Could I Be on the Autism Spectrum? A Guide to Pursuing an ASD Diagnosis (w/ Theresa Regan, Ph.D.)

Growing awareness about autism later in life has led a population of adults, including many diagnosed with ADHD, to suspect they may be on the spectrum.
Though researchers and clinicians have successfully improved the early detection of autistic behaviors in young children, many adults remain misdiagnosed or not diagnosed at all. Myths about ASD perpetuate the lack of attention and supports for adults in our communities. The good news is that having the facts about ASD can lead to an accurate evaluation and effective treatment for most.
In this hour-long webinar replay, Theresa Regan, Ph.D., explains the facts about autism in adults, factors contributing to misdiagnosis, and strategies to improve evaluation outcomes.
Download the slides associated with this webinar here:
additudemag.com/webinar/autis...
4:34 Myths About Autism
8:18 Why is Diagnosis Difficult?
14:48 ASD Criteria DSM-5
18:50 ADD/ADHD versus ASD
22:33 Seeking a Diagnosis
26:35 Importance of Diagnosis
29:50 Specific Interventions
32:02 Q&A
Related Resources
1. Self-Test: Autism Spectrum Disorder in Adults
www.additudemag.com/screener-...
2. Top Article: What is Autism Spectrum Disorder?
www.additudemag.com/what-is-a...
3. Download: The Truth About Autism in Adults
www.additudemag.com/download/...
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[@damescholar]

I struggle to make the doctors understand that when I was a child and even a young adult, there was no awareness of autism spectrum. There was only the very serious and disabling variety and that was autism. I was labeled patologically shy, clumsy, making strange movements, singing by myself, nerdy, totally inept in the word and power plays of other girls, a bore (matter-of-fact), a loner, naive because I thought that everybody always told the truth like I did, and irritable (because of my hypersensitivity) etc. etc. Nobody was there to diagnose me. Instead I was scolded, bullied, laughed at and hammered to fit the model of ”normal”. It hurt. It left its marks. It made me depressed and anxious, because I felt like an alien, a misfit, even though I was academically very bright and artistic (drawing and playing the piano). The masking has left me always drained and aching. It had been HARDER for us adults to live our life undiagnosed, and it is a double insult to be told now (as I was told by the GP): oh, you don’t need a diagnosis or support, you have coped well, stop burdening our health system.

[@annarounseville1392]

So sorry you experienced all this. Regardless of your eventual diagnoses, you deserve to be validated in your experience. I hope you find resources and compassionate people to help. Sometimes it only takes one person to make a difference. I hope your walk gets easier.

[@TSB-bd1kd]

I absolutely respect that advising anyone whether they should pursue assessment is complex, and that there are so many contextual factors to consider. However, I was struck by the advice that if later in life one is having a medical workup done, it's worth mentioning that it's suspected that there are autism traits because then that can be flagged... There are SO many of us who have tried to speak to health care providers about our suspicions, and we were laughed off. I mean, that in and of itself is a barrier to assessment. Too many providers aren't clear on subtle or non stereotypical presentation. I also didn't hear masking mentioned, or the importance of assessing to what degree an individual might mask or compensate in an assessment. For example, I could tell you what emotions are in a face, but that is because I have studied acting and did it professionally... and then went on to do my Masters in counselling psychology. I could only ever be assessed by someone who is aware of masking might show up, and what questions to ask to bringthat to the fore. Many late identified autists are masterful at behaving neurotypically, but it costs us dearly. Anyhow, I thought that was worth mentioning. I appreciated this presentation, but I'd love even more to hear from clinicians who are autistic themselves and "get it" from the inside.

[@thomaslgregoryjr]

Fight and flight are only two of the trauma responses, don't forget freeze, fawn, and flop. Great session, thank you!

[@divacassandra1]

All my life I've felt wrong, but I'm just wired differently and that is fine.

[@Megdracula]

I was the one doing my own thing while everyone else was listening

[@vickicarringer7038]

Yes. Me too. Tired of trying to change myself to fit into a world I don't fit in.

