Autism Tests for Adults

Learn about autism traits and how they are evaluated

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Autism tests for adults exist, though most people are diagnosed with autism spectrum disorder (ASD) as children. However, more adults are being identified later in life as autism is better understood. A diagnosis of adult autism can only be made by a qualified healthcare professional, such as a psychiatrist or psychologist.

This article will help you understand how an adult autism diagnosis is made. It covers traits and behaviors to look for, self-screening tools, and how a mental health professional evaluates an adult for autism while ruling out other possibilities.

A woman talking to her doctor
Tochen Sands Collection / Digital Vision / Getty Images 

Self-Observation

Adults diagnosed with autism are likely to be at what has been called the high-functioning end of the spectrum, now referred to as autism with low support needs. While not itself a diagnosis, autism with low support needs describes specific traits and behaviors.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the handbook used by mental health professionals to diagnose conditions, this is known as "level 1" autism.

Many adults have comparatively mild autistic traits, which typically relate to social communication and sensory responses. With these traits, it's possible to be an autistic adult with low support needs and not know it.

It's often not until people become more aware of what ASD is that they consider the possibility for themselves. Some may only realize it after an autistic child is diagnosed, and they notice similarities between their child's traits, behaviors, or feelings and their own.

Social Communication Traits

Social communication traits involve how you interact with other people. You may realize you've had some of these traits since you were a child, but you've learned to hide or manage them.

  • In social situations, you aren't sure what to wear, when to speak, or when to be quiet.
  • You use the wrong tone or word choice while talking to other people. You may speak too loudly when you should keep your voice down.
  • You have trouble interpreting other people's body language or words.
  • You struggle to keep up with conversations, especially when you aren't interested in the topic. It's especially hard for you to make small talk.
  • You're so fascinated by a particular topic you find it almost impossible to change the subject.
  • You aren't sure when it's appropriate to ask certain questions or to speak up; you may feel so uncertain you simply don't say anything at all.
  • You have a hard time coping with change. You may stick to the same schedule, eat the same foods, and take the same route to work every day, becoming upset if your routines are interrupted.

Anxiety and Autism

Symptoms of an anxiety disorder often coexist in autistic people. This is especially common in biological women and girls, whose ASD may be overlooked or misdiagnosed before a diagnosis of ASD is determined.

Sensory and Behavioral Traits

Many of these traits are common in all autistic people, but they may not be as obvious in those with low support needs. They may seem more like individual quirks than autism traits.

  • You're very sensitive to light, sound, smell, touch, and taste and do not like being touched or hugged.
  • You may need physical pressure to feel calm. You may hug yourself tight if you're upset, for example.
  • You move in unusual ways or make odd sounds. This is a form of self-calming called stimming. Examples include pacing, rocking, hair twirling, and humming. If you're in public, people may stare at you, but you can't stop the behavior.
  • You have "autistic meltdowns." You get very frustrated and upset, find you are unable to control your words and actions, and may even frighten other people.

Self Tests

Self-screening tools for ASD are questionnaires you can take yourself. Most are available online at no cost. They can't confirm an autism diagnosis but they can help you decide if you should see a professional to be formally evaluated.

Among the most common self-screening tools for ASD are:

  • Autism Spectrum Quotient (AQ-10): This is a 10-question screening tool adapted from a much longer questionnaire called the Autism Spectrum Quotient (AQ). The AQ-10 is a very popular screening tool, but note that some research shows this shorter version may not be the most reliable way to identify a person's autism. The AQ-10 test is available online.
  • Adult Repetitive Behaviours Questionnaire-2 (RBQ-2A): This 20-item questionnaire focuses on "restricted and repetitive behaviors." This refers to intensely focused interests, or actions repeated over and over, like switching lights on and off. It's been found to be a highly effective screening tool for autism. The RBQ-2A also is available online.
  • Adult Social Behavior Questionnaire (ASBQ): The 44 questions in this tool focus on a wide range of aspects of autism in adults. It's especially effective for identifying autism with low support needs. It can be used as a self-test and to evaluate someone else.

