Prosper Health's Autism Resource Center

As our understanding of the autism spectrum evolves, so does the language associated with autism spectrum disorder (ASD). And that language matters. 
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Right before my daughter was diagnosed with ASD, I felt like everyone around me was using the phrase “high-functioning autism” to describe her relatively moderate support needs. It also seemed to confirm why it took several years to receive an autism diagnosis at all. I soon learned, however, that describing someone with “high-functioning autism” was not only incorrect but harmful. 
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For starters, “high-functioning autism” isn’t even a clinical diagnosis, though the term is pervasive enough that some people may mistake it for one.  

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What the best-intentioned people usually mean when they say “high-functioning” is Level 1 or low support needs, which often refers to someone who needs circumstantial support with social communication and restricted or repetitive patterns of behavior and interests (RRB).

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Specifically, that can mean help with managing the need for sameness, recognizing neurotypical social functioning and cues, and managing sensory sensitivities. Autistic people who are Level 1 may also engage in masking, which can make someone seem to have fewer support needs than what is actually sustainable.
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Nasiyah Isra-Ul (they/she) is an autistic professional and disability advocate who believes that the once-prevalent “high-functioning autism” label prevented them from receiving the support they needed throughout their childhood and young adulthood. It could also explain why they received a late autism diagnosis as an adult.
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If you’re curious about signs of high-functioning autism in adults, you’re in the right place! But we won’t be using that problematic term, and neither should you. In this article, we’ll explain why the term is outdated, what people actually mean by it, and what the most common autistic traits look like for adults with Level 1 autism support needs or who mask heavily.

Getting diagnosed with autism later in life, whether it’s in your 20s or 40s or even your 60s, can be a total game-changer. It can impact your entire sense of identity and how you interact with the world and others. It can also bring a profound feeling of relief while answering many questions, including: why did it take so long to figure this out? 

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For Tobey, 41, the turning point following his clinical diagnosis was a deep sense of self-acceptance. “Once I stopped burning energy on hiding and masking, I was able to redirect that effort into becoming my true self,” he says. “The difference has been huge.”

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Tobey is far from the only adult who spent decades living with undiagnosed autism. In fact, the rate of autism in adults has been steadily increasing. Between 2011 and 2022, the autism diagnosis rate increased by 450% among 26-to 34-year-olds alone.

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Today, the Centers for Disease Control and Prevention (CDC) estimates that one in 45 adults is autistic, and even more are likely undiagnosed. This rise is due to the improved understanding of the condition (and acknowledgement that autism is a true spectrum, rather than a collection of specific traits) thus leading to updated diagnostic criteria.

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Whether you’re newly diagnosed yourself or are considering getting an adult autism evaluation, you probably have a lot of questions. In this article, we’ll provide a neurodivergent-affirming breakdown of why many adults receive a late autism diagnosis, and we’ll unpack both the challenges and benefits, as well as how to access support.

When you picture someone with autism, there’s a good chance that a child comes to mind. Maybe your nephew or a member of your child’s class is diagnosed, so you’re familiar with some of the behaviors associated with the condition...or at least how they show up in children. But millions of autistic adults exist too, since autism is a distinct neurotype, not something you grow out of. 

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However, if the condition wasn’t assessed already in childhood, it can be harder to spot as an adult. In fact, the Centers for Disease Control and Prevention (CDC) estimates that one in 45 adults is autistic, and even more are likely undiagnosed. 

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Though there are many shared traits between the age groups, autism can present differently in adults than in children, which is something we'll discuss in depth within this article. But fundamentally,  the signs of autism in adults include a range of characteristics like:

• Social interaction and communication differences 
• Self-soothing and self-regulatory behaviors
• Sensory and processing differences
• Special interests and activities
• Emotional regulation and cognitive traits

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If you suspect you may be autistic, you likely know the journey toward diagnosis isn’t so straightforward. It can be confusing and frustrating! Especially since no two people with autism are the same, and everyone has their own unique combination of strengths and challenges.

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On top of that, many adults tend to mask their autistic behaviors to fit in with their neurotypical peers, oftentimes without even realizing it. Plus, thanks to gender and cultural bias and other stereotypes, countless autistic adults are overlooked due to their more subtle presentation of the condition. 

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That’s why Prosper Health is here to provide you with a clear, inclusive, neurodivergent-affirming breakdown of adult autism signs: what they are, why they’re often missed, and what to do if they resonate.

Stimming, or self-stimulatory behavior, is self-regulating behavior common among autistic individuals. Autistic people stim for many reasons, including combatting sensory overload, interrupting anxious thoughts or satisfying sensory-seeking needs.

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When thinking of stimming, many people imagine rocking or hand flapping. These are common stims, but stimming can look many different ways. Stims can include behaviors like playing with a fidget toy, pacing, jumping, repeating words or phrases and many, many more.

While many autistic individuals frequently engage in stimming, it isn’t always something that they feel comfortable doing publicly. Often, stigma and mistreatment make us autistic individuals fear judgment or harassment when stimming around others. Stimming comes along with benefits, including helping us manage sensory input, regulate our nervous systems, unmask and live more authentically. However, it can take a lot of work to feel comfortable openly stimming. Read on to learn how to get comfortable stimming around others.

Many autistic individuals report experiences with postural orthostatic tachycardia syndrome (POTS), a disorder of the autonomic nervous system. Although there has been some research on comorbid autism and POTS, science is yet to reveal much about the two diagnoses’ relationship. However, we know that they have some overlapping features, and that people with either diagnosis can benefit from support strategies. Read on to learn more about what we know about POTS and autism.

Stress is a part of life, but excessive stress can make day-to-day activities difficult and even compromise a person's physical health. Autistic individuals tend to experience higher baseline stress levels, due to factors like stigma, social marginalization and unmet support needs. Many people still understand autism through stereotypes, or don’t understand autistic behaviors at all, leading to bullying and mistreatment. Environmental stressors like disorganized and loud public spaces, harsh fluorescent lights, and inaccessible communication norms also take a toll. 

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Furthermore, mental health conditions are very common among autistic individuals. Nearly half live with severe anxiety, up to 40% have experienced depression and as many as 45% of autistic adults have PTSD. Additionally, autistic people have higher rates of co-occurring health conditions like sleep disorders, seizure disorders, and GI issues like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). All of this can further contribute to stress.

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In addition to degrading a person’s long-term mental and physical health, chronic stress can lead to unique challenges for autistic individuals. It can contribute to autistic burnout, the intense state of fatigue that autistic people confront due to many different sources of chronic stress, and an increased volume and intensity of meltdowns, which are involuntary responses to an overloaded nervous system.

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For autistic individuals, who often face high levels of chronic stress, stress management strategies and coping skills are essential for long-term well-being. Read on to learn valuable strategies for autistic adults to manage stress.