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Prosper Health's Autism Resource Center
Featured Article
Social Cues and Autism: Why the "Missed Signals" Narrative Gets It Wrong
Consider this: a coworker asks you to complete a task, “whenever you get the chance,” and you take it at face value. Two days later, you find out the request was urgent, and your coworker assumed their tone made that obvious. Or another example: you're mid-conversation with a friend, and something in their face shifts. You notice it, and you're also tracking their tone, their words, and your own response, all at once. By the time it's processed, the moment to say something has passed.
If either scene felt familiar, you’ve probably been told that you missed something obvious. Maybe you’ve been called hard to read, rude, oblivious, cold, or “bad at people.” But inside, you know that’s not really what happened.
These messages put the entire problem on one person in a conversation between two people. This article looks at autism and social cues, including why social cues can be harder to read for some autistic adults, why misunderstanding is often mutual, and what can help in situations where it matters most.
Misophonia and Autism: Why Certain Sounds Feel Unbearable, and What to Do About It
Do certain everyday sounds — like slurping, tapping, or chewing — send you into a whirlwind of distress or discomfort? Perhaps it’s not just emotional, but also physical, and you can’t shove down the reactions no matter how hard you try. If this feels relatable, you might have a common condition called misophonia.
Research suggests a possible link between misophonia and autism. Autistic individuals are more likely to have sensory sensitivities, after all. In any case, misophonia is “a nervous system response and not a cognizant decision,” says Jacqueline Shinall, Psy.D., a psychologist at neurodivergent-affirming telehealth provider Prosper Health.
Delane, a 27-year-old autistic woman, experiences misophonia due to “human sounds” like eating. “It just feels like someone constantly poking at the same spot, to the point of overstimulation and irritation,” she says. “It takes a lot of self-control to not lash out.”
Let’s take a closer look at what misophonia is, what research shows and doesn’t show about its connection to autism, and how to manage it. Whether you're wondering whether misophonia may be a sign of autism, are autistic and want to understand misophonia, or are simply looking for relief, there's no wrong reason to be here.
The Fear of Being Perceived in Autistic Adults
Let’s say you’re about to go to lunch with a colleague, but you just need to make a few last tweaks on a task.
Your colleague is happy to wait for you and remains quiet while you finish up, but it doesn’t matter. You still feel like you’re being watched. Suddenly, your anxiety skyrockets, and completing your work task now feels impossible with your coworker standing idly by.
Many call this the fear of being perceived — and it’s become a viral shorthand for a much broader feeling — but for autistic and ADHD adults, there’s usually something more concrete that’s happening behind the scenes.
Autistic content creator Morgan Foley even made a video illustrating the fear of being perceived, in which she not only demonstrates how this feeling can present in several scenarios (work, socializing, chores, etc.), but also the thoughts going through her head in that moment.
After reading this article, you will be able to recognize this type of fear as a specific, explainable pattern connected to neurodivergence, understand why it hits differently depending on your neurotype, and identify at least one concrete step toward feeling safer while still being yourself.
Most importantly, this article will help you to answer the question, “Why do I hate being perceived?”
Black and White Thinking: What It Is and Why It Happens
“If I can’t do this project perfectly, I shouldn’t have this job, should I?”
“OMG, my friend canceled our coffee meetup. I knew she never really liked me.”
“My partner forgot I wanted to see The Odyssey this weekend. I think our relationship is in trouble.”
If any of these internal monologues sound familiar, it’s not because someone gained access to your innermost emotions: It’s because these thought patterns are more common than you may think, and they’re known as black-and-white thinking.
Before we delve into these patterns more deeply, know this: It’s okay if you’re unsure whether your black-and-white thinking is a problem, a trait, or both, even if you’ve been told that you tend to “overreact” or that you “can’t see nuance.” Examining this kind of dichotomous thinking doesn’t mean it’s a flaw to be fixed or even a symptom of a specific disorder.
These patterns are just one part of who you are, and you deserve to understand what exactly black-and-white thinking is, what’s driving these patterns, and if you should pursue support.
Support Needs, Not Labels: A Guide to “Levels” and “Types” of Autism
As a person diagnosed with autism as a child and then again as an adult, I’ve witnessed firsthand the way the Diagnostic and Statistical Manual of Mental Disorders (DSM) has changed to affirm autistic people. In 2013, the DSM updated its resources with an eye to supportive care.
