Prosper Health's Autism Resource Center

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.

Many autistic people experience relationship challenges—whether they’re romantic or platonic—in environments shaped around non-autistic social norms. Some unwritten rules and behaviors don’t necessarily come naturally to neurodivergent people. 
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Christal Castagnozzi, a clinical and school psychologist who received a late autism diagnosis, says that while she had friends growing up, there was an “underlying sense of being misunderstood.” She feels she “struggled to access deeper, more meaningful connections,” and ultimately believed she didn’t belong, even when her friends included her in their social activities. 
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Even in romantic relationships, Castagnozzi says she had difficulty “interpreting cues, flirting, [her partner’s] intentions, and emotional subtext.”
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If any of these experiences sound familiar, you are not alone. But more importantly, the challenges of autism and relationships are not a personal failing. They are often due to differences in communication style, sensory processing, social expectations, and mutual misunderstanding between autistic and non-autistic people. Castagnozzi says what made a difference for her was forming relationships with neurodivergent individuals who provided “less pressure to mask and more space for directness and authenticity.”
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In this article, we’ll examine how autism shapes all kinds of relationships, the roots of certain challenges, and practical strategies for effectively navigating relationships. 

As an adult diagnosed first with autism as a child and again as an adult, I have witnessed firsthand the change in the way the DSM, or The Diagnostic and Statistical Manual of Mental Disorders, has changed to affirm autistic people. In 2013, the DSM updated its resources with an eye to supportive care.

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Rather than labeling autistic people with misleading descriptors like high-functioning, low-functioning, or others, experts 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.

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Mental health professionals and patients can now navigate autism support without labels, a notable step forward in recognizing the individuality of care. 

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This DSM change also did away with the term pervasive developmental disorder, which encompassed disorders such as Aspergers and child disintegrative disorder. Instead, they were replaced by autism spectrum levels.

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Kaila Hattis, MA, LMFT, founder and therapist of Pacific Coast Therapy, explains, “The change focuses less on what someone has to more on what someone needs, and changes the way families access services and disperse information on what their loved one needs."

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While these three levels of autism don’t capture the full picture of autism spectrum disorder, they’re a move in the right direction to fuller, more nuanced autism treatment.