Autism in Adults: How Late Diagnosis is Made

There are many children identified with autism spectrum disorder (ASD). More specifically, the Diagnostic and Statistical Manual of Mental Disorders estimates that 1 in 44 eight-year-olds.

Autism is known as a “spectrum” disorder precisely because there is a wide variation in the type and severity of symptoms that people experience. For this reason, there are those who discover that they are part of this statistic only in adult life.

Singer Vitor Fadul – husband of historian CNN presenter Leandro Karnal – was diagnosed at age 25. It is a case similar to that of civil servant Mirtes Oliveira, who began to suspect her condition at the age of 28, when she watched the 2009 film “Adam”.

View this post on Instagram

A post shared by Leandro Karnal (@leandro_karnal)

The plot is a romance between Beth (Rose Byrne) and the protagonist Adam (Hugh Dancy), who has Aspenger syndrome – nowadays known as ASD level 1 support or, popularly, as “mild autism”. (It is worth remembering that the Austrian Hans Aspenger contributed to the death of several children during the Nazi regime).

In an interview with CNN the civil servant said that the difficulty in maintaining a banal conversation, social discomfort, sensory overload, crises, “inappropriate” speeches, hyperfocus (intense interest in a subject) of Adam were some of the characteristics with which she identified .

“That film had a great impact on me, it was as if someone had exposed my feelings, emotions and reactions there”, said Mirtes.

Right after the film, she researched the subject on the internet and read articles, posts, watched testimonials and even took tests like the “Aspie Quiz”, which only increased the suspicion that she was on the spectrum.

Seeking specialized professional evaluation, however, was difficult: “I found that finding a professional in the field of psychology and/or psychiatry who was trained to assess and diagnose autism in adults was almost like finding a unicorn”, he vented.

It took a medical student friend to find a psychiatrist specializing in ASD. “Even though he was a child and youth psychiatrist, he made an exception for me. Around March-April 2011, we started the evaluation process, and my diagnosis was confirmed in June. It is he who accompanies me to this day, ”she says.

How is the diagnosis made in adults?

In an interview with CNN psychologist Ashley Curcio, who works at Genial Care, a multidisciplinary clinic focused on children on the autistic spectrum, pointed out that diagnosing adults is often more difficult because ASD symptoms can overlap with symptoms of other mental health disorders, such as anxiety disorder or attention deficit/hyperactivity disorder (ADHD).

“Although the assessment of ASD in adults is still being refined, they can seek or be referred to a neurologist, psychologist or psychiatrist who has experience with ASD”, says the psychologist.

According to Ashley, these are some points that the professional will address:

• Social interaction and communication challenges
• Difficulties with sensory input (Are you anxious in noisy places?)
• Narrow interests (Mirtes’ hyperfocus, for example, is the K-Pop group BTS and Jungian psychology)

The assessment may also include talking with caregivers or other family members to learn about the person’s early developmental history, which can help ensure a more accurate diagnosis.

Before and after diagnosis

“Getting a correct diagnosis of ASD as an adult can help a person understand past challenges, identify personal strengths and find the best way to help as each of us is unique and needs different things,” says Ashley.

That’s what happened to Mirtes: “I spent 28 years of my life not understanding why things that are so simple for the people around me are so complicated for me”, he says.

A difficulty for civil servants was having fun at parties and concerts. For Mirtes, it was something that people quickly learned to do and she was taking her time to achieve.

“I was unaware of the fact that they hadn’t ‘learned to have fun’ at these events, they just found it fun, and went to them for that reason”, he explains.

According to psychologist Ashley Curcio, the signs in adults can be a little more subtle and even that is why a diagnosis was not given throughout life. She says it’s worth paying attention to these signs:

• Trouble understanding other people’s tone of voice, facial expressions or body language
• Difficulty understanding figures of speech, such as humor or sarcasm
• Difficulty making friends with peers and sustaining those relationships

Even if done late, Mirtes Oliveira says that the search for the diagnosis is very worthwhile, as there is a strong feeling of liberation.

“Liberation of our past selves, as we often carry a guilt that was not up to us to carry, as it was a guilt for failing to be someone we never were, nor should we have tried to be”, he says.

myths about autism

According to psychologist Ashley Curcio, the biggest myth that revolves around autism is the individual’s capacity.

“The fact of having this diagnosis does not mean that the individual cannot learn, cannot feel what is happening in his environment and does not know what is being said in his surroundings”.

The professional recalls that ASD is a spectrum, and what individuals will be able to do or not will be very variable. “We shouldn’t judge a book by its cover and assume that people diagnosed with autism will act or think a certain way,” she says.

See other myths cited by her:

• “Vaccines cause autism” – “Research shows that this is not true and this myth can be very dangerous for humanity as a whole”.
• “Autistic people have special talents” – “We all have special talents, it’s part of being human”.
• “Autism is caused by poor parenting” – “This is simply not true and can have major developmental impacts as children are highly dependent on parents who act as agents of change throughout their development.”