Complete Guide to Autism: Understanding Signs, Testing, and the Spectrum

The 5 most common signs of autism include:

1. Social Communication Challenges: Difficulty with back-and-forth conversation, understanding social cues, or maintaining eye contact
2. Repetitive Behaviors: Hand-flapping, rocking, spinning objects, or repeating words/phrases
3. Sensory Sensitivities: Over- or under-responsiveness to sounds, textures, lights, or other sensory input
4. Restricted Interests: Intense focus on specific topics, objects, or activities
5. Routine Rigidity: Distress when routines change or need for sameness in daily activities

Key red flags that may indicate autism include:

• No babbling or gesturing by 12 months
• No single words by 16 months
• Loss of previously acquired speech or social skills
• Lack of response to name by 12 months
• Limited or no eye contact
• Repetitive movements or play
• Extreme reactions to sensory experiences
• Difficulty with transitions or changes

The biggest indicator of autism is persistent challenges with social communication and interaction across multiple contexts. This includes:

• Difficulty with social-emotional reciprocity
• Problems with nonverbal communication
• Challenges developing and maintaining relationships

These social communication difficulties must be present alongside restricted, repetitive patterns of behavior, interests, or activities to meet autism diagnostic criteria.

Mild autism (now called Autism Spectrum Disorder Level 1) may present as:

• Social Challenges: Difficulty initiating conversations, unusual responses in social situations, reduced interest in social interactions
• Communication: Functional language but may struggle with conversational flow or understanding subtext
• Behaviors: Subtle repetitive behaviors, specific routines or interests that may seem quirky rather than disruptive
• Sensory Issues: Mild sensitivities that can be managed with coping strategies
• Daily Functioning: Generally independent but may need some support in social or organizational situations

Autism doesn’t “peak” at a specific age, but rather manifests differently across developmental stages:

• Early Signs (6-18 months): Reduced eye contact, limited gesturing, delayed babbling
• Toddler Years (18 months-3 years): Language delays, repetitive behaviors, and social interaction challenges become more apparent
• Preschool (3-5 years): Social difficulties with peers become more noticeable
• School Age: Academic and social challenges may emerge or become more pronounced
• Adolescence/Adulthood: May develop coping strategies, but core characteristics remain throughout life

Early identification and intervention (ideally before age 3) can significantly improve outcomes.

The 12 key signs of autism in adults include:

1. Difficulty reading social cues and nonverbal communication
2. Challenges maintaining eye contact during conversations
3. Preference for routine and distress when routines change
4. Intense interests in specific topics or hobbies
5. Sensory sensitivities (lights, sounds, textures, etc.)
6. Difficulty with small talk or casual social interactions
7. Repetitive behaviors or movements (stimming)
8. Taking language literally, missing sarcasm or jokes
9. Feeling overwhelmed in social situations
10. Difficulty expressing emotions or understanding others’ emotions
11. Preference for solitary activities
12. Challenges with executive functioning and organization

For adults, the biggest indicator is often lifelong patterns of social communication difficulties that have persisted since childhood, including:

• Consistent challenges in social relationships and interactions
• Difficulty understanding unwritten social rules
• Feeling like an outsider or different from peers throughout life
• Need for explicit instruction in social situations

Many adults recognize these patterns retrospectively when learning about autism or when their children are diagnosed.

High-functioning autism in adults (now termed Level 1 ASD) typically includes:

• Professional Success: Often excel in fields requiring attention to detail, pattern recognition, or specialized knowledge
• Masked Behaviors: May have learned to camouflage autistic traits in social situations
• Internal Struggles: High anxiety, exhaustion from masking, difficulty with change
• Relationship Challenges: Difficulty maintaining close relationships despite wanting them
• Sensory Management: Develop coping strategies for sensory sensitivities
• Late Diagnosis: Often diagnosed later in life as awareness increases

To assess if you might be autistic, consider these steps:

