How to Get Tested for Autism as an Adult: A Comprehensive Guide

Autism spectrum disorder (ASD) is a neurodevelopmental disability characterized by sensory sensitivities, social communication challenges, repetitive actions and special interests. Despite displaying autism traits, many adults reach later stages of life without an official diagnosis. This is partially due to masking, a coping strategy in which individuals consciously or unconsciously suppress their autistic traits to fit in with others. With growing awareness, more adults are recognizing that their lifelong challenges with social interaction, communication and sensory processing could be related to undiagnosed autism.

Getting an autism diagnosis as an adult can be life-changing. It provides clarity and validation of differences that may have caused confusion, frustration or isolation throughout life. An adult autism diagnosis can also help individuals access support services, workplace accommodations and tools for improved quality of life.

Autism can present differently in adults and children. Many adults have learned to "mask" or hide their autistic traits, making them less visible so they can appear more neurotypical. Common traits of autism may still manifest in areas such as: 

• Communication: Trouble understanding social cues, engaging in small talk or reading body language.
• Stimming behaviors: Body movements and repetitive actions, like humming and wiggling.
• Special interests: Intense, focused interests in specific hobbies, topics or activities, often dedicating significant time and energy to learning or engaging with them.
• Sensory sensitivities: Experiencing overwhelm or discomfort in response to bright lights, loud noises or certain textures.

Self-reflection is key. After reflecting on life experiences, adults might notice these traits have been present for many years. 

For example, when I was going through the diagnostic process for ADHD, I had to reflect and think through overlapping characteristics. A lot of ADHDers also have special interests or hyperfixations. During this reflection time, I also began to recognize the communication challenges that I’ve encountered throughout my life—which weren’t explained by ADHD alone. I regularly take what others say quite literally, which was a source of tension in my childhood home. As someone with a number of other co-occurring conditions, I’ve historically been quite clumsy as well.

After speaking about all of this with my therapist, we agreed that I may want to seek an autism evaluation.

If you recognize these characteristics in yourself, consider pursuing an evaluation.

If you’re seeking an autism diagnosis, you might be wondering what the process will be like. Here’s what to expect. 

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Finding a professional who specializes in adult autism

Getting tested for autism as an adult requires finding the right healthcare professional. This may be a psychologist, psychiatrist or other mental health professional. It’s important to choose a provider who works regularly with autistic adults. They should also be familiar with the challenges autism can present in adulthood. This is especially true if you have been masking symptoms for years. 

If you belong to a marginalized group, there are other things you’ll want to keep in mind. You should consider how familiar a clinician is in working with people from the communities you belong to. For example, one study found that 80% of autistic women aren’t diagnosed by the time they reach adulthood. Nonbinary and transgender folks are six times more likely to be autistic but, like women, are often underdiagnosed or misdiagnosed. This is also true of folks from the BIPOC community, with Black people being nearly 5 times more likely to be misdiagnosed in childhood. Individuals who have other disabilities also face difficulties in getting an accurate and timely diagnosis.

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Intake questionnaires or initial consultation

Before your first assessment appointment, you may be asked to fill out intake questionnaires about your concerns. Alternatively, your first appointment may involve an initial consultation with your clinician to discuss your concerns before the assessment proceeds. It’s important to be open and honest about your experiences since this will guide the autism evaluation process. On these questionnaires or during this consultation, the clinician may ask about social struggles, sensory sensitivities and other autistic traits. They may also ask about your coping mechanisms, like masking, stimming and special interests. 

You may even want to think of some instances beforehand of the behaviors and experiences you had in childhood that might display autistic traits. For example, were there times when you were particularly sensitive to sounds, textures or certain environments? Did you tend to engage deeply in specific interests or hobbies? Did you find social interactions confusing or tiring, or struggle to understand unwritten social rules?

You’ll also want to consider examples from adulthood and present day. Have you noticed patterns of sensory sensitivity, a strong need for routine or difficulty with unexpected changes? Do you often find yourself needing time alone to recharge after social situations or feel easily overwhelmed in busy environments? This step will help you think through the specific areas in which you have experienced difficulties. 

The diagnostic assessment process

There is no single autism test, and there is no one way that autism testing looks. The adult autism assessment process often involves multiple steps, including:

• Clinical interviews: In a diagnostic interview, the clinician will ask about your mental health history, as well as your developmental history, relationships and social behaviors. They will also cover your current concerns, strengths and challenges, and any signs of autism you may have noticed. 
• Self-reports and questionnaires: Your clinician may ask you to complete questionnaires like the Autism Spectrum Quotient (AQ). While this tool may be helpful to your clinician, it isn’t required for a diagnosis if signs of autism are clearly evident according to other sources of clinical information.
• Behavioral observations: The specialist might observe how you communicate or respond to social situations. Some things a clinician might watch out for include fidgeting, stimming, taking things literally or how you regulate your emotions.

