“Am I Autistic?”: Adult Autism Assessment

Autism presents differently, depending on the person. Not one autistic person will look exactly like another autistic person. The DSM-5 conceptualizes autism as a struggle with social communication along with the engagement of “repetitive behaviors” and “restricted interests”. Unfortunately, the diagnostic criteria for autism don’t capture all of the many different strengths and struggles of the autistic experience.

Below are some common autistic experiences and characteristics; these are not criteria to diagnose autism. Numerous of my autistic clients described or agree with each of the below. However, it is important to keep in mind that autistic traits occur along a spectrum. The “symptoms” of autism in adults often vary widely. Not everyone will relate to every single one of the descriptions.

Adult Autism Diagnosis “Symptoms” Checklist

Social Characteristics Of Autism In Adults

You’ve consistently felt different from your peers.
Even in situations where people have included you in social outings, you feel out of place or very uncomfortable.
You find it difficult to relate to the general public. Oftentimes, you don’t understand why they like the things they like or do what they do.
Others often misinterpret your behavior. People mistakenly think you’re being rude or behaving as if you don’t like them.
You often feel misunderstood by others.
To prepare for a social outing, you think of jokes or phrases ahead of time to use in conversation.
You feel like you’re playing a character or hiding your authentic self in social situations.
When you spend a lot of time with certain people, you find yourself mimicking their mannerisms (e.g., phrases they use, how they dress, how they behave).
You have trouble reading people’s non-verbal cues.
Small talk feels pointless. If you engage in it, it feels cumbersome.
You love talking about your passions. Spending hours discussing your hobbies or interests is easy and doesn’t feel boring.
You prefer to have a select few friends who you are deeply close to versus having numerous, more superficial friendships.
Some of your friends have ended their friendships with you, and you don’t understand why.
You are extremely loyal to your loved ones.
You value honesty, transparency, and truth in your relationships.

Sensory Characteristics Of Autism In Adults

Eye contact is extremely uncomfortable.
Your relationship with sensory input is at the extremes—you are either very sensitive to certain sensory input or you need a lot of input for it to register. For example, you may be sensitive to certain noises or smells but prefer deep hugs to light touch.
You’re a picky eater. Certain textures or smells of food can make you feel nauseous.
It feels impossible to ignore assaults on your senses. For example, a scratchy sweater can completely distract you from the work you need to complete.
You really enjoy certain sensory input, and engaging with that input can help you regulate your emotions. For example, rocking back and forth or rubbing your face with a soft fabric can calm your anxiety.
Doing the same thing repetitively is enjoyable. For example, listening to a favorite song for hours is pleasant and possibly even calming.
You sometimes feel the need to keep your body in motion. For some, this looks like fidgeting. For others, it looks like pacing back and forth or dancing.
When you’re excited, it feels good to move your body in a certain way.

Cognitive Characteristics Of Autism In Adults

You function best with routine and consistency.
It feels safest and most comfortable when you know what to expect.
Thinking in absolutes (i.e., always, never, definitely) comes most naturally to you. Needing to consider the in-betweens or “grey areas” (i.e., sometimes, only in certain situations) feels more difficult.
You care deeply and are extremely knowledgeable about a few specific areas of interest.
When you work on something you enjoy, you easily become absorbed in that activity.
You are exceptionally passionate about your hobbies and interests. You know more about your interests than most of the people you know.
Sudden changes in plans really bother you and can easily ruin your mood.
You are very persistent and goal-oriented when it comes to things you care deeply about.
It’s difficult to change your mind.
You struggle with executive functioning (e.g., time management, organization, working memory, task initiation).
Puzzles (i.e., Rubik’s cube, sudoku) are fun and possibly even soothing to you.
You are good at noticing details.

Emotional Characteristics Of Autism In Adults

More often than not, you feel anxious.
You struggle with extreme social anxiety.
When things feel out of control or chaotic, you feel especially anxious.
It’s easier to regulate your emotions when you feel like you have control over your environment.
Sometimes you feel like you can’t handle your emotions. Intense emotions seem to come and go without any discernible reason.
When something unexpected happens, you might have an emotional meltdown or anxiety attack.
It’s upsetting when your things are touched, moved, or rearranged without advance notice or your permission.

If you found yourself relating to many of the descriptions above, it may be worth pursuing an adult autism diagnosis with a psychologist or neuropsychologist.

An Adult Autism Assessment Can Help Bring Peace Of Mind

As an adult who is wondering, “Am I autistic?” you may question why you should bother getting an autism test now. After all, you have lived your entire life, thus far, not knowing. Drawing from my knowledge working with autistic adults identified later in life, there are numerous reasons to want an autism assessment as an adult.

Firstly, it can help you get specialized support for your struggles. You’re probably not surprised that therapeutic interventions for allistic (i.e., non-autistic) people don’t always work for autistic people. Working with an adult autism specialist will also ensure you’re not subjected to ableist attitudes by your therapist.

Even if you decide not to get therapy, oftentimes, a diagnosis provides context for better understanding yourself. So often, after being confirmed as autistic, I hear clients describe a feeling of everything suddenly making sense. So much of their life had been confusing. Now it’s understood through a helpful lens.

Additionally, because many autistic people tend to feel “othered”, knowing you’re autistic can help you find like-minded people. You can begin to feel as if you’re part of a community, rather than just an outsider always looking in. Many of my autistic clients have found that the struggles from socializing with allistic people are no longer an issue when they spend time with other autistic people.

As you consider seeking an autism diagnosis as an adult, you may wonder. . .

