Autism in Adults
Many individuals with autism receive a diagnosis during childhood, but sometimes the symptoms don’t show until adulthood. When that happens, it may be challenging to find a healthcare provider who is comfortable diagnosing adults.
Adults with undiagnosed autism may struggle to maintain a stable lifestyle, have meaningful relationships, or secure satisfying jobs. They may also have difficulty coping with sensory issues like textures, sounds and smells.
Often, people with autism have trouble in social situations because they lack certain basic skills. For example, they may not understand social norms such as how to initiate a conversation or what the other person is thinking. They also often fail to recognize emotions in others, or they may misread social cues and respond inappropriately. This makes it difficult to communicate, hold conversations and build relationships.
The good news is that it is possible for adults with autism to improve their social skills. They simply need more practice. One way to get this is by attending social skills groups. These are group settings where people with autism and their peers come together on a regular basis to role-play social interactions. These groups follow commercially available social skills curricula and have been found to be effective for people of all ages.
Another approach is to use social narratives, which are short stories that describe a specific social situation and offer examples of appropriate responses. These can be written by professionals or by parents. They are typically easy to read and may include pictures. Using these social narratives helps individuals develop better understanding of social situations and improve their ability to stay safe and participate in social interaction.
Finally, it is important to encourage and praise social interactions that are successful for the individual. For example, when your child shares a block with a friend or waits for his turn in a game, it is important to let him know how great this behavior is. This will help him feel more confident in his abilities and want to continue to interact with other children.
For adult children and adults with autism, a structured activity can be a good way to meet new people. This could be a class that focuses on a hobby, such as cooking, art, languages, model building, history or other topics of interest. The structure of the class and the fact that other people are there to talk about the same subject will make it easier for the individual to converse with them.
Our senses allow us to experience the world around us. We are able to see, hear, touch, smell and taste, but children and adults with autism often have difficulties with processing sensory information. They may either over react to or under react to information from their five basic senses (see, touch, smell, hearing and sight) but also from two more important sensation-detecting parts of the body called the vestibular and proprioceptive senses which impact balance and body awareness. They may also ignore some sensory information or become highly engaged in specific sensitivities.
In one study that asked participants to respond to multiple-choice questions, many autistic adults reported being hyperreactive in response to a variety of sensory input/contexts, including bright and flashing lights (75%), busy/chaotic environments (69%), loud noises (87.5%), high-pitch sounds (82%), music (81%), public transport sound (81%), clothes (62.5%), different fabric textures (55%), hot temperatures (65%), food flavors and scents (50%). In addition to this, they were also hyporeactive in relation to sensory input from interoceptive sensors, such as the feeling of physical pain (30%) and the sensitivity of their own skin to hot/cold temperatures (42.5%).
Over-responsivity to sensory stimuli can make it difficult to participate in everyday activities, and some people with autism can experience this over a long period of time, every day. It can occur in any environment and affect more than just one sense at a time. It can cause anxiety and distress, as well as be physically and emotionally draining.
Fortunately, there are ways to manage sensory overload. There are calming techniques that can help, and the use of earplugs or headphones can be beneficial in noisy environments. In some cases, aromatherapy can be used as a way to help alleviate stress and anxiety. Alternatively, some people find that taking part in a fun sensory activity helps to calm them down and can be a great stress relief. For example, dance parties can improve listening skills and coordination, as well as provide an outlet for energy. They can also boost self-esteem and confidence in a safe, friendly and supportive environment.
People on the autism spectrum can have trouble understanding the meaning of words and expressions. They may also have a hard time following back-and-forth communication and expressing their own emotions. They may have difficulty understanding body language and reading social cues, such as when someone else appears upset. They may have trouble understanding or interpreting sarcasm and humor. They may also have a hard time understanding metaphors and other figures of speech, including terms of endearment such as “honey” or “love.”
Many people on the autism spectrum have obsessive interests and can talk for hours about their chosen topic. This is why it’s important to listen attentively and to try to keep the conversation focused on what the person wants to talk about, rather than letting it stray off in other directions. This will help them maintain their focus and give them a chance to get the information they want, which will make them feel included in the conversation.
Some people on the autism spectrum can become overwhelmed when their schedule or routine is disrupted, and they can have a hard time communicating this to others. They may have a difficult time accepting changes in daily routines or rituals, and they may react with anger or anxiety. They may also have trouble with sensory stimuli, such as certain noises, smells or textures that cause discomfort.
Adults with mild autism can be just as independent as their peers, but they have challenges in navigating social interactions and communicating verbally. They may also develop coping strategies to manage daily life tasks, such as fidgeting with items or following routines.
When interacting with someone on the autism spectrum, always say their name at the beginning of the conversation or question to ensure they’re paying attention. Speak clearly and use simple sentences that have only one meaning. Avoid using slang, nuance or sarcasm, as these can have multiple meanings and confuse them. Also avoid using terms of endearment like “honey” or “love,” as these can be taken literally and may make the person uncomfortable. Be aware of the signs that they’re trying to communicate that they’ve had enough – these might include a grimace or pushing away the activity.
In many cases, a person with autism will exhibit a combination of social, sensory and communication issues in adulthood. Adults may have trouble reading facial expressions, hearing certain sounds or smelling, and they will often miss important cues that others pick up on with verbal and nonverbal communication. They may prefer written communication to oral and can also have trouble with transitions, routine and sensory input.
For instance, a person with autism may need to eat the same meal every day or have a strict routine for each weekday. They may become highly distressed when something changes. People with autism are also known to have a hard time with executive functioning, which means they will struggle with organizational skills or coping with the slightest change in plans. For instance, someone with high functioning autism will likely have a difficult time keeping track of their finances or making a simple dinner plan.
Another sign of autism in adults is repetitive behaviors and restricted interests. These can be as small as a need to neatly organize dishes or as large as a devotion to one type of video game. Often, people with autism develop these interests through their childhood or adolescence and they can be difficult to break. They are also likely to have hyper or hypo sensitivity to different types of input, including pain, noise, light and touch.
Sometimes, repetitive behaviors can become problematic and contribute to aggression or self-injury. These behaviors usually have a biological basis and are reinforced by social consequences, but they can still be challenging for people with autism to address.
Despite the challenges, it is possible for adults with autism to live independently. The key is to find the right support system and treatment options. This may include behavioral therapy, such as Applied Behavior Analysis (ABA), speech and occupational therapies and possibly a psychiatrist for psychiatric evaluations.
In some cases, a family doctor will be the first to spot autism in adults. The doctor will evaluate to make sure there is not an underlying health issue causing the symptoms and will then refer the individual to a specialist for more in-depth assessments of their communication, emotional, behavioral and range of interests.