Experts now categorize individuals based on levels of autism spectrum disorder (one, two, or three). These levels indicate varying degrees of support needs, which are often fluid and can change over time.
People can now navigate autism support without labels like “high-functioning” or “low-functioning.” It’s a notable step forward in recognizing the individuality of care and nuances of treatment. This can be useful whether someone's diagnosed, self-identified, or still exploring.
Let’s discuss levels of autism, why they're relevant, and how your level can look different depending on the day. We’ll also address how these levels relate to older diagnostic terms like Asperger's.
This article is for everyone—whether you have an assigned level, are reconciling an older diagnosis with today's terminology, or haven't been formally diagnosed at all.
Unlocking Support: The Importance of an Adult Autism Diagnosis
When I was growing up in the 90s and early 2000s, autism spectrum disorder was heavily stigmatized and misunderstood. Since I did exceptionally well in school, no one in my family even considered I might be autistic. Throughout my life, I struggled a lot with focus, sensory sensitivities and interacting with other people. When I was diagnosed with Ehlers-Danlos Syndrome (EDS) in 2019, I learned how common it is to have ASD or ADHD with EDS. I was diagnosed with ADHD in 2021, but it still felt like I was missing a piece of the picture.
Until recently, most adults were not diagnosed with autism in their youth. There are likely several reasons for this, including a variety of issues within the diagnostic process. People of color, nonbinary people, transgender individuals and women have been historically underdiagnosed. This is due to discrimination, stigma or misconceptions. The diagnostic process started to improve in the early 2000s, with new diagnostic criteria that more accurately represents how autism shows up in the world.
For those of us who weren’t diagnosed earlier in life, though, getting an accurate diagnosis can be hard. Some of us have learned how to mask or camouflage so efficiently that we blend into a neurotypical world really well, making it difficult to find a provider who will take our request for an autism assessment seriously.
This is one of the many reasons why working with a neurodivergent-affirming clinician is critical when seeking a formal diagnosis. Regardless of the outcome, the diagnostic assessment process can play a helpful role in better understanding yourself.
What Is Autistic Burnout? A Clear Guide for Autistic Adults
When autistic author Denea Marable experiences autistic burnout, she says it feels like she’s underwater. “I tend to move more slowly, I’m prone to sensory overwhelm, and I have challenges speaking. It’s tougher for me to focus when I’m in autism burnout; I feel as if the world is passing me by.”
Autistic burnout is a state of intense exhaustion and loss of function caused by the stress of ongoing sensory overload, constant masking, and pressure to exist in a neurotypical world without adequate accommodation.
For healthcare professional Jodes* (they/them), who has autism and ADHD, autistic burnout has a multilayered, almost snowball-like effect on their day-to-day life. “It looks like being in a consistent fog, and the pressure of the fog pushes you down, feeling so tired it's hard to move,” they explain.
Jodes also says their autistic burnout impacts their ability to complete daily living skills and tasks. Their burnout additionally causes a need for more sleep, increased procrastination, meltdowns, and migraines––as well as verbal shutdowns.
But Jodes’ and Marable’s stories just go to show that autistic burnout in adults is quite common, even more so in late-diagnosed adults.
If you’re someone who experiences autistic burnout, you deserve to understand why it occurs and its root causes. In this article, we’ll cover what autistic burnout is, why it happens, the early signs to look for, and the supportive steps you can take to recover and protect your well-being.
What is Autism Spectrum Disorder? A Comprehensive Guide to Understanding Autism
Autism spectrum disorder (ASD) is a neurodevelopmental disorder. This means it’s a developmental disability involving an individual's neurological system. It is not a mental disorder or mental illness. ASD affects how people communicate, behave and process sensory information.
Some people believe that the term "spectrum" means everyone falls somewhere on the spectrum of autism. This is because autistic traits are human traits. Many people do have some features of autism, but this does not mean they have enough features of autism, at a high enough level, to be clinically diagnosed as autistic. In actuality, the term “spectrum” helps to highlight that there are many ways that autism can affect people differently. There’s a wide range of how autism presents in someone’s life. For example, there are some autistic people who need significant support, while others can live more independently. This is why clinicians now categorize autistic individuals based on levels (one, two, or three). These levels indicate varying degrees of support needs, which are often fluid and can change over time.
