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Autism spectrum disorder (ASD) is one of the most commonTrusted Source neurodevelopmental disorders. In most cases, autistic people receive a diagnosis in childhood, usually after the age of 4 years. However, some autistic adults are not diagnosed in childhood, even if their symptoms are more severe.

For an autistic person not diagnosed in childhood, receiving an ASD diagnosis later in life may be helpful for many reasons. In particular, it can provide better access to services and support. In this article, we discuss the signs and symptoms of ASD in adulthood and what to do if a person would like a diagnosis.

Signs and symptoms of adult autism

Autistic people may find some aspects of communication and social interaction challenging. They may have difficulty relating to people and understanding their emotions. Autistic adults may also have inflexible thought patterns and behavior, and may carry out repetitive actions.

Common signs and symptoms of ASD in adults can includeTrusted Source:

  • difficulty making conversation
  • difficulty making or maintaining close friendships
  • discomfort during eye contact
  • challenges with regulating emotions
  • extreme interest in one particular topic
  • frequent monologues on the same subject or subjects
  • hypersensitivity to sounds or smells that do not seem to bother others
  • involuntary noises, such as repetitive throat clearing
  • difficulty understanding sarcasm or idioms
  • lack of inflection when speaking
  • limited interest in only a few activities
  • preference for solitary activities
  • problems reading the emotions of others
  • trouble understanding facial expressions and body language
  • reliance on daily routines and difficulty dealing with change
  • repetitive behaviors
  • social anxiety
  • superiorTrusted Source abilities in a particular field, such asTrusted Source mathematics or other disciplines
  • the need to arrange items in a specific order

Autistic people will not usually have all the above signs and symptoms, and they may experience others that are not on the list.

There may be some similarities between ASD and other disorders, such as attention deficit hyperactivity disorder (ADHD), but the signs and symptoms of ASD vary from person to person.

Also, the symptoms can differ across genders. Some people may seem able to cope better with social situations than others, as their symptoms may be more subtle and masked. As a result, it can be more challenging to diagnose ASD.


Seeking an ASD diagnosis as an adult can be challenging for several reasons:

  • People who did not receive a diagnosis in their younger years may have milder symptoms, which can be more difficult to recognize. At times, such people may never get a diagnosis.
  • If people have been living with ASD for some time, they may be better at masking the signs and symptoms.
  • Research shows that one of the common diagnostic tests for autism in adulthood, the ADOS-2, may be fairly reliable. But a doctor needs to recognize a person’s symptoms in order to refer them to testing.

Is there a test for ASD in adults?

Clinicians have developed different tests that can help diagnose ASD in adults. These include diagnostic tests such as ADOS 2 Module 4, ADI-R, and 3Di Adult.

However, it is not clear how reliable these tests are for adults. The reasons for this include:

  • Researchers who look at the reliability of ASD tests often useTrusted Source a small number of study participants.
  • Not many research studies on testing for adult ASD include enough participants from historically underserved groups, such as People of Color or people who are LGBTQIA+. This means the results of studies looking at ASD testing methods may not represent a true population of autistic adults.
  • Many clinicians may not be familiar with the signs of ASD in adulthood. This is especially true if the patient’s symptoms are not severe or if the patient also has other conditions, for example, anxiety.

Autistic people may have higher ratesTrusted Source of co-occurring conditions, such as anxiety or depression, than those in the general population.


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