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By Fraser Psychologist Jessica Dodge and Pam Dewey • adult autism diagnoses, adult autism, adult ASD, adult autism spectrum disorder, women and autism diagnoses, what causes delays in autism diagnosis, delays in autism diagnosis, therapy for adults with autism, therapists for adults with autism, adult autism therapists, adult autism therapy • March 28, 2024

The number of adults being diagnosed with autism is growing. Increased awareness, better diagnostic tools, and changing attitudes have contributed to the growing population. Whether you are considering pursuing an autism diagnosis or have recently been diagnosed, we reached out to Fraser Psychologist Jessica Dodge to answer some questions you may find yourself grappling with.

1. What causes delays in autism diagnoses?

Many barriers can prevent an autism diagnosis for a child or young person. Teachers, parents and healthcare providers can miss subtler traits or symptoms of autism. For example, if a child doesn’t have a language or developmental delay, they might not be identified as needing further assessment or evaluation. Another diagnosis, like attention-deficit/hyperactivity disorder (ADHD), can sometimes result autism being missed, says Fraser Psychologist Jessica Dodge. A person with ADHD might display similar symptoms, like difficulty with social interaction or have behavior problems in school.

Many autistic individuals also learn to mask some symptoms. Dodge says she has diagnosed adults who work hard to use eye contact, read social cues and engage in small talk. However, these things haven’t developed naturally and can require significant effort, at times. But, this can make it more challenging for clinicians to identify autism.

Parents may also deny that their child is autistic. While there is nothing “wrong” with having autism — it’s now accepted as a different learning style or way someone perceives the world — there’s still a stigma attached to it. In an attempt to protect their child from a label, a parent may not pursue an evaluation for autism.

2. Why is it harder for women to be diagnosed with autism?

Since most testing and research has previously focused on male autism traits, there isn’t as much research on what autism looks like in women, says Dodge. So, an autistic girl might not have a challenging behavior like an autistic boy does. Her autism might manifest as a fixation on certain topics and difficulty maintaining friendships. But these behaviors in girls may not always trigger testing for autism.

Girls can also be better at masking behaviors. An Australian study comparing boys and girls with autism found little girls were “more likely than boys to mimic others in social situations and to want to fit in with other kids.” So, although an autistic girl may be uncomfortable socializing, she has learned to mask her feelings when placed in social situations.  

“This is likely due to gender-based expectations girls and women experience,” says Jael Jaffe-Talberg, Fraser pediatric clinical psychologist. “They are socialized to ‘act like a girl’ and experience greater pressure to censure their own behaviors.”

Adult autistic women, who are diagnosed later in life, also report that they learned to study other people to know how to act socially.

3. How do most adults feel after a diagnosis?

For many of her adult clients, Dodge says, a diagnosis is usually a relief. They finally have an answer and clarity about what they have been experiencing. Autistic adults have often been diagnosed with a long list of other disorders, like anxiety, depression, obsessive-compulsive disorder (OCD), borderline personality disorder, etc.

“Autism can co-occur with other mental health diagnoses,” says Dodge. “But sometimes, we find that symptoms are best captured under autism. So instead of a long list of other diagnoses, they feel relief to have just one diagnosis.”

An adult autism diagnosis may also provide other answers. It gives them a new lens to better understand past feelings and needs. Perhaps after attending a social function, an autistic person will have to shut down completely and sit by themselves for several hours to recharge. They’ve never understood why, but now this need becomes clear.

4. What does an autism diagnosis change?

“When I diagnose an adult with autism, I always emphasize that they’re the same person. Having the diagnosis doesn’t change anything about them,” says Dodge. “It definitely shouldn’t change their expectations of themselves.”

However, they may have to make adjustments or find the right support. Maybe therapy has never really worked for them previously, but now, with an autism diagnosis, they understand their therapy needs will be a little different.

“It also opens them up to a whole community of people who have similar perspectives and viewpoints,” says Dodge.

Fraser offers a variety of autism group therapy options, catered to people of all ages and backgrounds. There are also a variety of other organizations, like the Association for Autism and Neurodiversity and Autism Society of Minnesota, Facebook groups and other resources to connect to other people with autism.

Dodge says it also varies whether adults disclose their new diagnosis at work. Disclosing at work can be helpful because it allows access to supports. Perhaps working in an office is too distracting, and working from home would be beneficial. Or maybe, a supervisor needs to modify their communication, so instead of verbal instructions, an individual would benefit from written instructions on a project. Disclosing an autism diagnosis can provide context and support when you ask for changes at work. However, disclosing at work should be assessed and discussed on an individual basis.

5. How hard is it to find a therapist who works with autistic people?

Dodge says it can be hard to find a therapist with an expertise in autism. It’s not something many psychologists and psychiatrists were previously trained in. However, having the right credentials doesn’t guarantee a therapist will be the right fit.

A good therapist and client match depends on rapport and the relationship. An autistic adult may need to meet with more than one therapist before they find the right fit. Dodge recommends an individual start by telling a bit of their story and seeing how the therapist responds. Ensure a therapist is offering strategies and supports that match your needs. A therapist who prioritizes what is important both to and for the client is critical, says Dodge.

“You have to be willing to self-advocate, and if it isn’t working, tell them that and find a new therapist,” says Dodge. “A good therapist will understand and have no problem with this.”

At Fraser, Dodge says, it’s much easier to find a therapist who specializes in supporting autistic adults, like herself. You can call 612-767-7222 to inquire about services.