Getting an autism diagnosis as an adult

Autism is a lifelong difference in how a person communicates, relates to others and experiences the world. Many autistic people are diagnosed as children. Others reach adulthood, or even later life, before anyone puts a name to what they have always felt.² If you are reading this, you may be asking yourself whether the name fits you or someone you love.

This page explains how an adult diagnosis works. It covers the difference between a quick screening quiz and a full assessment, who can do one, how to get ready, and what a diagnosis can and cannot do. If you want to start with the signs themselves, read signs of autism in adults.

Why do adults look for a diagnosis?

People come to this question in different ways. Some have a child who was just diagnosed, and they see themselves in the description. Some have struggled for years with work, friendships or noise and crowds, and no other explanation ever fit. Others were told long ago they had something else, such as social anxiety, and the label never felt complete.⁶

Common reasons include:

• Making sense of your past. A correct diagnosis can help you understand earlier struggles and see your strengths.¹
• Finding the right help. Some supports are built for autistic people and work better than general treatment.
• Getting services. A diagnosis may help you qualify for autism-related services and disability programs.⁶
• Asking for changes at work, at school or in health care. A diagnosis may support your legal right to accommodations.⁶
• Helping your family understand you.

Not everyone wants a formal diagnosis, and that is fine. Some people learn about autism, join peer groups and find what helps without one. A formal diagnosis is most useful when you need it to open a door, such as services.

Screening quiz or full assessment?

These two steps are often mixed up. They do different jobs.

One example of a screening tool is the AQ-10. In England, the national guideline suggests it for adults who may be autistic and have no major learning disability. A score of 6 or more, or a doctor's concern, should lead to an offer of a full assessment.⁵ A low score on a quiz does not rule autism out, and a high score does not prove it. Screening for adults is still being refined.¹

What does a full assessment include?

Doctors in the United States use a set of criteria from the American Psychiatric Association. In plain words, a person needs two things:⁴

1. Lasting differences in social communication and interaction. This can mean trouble with back-and-forth conversation, with body language and eye contact, or with building and keeping relationships.
2. Repeated or fixed patterns. This can mean repeated movements or phrases, a strong need for sameness and routine, very narrow and intense interests, or being over- or under-sensitive to sound, light, touch or other senses. A person needs at least two of these.

The signs must have been there in early childhood, even if they were not obvious. They may not have shown fully until life's social demands grew bigger than the person could manage. Learned coping strategies can also hide them in later life, a habit often called masking.^3,4 The signs must also cause real difficulty in daily life.⁴ Autism also looks very different from one person to another. Some people need a lot of daily help, and others live with little or none.²

To check all this, the professional will usually:

• Ask about your early years, school, friendships and work.
• Ask about your senses, routines and interests.
• Watch how you talk and interact during the visit.
• Ask about your mood, sleep, anxiety and health, because other conditions can look similar or occur alongside autism.^1,5
• Use set tools. Experts are advised to draw on several sources, including standard tools such as the ADOS or ADI-R.⁶

English guidance adds that the assessment should look at your daily functioning, sensory differences and risks. Routine blood tests, genetic tests and brain scans are not part of an autism diagnosis for adults.⁵ Ask the professional what their process will be, so there are no surprises.

Who can diagnose autism in an adult?

Psychiatrists and psychologists commonly diagnose autism. A neuropsychologist (a psychologist who studies how the brain affects thinking and behavior) may also do it.^1,6 Your primary care doctor is a good first stop, since they can refer you.¹

Finding the right person takes some work. Some providers mostly see children and do not take adults, or do not know how autism looks in adults. Others see adults but have little autism experience.⁶

When you call, you can ask:

• Do you diagnose autistic adults?
• How many adult assessments have you done?
• What does the process include, and how many visits?
• How much will it cost, and what will my insurance cover?
• How long is the wait?

What to bring

A little preparation makes the visit go better.

1. Write down your reasons. A few notes on why you are asking now, and what has been hard, will help you stay on track.
2. Gather old records. School reports, early doctor notes, or old evaluations can show how you were as a child. Guidelines say these records are useful when they exist.⁵
3. Ask someone who knew you young. A parent, sibling or older relative may be able to come, or to write or talk about your childhood.⁵ If no one is alive who knew you as a child, tell the professional. They can still work with what you remember.
4. List your health information. Bring your medicines and past diagnoses, including mental health care.
5. Plan for comfort. Ask for the quietest room, a written agenda, or breaks. Bring a support person if that helps you speak freely.

