How is autism diagnosed?

Autism is a spectrum, which means it can present in diverse ways. It can be understood by certain categories and subcategories. The two main categories can be broken down into (A) differences in social communication/interaction, and (B) restrictive/repetitive behaviors. You can find the DSM-5-TR diagnostic criteria here.

Autism can be identified in early childhood, usually showing by the age of 2 years old. However, it is common for signs to go unnoticed or misdiagnosed even into adulthood. 

Social communication/interaction differences can include, but are not limited to:

• Struggling with social reciprocity (the back-and-forth of social interactions)

• Having trouble understanding social norms

• Having difficulty with nonverbal communication 

• Experiencing difficulty making and maintaining relationships

Restrictive/repetitive behaviors may include, but are not limited to:

• Performing repetitive movements

• Repeatedly using the same objects

• Repeating words, sounds or phrases

• Insisting on sameness in one’s schedules, routines or environment

• Intense interest in specific subjects, topics or activities 

While autism can present many challenges, it can also come with strengths. Every autistic person is different, and as such, they often have unique talents and amazing qualities ranging from intense attention to detail, to a strong sense of justice, to extraordinary creativity and intelligence.  

Who can be autistic? 

Studies have shown that the most significant contributing factor associated with autism is inherited genetics. Autism occurs more frequently in families where parents are autistic as well. Environmental factors have also been studied as potential contributors to autism, including advanced parental age, prenatal exposure to pollution/toxins, maternal health, pregnancy complications, birth complications or very low birth weight. Ultimately, there still is no one “cause” of autism that has been definitively identified.

Autism can occur in any socioeconomic, racial or ethnic group. Those assigned male at birth are four times more likely to be diagnosed as autistic than those assigned female at birth. 

How is autism diagnosed?

Autism is typically diagnosed in childhood and is estimated that 1 in 36 American children have been identified as autistic. It can be diagnosed as early as 15 months of age, but the average age of diagnosis is 4.5 years old. Autism can go undiagnosed or misdiagnosed into adolescence or adulthood. Autism can be diagnosed by psychologists, qualified mental health providers, pediatricians and neurologists. 

Diagnosing autism in young children is often a multidisciplinary process:

• Well-child checkups — Well-child checkups at 9,18, 24 or 30 months allow for general developmental screenings to be done. Autistic-specific screenings are typically recommended at 18- and 24-month screenings. (The health care provider may refer the child for additional evaluation if the child shows developmental concerns.)

• Additional evaluation(s) — This evaluation can involve an interdisciplinary team that can include neurologists, developmental pediatricians, speech-language pathologists, child psychologists or psychiatrists, educational specialists, and occupational therapists. Early detection can be incredibly beneficial for an autism diagnosis. This allows caregivers to learn about and decide which services can benefit their child most.

Autism may go undiagnosed into adulthood. Diagnosing autism in adults requires providers with specialized training and understanding about how autism can present differently later in life, especially for high-masking adults and/or minorities. Autism is a spectrum and requires specialized understanding.

The process of adult autism diagnostic assessments varies greatly between providers. Some evaluations may require interviews with primary caregivers or close family members while others may include the ADOS, which was once considered the gold standard in assessment. You can read more about our affirming assessment procedure here. NeuroSpark believes receiving an accurate diagnosis of autism often helps a person make sense of past and current challenges, identify strengths and differences, and find needed support. 

Support options available for autistics

While autism presents challenges relative to how a person experiences and interacts with the world, it’s important to recognize that with the appropriate supports in place, one can embrace their neurodivergence and live their life in a way that is fulfilling, safe and meaningful to them. 

Autism is not a disease that needs to be cured, and not every autistic person requires professional assistance just because they are autistic. They may receive adequate support from their loved ones and communities. For those that do wish to receive professional help, care strategies for autistic adults must be affirming, consensual, and supportive. Strategies can include:

• Autism-affirming therapy

• Neuro-affirming coaching

• Disability accommodations

• Occupational therapy

• Treating co-occurring conditions 

• Connecting with community

NeuroSpark offers diagnostic assessment and autism-affirming therapy that respects the individuality of every person 

At NeuroSpark, we come from a lived experience perspective and a place of zero judgment. We would love to support you through autism assessment and/or autism-affirming therapy. We pride ourselves on authenticity — we are neurodivergent-led and neurodivergent-owned. 

We pride ourselves in creating an environment that is safe and affirming for all people, especially neurodivergent adults from marginalized communities. We offer one-on-one coaching and accommodations consulting. We also offer therapy in select states and are currently working to expand our practice.