Adults with hidden autism. This is UAn informative post about adults with high-functioning ASD by a girl with autism.

By: by Zurivette Martínez Febus, OTS
Occupational Therapy Student

Autism Spectrum Disorder (ASD) is a neurological condition that affects 1 in 59 children and approximately 1 in 100 adults. In 2017, the CDC identified that a total of 2,21%, approximately 5.4 million, of adults in the United States have autism.

Typically this diagnosis is given in infancy or early childhood. However, some of these children may go undetected and undiagnosed because they have developed the skills necessary to adapt to their environment. However, as adults they may feel differently, or face more apparent problems socializing at college or work as was my experience. They could feel different from their peers, that they do not "fit in", have challenges in the workplace when interacting with co-workers, among others. According to the literature, it is common for these manifestations to go unnoticed more frequently in women than in men. This is due to its ability to camouflage, but women experience more comorbid conditions, such as social anxiety (Lai, 2017).

Receiving the diagnosis of autism at the age of 24 has been a key piece in being able to give “an answer” to the challenges that I have presented in my social and physical development. Personally, knowing the diagnosis has helped me seek specialized help to refine those social areas that are still difficult for me. Knowing the diagnosis can also help many other people who are in a similar situation to mine, to understand themselves, to communicate the help they need, and to seek specialized help. Autism Spectrum Disorder is just that, a spectrum with diverse manifestations. It is for this reason that a specialized health professional, a Psychologist or Psychiatrist, is required to diagnose and treat it. Some of the common manifestations in adults are, but are not limited to:

  • Difficulty in expressive communication
    • When they speak they are very honest
    • have difficulty holding a conversation
    • Sometimes the conversation may sound programmed or practiced like a script
    • They avoid eye contact or maintain it for a prolonged and intense period
    • Difficulty identifying or expressing your thoughts and feelings
    • They remember a lot of trivial information, curious facts, or others.
  • Difficulty interpreting communication:
    • Difficulty reading and understanding nonverbal language (gestures and/or body language)
    • Difficulty understanding the intentions, thoughts, and feelings of others
    • They understand expressions literally and find it difficult to understand symbolic language
  • Repetitive and restrictive interests or behavior.
    • Insist on following a routine or plan, and get stressed if it changes or is interrupted
    • Particular, intense, and/or repetitive interest in a particular hobby or topic of conversation
  • Hyper or hyposensitivity to sensory stimuli. They may be more aware of or less sensitive to some sensory stimuli:
    • They are distracted by environmental noises
    • They use self-stimulatory regulatory behaviors
      • rub hands together
      • squeezing fingers
      • move the leg rhythmically
    • They prefer to wear comfortable clothing even when it is not the most ideal for the circumstance or scenario
  • Internalized manifestations that are not externally apparent. They manage to participate in social activities and interact, but these can be overwhelming due to the constant mental effort they must make.
    • They feel uncomfortable during conversations, feel social anxiety, or feel tired after interacting socially for long periods.
    • It is a challenge to regulate emotionally, they are prone to emotional discharges ("meltdowns"), or withdraw and block the environment ("shutdowns")

If you or someone you know has identified with any of these manifestations, please feel free to share your thoughts with a health professional. They may be able to help you understand more about the topic or direct you to someone they can. On the other hand, I encourage you to be a source of great support for those who have the diagnosis. Help others by being patient, providing them with constructive recommendations, keys on how they can adjust their actions or expressions, among other support in the field that they request, as has been personal experience. Being diagnosed with autism did not change anything in my life, it just added to what makes me a unique and incomparable person.



CDC. (April 27, 2020). Key Findings: CDC Releases First Estimates of the Number of Adults Living with Autism Spectrum Disorder in the United States. Center for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/features/adults-living-with-autism-spectrum-disorder.html

Lai, MC, Lombardo, MV, Ruigrok, AN, Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., Baron-Cohen, S., & MRC AIMS Consortium (2017). Quantifying and exploring camouflage in men and women with autism. Autism: the international journal of research and practice, 21(6), 690–702. https://doi.org/10.1177/1362361316671012

Lewis, L.F. (2018). Identifying autism spectrum disorder in undiagnosed adults. The Nurse Practitioner, 43(9), 14–18. doi:10.1097/01.npr.0000544285.02331.2c