Cost and wait times

Cost and waits vary a great deal, and it is hard to give one number. Insurance coverage differs. A full set of tests may need approval from your insurer before you start.⁶ Call your insurance company and ask what is covered for an adult autism assessment. Ask the clinic for the price in writing.

Waiting times differ too. In England, the national guideline notes that waits for diagnosis vary widely and cause delays.⁵ If you face a long wait, ask to be put on a cancellation list, and ask about other clinics. In Virginia, the Department for Aging and Rehabilitative Services (DARS) offers programs to help people with disabilities prepare for and keep work.⁸ Some state vocational rehabilitation offices can help with an assessment when work is the goal.⁶ Call your local office to ask.

What a diagnosis can and cannot do

What it can do. It can give a clearer picture of your strengths and your needs. It can help you find fitting support and peers.¹ It may qualify you for services, and it can support requests for accommodations at school, work or in health care.⁶

What it cannot do. It cannot change who you are. It is not a judgment on your worth. It will not by itself fix problems at work or at home, and some people around you may still not understand.⁶

What can be hard. The evaluation can be stressful or uncomfortable. Results can differ from one provider to another, especially for adults. A diagnosis may matter in a child custody case.⁶ Talk over the good and bad sides with someone you trust before you decide.

Work and the law. Under the Americans with Disabilities Act, an employer may ask for reasonable documentation of a disability and the need for a change only when these are not obvious. The employer should ask only for what is needed, and may instead talk with you about your limits.⁷ You can ask your doctor what to share, and you do not need to hand over your full medical records.⁷ Read more in daily life, work and autistic burnout.

If you are not diagnosed, or you disagree

Some people are told they do not meet the criteria. Others get a different answer, such as anxiety or ADHD, or both. This can feel like a loss, especially after a long wait. A different answer still points to help. Anxiety and ADHD are common and treatable, and they can occur alongside autism.¹

If you are unsure about the result, you can ask the professional to explain how they decided. You can also ask for a second opinion from another autism-experienced clinician.⁵

Later in life

Many people get diagnosed in their 50s, 60s and beyond, often after a child or grandchild is diagnosed. Older adults may have few school records and fewer relatives to ask. They may also have been given other labels over the years. A good assessor will take age into account. If memory is a worry, tell the assessor, because other conditions may need to be checked. See autism in later life for more.

What comes next

A diagnosis is a starting point. Next steps may include learning about autism and other health conditions, finding support and therapy that respects who you are, and telling the people close to you. Families can read supporting an autistic family member. Autism is not a disease to cure. The goal is understanding and the right supports. The main page, autism, links to every topic.

Questions people ask

Can I just decide I am autistic without a test?

Yes. Learning about autism and recognizing yourself is a valid step, and many people stop there. A formal diagnosis is mostly needed for services and some legal supports. Be careful about online tests that claim to give a final answer. They cannot.⁵

Am I too old to be assessed?

No. Autism can be diagnosed at any age, and some people are not diagnosed until adulthood.² Tell the clinic your age when you book, so they can match you with someone who sees older adults.

Should I say "autistic person" or "person with autism"?

Both are used. Many autistic people prefer "autistic person" because autism is part of who they are. Others prefer "person with autism." If you are not sure, ask the person what they like.

Will a diagnosis change my medicine?

Not by itself. There is no medicine for autism. Doctors sometimes treat other problems, such as anxiety or low mood. Never start, stop or change a medicine on your own. Talk with your doctor or pharmacist before changing anything.

When to get help

• Talk to your doctor if you think you may be autistic and want to be assessed, or if anxiety, low mood or exhaustion is getting in the way of daily life.
• Call or text 988 any time you have thoughts of suicide, or you are worried about someone else. It is free and open 24 hours a day. Help is available, and many people find that talking to someone helps. You can make a safety plan ahead of time.
• Call 911 if you or someone else is in immediate danger.

You can also visit our help page.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.