[@robertafierro5592]

You are UNIQUE! Never forget that!!

[@dmcsunshine1]

Brilliant and not functioning (and begging for help but being misunderstood!) help needed!

[@lweleven3423]

I wasn’t diagnosed with ADHD till my late 40 they say I am a Autism spectrum it’s hard enough to understand ADHD but Autism is just completely impossible to understand.. my symptoms seem to get worse as I get older

[@divine_feminine111]

Yes! I'm 38, still haven't got a diagnosis and it has 100% got more difficult the older I have got.

[@sarahferrell5458]

I’m 55, not dx, but YES!! Thanks for sharing.

[@battfamily435]

Can you share in what way it's gotten harder? I suspect my spouse is on the spectrum. He's in his late 40's and he makes sense when put into this context. He suffers a lot with anxiety, lack of close friendships, OCC, emotional regulation, sleep, etc. Can barely manage week of work environment without weekly explosive outbursts or meltdowns. He needs a lot of down time and makes marriage and co-parenting a single sided venture. How much worse can it get? Thanks for any input.

[@lweleven3423]

@@battfamily435 sorry to here of your struggles , yes it’s tuff I have just been put on Escitalopram t is helping I’ve had 3 jobs in 12 years and 2 relationships all ended i belive now because of my problems the strange thing is if you met me you would never know and I’ve found that hard when it comes to medial assessments it’s only when I’m put in situations my problems surface , the only way to cope I’ve found is focusing on what you like when you feel like it and when it’s a rough today just allow yourself to relax and find a calm place , I have my own theory to why there seems to me more and more people with problems , that’s hard to put into words . But go back in time 50 years or more and imagine life as it was back then far less stress in the world , times were quieter simpler less crowds etc etc etc today is far more stressful in all aspects of life and I truly belive that is playing a big part in it ,

[@TessaCoker]

Yes, gets worse and worse and I am 70 and trying to organise diagnosis, finally

[@SweetiePieTweety]

What a gift to the community Dr. Regan is! I can only hope her voice can grow to be loud and proud because she is spot on, in my opinion. I can only hope she will persistently lean towards a numerological based response vs catering to a society at large within the medical, psychological, and identity movements to push HARD its own narratives. IT HAS NOTHING to do with INTELLECT has to be the starting point each and every time. Following that could be IT HAS NOTHING to do with moral choices. Describing how the brain is processing differently despite and with intellect, moral disciplines, race, gender, identity politics, and the countless co-morbid conditions has to be the foundation to each response to shed a clarity and light. The autism is going to impact all things just as a connective tissue disorder will impact all aspects of the brain and body, so does a brain processing as an autistic brain does. And HOW the brain is functioning different and to WHAT the brain is responding differently to and WHEN the brain is responding differently and to WHO or WHOM the brain is responding differently. It’s not always easy but with dedicated application of seeking to understand as ask and dig it can be as simple as identifying the very consistent patterns by applying the… WHO WHAT WHEN WHERE questions and build the database models to identify the patterns to get yo the WHY the brain is producing a variant behavior. Rarely is it a moral failing or a lack of desire or trying or a lack of intellect There is always a reason. That reason will always be a different reason than the brain that is not processing in the autistic way. This is why people without the autistic brain never get the behavior labeling correct, unless they do the hard work to study the patterns and see what the brain is doing “differently” and ask and actually ACCEPT the why if the autistic person vs telling them the wrong reason why they are doing such and such. Eliminating the mis-labeling of diagnostic labels and behavior labels requires a constant methodical chipping away at the misconceptions backed with diagnostic evidence. The ability to see the brain operating differently to different stimuli in real time which is only what the neurologist has the ability to do must take precedence over old belief systems that have zero diagnostic criteria to back them up. There is nothing quite like having a child with an autism diagnosis to spark a flame of special interest in a mom who has that genetic brain to dig deeply and understand deeply with the intellect to do so to get to the root of things…. just like an autistic person tends to do. Sometimes you don’t meet the criteria but the genetic qualities of intellect and thinking deeply and the persistence of a special interest is the good fruit tree the hood fruit autistic apple falls from. ❤️ I am thankful for her work.