Depending on the clinician, the process may include additional assessments or input from family members or close friends, especially regarding your early developmental history and childhood. It’s important to prepare yourself for this process mentally and emotionally, as it can be an intense experience. 

To get ready, you might start by journaling about specific memories from different stages of your life. If you have sensory sensitivities, social challenges or repetitive behaviors that stand out to you, can you remember when they began? If possible, reach out to supportive family members or friends who might be willing to share their observations of your childhood, as these details can offer valuable context. Finally, plan some downtime after the evaluation to decompress and process the experience, as it may bring up emotions or insights you’ll need time to reflect on.

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Receiving the diagnosis

Once the autism evaluation is complete, the clinician will discuss the results with you. If you receive an autism diagnosis, the clinician may provide detailed feedback about the specific traits they observed, what that means for your day-to-day life and recommendations for the next steps. 

Post-diagnosis, it’s common to experience a mix of emotions, from relief to uncertainty about what comes next. The diagnosis can open doors to resources, accommodations and support tailored to autistic individuals. However, navigating the post-diagnosis landscape can involve challenges like finding the right support network or services.

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Many factors play into the challenges related to diagnosing autism in adults. Here are a few examples.

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Late diagnosis and masking

Many autistic adults have learned to "mask" their symptoms, consciously or unconsciously. They might do this to fit in with others, meet societal expectations or even for safety purposes. Masking can make it more difficult for professionals to identify autism, which is why finding an experienced clinician is important. 

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Misdiagnosis and co-occurring conditions

Autism often co-occurs with other conditions, such as anxiety, attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). These conditions can complicate the diagnostic process, leading to misdiagnosis or delayed diagnosis. Plus, some symptoms of these conditions overlap with autistic traits, further contributing to misdiagnosis. 

A thorough evaluation with a clinician who deeply understands neurodivergence can ensure that you get an accurate diagnosis. This can also allow you to get the right therapy or medication (if applicable) if you do have multiple forms of neurodivergence or any co-occurring conditions.  

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Cost and accessibility

Testing for autism spectrum disorder as an adult can be expensive. The cost depends on factors like the clinician’s expertise, your location, insurance coverage and the complexity of the evaluation. Accessibility can also be challenging, especially for those living in rural areas where diagnostic services may be limited. 

As you search for a clinician, consider if seeing a provider via telehealth might be right for you. If you’re looking for a virtual evaluation covered by insurance, consider Prosper Health. Prosper Health offers virtual autism assessments for adults conducted by psychologists specializing in adult autism.

Receiving a diagnosis is a major milestone, marking the beginning of the next phase in your journey. Post-diagnosis, it’s important to explore support options that cater to adults with autism. These might include therapy, social skills training or sensory processing support. Some autistic adults may find accommodations at work or school beneficial. Other people might look for social networks or peer support groups to help them navigate their newfound understanding of themselves.

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Accessing support resources

Once diagnosed, many autistic adults find it beneficial to connect with advocacy organizations or support groups. These networks provide opportunities to share experiences, seek advice and access valuable resources. 

Therapy can also play an important role. A therapist can help autistic adults implement practical strategies and coping mechanisms to improve daily life. The right clinician can also help individuals manage co-occurring conditions.

Workplaces may offer accommodations under the Americans with Disabilities Act (ADA), such as flexible scheduling, quiet workspaces or adjusted communication methods.

These accommodations can be essential, but they often only address part of the support needed for autistic adults to thrive.

Therapy plays a critical role in helping autistic adults understand their strengths and challenges. A therapist can help foster personal growth by helping you reach your personally chosen goals, which may include addressing sensory sensitivities, social communication struggles or co-occurring conditions like anxiety and depression.

Practical strategies such as using noise-canceling headphones, establishing routines and employing executive functioning aids (e.g., planners, apps) can help manage daily life more effectively.

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Building a support network

Connecting with other autistic individuals—whether online or in person—can provide a sense of belonging and reduce feelings of isolation. Peer support groups, autism forums and local advocacy organizations can be great places to start. Building a support network of friends, family and professionals will make navigating post-diagnosis life easier and more rewarding.

Seeking an autism diagnosis as an adult can be an empowering and life-changing experience. Understanding your neurodivergent identity opens the door to a range of support and accommodations that can improve both personal and professional aspects of life. 

Getting tested for autism as an adult may feel like an intimidating process, but it doesn’t have to be. If you believe that you may be autistic and need support, Prosper Health can help. We are the first telehealth provider focused exclusively on autistic and neurodivergent adults. 

Our clinicians specialize in autism spectrum disorder and practice neurodivergent-affirming assessment and therapy. We offer virtual assessment and therapy appointments and quick scheduling. We are here to help support you with your goals, regardless of whether you have a formal autism diagnosis.