1. Self-Reflection: Review your lifelong patterns of social communication, sensory experiences, and behaviors
2. Screening Tools: Take validated assessments like the AQ-10 (Autism Quotient-10) or RAADS-R
3. Childhood History: Reflect on early development, school experiences, and social interactions
4. Current Challenges: Identify ongoing difficulties with social situations, sensory issues, or rigid thinking
5. Professional Consultation: Seek evaluation from qualified mental health professionals specializing in autism

Signs you might have mild autism (Level 1 ASD) include:

• Feeling socially awkward or different but able to function in social settings
• Having intense interests that others find unusual
• Needing routine and feeling uncomfortable with unexpected changes
• Experiencing sensory sensitivities that affect daily life
• Difficulty with nonverbal communication (reading facial expressions, body language)
• Feeling exhausted after social interactions
• Taking things literally or missing social subtext

Consider keeping a journal of these experiences and discussing them with a healthcare provider familiar with autism spectrum disorders.

While self-identification can be a valuable starting point, it’s important to understand:

• Self-Recognition: Many autistic individuals first recognize their traits through research or when family members are diagnosed
• Validity: Self-identification based on thorough research and reflection can be accurate
• Limitations: Some traits overlap with other conditions (anxiety, ADHD, trauma)
• Professional Value: Formal diagnosis provides access to services, accommodations, and treatment
• Community Acceptance: Many autistic communities accept self-identified individuals

Whether you pursue formal diagnosis depends on your needs for accommodations, services, or personal clarity.

The process of determining if you’re autistic involves several steps:

1. Initial Research: Learn about autism characteristics and take online screening tools
2. Self-Assessment: Document your experiences, behaviors, and challenges throughout life
3. Gather Information: Collect childhood records, school reports, and input from family members
4. Find Professionals: Locate psychologists or psychiatrists experienced in adult autism diagnosis
5. Formal Evaluation: Undergo comprehensive assessment including interviews, questionnaires, and sometimes cognitive testing
6. Follow-up: Discuss results and develop appropriate support strategies

Adult autism assessment focuses on lifelong patterns:

• Social History: Difficulty making friends, feeling different from peers, challenges in romantic relationships
• Work Patterns: Preference for routine tasks, difficulty with office politics, sensory challenges in workplace
• Sensory Experiences: Ongoing sensitivities to sound, light, texture, or other stimuli
• Coping Strategies: Development of masking behaviors or rigid routines to manage daily life
• Mental Health: History of anxiety, depression, or eating disorders that may be related to undiagnosed autism

Adult diagnosis often requires specialized professionals familiar with how autism presents in adults, particularly women and gender-diverse individuals.

You might have undiagnosed autism if you experience:

• Lifelong feelings of being different or not fitting in
• Difficulty understanding social rules that seem intuitive to others
• Intense interests that others find excessive or unusual
• Sensory sensitivities that significantly impact daily life
• Need for routine and difficulty with unexpected changes
• Exhaustion from social situations or “masking” behaviors
• History of being labeled as “shy,” “weird,” or “difficult”
• Late-developing social skills or learned social behaviors

Many adults discover they’re autistic later in life, especially women and those with fewer obvious symptoms in childhood.

Autism testing involves several types of assessments:

Screening Tools:

• AQ-10: Quick 10-question screener
• RAADS-R: Comprehensive adult autism questionnaire
• CAT-Q: Camouflaging Autistic Traits Questionnaire
• ADOS-2: Gold standard observational assessment

Professional Assessment Includes:

• Detailed developmental history
• Clinical interviews
• Behavioral observations
• Cognitive and adaptive functioning tests
• Ruling out other conditions

Mild autism, now officially called Autism Spectrum Disorder Level 1 “Requiring Support”, is characterized by:

• Social Communication: Noticeable difficulties initiating social interactions and atypical responses to social overtures
• Independence: Can function relatively independently with minimal support
• Flexibility: Some ability to adapt to changes but may still struggle with transitions
• Masking: Often able to camouflage difficulties in social situations
• Employment: Usually able to work and maintain employment with some accommodations
• Relationships: May have difficulty maintaining relationships but can form them

People with Level 1 autism often go undiagnosed until adulthood because their challenges are less obvious.