Signs of Autism in Adults

Introduction

Although autism is a lifelong condition, the signs of autism are not always picked up in infancy and childhood. It is not uncommon for autism to be first diagnosed in adulthood, often after a lifetime of finding day-to-day tasks daunting or overwhelming.

Autistic adults show differences in two core areas:

  • Social communication and interaction, and
  • Restricted/repetitive patterns (which can include sensory differences)

These differences can be subtle, and other people may not be aware of them, especially if you’ve spent years coping, compensating, or masking

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What is autism?

Autism is a lifelong neurodevelopmental difference that affects how a person communicates, relates to others, and experiences the world.

This page explains common signs of autism in adults, including high-masking presentations, and what to do if you recognise yourself in the descriptions.

This page outlines traits and common experiences of autistic people; it is not a diagnostic tool.

Signs of autism in adults and common experiences

Signs of autism can look different depending on a child’s age, personality, and environment. Below, we outline common signs grouped by age at which children are often first recognised as autistic.

Social interaction difficulties

Many autistic adults feel that social interaction is hard work and something that they have to put a lot of mental effort into, especially when interacting with less familiar people.

You might notice that you:

  • Have always felt ‘on the outside’ of social groups, or feel you have never fitted in
  • Feel anxious about or avoid social situations, especially with unfamiliar people or large groups of people
  • Find it difficult to work out what others are thinking or feeling, or what they expect from you
  • Rehearse conversations in your head before having them
  • Revisit conversations you have had, wondering if you said the right thing or worrying how you were perceived
  • Prefer to be alone rather than with others, or only like being around a few people you feel comfortable with
  • Find social chit chat difficult, preferring to discuss specific subjects or areas of interest
  • Often find yourself copying other’s behaviours or mannerisms
  • Feel exhausted or drained after social interaction, needing alone time to recover

The way in which social interaction difficulties affect someone can vary; some people prefer to avoid interaction at any cost, while others enjoy interacting with familiar people but need to factor in time alone to manage this.

Communication differences

Autistic adults often have a communication style that is more direct and honest, though past experiences may have caused you to change your style of interaction through copying or rehearsing.

You may have experienced:

  • Confusion when people speak figuratively or use humour and sarcasm
  • People telling you that you have been rude or blunt when that was not your intention
  • Not understanding why people do not always appreciate a truthful answer
  • Finding eye contact uncomfortable, or you have to try to remember to look toward someone, because that is what is expected
  • Feeling distracted when others use gestures or facial expressions

Negative experiences in relation to communication can cause significant anxiety and can also lead to masking and camouflaging behaviours.

Preference for predictability

Many autistic adults prefer predictability over spontaneity and prefer structure and clear expectations.

You may find that you:

  • Undertake certain tasks in the same way, and like things to be ‘just so’
  • Become anxious when there is a change to your usual routine
  • Need to plan and prepare for out-of-the-ordinary events
  • Become irritated when people are late, change plans at the last minute, or surprise you
  • Struggle with uncertainty, preferring clear plans and expectations

Major changes in life, such as moving home, starting a new job, having children, having a new manager, or the death of a loved one, can often be overwhelming for autistic people.

Focused Interests

Many autistic adults find themselves in a flow state when engaging in their interests, with their mind focused on that interest rather than full of anxious thoughts.

You may find yourself:

  • Having a hobby or interest that absorbs your time and makes you feel calm and regulated
  • Spending a significant amount of time researching and learning facts about certain topics that interest you
  • Becoming so focused on an interest or activity that you can easily forget to eat or drink
  • Collecting items, which bring you pleasure through looking at them or organising them

For some autistic people, focused interests are expressed in their jobs or careers or are the drivers behind educational and career choices.

Sensory differences

Sensory processing differences can include finding sensory information anxiety-provoking, overwhelming or irritating or finding sensory activities calming and soothing.

You may experience:

  • Feeling overwhelmed in busy, crowded places
  • Feeling irritated or annoyed by specific sounds or repetitive sounds
  • Being sensitive to bright lights, strong smells or extreme temperatures
  • Certain fabrics irritate you
  • Finding comfort from touching certain textiles or being wrapped in heavier blankets and clothing

Sensory processing difficulties can impact someone in and out of work, and can cause significant difficulties in day-to-day life.

Masking and Camouflaging Behaviours

Masking and camouflaging behaviours are common amongst ‘high-functioning’ autistic adults, especially women.

Masking and camouflaging strategies are used to blend in in social situations. You may find yourself:

Rehearsing: Practising conversations before you have them, rehearsing how you will respond to different comments or questions

Conversational tactics: Using stock phrases to respond to questions that you don’t know how to answer, such as “I’ll have to think about that”; asking prepared questions so that the other person does the talking

Copying: Copying others' behaviours, for example, laughing at a joke because others are; watching television programmes to learn how to behave in social situations

Blending in: Being the quiet ones in groups, allowing others to ask questions that you need the answer to, avoiding situations where small talk is expected.

Suppressing or hiding behaviours: Hiding your sensory differences, not talking about your interests around others.
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The impact of masking and camouflaging:

A comprehensive adult assessment typically involves:
Overwhelm
Burnout
Exhaustion
Low self-esteem
Anxiety and depression

Should I seek an autism assessment as an adult?

If you have been experiencing the pattern of traits and experiencing outlined above, you should consider whether you should seek an autism assessment. An assessment may be warranted if:

  • You have been experiencing these traits for a long time, and can relate to having issues in childhood
  • Your differences are having an impact on you in daily life, whether at work or in personal life or both
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What are the benefits of an autism diagnosis in adulthood?

An autism diagnosis can bring about life-changing clarity in helping you to understand yourself and how past experiences have impacted you. An autism diagnosis as an adult will help:

  • You to recognise your strengths and differences and embrace your uniqueness
  • Others to understand you and recognise your needs and strengths
  • Support you to be able to request adjustments in the workplace or educational settings, such as a university

If you are receiving counselling or other therapeutic support, an autism diagnosis will help professionals to know how to adjust input in an appropriate way.

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What happens during an adult autism assessment?

You can expect:

  • Detailed background/developmental history
  • Structured clinical diagnostic interview (sometimes with an informant)
  • Observation of social communication and interaction
  • Multidisciplinary review against recognised diagnostic criteria
  • Comprehensive report
  • Feedback appointment
Our assessment process

Next Steps

If you are questioning whether autism may explain your differences, you may find it helpful to:

  • Review the information on this page and think about whether you have both difficulties with social interaction and also have repetitive behaviours
  • Complete our free screening test and see if your responses indicate an autism assessment is needed (LINK TO AQ50)
  • Talk to your GP about a referral to your local NHS assessment pathway
  • If you are interested in a private autism assessment, contact us. We offer free screening and will advise you whether an autism assessment is indicated
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Frequently Asked Questions