

Autism sometimes goes undiagnosed until a person is an adult. Here are eight signs of possible adult autism.

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Nov 1, 2021 PUBLISHED

Autism Spectrum Disorder (ASD) is, according to the American Psychological Association (APA), “a neurodevelopmental disorder that is characterized by difficulties with social communication and social interaction and restricted and repetitive patterns in behaviors, interests, and activities.” 

ASD develops in early childhood and affects daily life. The Centers for Disease Control and Prevention (CDC) estimated in 2017 that 2.21% of adults in the United States have ASD, with men four times more likely to be diagnosed with ASD than women. 

ASD is a spectrum disorder, so presenting symptoms and their severity will vary depending on the individual, meaning that ASD looks different in everyone. Both psychologists and psychiatrists can make ASD diagnoses. An ASD diagnosis can help an adult better understand themselves and be the first step in treatment.

If the symptoms listed below resonate with you, consider speaking with a medical professional who has experience diagnosing and treating individuals with ASD. 

1. Difficulty maintaining eye contact

People on the ASD spectrum may avoid eye contact because it can cause them stress or pain. This goes beyond not meeting a stranger’s gaze; adults on the ASD spectrum consistently struggle to make or maintain eye contact even with people they are comfortable around, including family, friends, and coworkers. 

The lack of eye contact doesn’t mean there’s a lack of interest. Adults on the ASD spectrum may experience high levels of stimulation in their brain when making eye contact with others, so avoiding eye contact is a way of avoiding anxiety or physical discomfort.  

2. Difficulty picking up on small social cues

Deciphering nonverbal, subtle social cues can be hard for adults on the ASD spectrum, so they often feel lost in conversation. Adults on the ASD spectrum typically may interpret nonverbal communication such as facial expressions, eye-rolling, and hand gestures differently than neurotypical people.

3. Struggle to empathize

Individuals on the ASD spectrum are often mistakenly seen as apathetic because ASD may interfere with an individual's ability to accurately interpret social cues that allow a neurotypical person to more easily infer what others are thinking or feeling. 

This means that for individuals on the ASD spectrum, providing an “appropriate” emotional response or looking at things from someone else’s perspective can be challenging. People on the ASD spectrum tend to listen and use words literally as opposed to using inference and accounting for the entire context of a conversation. 

4. Struggle to hold back and forth conversations 

In addition to struggling with nonverbal communication, the “art of conversation” is often a difficulty for adults on the ASD spectrum. This can exhibit as dominating a conversation by rambling, rather than a more typical back-and-forth.

5. Repeated physical behaviors

Engaging in certain physical motions repetitively can relieve stress or anxiety for an adult on the ASD spectrum. This is called self-stimulating, or “stimming,” and people throughout the neurotypical spectrum do it. The difference is that adults on the ASD spectrum may have more visible/obvious ways of stimming: Instead of drumming their fingers on a table, a person with autism may rock back and forth or flap their hands.

A Monarch by SimplePractice illustration of a pair of brown eyes.

6. Strict adherence to a routine (and outbursts when it’s disrupted)

ASD can manifest in a strict dependence on daily routines. Individuals on the ASD spectrum may become angry or upset when any detail of their day—whether it be a misplaced item or canceled activity—is changed. Stringent routines have some overlap with Obsessive-Compulsive Disorder (OCD) tendencies, though ASD and OCD are two separate things. Doctors still have a lot of research to do on the overlap between the two disorders, but it’s thought that 17% of individuals on the ASD spectrum also have OCD. A significant difference between ASD and OCD tendencies is that people suffering from OCD have a need to do a specific task, whereas people on the ASD spectrum are more soothed by repetition than the specific task. 

7. Laser focus on details and facts

Some people on the ASD spectrum have trouble organizing details and inferring the big picture from facts or smaller pieces of information. It’s easier for them to pay attention to every small detail individually, so adults on the ASD spectrum may have a hard time categorizing and prioritizing information or applying information from one setting to another. For example, people on the ASD spectrum may remember and understand the facts of an article they read, but not be able to identify the main idea or theme of the article if it is not explicitly stated. 

8. Sensitivity (or lack thereof) to sounds, textures, light

People on the ASD spectrum sometimes process sense stimulants—things we hear/see/touch, etc.—with different intensity than neurotypical people. They may have an extreme reaction—or no reaction at all—to sensory stimulants like loud sounds, bright lights, or pain.

The symptoms listed above are not an exhaustive list, and an ASD diagnosis must be made by a licensed medical professional. For some adults, an ASD diagnosis can provide comfort, relief, and a clearer path forward.

There are support groups, social groups, and programs that can help individuals on the ASD spectrum find a job or housing. There is no cure for ASD,  but some treatments, like applied behavioral analysis, cognitive behavioral therapy, or certain medications can help manage symptoms. Every individual’s treatment plan is unique, but an ASD diagnosis can help guide the way for adults looking for medical support. For more information on treatment, support programs, and ASD diagnoses, check out the resources below.

Article originally published Nov 1, 2021.

Autism and Autism Spectrum Disorders. (2014). Autism and Autism Spectrum Disorders. Retrieved from https://www.apa.org website: https://www.apa.org/topics/autism-spectrum-disorder 

Autistic Self Advocacy Network. (2021). About Autism. Retrieved January 4, 2021, from Autistic Self Advocacy Network website: https://autisticadvocacy.org/about-asan/about-autism/

CDC. (2020, June 29). Diagnostic Criteria. Retrieved from: https://www.cdc.gov/ncbddd/autism/hcp-dsm.html

Massachusetts General Hospital. "Why do those with autism avoid eye contact? Imaging studies reveal overactivation of subcortical brain structures in response to direct gaze." (2017) ScienceDaily. www.sciencedaily.com/releases/2017/06/170615213252.htm

Why Do Autistics Have Issues with Social Skills? (2017, August 8). Retrieved from: https://www.appliedbehavioranalysisedu.org/why-do-autistics-have-issues-with-social-skills/

Marchetti A, Miraglia L, Di Dio C. Toward a socio-material approach to cognitive empathy in autistic spectrum disorder. Front Psychol. 2020;10:2965. doi:10.3389/fpsyg.2019.02965

Ryan, G., Brady, S., Holloway, J., & Lydon, H. (2018). Increasing appropriate conversation skills using a behavioral skills training package for adults with intellectual disability and autism spectrum disorder. Journal of Intellectual Disabilities. https://doi.org/10.1177/1744629517750744

van Steensel, F. J. A., Bögels, S. M., & Perrin, S. (2011). Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis. Clinical Child and Family Psychology Review, 14(3), 302–317. https://doi.org/10.1007/s10567-011-0097-0

‌Autism and Autism Spectrum Disorders. (2014). Autism and Autism Spectrum Disorders. Retrieved from https://www.apa.org/topics/autism/index.html

Asperger Profiles: The Big Picture-Challenges – The Asperger / Autism Network (AANE). (2016, July 22). Retrieved from: https://www.aane.org/asperger-profile-big-picture-challenges/

Yuhas,Spectrum, D. (2019, February 28). Untangling the Ties between Autism and Obsessive-Compulsive Disorder. Retrieved from Scientific American website:https://www.scientificamerican.com/article/untangling-the-ties-between-autism-and-obsessive-compulsive-disorder1/

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