Though some seem concerned with so-called “overdiagnosis” of autism, the stats tell a different story.
The National Autistic Society (NAS) says that roughly 750,000 autistic adults in the UK are undiagnosed, while the Children’s Commissioner’s 2024 report on waiting times for assessment found “inequalities between the most and least advantaged children.”
Women and girls may be even less likely to get an accurate, early diagnosis of autism, the NAS add; they might only realise they’re autistic late into adulthood.
Speaking to HuffPost UK, Dr Mikki Lee Elembaby Psy.D, a psychologist from Clarity Therapy NYC who specialises in autism assessment and diagnosis, said it is common for adults of all genders to have gone their whole lives without having their autism recognised or diagnosed.
Here are five signs she often sees that might warrant further exploration (though they certainly don’t count as a formal diagnosis):
1) You’ve always felt “different”
“Many adults with undiagnosed autism have often spent their lives feeling ‘different’ without knowing why,” Dr Elmbaby told us.
They may have spent much of their childhood feeling unlike their peers, and have spent much of their lives struggling with socialising.
“They might describe always feeling ‘misunderstood,’ missing unspoken social rules, or being accused of being too blunt or direct,” the psychologist told us.
“Many find small talk to be confusing and exhausting. Even when they have a desire to connect, the effort it can take to decode social cues (e.g. body language or sarcasm) can be mentally draining.”
One late-diagnosed adult told Dr Elembaby, “I feel like I’m missing the manual that everyone else seemed to just get.” It’s a sentiment she hears often.
2) You have sensory issues
Sensory sensitivities, or struggling with certain sights, sounds, smells, tastes, and textures, can be another “hallmark” sign.
“Bright lights, loud noises, scratchy fabrics, certain food textures, or strong smells might provoke intense discomfort or even pain,” Dr Elembaby informed us.
As people age, they may compensate for their sensory issues without even realising, the psychiatrist continued.
“Emotional regulation can be an ongoing challenge. Some adults experience meltdowns, or emotional outbursts, during periods of stress or when faced with sensory overload.”
3) Having very strict routines
This is common among adults with undiagnosed autism, the assessor said.
“Sudden and unexpected changes to plans or ambiguous situations can provoke anxiety or distress,” she said.
If, for instance, you hate not knowing where, when, and how you’ll be able to stick to your usual schedule on holiday, that might be worth investigating.
“Autistic adults may depend on strict routines or repetitive habits to provide a sense of calm or self-soothing,” she added.
4) Having very intense passions and even obsessions
“Another defining trait is the presence of intense interests or passions. These passions are pursued with deep enthusiasm and often accompanied by considerable expertise,” Dr Elembaby shared.
She previously told HuffPost UK that “autistic men might fixate on numbers, trains, or mechanics,” which more of us associate with autism than a love of literature or nature, but makeup, literature, art, dolls, TV shows, and more can all count.
5) “Masking”
Describing this as the most “overlooked” sign of autism, the psychiatrist said that “masking” – when people with autism consciously or unconsciously hide or suppress their natural autistic traits to fit in with neurotypical “norm” – is “mentally exhausting.”
Over time, she says, it can lead to chronic stress, burnout, and identity confusion.
“Many autistic adults, especially women, learn early on how to copy or camouflage socially ‘appropriate’ behaviours,” she ended.
What if I think I’m autistic?
Identifying with one or all of these traits does not mean you definitely have autism. But if you feel that it’s something you want to investigate, the NHS says that you should try to get an autism assessment. Adults and children can both apply (but the waitlists can be very long).
The National Autistic Society has offered advice for adults who suspect they have autism regarding whether seeking a formal diagnosis is the best step for them.
They outline the benefits of diagnosis, offer some pre-diagnosis questionnaires, and share which supports do or do not need an official diagnosis and in which cases.