Examples of online test questions include:

  1. Do you prefer to do things the same way over and over again?
  2. Do you tend to notice details that others do not?
  3. Do you tend to have very strong interests and get upset if you can't pursue them?
  4. Are you fascinated by dates or numbers?
  5. When you talk, is it hard for others to get a word in?
  6. Do you repetitively fiddle with items? (e.g. spin, twiddle, bang, tap, twist, or flick anything repeatedly?)
  7.  Do you repeatedly play the same music, game, or video, or read the same book over and over again?

Professional Evaluations

The only way to get an accurate adult autism diagnosis is to see a mental health professional.

A comprehensive autism assessment relies on several factors, including:

  • Your own observations about how you communicate in social situations and if you have any sensory sensitivities
  • Reports about odd behaviors or movements, as well as outbursts
  • Results of self-screening questionnaires, such as the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS–R)
  • Results of clinical evaluations and observations

The practitioner will ask questions, have you complete one or more evaluations, and observe your behavior, speech, and how you interact with them.

Who to See

Some health providers may not immediately consider autism as a possible diagnosis for an adult. Autistic women, in particular, are often overlooked.

Thus, you should seek an evaluation from someone with experience diagnosing ASD if you decide you need to be evaluated. Ideally, this person will have a background working with adults, but this may be hard to find.

In that case, you may want to try looking for a developmental pediatrician, a child psychiatrist, or a pediatric neurologist who specializes in autism and would consider evaluating an adult. You might also look for a local autism center with a good reputation.

Autism Tests for Adults

Autism tests for adults may include several options:

  • Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Module 4: The ADOS-2 is the gold standard for diagnosing autism in people of all ages. Module 4 is used specifically for adults and is not a questionnaire. Instead, the professional administering the test will observe how you respond to certain prompts. They evaluate both what you say and how you behave.
  • Developmental, Dimensional, and Diagnostic Interview-Adult Version (3Di-Adult): This standard tool for diagnosing adult autism focuses on how you communicate and interact in social situations. It also looks for intensely focused interests, such as an obsession with a particular object, and certain behaviors.
  • Social Responsiveness Scale (SRS): This 65-question test assesses social challenges, and is often used as part of a comprehensive battery of tests used to diagnose autism.
  • Autism Diagnostic Interview-Revised (ADI-R): This test focuses on the three main areas affected by autism: language and communication, social interaction, and repetitive behaviors or interests. There are 93 questions in the ADI-R.

Could It Be Asperger's Syndrome?

Asperger's syndrome was once considered a separate autism-like disorder. However, in 2013, it was folded under the umbrella diagnosis of autism spectrum disorder (ASD) in the DSM-5. Today, what was once called Asperger's is often called autism with low support needs.

The traits include:

  • Obsessing over a single interest
  • Craving repetition and routine (and not responding well to change)
  • Missing social cues in play and conversation
  • Not making eye contact with peers and adults
  • Not understanding abstract thinking

Diagnosing Adult Autism

In adults, autism spectrum disorder can look a lot like other developmental or psychiatric disorders. These often need to be ruled out in a process called differential diagnosis.

Autism can most easily be mistaken for social communication disorder (SCD). People with SCD struggle with using words and language appropriately. They might use overly-formal words and tone during a casual conversation with a friend, for example.

Research has also found it's not uncommon for someone to have a psychiatric disorder along with ASD. For example, a 2019 meta-analysis found that among autistic adults:

A healthcare provider may consider various additional evaluations depending on what other disorders they suspect.

Getting Support

For some people, going through the process of getting an adult autism diagnosis can be stressful. Getting support during this time and after diagnosis may help.

Consider finding resources online offered by the Autistic Self Advocacy Network, the Autism Research Institute, or other organizations.

Connecting with autistic people in your local community may help you feel less alone and empower you to be your own advocate, speaking up for yourself and your needs.

Summary

Diagnosing autism in adults can be tricky. People who weren't diagnosed as children are likely to have mild autism traits that they've unknowingly learned to cover up or manage.

That said, there are plenty of autism traits and behaviors a person may be aware of, such as trouble navigating social interactions and extra sensitivity to smells or touch.

People who suspect they may have an autism spectrum disorder can screen themselves using free questionnaires found on the Internet. But to get an actual autism diagnosis, it's necessary to see a mental health professional.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Lisa Jo Rudy

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.