Autism Throughout the Lifespan: Did I Miss My Child's Diagnosis?

Nicole Peniston, Psy.D.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects individuals in different ways throughout their lives. Early diagnosis is crucial for accessing interventions and support, but for many, autism can go undiagnosed until later in life. Recognizing the signs of autism at different stages—from childhood through adulthood—can make a significant difference in understanding and supporting individuals with ASD.

Who Should Be Tested for Autism?

While autism is typically diagnosed in early childhood, it can be missed, especially in cases where the symptoms are mild or masked by other developmental behaviors. Let’s take a closer look at the different stages of life and how autism may present itself.

Children (Ages 2 and Up)

Early detection of ASD in children is key to accessing early intervention services, which can significantly improve developmental outcomes. According to the Centers for Disease Control and Prevention (CDC), early intervention services can help children with autism develop critical social and communication skills. The American Academy of Pediatrics (AAP) recommends that all children undergo developmental screenings with their pediatrician at 18 and 24 months to identify possible developmental delays, including signs of autism.

Signs to Look for in Children:

In young children, certain behavioral and developmental signs can indicate the need for an autism evaluation:

– Delays in speech: Children with ASD may have delayed language development or difficulties in forming sentences and expressing themselves.

– Limited eye contact: A child who avoids eye contact or seems indifferent to social interactions may exhibit early signs of autism.

– Repetitive behaviors and non-functional play: Repetitive actions, such as flapping hands, rocking, or repeating the same words or phrases, are common indicators.

– Social challenges: Children with autism may have trouble forming relationships with peers, engaging in pretend play, or understanding social cues.

– Sensory sensitivities: Sensitivity to sounds, lights, textures, or certain tastes may also be present.

Parents or caregivers who notice these signs in their children should consider seeking an autism evaluation from a psychologist or developmental specialist. Early testing can lead to effective, targeted interventions that help children build necessary skills for success.

Why Testing Adolescents is Important:

As children enter adolescence, some signs of autism may become more evident, particularly as social, academic, and emotional demands increase. Adolescents with ASD often face new challenges related to peer relationships, school performance, and managing emotional regulation. Identifying autism at this stage can help guide interventions that address these specific developmental needs.

Signs to Look for in Adolescents:

– Struggles with social relationships: Adolescents with autism may find it difficult to make friends, understand social norms, or engage in reciprocal conversations.

– Difficulty with non-verbal communication: Challenges in interpreting facial expressions, tone of voice, or body language are common.

– Rigid thinking patterns: Adolescents with ASD may show resistance to changes in routine or have a strong preference for structured, predictable environments.

– Intense focus on specific interests: While adolescents may have hobbies or passions, those with autism may develop narrow and intense interests that dominate their thoughts and conversations.

– Difficulty with transitions, both major (moving, changing schools, graduation) and minor (changes in friend groups, changes in socially appropriate interests/topics).

An evaluation during adolescence can help students who qualify for and would like to receive accommodation in school, such as individualized education programs (IEPs), as well as targeted support for social skills and emotional regulation. Students who do not wish to have an IEP or school accommodations can benefit from outside resources such as online learning or technologies to assist with homework or other challenges outside the classroom.

Why Some Adults Seek Late Diagnosis:

Many adults may not have been diagnosed with autism during childhood, especially if their symptoms were mild or masked by compensatory behaviors. As these individuals age, they may encounter difficulties in social relationships, work environments, or personal settings that are difficult to explain. For these adults, seeking a formal diagnosis of autism may help clarify their experiences, provide a greater understanding of their behavior, and grant access to necessary support and accommodations. Adults who test for autism do not need to disclose a diagnosis or qualify for all accommodations, however, may benefit from understanding of resources available to them based upon their difficulties.

Signs to Look for in Adults:

– Challenges with social relationships: Adults with autism may struggle with forming or maintaining friendships, romantic relationships, or professional networks.

– Sensory sensitivities: Sensitivities to noise, lights, or textures may persist into adulthood.

– Organizational difficulties: Some adults may find it hard to manage tasks, deadlines, or time effectively, impacting their work or personal life.

– Unexplained struggles in life: An adult may seek a diagnosis to better understand difficulties they’ve faced in communication, social interaction, or emotional regulation, which may have gone unnoticed or misunderstood in childhood.

Individuals with Co-Occurring Conditions

Individuals with conditions such as ADHD, anxiety, or learning disabilities may also be on the autism spectrum, but the overlapping symptoms can make diagnosis challenging. For example, a child with ADHD may exhibit impulsive or inattentive behaviors that mask social communication challenges related to autism. A formal ASD diagnosis can lead to a more effective, specialized treatment plan that addresses both autism and the co-occurring condition.

Signs to look for in individuals with Co-Occurring Conditions:

– Difficulty managing social interactions in addition to their primary diagnosis.

– Repetitive or restrictive behaviors alongside ADHD or anxiety.

– Sensory issues that seem more extreme than what is typical for their diagnosed condition.

The Importance of Seeking Evaluation

Autism Spectrum Disorder presents differently in each individual, but recognizing key signs across age groups can help identify when testing is appropriate. Early diagnosis can significantly improve outcomes, particularly when paired with interventions like speech therapy, behavioral therapy, or educational accommodations. If you, your child, or a loved one are exhibiting signs of autism, consulting a psychologist for a formal evaluation is a crucial first step toward understanding and support. Seeking help early can set the stage for a more successful and fulfilling life.

Dr. Nicole Peniston is a highly skilled rehabilitation and clinical psychologist with extensive expertise in neurodevelopmental disorders and autism evaluations. With a compassionate approach and years of experience, she is dedicated to helping individuals achieve improved outcomes and quality of life through personalized assessments and evidence-based interventions.