Autism in Adulthood

Autism can persist with its unique symptoms not only in childhood but also in adulthood. Many autistic individuals may not have been diagnosed during childhood or may have hidden their symptoms with a strategy called “masking.”.

Thanks to the increased awareness of autism and related neurodiversity characteristics in adults, there is currently an increase in the number of adults who are diagnosed with autism.

What is masking?

Masking is the conscious or unconscious suppression of one's natural behaviors by individuals with autism in order to adapt to social environments. This can make it difficult for the environment to detect autism. Masking can occur in formal situations such as school or work, at home with the family, or during social interactions with friends.

Masking by an autistic individual;

Not having people believe that the individual is autistic,
The misdiagnosis of autism, its late or insufficient diagnosis, and the inability of the person to receive the support they need,
Failure of doctors, teachers, and experts to understand masking and assume that the individual is not experiencing difficulty can lead to misunderstandings.

Autism Symptoms in Adulthood

The symptoms of autism seen during adulthood are classified below. It should be kept in mind that not every autistic individual has all of these symptoms.

Social Interaction Problems

Feeling excluded from social circles or being unable to adapt to the environment,
Having difficulty understanding what others think and feel,
Not understanding or misunderstanding non-verbal expressions such as eye rolling, shoulder shrugs, and face-swallowing,
Inability to see/analyze another person's perspective,
Being unable to maintain personal distance; being physically too close or feeling excessively uncomfortable from contact,
Avoiding or not liking eye contact,
High levels of anxiety in social settings,
Difficulty following social rules or signs,
Difficulty forming and maintaining friendships.

Communication Differences

Difficulty following the conversations between them,
Having difficulty catching the topic of conversation or getting involved in the conversation,
Not speaking for long periods of time on favorite topics,
Difficulty expressing emotions,
In other words, difficulty in understanding idioms, metaphors, and proverbs,
Being noisy in environments where silence is required,
Speaking in the same tone regardless of the home, work, or social environment.

Recurrent/Obsessive Behaviors

In unrelated situations, movements such as swinging/volta-throwing, or the production of specific sounds/words,
The desire to keep belongings in a fixed order; excessive discomfort when the order is disturbed,
Difficulty in regulating emotions and reactions,
Sticking rigidly to daily routines, not being able to adapt,
An outburst of anger in routine/expectations when there is a sudden change,
Having intense and obsessive interests (e.g., machines, historical periods, collections),
Having excessive detailed knowledge about a subject,
Experiencing a burst of anger in the face of an unexpected situation.

Note: High-interest areas can also have positive effects on quality of life; in some cases, they can even lead to employment opportunities.

Other Symptoms

Being very successful in several challenging academic fields (being very good in some fields while struggling in others),
Learning by listening or visual learning,
Quickly learning and retaining complex and detailed information for a long time,
Being defined by others as “academic” or “eccentric”,
Not choosing to be alone,
Feeling clumsy or having difficulty with coordination,
Mastering the small details/patterns that other people don't notice,
Excessive sensitivity or insensitivity to sensory stimuli such as pain, sound, touch, and smell.

What issues do adults with autism need support for?

Social isolation and difficulties in establishing relationships,
Anxiety and emotional regulation problems,
Workplace adaptation,
Establishing and maintaining routine in daily life,
Behavioral therapy or medication treatment,
Advocacy and participation in support groups.

Is ABA available for adults with autism?

As in childhood, many principles and strategies based on applied behavioral analysis (ABA) can be utilized in adulthood. ABA is the process of teaching new behaviors by systematically organizing the environmental characteristics that occur before and after the behaviors, as well as changing or eliminating inappropriate behaviors with appropriate ones. Adult individuals with autism can apply the ABA principles through the following steps:

Listing the goals the individual wants to achieve: Goals should be written in a way that can be observed and measured. For example, “having acceptable social skills” is a very broad statement, whereas “waiting without speaking until my friend finishes their conversation” is a more observable statement.
Prioritizing goals: Achieving all goals simultaneously may not be realistic. Therefore, starting with the goal that is most frequently used in daily life or changing the behavior that is most challenging would be more functional.
Establishing a strategy to achieve the target behavior: For this, it is necessary to utilize strategies based on ABA. Behavior control checklists, visual reminders, skill analysis lists, self-monitoring tools, etc. can be used to remind goals. Furthermore, role-playing and rehearsing strategies can also be used, and the individual can reward themselves as goals are achieved.
Practical application in daily life: The targeted behavior should be practiced by using it in different environments and with the presence of different people.
Always having a B plan: Daily life is full of surprises. Not everything can go as planned. For example, at the restaurant where the individual enjoys going and always eats at the same table, that table may be full that day. The individual should be prepared for such unexpected situations.
Watching oneself, evaluating oneself, and rewarding oneself when one achieves gains: It is important to evaluate whether the goals have been achieved and for the individual to reward themselves for the achieved goal. New goals can be set in place in place of the previously achieved ones, or intermediate steps can be taken for goals that have not been achieved, or the goal can be made more achievable.