Although many people associate autism with childhood, an increasing number of adults are now discovering they are on the spectrum. As awareness grows and diagnostic tools improve, experts say these diagnoses later in life provide better understanding of lifelong traits that previously were overlooked.
Autism spectrum disorder (ASD) — sometimes referred to as simply autism — describes a condition that affects how people process information, communicate and connect with others. In the past, ASD was divided into different conditions, including Asperger’s syndrome. But now, researchers, healthcare professionals and many people living with ASD find it both more useful and more accurate to understand this condition as a spectrum of potential symptoms.
Some children start to show signs of autism in early childhood, around 2 to 3 years of age. For others, certain characteristics may not be recognized until later on. But not everyone is diagnosed in childhood, and some people may not receive a diagnosis until much later in life. In fact, a 2024 study published in JAMA Network Open found that diagnosis rates for adults increased substantially between 2011 and 2022, especially for young adults and women.
“But rates are rising because our understanding has improved,” says Kristin S. Vickers, Ph.D., L.P., a psychologist at Mayo Clinic in Rochester, Minnesota. There are better screening methods, changes in diagnostic criteria and improved access to screenings across age groups, among other factors. “Autism didn’t suddenly appear in adults. We’re finally just recognizing people who were overlooked,” says Dr. Vickers.
Autism symptoms in adults
There is an incredible amount of misinformation about autism, what it looks like and what causes it.
In reality, ASD has no single known cause. It’s thought that genetics and other factors may play a role.
There are also misconceptions — and stigma — around what autism can look like. But at its core, autism is a neurodevelopmental condition that affects sensory processing and social communication, explains Dr. Vickers. “It’s about how someone experiences and processes their environment.”
For those diagnosed in adulthood, signs may include:
Struggling to understand or anticipate what others may think, feel, do or say.
Feeling like you miss important social cues or unspoken social “rules” — you may feel socially anxious, take certain jokes or situations too literally, or have a hard time connecting with others. Or you may be misunderstood as rude or too direct.
You may stick to a strict routine and have a hard time adapting when that routine changes.
You may avoid eye contact or feel you have to force yourself.
You may be more sensitive to certain sensations, such as touch, taste, noise or textures.
Even for those diagnosed in adulthood, some traits were likely present in childhood — they just may not have been recognized.
“Early diagnosis often depends on how visible and disruptive the behaviors are, not how much someone is actually struggling,” says Dr. Vickers. “People learn to compensate, mask and push through, sometimes until they can’t anymore.”
Masking describes the strategies some people with autism use to compensate for their behaviors to better “fit in.” Masking behaviors can include adjusting your behaviors, facial expression, body language or communication patterns to more closely fit cultural, societal and gender expectations. But often, Dr. Vickers adds, masking isn’t just about fitting in — it’s a survival skill used to avoid judgment or other negative experiences.
In her experience, Dr. Vickers says people who get a late diagnosis often rely on masking, whether they realize they are doing it or not. “Girls and women are more likely to mask, so their struggles often look more internal and are less noticeable to others. And that delays diagnosis,” says Dr. Vickers.
There are also important barriers — and biases — in the diagnostic process itself. Girls are less likely to be diagnosed than boys, and children of color are less likely to be diagnosed than white children.
“Bias matters. Who gets referred, who gets believed and who has access to evaluation all shape who gets diagnosed and when,” says Dr. Vickers.
Getting a diagnosis of autism as an adult
There’s no right or wrong way to feel about a diagnosis. But often, there may be a sense of relief or recognition.
“For many adults, diagnosis is profoundly validating. It shifts focus from shame and self-blame to understanding,” says Dr. Vickers. “It answers the question ‘why are some things so hard when it seems like they shouldn’t be?’“
Even so, grief and frustration also may be part of the process. You may grieve lost opportunities, especially as a child or during important moments of your life. It may be painful or uncomfortable to look back at situations where you felt judged or punished and see them in a new light. Or you may feel frustration and anger that you struggled for so long without the resources you needed.
Often, a diagnosis can impact your sense of self, your relationships and who you are in the world, says Dr. Vickers. As a result, the period after diagnosis is often when people need the most support.
After a diagnosis, consider taking stock. Do you want to inform family or friends? Would you like to request accommodations at work? Is it time to seek out professional help?
A therapist or mental health professional experienced in supporting people with ASD can help you work through your feelings or develop healthy coping strategies in your personal or professional life. But remember — the goal is to have a container to discuss your feelings, better understand yourself and get the support you need.
There are also a number of support groups and resources from organizations such as the National Autistic Society, the Autistic Self Advocacy Network (ASAN), the Color of Autism Foundation, and the Autistic Women and Nonbinary Network (AWN).
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