“Am I Autistic?”: Adult Autism Assessment

Autism presents differently, depending on the person. Not one autistic person will look exactly like another autistic person. The DSM-5 conceptualizes autism as a struggle with social communication along with the engagement of “repetitive behaviors” and “restricted interests”. Unfortunately, the diagnostic criteria for autism don’t capture all of the many different strengths and struggles of the autistic experience.

Below are some common autistic experiences and characteristics; these are not criteria to diagnose autism. Numerous of my autistic clients described or agree with each of the below. However, it is important to keep in mind that autistic traits occur along a spectrum. The “symptoms” of autism in adults often vary widely. Not everyone will relate to every single one of the descriptions.

Adult Autism Diagnosis “Symptoms” Checklist

Social Signs Of Autism In Adults

You’ve consistently felt different from your peers.

Even in situations where people have included you in social outings, you feel out of place or very uncomfortable.

You find it difficult to relate to the general public. Oftentimes, you don’t understand why they like the things they like or do what they do.

Others often misinterpret your behavior. People mistakenly think you’re being rude or behaving as if you don’t like them.

You often feel misunderstood by others.

To prepare for a social outing, you think of jokes or phrases ahead of time to use in conversation.

You feel like you’re playing a character or hiding your authentic self in social situations.

When you spend a lot of time with certain people, you find yourself mimicking their mannerisms (e.g., phrases they use, how they dress, how they behave).

You have trouble reading people’s non-verbal cues.

Small talk feels pointless. If you engage in it, it feels cumbersome.

You love talking about your passions. Spending hours discussing your hobbies or interests is easy and doesn’t feel boring.

You prefer to have a select few friends who you are deeply close to versus having numerous, more superficial friendships.

Some of your friends have ended their friendships with you, and you don’t understand why.

You are extremely loyal to your loved ones.

You value honesty, transparency, and truth in your relationships.

Sensory Signs Of Autism In Adults

Eye contact is extremely uncomfortable.

Your relationship with sensory input is at the extremes—you are either very sensitive to certain sensory input or you need a lot of input for it to register. For example, you may be sensitive to certain noises or smells but prefer deep hugs to light touch.

You’re a picky eater. Certain textures or smells of food can make you feel nauseous.

It feels impossible to ignore assaults on your senses. For example, a scratchy sweater can completely distract you from the work you need to complete.

You really enjoy certain sensory input, and engaging with that input can help you regulate your emotions. For example, rocking back and forth or rubbing your face with a soft fabric can calm your anxiety.

Doing the same thing repetitively is enjoyable. For example, listening to a favorite song for hours is pleasant and possibly even calming.

You sometimes feel the need to keep your body in motion. For some, this looks like fidgeting. For others, it looks like pacing back and forth or dancing.

When you’re excited, it feels good to move your body in a certain way.

Cognitive Signs Of Autism In Adults

You function best with routine and consistency.

It feels safest and most comfortable when you know what to expect.

Thinking in absolutes (i.e., always, never, definitely) comes most naturally to you. Needing to consider the in-betweens or “grey areas” (i.e., sometimes, only in certain situations) feels more difficult.

You care deeply and are extremely knowledgeable about a few specific areas of interest.

When you work on something you enjoy, you easily become absorbed in that activity.

You are exceptionally passionate about your hobbies and interests. You know more about your interests than most of the people you know.

Sudden changes in plans really bother you and can easily ruin your mood.

You are very persistent and goal-oriented when it comes to things you care deeply about.

It’s difficult to change your mind.

You struggle with executive functioning (e.g., time management, organization, working memory, task initiation).

Puzzles (i.e., Rubik’s cube, sudoku) are fun and possibly even soothing to you.

You are good at noticing details.

Emotional Signs Of Autism In Adults

More often than not, you feel anxious.

You struggle with extreme social anxiety.

When things feel out of control or chaotic, you feel especially anxious.

It’s easier to regulate your emotions when you feel like you have control over your environment.

Sometimes you feel like you can’t handle your emotions. Intense emotions seem to come and go without any discernible reason.

When something unexpected happens, you might have an emotional meltdown or anxiety attack.

It’s upsetting when your things are touched, moved, or rearranged without advance notice or your permission.

If you found yourself relating to many of the descriptions above, it may be worth pursuing an adult autism diagnosis with a psychiatrist or neuropsychologist.

Adult ADHD

For many years the diagnosis of Attention-Deficit/ Hyperactivity Disorder (ADHD) was reserved for children, and not adolescents or adults. This means adolescents and adults with symptoms of the disorder, who might have been struggling for many years, not exactly knowing what they’re struggling with, couldn’t officially be diagnosed with ADHD. This changed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Adolescents and adults can now officially be diagnosed with ADHD. The diagnostic criteria in the DSM-5 mentions and gives examples of how the disorder presents in adolescents and adults (aged 17 and older). When diagnosing an adult with ADHD, clinicians now look at the individual’s middle childhood (age 12) and their teen years, instead of going all the way back to their childhood (age 7

ADHD in ADULTHOOD

About one in three children with ADHD show remission by adulthood. Inattention symptoms have a greater persistence into adulthood and show a slower decline than hyperactivity and impulsivity symptoms. For adults, hyperactivity symptoms become felt more internally than observed outwardly. Adults with ADHD have shown to struggle with occupational rank, academic achievement, and job performance. They also engage in risky sexual behaviour, are more likely to have early unwanted pregnancies, traffic violations, car accidents and marital or relationship distress and psychiatric comorbidities. Studies have shown elevated rates of ODD, conduct disorder and Antisocial Personality Disorder with adults that suffer from ADHD. Adults having grown up with ADHD also have higher rates of criminal behaviour • Adults experience hyperactivity more as a general restlessness and feeling as if they are being driven by a motor. This can be seen in difficulty to sit still for long periods of time (through meals, meetings or movies), feeling fidgety, talking excessively, becoming easily bored once a task has been mastered. They are always on the go and generally don’t respond well to frustrating situations. • Inattentive symptoms in adults are more present in their work or with daily activities of living, and presents itself as making careless mistakes, losing things, not paying attention to detail, not being able to follow-through with instructions, having difficulty with organisation, being forgetful in daily life or they try to multi-task without actually completing any of the tasks. • Impulsiveness can manifest itself at work, for example blurting out answers at a meeting, but can also be seen in their spending patterns, engaging in risky behaviour, interrupting other people’s conversations, making inappropriate comments, intruding upon others or even monopolising a conversation. When making a diagnosis of ADHD, it’s vital to look at the person/ child holistically, as a lot of the symptoms are things most people do every once in a while. For it to be considered as a symptom of ADHD, they have to have these symptoms all the time and can’t help themselves from doing them. The symptoms also have to impact their ability to function in two or more areas of their life, for example at work and home, or school and home. Symptoms also worsen during times of stress. Clinical practices for ADHD in childhood depend heavily on the developmental stage of a child and may include optimal prenatal practices, pharmacological or multimodal treatment, and parent training for parents with children that have been diagnosed with ADHD. In adulthood a combination of medication and therapy (often CBT) is recommended. ADHD is a lifelong condition and may require ongoing treatment to promote optimal long-term outcome