Adult Autism Assessment
& Psychological Evaluations
Discover Your Strengths: Create a Life That Fits You
WHY SHOULD I GET AN AUTISM ASSESSMENT?
Experiences of Late-Diagnosis Among Autistic and/or ADHD Adults
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Participants:
The 20 participants in this qualitative study included:
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7 healthcare professionals specializing in ADHD/autism diagnosis
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13 late-diagnosed adults (5 with autism; 5 with ADHD; 3 with both)
Inclusion Criteria:
Participants were required to be older than 25, and to have received their diagnosis at least 4 years ago
Methods:
Researchers conducted an interview with each participant
Results:
Five themes were identified that encapsulate the reactions of late-diagnosed adults:
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Theme 1: Relationships and mental well-being:
Before getting a diagnosis, many adults felt vulnerable—almost as if they were easy targets who ended up believing the negative things people said about them. After being diagnosed, they noticed that their relationships improved and they began to see that they weren’t “broken.”
Theme 2: Changes in overall well-being and mental health:
Before the diagnosis, many of these adults felt like they didn’t quite belong and struggled with serious mental health issues. Once they understood what was behind their challenges, they felt more hopeful, understood themselves better, and found that they could manage their emotions more effectively—leading to fewer emotional outbursts and burnouts.
Theme 3: Finding answers through diagnosis:
Getting a diagnosis helped many adults finally understand why they faced certain challenges. This new insight helped them to be kinder to themselves, and also, to be more accepting of others. It also gave them a clearer idea of how to move forward with their lives.
Theme 4: The burden of a label:
Even though a diagnosis can be very helpful, it isn’t always free of problems. Some people might use the label to stereotype or dismiss someone—especially if they don’t “look” autistic or have ADHD in the way others expect. These reactions sometimes lead adults to question the validity of their own diagnosis.
Theme 5: The impact of timing:
For some, learning about their autism/ADHD later in life comes with feelings of anger or regret over what might have been if they’d known sooner. However, many also believe that an earlier diagnosis might not have been any easier because there was much more stigma in the past. Some even felt that not having a diagnosis pushed them to work harder and achieve success in their own way. Overall, having support after a diagnosis is seen as very important.
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French, B., & Cassidy, S. (2024). “Going Through Life on Hard Mode” - The Experience of Late Diagnosis of Autism and/or ADHD: A Qualitative Study. Mary Ann Liebert, Inc. Publishers, Epub online ahead of print. https://doi.org/10.1089/aut.2024.0085
IS CAMOUFLAGING UNIQUE TO AUTISM?
Adults with ADHD and Autism Both Engage in Masking
Introduction:
Many late-diagnosed autistics use camouflaging (masking), which is associated with higher rates of mental health symptoms. The question is, do other neurodivergent individuals, (i.e., ADHD) also camouflage?
Participants:
Part I: Three groups of adults (aged 30–90) were compared:
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105 adults with ADHD
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105 adults with autism (matched by age and gender to the ADHD group)
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105 adults without ADHD or autism (a control group)
Part II: A larger group of 477 adults who had ADHD and/or autism participated
Methods:
Researchers used a Dutch questionnaire (CAT-Q-NL) that looks at three aspects of masking:
• Compensation: Changing behavior to cover up challenges
• Masking: Hiding natural reactions to appear “normal”
• Assimilation: Trying to blend in with others by imitating social behaviors
They also used standard self-report measures to assess ADHD and autistic traits
Results:
Part I:
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Autistic adults scored the highest overall on masking, especially in the areas of compensation (adjusting behavior) and assimilation (blending in)
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ADHD adults scored higher than the control group overall and on assimilation, but not on the basic masking or compensation parts.
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Part II:
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In adults with autism and/or ADHD, having more autistic traits was linked to higher scores on overall masking, compensation, and assimilation.
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In contrast, ADHD traits did not predict masking scores.
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Conclusion:
Both autistic and ADHD adults tend to mask or camouflage themselves, but—at least when using a measure designed for autism—autistic adults mask more than those with ADHD. The masking subscale of the CAT-Q might actually be picking up on general impression management (the effort to control how others see you), which is not necessarily unique to autism.
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van der Putten, W. J., Mol, A. J. J., Groenman, A. P. Radhoe, T. A., Torenvliet, C., Agelink van Rentergem, J. A., & Geurts, H. M. (2024). Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD. Autism Research, 17, 812-823. https://doi.org/10.1002/aur.3099
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​AUTISM AND THE NERVOUS SYSTEM​​
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​Autistic Individuals Exhibit Lower Parasympathetic Activity than Neurotypicals​
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Introduction:
Our bodies have an autonomic nervous system with two parts: the sympathetic nervous system (SNS), which triggers our "fight, flight, or freeze" responses, and the parasympathetic nervous system (PNS), which helps us relax and "rest and digest." Some research shows that lower PNS activity at rest is related to social and emotional difficulties in autistic individuals, and that compared to neurotypicals (NT), autistic PNS activity levels are significantly lower. However, research on SNS or combined SNS+PNS activity across neurotypes has shown mixed results. To better understand how the autistic versus NT autonomic nervous system reacts during social situations, this review article and meta-analysis compares the results of 26 different studies in this area.
Inclusion criteria:
All included studies measured the physiological response of autistic and NT individuals to social stimuli. Autistic participants were previously diagnosed, and diagnosis was re-confirmed for the study using validated clinician-administered measures. Participants included preschoolers (up to age 6), children (ages 6-12), adolescents (ages 12-18), and adults (over age 18).
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Methods:
SNS activity was measured via pupil dilation and electrodermal activity. PNS activity was assessed with measures of heart rate variability such as respiratory sinus arrhythmia (RSA) and multiscale entropy. Combined SNS+PNS activity was assessed with heart rate and inter-beat intervals. The review also looked at what kinds of social situations participants experienced. For example, watching a social interaction in a photo or video was considered "passive" exposure, while speaking publicly or interacting live was seen as "active" exposure.​
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Results:
Autistic individuals generally showed lower "rest-and-digest" (PNS) activity compared to NT individuals. However, there were not clear differences in the "fight, flight, or freeze" (SNS) responses or the combination of both (SNS+PNS). The only exception was when the social task required active participation—here, autistic individuals had a stronger combined (SNS+PNS) response than NT individuals.
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Discussion:
Successfully navigating social environments requires accurately interpreting social cues and swiftly adapting one’s behavior. This ongoing adjustment depends on regulatory mechanisms within the autonomic nervous system, particularly the PNS, which can be assessed using measures such as RSA. When these regulatory systems are disrupted, it can become challenging to respond effectively to changing social signals, potentially resulting in more rigid or repetitive behaviors—a pattern frequently observed in autistic individuals.
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Zadok, E., Golan, O., Lavidor, M., & Gordon, I. (2023). Autonomic nervous system responses to social stimuli among autistic individuals: A systematic review and meta-analysis. Autism Research, 17(3), 497-511. https://doi.org/10.1002/aur.3068