If you have ever wondered, “Do I have autism?”, you are not alone. Many adults begin considering autism in adults after someone else points out certain patterns, after reading about autism online or seeing it discussed on social media, or after years of feeling like something about their relationships, communication, or experiences simply does not make sense. Some people have always felt different from those around them but have never had a clear explanation for why.
Autism can be more difficult to recognize in adults than many people expect. It does not always look like the stereotypes, and no single behavior—whether someone makes eye contact, has friends, or appears socially comfortable—can tell us whether that person is autistic.
A good autism evaluation asks a much bigger question: Is there a longstanding developmental pattern that helps explain how this person experiences and navigates the world?
How Do I Know If I Have Autism?
There is no single experience that tells you whether you are autistic.
Adults who seek an autism evaluation often describe persistent difficulties with relationships or communication. Some say they have always felt like a misfit or an outsider. Others have difficulty developing or maintaining close relationships, even though they want those relationships.
Sometimes the problems become particularly noticeable at work. For example, a person may repeatedly receive feedback about their interpersonal style or communication. They might feel that their manager doesn’t like them or is constantly misinterpreting what they say. Their manager, meanwhile, may perceive them as rude, dismissive, argumentative, or uninterested when that was never the person’s intention.
In some cases, the underlying issue may involve differences in how the person understands or uses nonverbal communication or interprets social information.
That does not automatically mean someone has autism. But persistent difficulties with social communication or relationships—particularly when they are also affecting employment, education, or other areas of life—are among the reasons clinical guidelines recommend considering an autism assessment.
What Does Autism Look Like in Adults?
Autism can look very different from one person to another.
At its core, autism involves differences in social communication and interaction along with restricted or repetitive patterns of behavior, interests, routines, or sensory experiences. However, how those characteristics appear in someone’s everyday life can vary considerably.
One adult might have obvious difficulty knowing how to enter or maintain conversations. Another might talk easily but struggle to recognize when someone has lost interest or wants to change the subject. Someone might have difficulty interpreting subtle changes in facial expression, tone of voice, or body language. Another person may have learned to consciously watch for those things because they don’t come intuitively.
Some autistic adults are highly social. Others prefer much more time alone. Some have successful careers and relationships. Others experience substantial difficulties with work, independent functioning, or relationships.
This is why diagnosing autism based on whether someone “looks autistic” can be so problematic.
Can You Be Autistic and Still Make Good Eye Contact?
Yes. Good eye contact does not rule out autism.
Eye contact is probably one of the stereotypes about autism that I encounter most often, even among clinicians.
Differences in eye contact can certainly be associated with autism. But eye contact is only one aspect of nonverbal communication, and the diagnostic criteria do not require a person to have poor eye contact.
It is also important to consider why a behavior is occurring. Someone with significant social anxiety, for example, may avoid eye contact because they feel anxious or self-conscious. Meanwhile, an autistic person may make perfectly appropriate eye contact, either naturally or because they have learned how and when other people expect it.
The presence or absence of one behavior doesn’t answer the diagnostic question.
Can You Be Autistic and Still Be Social and Have Friends?
Absolutely. Being autistic does not mean someone cannot want friendships, enjoy socializing, or maintain meaningful relationships.
The more useful questions are often about the quality and experience of those relationships. Does the person understand the nuances of relationships? Do social interactions come relatively intuitively, or does the person feel as though they have had to consciously learn rules that other people seem to understand automatically? Do misunderstandings happen frequently? Does the person have difficulty recognizing subtle shifts in other people’s expectations?
There are also important differences in how autism may present across individuals and genders. For example, research has found higher self-reported social camouflaging among autistic women than autistic men in some samples. Camouflaging can include strategies intended to mask autistic characteristics or assimilate socially, which may make someone’s difficulties less obvious to other people.
Read the PubMed study on gender differences in autistic camouflaging
These are group-level findings, not rules. Autistic women are not necessarily social and autistic men are not necessarily socially withdrawn. Autism varies tremendously from person to person, and camouflaging occurs across genders.
What Is Autism Masking?
Autism masking, often discussed in research as social camouflaging, refers to strategies a person uses to conceal autistic characteristics or adapt their behavior to fit social expectations.
Someone might consciously remind themselves to make eye contact, rehearse what they plan to say before an interaction, imitate other people’s expressions or gestures, or develop rules for navigating situations that other people seem to handle more intuitively.
Importantly, masking does not mean someone is being dishonest or pretending to be someone else.
Research describes social connection and self-protection as motivations for camouflaging, and studies have also raised concerns about its relationship with poorer mental health outcomes.
Masking can also make an adult’s presentation more complicated to evaluate because the question isn’t simply “Can this person perform this social behavior?” We may also want to understand how naturally that behavior occurs, how the person learned it, and how much effort it requires.
Can Someone With Autism Know That They Are Different?
Yes. An autistic person can have substantial insight into their own social differences.
Some people come into an evaluation precisely because they have spent years recognizing that something seems different. They may know that relationships are harder for them. They may recognize that conversations sometimes go wrong. They may notice that other people seem to intuitively understand social situations that they have to consciously analyze.
What they may not understand is why. Someone can therefore have excellent insight into the fact that a pattern exists without necessarily understanding the mechanism underlying that pattern.
What’s the Difference Between Autism and ADHD?
This is one of the reasons comprehensive psychological evaluation can be so helpful: ADHD and autism can sometimes produce behaviors that look similar on the surface for very different reasons. They can also occur together.
Consider someone who frequently misses social cues or interrupts other people.
A person with ADHD might understand the social cue perfectly well but respond impulsively before fully processing it. Their difficulty may be driven primarily by impulsivity or inconsistent attention.
For a person with autism, a superficially similar interaction could instead reflect difficulty identifying or interpreting the social cue itself.
