Late Diagnosis of An Autism Spectrum Disorder

A diagnosis of an autism spectrum disorder typically occurs in toddlerhood or early childhood.  It is possible for physicians, clinicians, and parents to miss or overlook the sign of Autism until late childhood, adolescence, or even adulthood.  People that are diagnosed later often have received another diagnosis while the underlying Autism went undetected.  Many people with Autism have a co-morbid (co-occurring) diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) and/or Generalized Anxiety Disorder (GAD). Even when a person is diagnosed later in life, the symptoms will have been present since they were very young.  Though they may have been masked, in order to qualify for an Autism diagnosis, symptoms must have been present from early childhood.

Why do some children receive an autism diagnosis later in life?

The symptoms of Autism may be masked for many reasons and therefore diagnosis during early childhood did not occur.  People with Autism that are high functioning are usually of average or even above-average intelligence.  In many situations, children with undiagnosed Autism have immense strengths that do not raise many red flags in the elementary school settings.  When children are able to do well in school, perform well on an IQ test and communicate it will usually send parents, teachers, and pediatricians to explore other options for a child’s unexpected or unusual behaviors.  When academic work becomes more abstract and social interactions become more complex these children/adolescents begin to show more challenges in the home, school, and community settings. 

Some research suggests that females are less likely to be diagnosed at a young age.  A 2015 study titled “Sex and gender differences in autism spectrum disorder,” reports that symptoms of autism manifest differently in females and tend to display better functional social skills and awareness than males on the autism spectrum.

What are the early signs of autism disorder?

There are some signs to be aware of if you are unsure if your loved one may be on the autism spectrum but is undiagnosed. Some of the signs to look for are being overly anxious in social situations, appearing blunt or rude without intention, avoiding eye contact or giving uncomfortable eye contact, difficulty making and/or maintaining friendships, and difficulty understanding what others are thinking and feeling (theory of mind), having exquisite knowledge about a narrow topic of interest, engaging in strict routines and becoming dysregulated when change occurs, difficulty understanding social norms and social cues and high levels of sensory sensitivity (smells, tastes, textures).

If you think you or your loved one may have an autism spectrum disorder your physician or a mental health professional can support and guide you to find the appropriate referrals for a neuropsychological assessment.  These assessments are usually completed by a clinical psychologist.  When a diagnosis occurs later in life, there are appropriate therapies and ASD programs including cognitive behavioral therapy, social skills training, and behavioral therapy that can help a person to gain more insight into themselves as well as increase socially appropriate interactions and behaviors.

Having a loved one diagnosed later in life may come with guilt due to not recognizing the signs earlier.  It is important to remember that receiving a diagnosis for many people that have an autism spectrum disorder begins a journey toward self-awareness and acceptance.