Autism affects the way a person interacts with others, communicates, and experiences the world around them. While many people associate autism with childhood, it’s important to know that adults can also be diagnosed with autism.
Recognizing autism in adults might look different than in children, but it’s just as important. If you’re an adult or know someone who suspects they might be on the autism spectrum, understanding the criteria for diagnosis can help bring clarity.
This guide will walk you through what to know about the process and signs of autism in adults.
What is Autism Spectrum Disorder?
As a spectrum disorder, autism is a condition that manifests differently in each individual, ranging from mild to severe.
The condition affects how individuals perceive and interact with the world around them. It can impact various aspects of life, including social relationships, communication skills, sensory processing, and behavior patterns.
While its exact causes are still being studied, a combination of environmental and genetic factors is believed to contribute to its development.
DSM-5 Diagnostic Criteria
The DSM-5 which was published by the American Psychiatric Association (APA) in 2013 introduced significant changes to the diagnostic criteria for autism and related disorders.
The DSM-5 combined autistic disorder, Asperger’s, and PDD-NOS into one label: Autism Spectrum Disorder. The Pervasive Developmental Disorder category no longer appears in the DSM-5.
The DSM-5 diagnostic criteria for autism include two main domains: deficits in social communication and social interaction, as well as restricted patterns of behavior or interests. These criteria are as follows:
Deficits in Social Communication and Social Interaction
- Difficulties with back-and-forth conversation, sharing of emotions, and understanding social cues.
- Nonverbal communication deficits, including difficulties with eye contact, body language, and facial expressions.
- Deficits in developing, maintaining, and understanding relationships, resulting in challenges with forming meaningful connections.
Restricted Patterns of Behavior or Interests
- Stereotyped or repetitive motor movements, such as hand-flapping or body rocking.
- Insistence on sameness and resistance to change.
- Highly restricted, fixated interests that are abnormal in intensity or focus.
- Hyper- or hypo-reactivity to sensory input, such as extreme sensitivity to certain sounds or textures.
Autism Diagnosis in Adults
Diagnosing autism in adults is a complex process that requires a thorough understanding of the diagnostic criteria and the challenges specific to this population.
The DSM-5 provides the criteria for diagnosing autism. In 2022, however, the American Psychiatric Association (APA) released the DSM-5-TR, a text revision to the DSM-5, which included a clarification of the autism diagnostic criteria to improve clarity.
The DSM-5-TR specifies diagnostic criteria for autism in adults, focusing on social-communication challenges and differences in information processing. One important clarification in the DSM-5-TR is the change in wording from “manifested by the following” to “as manifested by all of the following.”
This change emphasizes the requirement for individuals to meet all three criteria listed in the diagnostic manual to receive a diagnosis of ASD.
The updated diagnostic criteria in the DSM-5-TR allow clinicians to diagnose individuals who may have shown signs of autism early in development, but whose symptoms became clear only in adolescence or adulthood.
This expansion of diagnostic criteria acknowledges the varied manifestations of autism and the fact that individuals on the autism spectrum may present differently across the lifespan.
Challenges in Diagnosing Adults
Unfortunately, diagnosing autism in adults can be challenging due to several factors.
First, adults on the autism spectrum may display traits differently from children, and coping strategies developed over time may make autistic traits harder to recognize. This can lead to delays or missed diagnoses, resulting in individuals not receiving appropriate support and interventions.
Additionally, there is a lack of awareness and understanding among healthcare professionals about autism in adults. This can lead to misdiagnosis or the assumption that certain behaviors or challenges are unrelated to autism.
It is crucial to raise awareness and provide training to healthcare professionals to ensure accurate diagnosis and appropriate support for autistic adults.
The diagnostic process for adults with suspected autism often involves a comprehensive evaluation by a multidisciplinary team, including professionals such as psychiatrists, psychologists, and speech-language pathologists. The evaluation may include interviews, observations, and standardized assessments to assess social communication, behavior, and cognition.
Clinical Presentation in Adults
Understanding the clinical presentation is essential when it comes to diagnosing autism in adults. Autism can manifest differently in adults compared to children, and recognizing the unique challenges faced by autistic adults is crucial for accurate diagnosis and support.
In this section, we will explore two key aspects of the clinical presentation in adults which are as follows:
Social Communication Challenges
One of the core diagnostic criteria for autism in adults is deficits in social communication and social interactions. The DSM-5 criteria specify three deficits that individuals must meet to be diagnosed with autism.
These deficits include:
It’s important to note that social communication challenges can manifest differently in adults on the autism spectrum. Some individuals may have developed coping strategies over time, making their autistic traits less apparent. This can make it harder to recognize and diagnose autism in adulthood.
Restricted and Repetitive Behaviors
In addition to social communication challenges, restricted and repetitive behaviors are another key aspect of the clinical presentation of autism in adults. These behaviors can include a wide range of repetitive actions, interests, and behaviors.
Notable examples of restricted and repetitive behaviors in autistic adults may include:
- Engaging in repetitive movements such as hand-flapping or body rocking.
- Following rigid routines and getting distressed by changes in plans.
- Having highly focused or intense interests in particular topics.
- Displaying repetitive speech patterns or using unusual language.
- Showing sensitivity to specific sensory stimuli, such as loud noises or certain textures.
The presence of restricted and repetitive behaviors, along with social communication challenges, helps clinicians in diagnosing autism in adults. However, it’s important to recognize that the clinical presentation of autism can vary greatly among individuals. Each person may exhibit a unique combination of symptoms and challenges.
In the end, understanding the autism diagnosis criteria for adults can be empowering. It opens doors to the right support, answers lifelong questions, and helps individuals embrace their unique strengths.
If you think you or someone you know may be on the spectrum, seeking a diagnosis could be the first step toward a clearer, more supported future. For those in need of autism services in Michigan, Entiva Behavioral Health offers comprehensive support tailored to individual needs. Contact us today to learn more about how we can help you or your loved one.
