Diagnostic Criteria for Adults
Autism is often identified in childhood, yet many are first recognized in adulthood. Per DSM-5-TR, ASD involves (1) persistent difficulties in social communication and interaction; (2) restricted or repetitive behaviors/interests; (3) symptoms present from early development; (4) clinically significant functional impact; and (5) not better explained by intellectual disability or global developmental delay. If this reflects your experience, speak with your physician for diagnosis; SLPs don’t diagnose ASD but can support communication, social, and sensory-related goals.
What ASD Is and Is Not
ASD is a neurodevelopmental disability with a wide spectrum of strengths and support needs across ages, cultures, and contexts; DSM-5 consolidated prior terms (Autistic Disorder, Asperger’s, PDD-NOS). Respect identity preferences (person-first vs identity-first). ASD is not contagious, an illness, caused by vaccines or parenting, nor a marker of lower intelligence; profiles vary and many autistic people have average or higher IQ with uneven skills.
Levels of ASD
Support levels describe current help needed, not worth or potential, and can change over time or differ by domain. Level 1 (“requiring support”) may mask effectively yet still face significant, overlooked needs. Level 2 (“requiring substantial support”) often includes pronounced rigidity, narrowed interests, and repetitive behaviors that may clash with context. Level 3 (“requiring very substantial support”) involves high support needs and limited ability to mask, with intensive challenges in daily regulation.
Adult ASD
Adult presentations vary widely. At work, challenges can include reading supervisors’ cues, navigating unwritten rules, tolerating sensory load, managing ambiguous instructions, and coping with schedule changes—alongside strengths like pattern detection and detail focus. Socially, people may prefer routines, find sarcasm or subtext hard, take language literally, struggle with turn-taking, or feel anxious in groups, yet connect deeply on shared interests and thrive with clear expectations and supportive environments.
Masking in ASD
Masking (camouflaging) is adjusting or suppressing authentic behaviors to appear neurotypical—e.g., forcing eye contact, inhibiting stims, scripting jokes. It may grant access to social spaces or safety, but sustained masking is linked to exhaustion, identity loss, delayed diagnosis, and poorer mental and physical health. Support aims to reduce the need to mask by adapting environments and building affirming communication strategies.
Women and ASD
Men are diagnosed more often, but women and girls may mask more, internalize challenges, or show interests perceived as socially acceptable, contributing to under-identification and reduced support. Continued research is needed; meanwhile, clinicians should use gender-informed screening, listen to lived experience, and avoid stereotypes that delay care.
Conclusion
ASD can significantly affect daily life, but understanding your profile—and securing tailored supports—can improve communication, regulation, relationships, and participation. For practical strategies and communication coaching, book with Well Said: Toronto Speech Therapy at (647) 795-5277.