Those are simplified examples rather than diagnostic rules, but they illustrate an important point: We need to understand the reason behind a behavior, not simply whether the behavior is present.
This is also why a checklist alone is rarely sufficient for a complicated diagnostic question.
Can Anxiety Look Like Autism?
Yes, some features of anxiety—particularly social anxiety—can overlap with behaviors associated with autism.
A socially anxious person may avoid eye contact, have difficulty participating in conversations, appear uncomfortable socially, avoid social events, or have trouble developing relationships.
The important question is what is driving those difficulties.
Are social interactions difficult primarily because the person fears embarrassment, rejection, or negative evaluation? Or are there more fundamental and longstanding differences in social communication and understanding?
The answer can also be both. People with autism can have anxiety, ADHD, depression, and other psychological conditions in addition to autism.
This is why comprehensive adult autism assessments should consider alternative and co-occurring conditions rather than simply looking for evidence that confirms autism. Clinical guidelines specifically recommend considering conditions including ADHD, anxiety disorders, mood disorders, OCD, communication difficulties, and other neurodevelopmental and mental health conditions during an adult autism evaluation.
Why Does Childhood History Matter When Diagnosing Autism in Adults?
Developmental history is one of the most important pieces of an adult autism evaluation because autism is a neurodevelopmental condition. We should expect to find some evidence of the underlying pattern during development.
That doesn’t necessarily mean that an adult’s autism was obvious when they were three or four years old. Current diagnostic criteria specifically recognize that characteristics may not become fully apparent until the demands placed on a person exceed their capacities, and that characteristics can also be masked by strategies learned later in life.
A child may function relatively well within a structured environment, for example, but have increasing difficulty as friendships become more complicated, academic expectations increase, or adolescence and adulthood introduce more nuanced social and occupational demands.
That’s why an adult autism evaluation often involves looking backward. What were friendships like growing up? How did the person play? How did they respond to changes in routine? Were there unusual sensory experiences or particularly intense interests? Did they have recurring social misunderstandings? When did their current difficulties first become noticeable?
When possible, information from parents or other people who knew the person during childhood can be especially useful. School records and other historical information can sometimes help as well. NICE guidelines for adult autism assessment specifically recommend examining early developmental history and, when possible, incorporating an informant or documentary evidence of early development.
Is an Online Autism Test Accurate?
An online autism questionnaire can identify characteristics that may be worth exploring, but it cannot by itself determine whether you have autism.
Screening and diagnosis are different things.
A screening questionnaire essentially asks whether there is enough evidence to investigate further. A comprehensive evaluation asks a much more difficult question: What best explains this person’s lifelong pattern of functioning?
There is no blood test, brain scan, or single psychological test that establishes an autism diagnosis. Clinical assessment relies on developmental history, current functioning, behavioral observations, and other relevant information.
So, if an online autism test is what first made you wonder about yourself, that information doesn’t need to be dismissed. It may provide a useful starting point.
It just shouldn’t necessarily be the ending point.
Is Getting an Autism Diagnosis as an Adult Worth It?
For some adults, a formal autism evaluation can provide an explanation for patterns they have struggled to understand for years.
You do not have to be failing at life to benefit from understanding yourself better. Someone may have graduated from college, developed a successful career, gotten married, or built friendships and still feel that certain parts of life are much harder than they seem like they should be.
Perhaps relationships repeatedly break down in ways the person doesn’t understand. Maybe they continue getting similar feedback at work. Maybe social interactions require enormous effort. Or perhaps they have spent years feeling fundamentally different from other people without knowing why.
If those patterns are causing distress or interfering with relationships, work, or other important parts of life, understanding their source can be valuable.
The purpose of an evaluation should not simply be to put someone into an “autism” or “not autism” box.
The goal is to understand why this person is experiencing the difficulties they are experiencing and what that means for what they should do next.
What Happens During an Adult Autism Evaluation?
A comprehensive evaluation generally involves much more than completing an autism questionnaire.
At Utah Center for Psychological Services, we want to understand the person’s developmental history, relationships, education, work functioning, mental health history, current concerns, and the specific patterns that led them to wonder about autism in the first place.
Depending on the referral question, an evaluation may include clinical interviews, psychological questionnaires, autism-specific assessment measures, cognitive testing, review of records, behavioral observations, and information from someone who knows the person well.
We also consider other explanations for the person’s difficulties rather than beginning with the assumption that autism must be the answer.
Ultimately, all of that information has to be integrated into a coherent explanation of the person’s functioning.
A diagnosis can be useful. But the most meaningful outcome is often understanding why certain things have been difficult, recognizing the strengths the person already has, and developing recommendations that actually fit the person rather than simply the diagnostic label.
When Should I Consider Autism Testing as an Adult?
You might consider an adult autism evaluation if you have longstanding patterns involving social communication, relationships, sensory experiences, rigidity or difficulty with change, or other characteristics associated with autism, particularly when those patterns are creating difficulties in your everyday life.
An evaluation may also be worth considering when you have received other diagnoses or treatment but still feel that an important piece of the picture is missing.
You do not need to know whether you have autism before seeking an evaluation.
Figuring that out is the point of the evaluation.
Looking for an Autism Evaluation in Salt Lake City?
Utah Center for Psychological Services provides comprehensive autism evaluations for adults in Salt Lake City, Utah. Our evaluations are designed to look beyond individual symptoms or stereotypes and consider the whole person, including developmental history, relationships, communication, psychological functioning, strengths, and current concerns.
If you have been wondering whether autism could help explain longstanding difficulties with relationships, communication, work, sensory experiences, or simply feeling different from other people, a comprehensive evaluation can help you better understand what is contributing to those experiences and what may help moving forward.
Learn more about our autism evaluations here.
