For some Autistic individuals, the nature of their difficulties bring them for assessment and diagnosis in childhood. For others, the signs of Autism may be more subtle or obscured by other challenges, resulting in later recognition. Many individuals encounter a range of other significant barriers to early diagnostic assessment, thus may not be diagnosed until adulthood.
Individuals with Autism experience higher rates of co-occurring mental health conditions and therefore may be attending mainstream health services where the presenting problem is related to mental health concerns.
Opportunities are present for mental health professionals to detect individuals who may not have been diagnosed in childhood. Consequently, it is important to be aware of key signs of Autism in adolescents and adults.
This poster, developed by the Autism Association of WA, outlines some of the key signs of Autism in adults & adolescents. This tool should be used as a guide only. If multiple characteristics associated with Autism are identified, it may be worth progressing to a more formal screening tool.
Click here to download.
Where traits consistent with Autism are identified, a number of freely accessible tools are available to assist clinicians in further screening. However, it is essential to recognise that the target population for these tools is for those individuals with Autism without co-occurring intellectual disability or psychiatric comorbidities. Traits detected in these screening tools are sensitive but not specific to Autism, and the presence of comorbid mental health conditions is likely to inflate scores on screening measures, reducing the validity of these measures in psychiatric populations.
Therefore taking a good developmental history around characteristics of rigid & repetitive behaviours, and social communication difficulties is the foundation of screening in mental health settings. The standardised screening tools below are provided for general information.
The University of Cambridge have developed a screening tool called the Autism Spectrum Quotient (AQ). The AQ-10 is a 10 item self-report questionnaire that is quick to complete and score, and available in both adolescent and adult versions:
The Ritvo Autism Asperger’s Diagnostic Scale-Revised (RAADS-R) is another useful resource in the screening and assessment of adults for possible Autism. The Autism Association has developed a screening tool based on the RAADS-R – click here to view.
There are many potential benefits to making an Autism diagnosis, at any age. Many individuals find a diagnosis in adolescence or adulthood an empowering tool for improved self-knowledge and better understanding of their individual challenges and strengths. Adults on the Autism Spectrum can also access a range of supports, including peer support, therapy, education and employment support, and support with independent living.
The Autism CRC has produced a comprehensive document outlining evidence-based approaches to diagnosis in Australia called the National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia.
For further education for Psychiatrists, the RCPSYCH has developed the following CPD module:
Quickbite: Diagnosis of Autism Spectrum Disorders in Adults
Please note. You will require a CPD eLearning subscription to access this training module.
For Psychologists, the Australian Psychological Society has produced the following Module on assessment and diagnosis:
In Western Australia there are a number of referral pathways for accessing a diagnosis. You can read about the diagnosis processes in WA by clicking here.
Alternatively, diagnostic assessments can also be coordinated through relevant specialists (Pediatricians, Psychiatrists) working in private practice.
Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge University, summarises strategies for improving the recognition of Autism in the following key articles:
NICE provides the following clinical guidance regarding diagnosis for specialists:
Diagnostic Instruments for Autism Spectrum Disorder (ASD).
This article looks at the the accuracy of diagnostic tests for diagnosing Autism Spectrum Disorders across the lifespan.