The diagnosis “autistic disorder” was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R)––a reference manual for mental health providers—in the late 1980s.
However, the DSM-5, released in 2013, resulted in a major change in language surrounding autism. Autism spectrum disorder (ASD) is now an overarching diagnosis, encompassing the older diagnoses of Asperger’s syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS), and autistic disorder.
Increasing awareness and understanding autism
People used to think autism spectrum disorder was rare, but many people are realizing it’s more common than they thought.
The Cleveland Clinic estimates that 1 in 36 children in the U.S. is autistic, and the CDC estimates that 2.21% of U.S. adults are autistic.
However, these percentages may actually be higher due to factors like misdiagnosis, underdiagnosis or late diagnoses. These occurrences are particularly common among certain groups, such as girls and women, people of color and those from marginalized communities.
This doesn’t mean autism is more common now than it used to be. Rather, autism awareness among healthcare providers is higher, especially now that there’s better access to tools and resources for continued learning. The general public knows more about autism, too. These advances help foster better understanding for autistic people as well as their families, friends and communities.
Navigating the Workplace: A Guide for Autistic Adults Seeking Accommodations
In 2017, the CDC released findings where they estimated that 2.21% of adults in the US were autistic. This data is imperfect. First, it’s from 2017. And, secondly, it’s mostly based on childhood diagnoses of autism. But, it gives us a number to start from, showing that adult autism is not absent from most workplaces.
Research also shows that people with autism spectrum disorder are more likely to be underemployed or unemployed than their neurotypical peers. That number may be as high as 85%. This can be due to burnout, inaccessibility, or not having appropriate support and accommodations at work.
Being autistic can make working difficult. Many jobs are incompatible with autism, like working at the customer service desk of a department store. There can be a lot of unpredictability, challenging social interactions, and stress.
Plus, stimming and fidgeting may not be easy to do at work. These coping mechanisms might draw negative attention and are sometimes seen as unprofessional. It is vital for us to be able to engage in these activities, because they can quickly and drastically improve our health and well-being.
But, often, workplaces don’t see the benefits of hiring and working to retain autistic individuals. They don’t know that we’re often more productive than our neurotypical counterparts—or that, many times, a combination of a severe lack of resources and some intolerance lead to us leaving for another position.
Thankfully, employees can take steps to get our needs met by seeking out reasonable accommodations.
Understanding AuDHD: What It Is and How to Get Support
YouTube educator Chris was a child when he was first diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), but he didn’t get his autism spectrum disorder (ASD) diagnosis until he was in his 40s. Like many people who have recently received this dual diagnosis, he’s only now truly learning what it means to be “AuDHD”. This includes an acute awareness of the tension and overlap of traits and how to manage their impact.
"AuDHD is when somebody has co-occurring diagnoses of both autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD),” says Jacqueline Shinall, PsyD, Quality Control and Reliability Lead Psychologist at Prosper Health.
And in true neurodivergent fashion, Chris is learning everything he can about the management of AuDHD. As the cofounder of Audicate, an educational vlog about managing Autism and ADHD, he makes popular videos that teach others about what it’s like to live with both disorders.
“AuDHD isn’t a rare overlap—it’s much more common than anyone realized prior to the dual diagnosis,” says Chris. “But diagnostic data is going to take time to catch up to that. And when you don’t know you’re both, you can end up blaming yourself for contradictions: ‘Why do I want change but resist it? Why am I both restless and rigid?’ Understanding both diagnoses brings compassion and clarity.”
As awareness grows and diagnostic criteria evolve, more and more people are being diagnosed with both conditions.
That’s why, if you have been diagnosed with Autism and ADHD, or suspect you might be an AuDHDer it’s essential to understand the overlaps and interactions between the characteristics. Because just as these traits will manifest differently for every autistic and ADHD individual, the same goes for people with AuDHD.
It’s like if you were to give yellow and blue paint to a group of children and tell them to make green—every shade will be different. And your unique shade will inform what level of support you need and the accommodation strategies that will help you thrive.
Whatever stage of your neurodivergent journey you’re at, Prosper Health can help.
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