[@annak29]

Very well-articulated perspective. It's a similar scenario with "speech therapy", many ineffective treatment approaches result in stilted artificial humans living in copy-paste mode. That "functioning in society as normal as possible" goal can go awry very quickly. There are so many ways to recover now. Do you know about this?

[@MayraRodriguez-qu6xe]

I was diagnosed with Social Anxiety, but now my little girl is presenting autistic traits. Now I kind of see the correlation between both, maybe I was just diagnosed wrong. 🤦🏻‍♀️

[@divine_feminine111]

Quite possibly, I was diagnosed as having Borderline Personality Disorder which was incorrect.

[@turtleanton6539]

It can be both it is for me

[@amybe3]

I was dx with depression and anxiety. My mom came with me to YAI and I was dx with ASD at 42

[@nnylasoR]

Diagnosed at 39 with anxiety, depression, ADHD, OCD, and Hoarding Disorder… No surprises there - and yet, there were still so many questions ~and traits~ without explanation. Well- at 41, I started researching Autism (for my husband) back in October and quickly became fascinated ~nay, OBSESSED~ with Asperger’s / ASD *for myself*… then began self-identifying as [AuDHD / AspieDHD with a PDA profile] in February. I am awaiting an official ASD assessment (July 28th) - but I already *KNOW,* in my heart of hearts… I finally have a name for my frustrating awesomeness!!! It just makes too much sense not to be. My current diagnoses are all labels for the pieces of my own big picture. ✨✊❤️‍🔥✨ Side note: “Attachment to objects” … “hoarding or packrat behaviors” !! SEE! I’ve been trying to tell people- my “hoarding disorder” has a MUCH deeper explanation! Thank for the validation. ✋😭🤚 Also… I’m watching this at 3 in the morning. 😂🙃

[@chrismcwilliams3552]

Seeking diagnosis at 68. Have taken several online tests and scored high. It would certainly explain a lot of my past and present. Also have several common comorbities.

[@TessaCoker]

Ditto, age 70. Did you get your diagnosis?

[@chrismcwilliams3552]

@@TessaCoker No. told my doctor, but he didn’t respond. Hard to find someone to diagnose here in the US.

[@taracat7141]

Excellent information!

[@garygriffieth1742]

I would agree with Alexis' comments and think Shani's comments are a little too harsh. I believe Dr. Regan has it right, that our venture into adult autism is a nascent one. There are many persons out there professing to do this or that, and she pointed out the pitfalls. She is exactly right that sticking to the criteria is very important. As a developmental-behavioral pediatrician (about 15 yrs), I've witnessed a lot of sloppy diagnoses in the past and I have witnessed children who were not appropriately diagnosed due to the lack of experience and professional expertise of the provider. Also, I think that her points on ABA were right on target as well. Shani you are missing the point. She is not talking about normalizing, she's talking about functioning, a very important point. I typically will do an adaptive behavior screen in my children with Autism. It's not important if a child can perform a taks but DO they perform when the environment demands. In my opinion, that's where many children and adults get stuck. Kudos to Dr. Regan!

[@cynthiaswank6678]

I'm 66 and can't find a psychiatrist or neuropsychologist to diagnose me. My brother has Autism. Most say it's mainly done in pediatric I live inn southern calif. It's very frustrating I want to know if I have issues or if related to Autism. I never talked all through school and avoid communicating to this day.

[@Megdracula]

Keeping looking for a good psychiatrist

[@TessaCoker]

Did you get your diagnosis. Where? I am 70 in CA (Mammoth Lakes) and willing to travel.

