Autism spectrum disorder (ASD) isn’t a single disorder but a group of developmental disorders that affect the way a person communicates with and relates to other people. Although symptoms appear during childhood, some people don’t receive an official autism diagnosis until they are adults, leaving them wondering what they should do to address their symptoms. This guide provides an overview of adult autism spectrum disorder and explains what treatment options are available to newly diagnosed adults who want to improve their day-to-day functioning.
Autism spectrum disorder is classified as a neurodevelopmental disorder, or a condition that develops due to differences in brain development.(1)Â ASD affects behavior, learning, and communication, which may make it difficult to build relationships or enjoy social interactions.(2) Family members may also have to adjust their routines or communication styles to accommodate an individual with an ASD diagnosis.(3) As a result, stress tends to be higher in families that have at least one member with ASD.(4) Autism spectrum disorders may also affect an individual’s choice of career, as differences in communication skills, social skills, and verbal skills may make it more difficult to perform some tasks.
Adults with autism may exhibit any of the following symptoms:
Repetitive behaviors. Some adults with ASD use repetitive behaviors as a coping mechanism when they feel overstimulated.(5) These behaviors may include following a restricted schedule, fidgeting, and developing intense obsessions.
Executive function. Many adults with autism have trouble with complex thinking and planning. They may arrive late for appointments, forget that they have appointments scheduled, or need long-term support when planning complex activities.
Social difficulties. Adults with autism often have difficulty communicating with and understanding others. This may cause them to use stilted language, have difficulty staying on topic, make frequent social blunders, or have difficulty expressing their thoughts in a way that other people can understand.
High-functioning autism isn’t an official diagnosis. It’s an informal term used to describe someone who’s at the higher end of the autism spectrum.(6) This form of ASD used to be called Asperger’s syndrome, but that term was eliminated from the in 2013.(7) Medical professionals use the DSM-5 to diagnose a broad range of mental health conditions. Due to its mild symptoms, high-functioning autism doesn’t interfere as much with work and school as other forms of the disorder.
No two people with autism have exactly the same symptoms, but these are some of the most common challenges associated with having high-functioning ASD:
Social challenges. Adults with this type of ASD may have trouble interacting with others. They may also spend more time talking about themselves than they do listening to other people and learning about their interests.
Physical sensitivity. It’s common for someone with this disorder to be extremely sensitive to noise, smells, textures, and tastes. Uncomfortable clothing, strong scents, clothing tags, and other triggers may cause emotional distress.(8)
Repetitive behaviors. An adult with high-functioning autism may wear the same outfit daily, eat the same foods for every meal, or engage in other repetitive actions.
Emotional sensitivity. Adults with autism may experience intense emotional reactions when exposed to stressful situations. These reactions are often out of proportion to what’s going on.
Treating autism helps make the symptoms more manageable. It’s important for each person to receive an individualized treatment plan made up of the therapies most likely to help them improve their day-to-day functioning. Autism treatment modalities usually encourage positive behaviors and help people with ASD improve their coping skills. Some individuals may also benefit from speech therapy or occupational therapy.
Online therapy makes it possible for an individual with ASD to meet with a trained therapist without leaving their home. This is especially helpful for adults who experience severe distress when meeting new people or going to unfamiliar places. Many services, such as speech-language therapy, are just as effective online as they are when delivered in person.(9) Therefore, online therapy gives individuals with autism the opportunity to improve their functioning without adding to their distress. With advanced technology, it’s even possible for therapists to change their video backgrounds to simulate other environments, allowing patients to work on their social skills or “visit” new places without the stress of having to leave the house.
Some popular online therapy providers include BetterHelp, Amwell, Talkspace, Cerebral, and Teen Counseling.
The main benefit of attending in-person therapy is that the individual has an opportunity to improve their coping skills. When they attend a therapy appointment, they may have to interact with a receptionist, therapist, and other staff members. They may even see other individuals in the waiting room. This can help them learn how to cope with stressful situations. During in-person therapy, the therapist can also use specific objects to help the individual learn new skills. For example, some objects can be used to promote interaction between the therapist and the client.(10)
People with autism have access to multiple treatment options, but what works for one person may not work as well for someone else. That’s why it’s so important to seek personalized care. Some of the most common approaches include early intensive behavioral intervention, applied behavior analysis, cognitive behavioral therapy, and social skills training. Many people with ASD also have other mental health conditions, such as attention-deficit hyperactivity disorder (ADHD). Therefore, it’s important for an individual’s treatment plan to focus on their unique needs.(11) In other words, someone who has more than one diagnosis should have a treatment plan that addresses each condition.
Early intensive behavioral intervention is appropriate when an individual receives an ASD diagnosis before turning 5.(12) It consists of 20 to 40 hours per week of personalized instruction delivered over a period of 2 to 3 years. During EBI sessions, children with autism symptoms work to improve their skills in play, communication, and social interaction. EBI programs are delivered using discrete trial training, a teaching method that involves asking the child to display a specific behavior and then providing positive reinforcement or correction based on their response.(13)
Applied behavior analysis (ABA) is a common therapy for adults with autism. The purpose of an ABA program is to reduce problematic behaviors and help individuals with ASD learn new skills.(14) This treatment method is based on the idea that having some type of reward system encourages people with ASD to repeat positive behaviors. Although discrete trial training is based on the principles of ABA, it’s extremely repetitive. Some newer treatment methods focus on helping people with ASD learn new skills in the context of activities they already do each day. For example, instead of having a therapist choose a random activity, the individual may have an opportunity to learn skills they can apply in the workplace or in unfamiliar social settings.
Cognitive-behavioral therapy (CBT) is a form of talk therapy. It’s based on the theory that many mental health conditions are the result of unhealthy patterns of thinking and behavior.(15) Therapists who practice CBT believe that addressing these harmful patterns can help people with ASD manage their symptoms. A typical CBT session may focus on the following:
Learning to recognize when faulty thinking is creating problems
Developing problem-solving skills
Gaining a better understanding of why other people think and act the way they do
Role playing to practice new skills and prepare for social interactions
Unlike some forms of therapy, CBT doesn’t focus on the past. It emphasizes what’s currently happening in the individual’s life, allowing people with ASD to learn new skills that they can apply immediately. One of the main benefits of CBT is that it allows individuals with ASD and other neurodevelopmental disorders to take control over their lives. Rather than waiting for someone else to provide support, they can develop better coping skills and work to adjust their own behavior.
Social skills training (SST) helps adults improve their functioning in social situations. This type of treatment is especially helpful for adults who weren’t diagnosed with ASD until later in life, preventing them from accessing early intervention programs.(16) During an SST session, a therapist uses direct instruction, modeling, role playing, and other techniques to help people with ASD learn how to communicate more effectively. Depending on the individual’s needs, this type of therapy may focus on increasing self-confidence, using appropriate nonverbal cues, or listening carefully when other people are talking. SST is useful for targeting any social skill that needs improvement.(17)
