Signs and Symptoms of Autism in Adults
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Medically reviewed by Aleesha Grier, PsyD
Autism spectrum disorder (ASD), often known simply as autism, is a developmental disability that affects social skills as well as both verbal and nonverbal communication. Typically, the symptoms of autism spectrum disorder appear before the age of three. Infants and young children are often screened for autism. It can be more challenging to be diagnosed with autism as an adult.
Many of the signs of autism in adults are similar to those in children. Examples include challenges with reading and responding to social cues, difficulty communicating in ways that others understand, repetitive behaviors, and restricted interests.
In this article, we’ll go over the symptoms of autism in adults, as well as when to contact a healthcare provider.
Social Symptoms
Many adults with autism find it challenging to relate to and communicate with others in a way that is considered "typical" in society. Symptoms of autism related to social interactions, relationships, and communication may include:
Not making eye contact
Having trouble listening while others speak
Finding it hard to express emotions, whether through words, body language, or facial expressions
Low empathy
Difficulty making and keeping friends
Having trouble understanding nonverbal communication
Finding it difficult to read social cues in others, such as facial expressions or tone of voice
Not understanding social norms, such as unspoken “rules of etiquette”
Having a “flat” tone when speaking
Taking words and phrases literally (for example, someone with autism may struggle to understand sarcasm)
Not adapting or difficulty adapting to different social situations
Restricted and Repetitive Behaviors
Adults with autism often engage in repetitive and/or restricted behaviors. These may affect their physical movements, speech, interests, and daily habits.
Symptoms of autism related to repetition and restriction may include:
Echolalia (repeating words or phrases)
Difficulty shifting focus from one topic or activity to another
Limited, narrow, or obsessive interests
Repetitive movements (sometimes called “stimming”), such as flapping hands and rocking back and forth
Being more interested in objects than people
Following a strict routine and feeling stressed when it changes
Sensory Issues
Some adults with autism experience and respond to sensory input (i.e., touch, tastes, smells, sounds, and sights) in atypical ways. Sensory symptoms associated with ASD include:
A low or high pain tolerance
Being hypo- or hypersensitive to sensory stimuli such as lights or sounds
Being overstimulated by lights, crowds, and/or noise
Sensitivity to heat and/or cold
Avoiding physical touch
Feeling less or more startled than usual by noises
Food aversions (intense dislike of specific foods)
Eating only certain foods
Being more sensitive to the tastes, smells, and textures of particular foods
Other Symptoms
Autism can present in many different ways and to different extents (which is known as the autism spectrum). Some adults with autism show nearly all of the “typical” symptoms, while others have only a few.
In addition to sensory issues, restricted and/or repetitive behaviors, and social and communication challenges, other symptoms of ASD may include:
Difficulty sleeping
Irritability
Gastrointestinal problems, such as constipation
Cognitive and/or learning disability
Impulsivity
Difficulty concentrating
Hyperactivity
Unusual moods
Being either very fearful or unusually fearless
Difficulties with imagination
Also, a disproportionate number of ASD experience seizures. Up to 30% of children with autism will develop epilepsy, a seizure disorder, at some point during their lifetime.
When to Contact a Healthcare Provider
While signs of autism often first appear in early childhood, many people with autism aren’t diagnosed until their adolescent or adult years. There are many resources available for adults with autism, from peer support groups to treatment options, if necessary.
Reach out to a healthcare provider if you think you have symptoms of ASD, such as:
Have trouble reading, understanding, and/or responding to social and emotional cues
Have trouble communicating in ways that others understand
Find it hard to make and keep friends
Feel overstimulated by sensory input, such as loud noises or bright lights
Tend to focus intensely on specific interests
Become extremely distressed if your daily routine changes
A Quick Review
Symptoms of autism spectrum disorder in adults may include challenges with social interactions and communication, repetitive and/or restricted behaviors, and sensory sensitivities. Adults with autism may also have difficulties with eating, sleeping, and managing anxiety.
Autism is a chronic condition and can’t be cured. However, it can be effectively managed. If you think you may have ASD, reach out to a healthcare provider. They can refer you to a specialist like a neuropsychologist or a psychiatrist to perform a thorough assessment and connect you with appropriate treatment and resources.
Frequently Asked Questions
How can I tell if I'm autistic?
Signs of autism may include repetitive movements, sensitivity to certain sensory stimuli, hyperfixating on particular interests, and difficulties with reading body language and social cues. You may also experience challenges with making and keeping friends. However, you can’t definitively determine whether or not you are autistic without an assessment from a healthcare provider.
Am I autistic or ADHD?
There are several symptoms that people with attention-deficit hyperactivity disorder (ADHD) and autism may have in common, such as fidgeting and restlessness. Also, autism and ADHD can occur together. However, people with ASD are more likely to have trouble shifting their focus from one thing to another rather than being easily distracted and hyperactive in general. Autism is also more likely to be associated with difficulties with social situations and communication.
What can be mistaken for autism?
There are several different mental health diagnoses that can be mistaken for autism. Examples include ADHD, anxiety disorders, and obsessive-compulsive disorder (OCD). Symptoms of other developmental disorders may also overlap with those of autism.
How do doctors test for autism in adults?
The exact process for screening for autism in adults is still being developed. Usually, a specialist such as a neuropsychologist, psychiatrist, or neurologist will diagnose an adult with ASD. They may use the criteria for ASD in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as well as behavioral observations to make a diagnosis.
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