[@josephsprouse9928]

I'm here Self diagnosed and I need to get my legit Dr appointment for me to get my diagnosis and Provide Proof of my problem. Alot of people who are around me. Don't think I have Autism and I need to get my diagnosis, and Provide Proof of my accounts for Saying I have ASD.

[@Catlily5]

I did well in school until college. I had to drop out of college. I can't function well as an adult. I don't work. I am on disability. Yet I would be described as "high functioning".

[@nonickname9612]

Same story here. I had to leave organised / group learning and the hate and ridicule that came along with it. I gave up even attempting to fit in anywhere......or trying to "be like the other kids". Now that I'm a bit older, I understand why things were so awkward and painful when I was younger. I'm also on a disability pension, I know that I don't fit in anywhere and have come to accept the fact that I just never will. I keep myself company and pursue my own area of interest and learning. I don't care if any of the few people who think they know me believe me to be strange or eccentric. I keep every other person at arms length now, in much the same way they have always distanced themselves from me. I know that I won't ever get to have a family of my own, or even be included in the one I originated from. I've come to terms with this and have mostly banished it from my thoughts. I can't say that I'm happy or in any way at peace with myself or the small world I've managed to create for myself. I do know that things became a lot more bearable once I gained an understanding of what the problem has always been and why things turned out the way they have.

[@tomsale5142]

Do you have àspergers

[@lucycburton-johnson5757]

I am searching for info for myself. Have no idea if I am autistic; think I have ADHD. Talking about this with my psychiatrist later this week. I am 73 years old: chronic depression since childhood that was diagnosed as bipolar 20 years ago. I know it's just me, but I find it very difficult to follow the pod host's instructions on how to see videos(?) . I feel totally overwhelmed so I'm going now. I hope this helps your survey.

[@brigitteemme1460]

Seeking for myself secondary to looking for symptoms for a grandchild

[@Smlzqt1]

Please help south ms I am diagnosed and I think my kids are but no one will help

[@angieogden2308]

Can you have an accurate test from a simple questionaire my son been told he's not autistic but I'm convinced so many. Sensory issues😢

[@turtleanton6539]

Wow😊

[@craygraydeb1916]

I am very saddened by a (dis)order that impacts so many facets of an individual's life to 1) not have much testing or information 2) focus on making the individual fit into a system that is incredibly flawed. The logic does not support the thesis.

[@Lil_Yuri]

Video: for ADHDers Video length: just over 59 minutes 😅

[@dj.paleface]

I paused and came back to it a few times 😂

[@sharonaumani8827]

