Should I Tell an Adult "I Think You May Be Autistic?"

Should you tell an adult "you may be autistic?"

Girl with Computer
Girl with Computer. Getty

Your adult friend, relative, or colleague seems socially "off," unusually into online gaming, extremely limited in clothing and food choices. He's been passed over for promotions, socially ostracized, or even bullied.

To you, the reason for this issues seems obvious: your friend or relative is probably autistic.

What should you do next?

Start By Checking Your Understanding of Autism

Before you do anything at all, it's important to know more about autism than what's commonly shared on the media or among friends.

To qualify for an actual autism spectrum diagnosis, a person must have multiple symptoms -- and those symptoms must be severe enough to seriously impact their ability to live a normal life. Just as importantly, the symptoms must have been present from the time the individual was a very young child.

If your friend or acquaintance has just one autism-like, challenge, has challenges that don't seriously impact his life, or recently acquired certain challenges, he is not autistic.

Here are some misconceptions about what autism really looks like:

  • My co-worker has become very shy since her divorce. She has only a couple of friends. If your friend WAS social and is NOW shy, autism is not the issue. What's more, not all people with autism are shy! People with autism may be shy or social -- but they are likely to find social communication tricky. They may not pick up on sarcasm, talk about the "right" topics, or know when to join in and when to step away from a private conversation. 
  • My adult son graduated from college and is holding down a job -- but when he's home, he's so fascinated by online gaming that he never wants to leave the house. If a person has graduated from college, is holding down a job, and happens to be fascinated by online gaming, it is unlikely that he is autistic. While people with autism may perseverate (over-focus) on areas of special interest, perseveration alone isn't enough to qualify for a diagnosis. What's more, if the issue of perseveration is new, then autism is not the problem.
  • My brother is terrific at computer programming, but has never been able to find a girlfriend. Many people with autism have a talent for programming, and relatively few find it easy to connect romantically. But that can be said for many, many people who are NOT autistic.
  • My sister has the same routines that she has to go through every day. People with autism generally prefer routinized schedules as opposed to spontaneity. But the need to, for example, touch objects in the same order in order to reduce anxiety, is not usually associated with autism. If the person in question has no other symptoms, it is possible that she suffers from a disorder such as Obsessive Compulsive Disorder -- but it's unlikely that she's autistic.

What Should You Do if You Still Think Someone in Your Life Is Autistic?

To start with, while an adult in your life may, in fact, be diagnosable with high functioning autism (Asperger syndrome), it's not absolutely necessary to do anything at all. That's because (1) it's hard to find a specialist with experience in diagnosing adults with high functioning autism  and (2) there are few autism-specific treatments for adults.

Before saying anything at all, therefore, it's important to do a quick cost-benefit assessment. Ask yourself:

  1. Is it really my place to say anything? If you're a close friend or relative, the answer may be "yes," otherwise the answer is probably "no."
  2. Will it be helpful to say anything? If the person in question seems content with the life he or she is living -- even if it is limited -- there may be no benefit in speaking up. If he or she is lonely, frustrated, or feeling marginalized, a diagnosis could be helpful.
  3. How is this person likely to respond? Some people are relieved by a diagnosis, while others are upset -- and still others simply deny the possibility and lash out at the messenger. 

Assuming that you are close to the person in question, you should be able to accurately answer these questions and come to a decision.

What Kind of Treatment Is Available to an Adult with Autism?

Generally speaking, adults with autism receive treatment for specific symptoms through a combination of cognitive (talk) therapy, direct instruction for particular social situations, and appropriate medications. They may also choose to seek help from an occupational therapist for sensory problems: Many people on the autism spectrum over or under-react to sound, light, pain, and so forth.

The most effective course to follow for an autistic adult is:

  • Seek out a psychiatrist who can work with him on his social anxieties and shyness (in some areas it may be possible to find a psychiatrist with experience working with adults on the autism spectrum, but it's not absolutely critical);
  • Consider any medications the psychiatrist may recommend;
  • Consider using videos, books and other tools that provide direct instruction in handling problem situations at work or in the community;
  • Consider connecting with online support groups for adults with Aspergers and related disorders.

Sources:

Gaus, Valerie. Cognitive-Behavioral Therapy for Adult Asperger Syndrome. Guilford Press, 2007. 

Mandy, Roy et al. Asperger’s syndrome in adulthood. Dtsch Arztebl Int. 2009 Jan; 106(5): 59–64. Published online 2009 Jan 30.

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