Autism in adults: recognising signs

Signs named by the guideline

In the case of one of the three key symptoms mentioned (see above), the guideline recommended considering the possibility of autism. According to the guideline, the recommendation was based not on high-quality studies but on the classification systems and expert knowledge; the criteria were ease of use in practice and comprehensibility for those affected. ^{[2, Ch. B.2.2]} More on the criteria: Diagnostic criteria.

Biographical signs

In addition, according to the guideline, the following should be taken into account: problems entering or keeping employment or training, difficulties starting or maintaining social relationships, and past or present contact with psychiatric services or other support systems for people with disabilities. ^{[2, Ch. B.2.2]} Such experiences have many causes; they are not proof of autism.

Why it can be noticed late

• The guideline stated that people on the spectrum without intellectual disability can develop their own compensation strategies that mask features and make diagnosis harder. ^{[2, Ch. A.2.1]} More: Masking: when adapting is exhausting.
• Adults often seek help for other health or mental health problems; co-occurring conditions such as depression make the assessment harder. ^{[2, Ch. B.2.2]}
• The guideline described the symptoms in adulthood as little known; many adults are therefore underdiagnosed. ^{[2, Ch. B.4.13.1]}

What you can do

1. Collect signs, e.g. when difficulties began and what stood out in childhood and school (practical tip from the editorial team). For the assessment, at least one close person who has known you since childhood is included; in addition, documents such as school reports. ^{[2, Rec. 18]}
2. Find a specialist centre: Assessment in adulthood, Referral, costs and waiting times.
3. Put questionnaires in context: Screening questionnaires and online tests.

What else you should know

• A late diagnosis brings mixed feelings for many people: Late diagnosis: what can change.
• In acute emotional distress: TelefonSeelsorge (crisis helpline in Germany), 0800 1110111. ^[3]
• Not covered: self-assessments on the internet and personal accounts.

Sources and literature

1. DGKJP. Aktuelle Leitlinien (Einträge 028-018 „Gültig bis 04.04.2021“ und 028-047 „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)
2. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 1: Diagnostik. S3-Leitlinie, AWMF-Reg.-Nr. 028-018, Textstand 23.02.2016. – Guideline (in German) (expired; according to the document note under revision)
3. TelefonSeelsorge Deutschland: Startseite mit Rufnummern. https://www.telefonseelsorge.de/ – Counselling service (website in German)