Autism Spectrum Disorder in adults

Student looks for answers on a computer

Difficulty maintaining eye contact. Sitting and standing in weird positions. Sensory issues. Repetitive movements. These are just a few symptoms of autism spectrum disorder, often known as autism or ASD, in adults.  

According to the Centers for Disease Control and Prevention, about 1% of the world – or 75,000,000 people – have ASD. Even more surprising, an estimated 5.4 million (or 2.2%) U.S. adults have ASD. That number may seem large, but ASD features a wide range of symptoms and levels of severity. 

Although not everyone is diagnosed at an early age, early detection in childhood is key to improving outcomes later in life. 

Below, we outline five common questions (and answers) about ASD in adults. 

1. Can adults be diagnosed with autism spectrum disorder? 

Adults can be diagnosed with ASD. Most symptoms typically present before age 18, but others may not fully manifest until later when social demands exceed individual capabilities. 

2. What are the signs of ASD in adults? 

Some adults with ASD exhibit symptoms that resemble attention deficit hyperactivity disorder or ADHD. Other symptoms may include: 

  • Difficulty interpreting what others are thinking or feeling 
  • Trouble interpreting facial expressions, body language or social cues 
  • Difficulty regulating emotions 
  • Trouble keeping up a conversation 
  • Inflection that does not reflect feelings 
  • Difficulty maintaining the natural give-and-take of a conversation 
  • Tendency to engage in repetitive or routine behaviors 
  • Only participating in a restricted range of activities 
  • Strict consistency to daily routines or outbursts when changes occur 
  • Exhibiting strong, special interests 

3. How is autism diagnosed? 

A multifactorial evaluation is the best tool for diagnosing ASD in adults. The evaluation should include an in-person evaluation and a thorough assessment of your developmental history from a parent or caregiver who knew you during your childhood. Sometimes it may be difficult to find an informant like this. If so, a spouse, partner, or close friend can help complete the necessary screenings by reporting on your current behavior. 

If you're thinking about seeking an autism evaluation, online ASD assessments can provide a good starting point. However, most online rating scales do not have adequate reliability and validity to provide accurate diagnoses and  don't consider your developmental history. Therefore, clinical expertise is required to correctly interpret your results and make a proper diagnosis. 

4. Who can diagnose ASD in adults? 

If you suspect ASD, you should talk to your primary care provider. Your doctor can refer you to abehavior health specialist, such as a licensed psychologist, who is authorized to complete psychological testing. While we don’t provide psychological testing at the University Health Center, we can refer you to psychologists in the community who do. It's important to find a health care provider with specific knowledge of ASD developmental disabilities and evaluation methods suited for adults, as they differ from those for children or adolescents. (Some clinicians with experience evaluating children and adolescents may not have experience evaluating adults.)  

5. Is an autism diagnosis covered by insurance? 

Although ASD evaluations are increasingly recognized as medical necessities, insurance coverage often differs among providers. Check with your insurance provider to see what they will cover. 

The bottom line: ASD can manifest differently and is often a life-long condition. But, early diagnosis and treatment can make a significant difference. 

If you are concerned you might have ASD and would like to talk to a health care provider about your symptoms for a possible referral; the University Health Center can help. Call 402.472.5000 to schedule an appointment. We do not provide autism assessments, but we can provide a referral to community resources that do.