When is autism normally diagnosed?

There’s a misconception that you need to be diagnosed with autism when you’re a child. Sadly, this leads to many adults thinking it’s a waste of time to get assessed. The truth is, a psychologist or neuropsychologist with a specialty in adult autism will be able to help you get clarity. The assessor will ask you about your childhood. However, being assessed as an adult doesn’t eliminate your ability to get diagnosed.

Many therapists are not very familiar with adult autism, but autism treatment is Dr. Lee’s specialty. She has been working with autistic people for over 20 years. Additionally, autistic adults make up more than three-quarters of her caseload at any given time. By working with an adult autism specialist, you give yourself access to someone who truly understands how autism works and how to identify it, even with non-stereotypical presentations.

How much does an autism assessment cost?

The majority of testing psychologists and neuropsychologists in California don’t accept insurance. Getting assessed privately costs anywhere from $5,000 to $10,000 on the Westside of Los Angeles. This includes an intake appointment, one to two testing sessions, a feedback session, and a written report. The majority of the cost is actually for work the psychologist or neuropsychologist does independently. This includes tasks such as scoring assessment measures and writing the report.

In comparison, an assessment with Dr. Lee costs $1,500-$2,250. The variability in price is due to how autism is diagnosed differently at LA Concierge Psychologist. An adult autism test with Dr. Lee consists of four to six weekly sessions. The cost is made more affordable by limiting the assessment process to these collaborative sessions and some brief time outside of sessions for Dr. Lee to reflect on the data she is collecting. Because there is no written report provided at the end of the process, you’re able to save thousands of dollars on your adult autism assessment.

Learn more about why an assessment with Dr. Lee may be a better fit than a formal neuropsychological assessment.

How is adult autism diagnosed?

If you want to know if you’re autistic for your own personal reasons, an assessment with Dr. Lee is a great fit. However, if you need a written report to submit to school or a government agency in order to receive accommodations or services, you are better served by a formal neuropsychological assessment that culminates with a written report. Most colleges require an assessment report to access accommodations. If you need accommodations at work, please confirm with your Human Resources department what documentation is needed in order to determine if this assessment service is appropriate for your needs. At the end of the assessment process, Dr. Lee can provide a simple letter confirming your diagnosis, but there is no option to receive a written report. If additional paperwork needs to be completed (e.g., your school does not require a written report but does need a psychologist to confirm a diagnosis), Dr. Lee can complete paperwork at an additional cost.

If your goals for an autism assessment align with Dr. Lee’s assessment process and you are physically within California or Nevada (the only two states in which Dr. Lee is licensed and allowed to practice in), email Dr. Lee and let her know you read her assessment webpage and want to move forward with an assessment. Dr. Lee may let you know that she has a waitlist and will explain the waitlist process to you. Oftentimes, Dr. Lee does have a short waitlist for assessments.

Once it’s time for your assessment, Dr. Lee emails you some initial paperwork. The email provides detailed instructions about the paperwork and deadlines for submission. The email also includes information about payment. Your paperwork and payment are due 48 business hours/2 business days prior to your first session.

When you submit your paperwork and payment, Dr. Lee confirms your sessions via email. In that same email, she provides you with a link to the secure video chat. Dr. Lee also shares further information about what to expect during the assessment process.

The assessment consists of four or more 45-minute weekly sessions via teletherapy (e.g., secure video chat). From Dr. Lee’s experience, about half of clients finish the process in four sessions; the other half of the time, five or more sessions are needed before a diagnosis can be confirmed. Each session is the same day and time each week. Sessions are only available Tuesdays through Friday during the hours of 10 am to 5 pm; if you are not able to meet those days and timeframes, unfortunately, this assessment process is not a good fit for your needs. The adult autism assessment is conducted via teletherapy only; there is not an in-person version of this service. You start with an initial four sessions, paid for upfront, which is $1,500. If you need additional sessions, Dr. Lee lets you know by the end of the third session so you have time to adjust to the idea of additional sessions. Each additional session is $375.

The majority of the sessions consist of you sharing information about your current struggles and history of those same struggles. Dr. Lee asks follow-up and clarification questions as needed. Throughout the process, she shares some of her thoughts with you. This contributes to a feeling of being part of a collaborative autism assessment process— a conversation being had with you rather than a test being done to you.

Conducting the autism assessment in this way, Dr. Lee gets to know you over many weeks. This allows you to become more comfortable with her and increasingly more vulnerable and authentic in sessions. This comfort and authenticity is key to accurate identification. Getting to know you over numerous weeks also enables Dr. Lee to take note of more varied data. This process increases the accuracy of identifying autism, especially in women/those assigned female at birth, non-binary people, the transgender community, and people of color.

In the last session, Dr. Lee provides her diagnostic impressions. She explains how and why she arrived at her conclusion and then leaves time for you to ask questions and begin to process the new information.

Find Clarity With An Adult Autism Assessment

No matter how confusing things seem right now, Dr. Lee has the knowledge, expertise, and compassion to help you find clarity regarding an adult autism diagnosis. As an adult autism specialist, she will take your complex set of struggles and help you make sense of them. Email Dr. Lee to be placed on her waitlist.

Dr. Lee is only able to assess those physically located in California or Nevada.

Dr. Marin (formerly Abbene) is now available to assess those physically located in Texas and all 23 PSYPACT states. The assessment process is modeled after Dr. Lee’s, and the cost is $1,000 to $1,500, starting with $1,000 for the initial four sessions and $250 per additional session.