The Signs of Autism in Adults

Don’t think that just because you are an adult and have never been diagnosed, you are not on the autistic spectrum. Some people are not diagnosed until adulthood, even though autism does begin in childhood.

The behaviours associated with autism fall into two broad areas:

• impaired social interaction and communication

• restricted and repetitive behaviours and interests.

The common signs and symptoms of autism are:

• lack of social or emotional exchanges

• lack of non-verbal communication such as nodding and shaking head, using hand gestures

• difficulty developing and maintaining relationships appropriate to the age, such as peer play, lack of close friends

• delayed expressed speech and understanding of speech

• lack of eye contact when speaking

• loss of language skills at any age

• excessively following routines, patterns of behaviour, and becoming distressed at changes

• strongly reacting to sensory input such as sound, pain, or textures

• restricted or fixated interests

What causes autism?

Autism is caused by the way that the brain develops. If someone in your family has autism, it is more likely that other family members will also have autism.

Research is also looking at the role of the environment in triggering autism, such as viral infections, complications during pregnancy and air pollutants.

There is no evidence that autism can be caused by vaccinations, foods or other lifestyle factors or by a person’s cultural or social surroundings.

Referral process

Manor Clinic provides autism assessment services for children, adolescents, and adults. We accept referrals for autism diagnosis from a wide range of professionals, including your family physician, psychiatrist, psychologist, or social worker. We prefer to have a referral so that the professionals involved in your care can be roped in to offer multi-disciplinary support. We also accept direct referrals for the autism assessment.

How is Autism Spectrum Disorder Diagnosed?

There is no single test or examination for diagnosis; instead, a broad range of information is considered. This condition is diagnosed clinically based on information gathered from a comprehensive psychiatric evaluation, physical examination (if needed), and the observation of specific characteristic behaviours.

Manor clinic provides comprehensive multi-disciplinary autism assessments using standardized gold standard assessment tools like the Autism Diagnostic Interview-Revised (ADI-R) or Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Our experienced multi-disciplinary autism assessment team includes a psychiatrist and an autism consultant/psychologist.

Manor clinic may provide screening questionnaires to you. These screening questionnaires need to be completed before the autism assessment meeting.

Meeting with autism consultant/psychologist:

This meeting could happen over one or two sessions. This assessment focuses on eliciting core symptoms of autism and observing specific characteristic behaviours by using one of the comprehensive interview tools like the ADI-R or ADOS. The autism consultant/psychologist may also ask questions about your living situation, social and family relationships and employment.

1st Interview: This interview is arranged with or without parents (when parents are available and only if you consent).

2nd Interview: The second meeting is arranged with parents only (when possible). Parents can be interviewed in person, via videoconferencing or over the phone.

Each appointment could last for up to 120 minutes.

Psychiatrist interview:

This interview is for comprehensive psychiatric evaluation. This appointment could last for up to 90 minutes. You will meet the psychiatrist with your parents (if your parents are available for the interview and only if you consent). When making an ASD diagnosis, the psychiatrist will consider and assess you for other disorders that might overlap or mimic ASD symptoms. The evaluation may include (where relevant) an assessment of your:

• mental health symptoms and experiences

• previous diagnosis

• prescribed medications

• blood or radiological investigations

• feelings, thoughts and actions

• physical health and wellbeing

• housing and financial circumstances

• schooling and training needs

• employment

• social and family relationships

• culture and ethnic background

• gender and sexuality

• use of drugs or alcohol

• safety and safety of others

You only have to talk about what you want to talk about.

In this meeting, the psychiatrist will also discuss the outcome of the assessment with you (and your parents if they are available and if you consent) to explain whether you have autism or not. A written copy of the report will be provided to identify any inaccuracies. Once you accept the information, the assessors will send a copy of the finalized report to the referrer.

If the team makes the diagnosis of autism, you will be provided:

• Information about what autism is and what it might mean for you and your family, now and in the future.

• Information about supports available for you and your family.

If the team does not think you have autism, the psychiatrist will explain how the team reached this decision. The psychiatrist can provide information about any other mental health conditions that you could have and where you can get the necessary support.

Supports and treatments for individuals with autism

While there is no cure for autism, there are a wide variety of interventions, treatments, and therapies that have shown success in reducing symptoms and improving the quality of life for individuals that live with this disorder. A treatment plan depends on the individual, given the spectrum of the disorder.

Typically, interventions address one or more core areas of functioning, including: -

• Social skills

• Communication skills

• Cognitive skills

• Academic skills

Adults with autism might benefit from some of the same treatment that children do, but there are also support networks for adults that can help, such as social learning programs and daily skills programs. Interventions to address comorbid mental health problems (like anxiety, depression, ADHD, trauma-related symptoms etc.) with the help of psychological therapies like Cognitive-Behavioural Therapy (CBT), Family Therapy (FT), Eye Movement Desensitization and Reprocessing (EMDR), Social Skills Training, Anger Management training and Emotional Regulation Skills training can be offered after the assessment.

No Biomedical (pharmacological, physical and dietary) interventions have been effective in treating the core symptoms of autism. This includes antipsychotic medications, antidepressant medications, anticonvulsants, vitamin or mental therapy, chelation therapy and hormonal therapy.

Pharmacological interventions for coexisting mental disorders: For adults with autism and coexisting mental disorders, pharmacological interventions (medications) informed by existing standardized guidance (like CANMAT or NICE) for the specific condition will be discussed with you.