The challenges and opportunities of an adult autism diagnosis

If you’re parenting a child with autism, you may start to notice similar traits in yourself or your partner. It’s a common experience, and one that often leads to the question: Who is qualified to diagnose autism in adults? Understanding this is the first step toward getting clarity and support.

According to Harvard Medical School, it's estimated that about 2.2% of people over the age of 18 are autistic. The diagnoses of adults with autism are on the rise, with the greatest increase in diagnosis rates occurring among people ages 26 to 34. JAMA Network Open estimates that the rate of diagnosis in this age group increased by 450% from 2011 to 2022.

Receiving an autism diagnosis in adulthood can be challenging. But it can also present areas of opportunity and support.

How autism symptoms in adults may be different than symptoms in children

Autism symptoms in adults are similar to those seen in children. But Harvard Medical School also notes that adults with ASD may have learned to suppress their autistic behaviours and characteristics. This masking, and it can lead to stress, anxiety, depression, and other negative effects.

1. Many adults with ASD report that they feel awkward in social situations. They may prefer to be alone, and have trouble making friends. They may find it hard to understand what others think or feel, and to see things from their perspective.

2. Adults with ASD also prefer order and routine. Slight changes may stress them out or even make them angry. They may also have intense, specific interests.

3. These symptoms can wax and wane over time. They may worsen during times of stress or major life change, like going off to college, getting a new job, or getting married or divorced.

4. Adults with ASD may also be more likely to experience mental health conditions such as anxiety or depression. A 2022 study found that people who aren't diagnosed with ASD until adulthood are almost three times as likely to be diagnosed with a mood, anxiety, or personality disorder than those who were diagnosed in childhood.

Who is qualified to diagnose autism in adults?

Autism Parenting Magazine reminds us that while pediatricians and school psychologists are commonly involved in childhood assessments, diagnosing autism in adults requires a specialist with specific experience.

According to Autism Awareness Australia, there are two distinct pathways when seeking an adult diagnosis. Assessments can be conducted by a psychologist or by a psychiatrist with experience in assessing autism. Both will conduct some form of standardised testing for autism and other conditions, such as ADHD or mood disorders, and provide you with a report.

However, there are some differences between the services and support they can provide. Ensure you ask upfront what is entailed in the assessment and report process including the time and cost involved.

A psychologist: A psychologist may offer you ongoing therapeutic support after your assessment and diagnosis. They may use evidence-based therapies such as modified cognitive behaviour support (CBT). They can also be helpful in providing a safe space for you to talk through your experiences and support you through the process of understanding your diagnosis. Make sure when you see a psychologist, you ask them if they are experienced in seeing people on the spectrum, as they will need to modify the therapies for you appropriately.

A psychiatrist: A psychiatrist primarily focuses on providing assessments and diagnoses—and can prescribe medications. (A psychologist is unable to prescribe medications, but may refer you to a psychiatrist if they feel medications may be beneficial to you.)

Some medications can only be prescribed and reviewed by a psychiatrist (e.g. those used to treat ADHD). Your GP (or doctor) will be unable to prescribe ADHD medications in the first instance but may be able to write repeat scripts on behalf of your psychiatrist, though this varies from state to state. A psychiatrist usually does not provide therapeutic sessions. Your psychiatrist may recommend you see a psychologist for further mental health support and therapy.

A psychiatrist usually does not provide therapeutic sessions. Your psychiatrist may recommend you see a psychologist for further mental health support and therapy.

Remember, not every mental health provider is trained in diagnosing autism, especially in adults. It’s important to work with someone who understands the nuances of adult presentations, including masking, camouflaging, and co-occurring conditions like ADHD or anxiety.

What does the testing process involve?

Diagnosing autism in adults isn’t a quick appointment or a single quiz. It’s a multi-step process designed to explore your developmental history, current traits, and how these impact your daily life. A comprehensive evaluation typically includes:

1. Clinical interviews: You’ll discuss developmental milestones, communication style, social relationships, work history, and more.
2. Input from family or partner (if available): This can provide context and examples from your early development and current behaviour.
3. Standardized assessment tools, such as the Autism Diagnostic Observation Schedule (ADOS-2), Autism Diagnostic Interview-Revised (ADI-R), and more.
4. These tools assess how you process social interactions, interpret sensory input, and handle routines or transitions.
5. Some providers may also conduct cognitive or executive functioning tests as part of a broader neuropsychological evaluation.

Look for providers who mention experience with diagnosing autism in adults, not just children, and who are familiar with current diagnostic criteria.

Is self-diagnosis valid?

For many adults, especially women, autism traits have gone unrecognized for years. The result? They turn to research, community forums, and self-assessment tools to make sense of their experiences.

So, is self-diagnosis valid? In a word: yes.

Self-identification can be incredibly empowering and validating, especially when cost, location, or waitlists make formal testing for autism inaccessible. Recognizing yourself in autism traits is often the first step toward healing and self-understanding.

That said, a formal diagnosis provides access to accommodations, workplace protections, and therapeutic support. It also carries weight in clinical, educational, and legal contexts. If those supports matter to you, pursuing an official evaluation is a worthwhile next step.

Why an adult autism diagnosis matters

According to Autism Parenting Magazine, receiving a diagnosis as an adult can be life-changing, practically, emotionally, and socially. For so many neurodivergent adults (myself included), an adult diagnosis can feel like someone finally turned the lights on in a room you’ve been stumbling through your whole life.

This newfound clarity can bring a mix of emotions: relief, empowerment, and even grief for what you didn’t know sooner. However, it also opens the door to a whole new understanding of yourself.

Here’s what an adult diagnosis can mean:

• Clarity and relief: Many adults report feeling validated after years of confusion or self-doubt.
• Improved relationships: Understanding your communication style and needs can enhance connection with others.
• Workplace accommodations: With a formal diagnosis, you may be eligible for adjustments that support executive functioning or sensory needs.
• Mental health support: Diagnosis can lead to therapies or coaching that’s tailored to your neurotype, not just treating symptoms of anxiety or depression.
• Connection to community: Many adults find comfort in discovering they’re not alone and joining autism-affirming communities.

Getting an autism diagnosis as an adult won’t rewrite your history, but it can help you make sense of it and plan your next steps with a clearer understanding.

You deserve clarity and support

Whether you’re seeing traits in yourself, your partner, or both, pursuing a diagnosis takes courage. While it may feel overwhelming at first, you don’t have to go it alone.