Wow. Maybe this IS a missing piece for me in my puzzle (?). I have been frustrated with the label of C-ADHD because, even though I check off all of the right boxes, my life outcomes more closely match someone with SCT/CDS, as did my father's [across all domains]. The ADHD fits me. Problem is, so does Complex PTSD [I've only learned in the last few years] which can also cause the [mostly verbal variety] of hyperactive symptoms [blurting out a response before being called upon, impatience] that can also come up with physical [medical] and emotional neglect due to similar parts of the brain affected. Also, even though I check the right boxes for the C-ADHD diagnosis, I have had a strong presentation of Primary Inattentive 'type' ADHD for most of my life, but with the seeming added language disorders or disabilities [never diagnosed, but that I have struggled with] much like what is described for those with CDS. I am still uncertain that I would fall on the Autistic Spectrum [maybe I would have fit better for Asperger's and I think it is unfortunate that they didn't just scrap the name for a new one, rather than the whole diagnosis!]. I don't fit any of these perfectly in that I WAS self-reliant [like my father taught me to be]. I may have had issues with sleep because of my busy head, making it tough to get up in the mornings, but I still did so. I always got my school assignments [and work assignments ] in on time, without other's reminders or nagging, though I needed every minute and struggled, even though the outcome was usually good [until perimenopause when my usual life coping skills I never realized I had been utilizing all of my life started falling apart, right when WHO came out with the hormone studies. I had to research to find out what to do for myself, trial and error. I finally advocated for an FDA approved hormone patch and vaginal progesterone because I am so sensitive to the depressive effects of the progesterone. I also had night terrors happen during the start of my menses [or when I would have started, if I skipped that month]. I am also more sensitive to thyroid issues [up or down] if my TSH is not kept within a more narrow range. The hormones, at least, brought me back to my pre-peri-menopausal baseline [still before I figured out I had ADHD]. Vyvanse is the only stimulant that helps without significant side effects [aside from Bupropion which helps some with the motivation and depression, but not enough]. Atomoxetine is out because of issues I developed with Venlafaxine. Methylphenidates are no good for me. Adderall is about the only other stimulant helpful, aside from Vyvanse, but unfortunately I don't respond well to the longer acting and I hate the rebounding of the Adderall that lasts only about 3 1/2 hours and is so up and down. But, looks like that is going to be a forced financial change for me at 65 years thanks to Medicare and drug costs. Up until realizing I had ADHD, I had only been diagnosed with "treatment resistant depression" and anxiety. In hindsight, the "resistance" came from trying to treat my depression with SSRI's before ever knowing I had ADHD [that I figured out myself, later, and that is why my Bupropion quit working, not because it went generic, but I never put that together either, until years later, when I figured out just how much hormones affected my physical and mental health!]. I have been a mental health RN for 30+ years, but I never had kids or an interest in working with them and I kept an outdated '60's notion of ADHD until I decided to read about "ADD" in peri-menopause and got the shock of my life. But, since then, I feel the frustration all over again, because that diagnosis also doesn't quite fully fit and many things "helpful for those with ADHD" I already do, like I was taught or learned/picked up along the way to make life easier. NOW I am learning my whole notion of Autism is also way outdated [and I never learned about "the Spectrum" as I always affiliated it with severe illness, for ex., thinking of, "Dibbs, In Search of Self". I am still uncertain.....am I confusing some of the CDS traits with Autistic traits? I did have some of that daydreaming fantasy stuff as a kid [as well], not just "zoning out", more characteristic of me as an adult]. But, I don't recall having issues with eye contact. …lots of sensory/processing stuff. It confuses me because I identify with being "highly sensitive" and I never even imagined I could even get along with someone "on the spectrum" because, even though intellectually I could tell myself, "they didn't mean it that way," when saying something insensitive, it would still hurt too much to be around "someone like that" [as depicted in some shows about neurodiversity]. Now I look at autism traits and I think back [parallel play, staying on the sidelines, preferring not to want to directly interact with other kids in kindergarten and bullied 1st through 8th grade, I used to like to spin, I am double jointed [more flexible as a kid], I rode my tricycle down cement steps age 4 because of the fascination of what it might feel like and delighted in watching it roll down a driveway, once, while getting an adult to retrieve it from the street, odd play, my usual friends just happen to be 15-20 years older and the list goes on....I am starting to wonder, is it possible I COULD be on that spectrum??? Or just traits? Is there a self-test to help determine? I know med treatment will not change for me, at this point, but this has been making me crazy and contributes to my lifetime of feeling invalidated and feeling stupid and shamed. I just need to know for me!

[@user-gr7jo9qb3l]

I stopped listening when she recommended ABA. Imagine if we punished neurotypicals for disordered behavior when they couldn't isolate during covid, etc. Autistic "behavior" are reactions to being forced to be in environments contradictory to their needs, not personality defects or rebelling.

[@robertafierro5592]

Of you have the cognitive ability to SEE that something is wrong with you, you're probably not Autistic. Autism carries a big Unawareness within the patient. No one seems to CARE about Autistic Adults, because they really can't profit from them. When profit is the incentive, expect EVERYTHING to fall apart. HELPING SOMEONE OUT should never, NEVER, involve money, EVER!

[@gor3bunni367]

by saying that you are invalidating a shit ton of people.

[@cody_go_create]

So much wrong here but I understand your frustration for sure.

[@miriamadahan1730]

Very boring

[@Prince_Yonte]

Naw this is pretty interesting because its real. Real life stuff.