Who Can Diagnose Autism in Adults?

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Language note: Although individual preferences exist, surveys of the autistic community consistently show that autistic people prefer identity-first language rather than person-first language (i.e., “autistic person” rather than “person with autism”). This article reflects the community's language preference.

Someone who suspects they might be autistic may seek an official diagnosis from a qualified provider.

Who Can Diagnose Autism in Adults?

Usually, this evaluation is completed by a psychologist or a psychiatrist with specialized training in this type of evaluation.

Read on to learn more about the diagnostic process, why it's harder to identify autism in adults than children, and whether getting an evaluation will be helpful to you.

Who Conducts Autism Evaluations for Adults?

A psychologist or a psychiatrist completes an evaluation if they have specialized training in autism.

Certain master's degree-level mental health professionals can also receive training in psychological assessments and autism.

Where to Find a Professional Who Can Diagnose Autism in Adults

Many providers list their services on various directory websites to help potential clients find them and determine if they are a good fit. Those with expertise in diagnosing autism will typically list this on their profiles or professional websites.

Neuroclastic has a diagnostician directory and Embrace Autism offers empirically validated assessments online as well as self-assessments.

Neurodiversity-Affirming Organizations

How Is Autism Diagnosed?

Typically, when seeking an autism diagnosis, an individual completes a psychological evaluation that includes gathering detailed information about their history, early development, relationships, behaviors, symptoms, and difficulties.

Most Autism Diagnoses Are Geared Toward Children Rather Than Adults

Many measures developed to evaluate for symptoms of autism focus on early childhood. Measures to assess for autism in early childhood are typically not normed for adults, meaning they cannot be administered to someone over the age of 18.

What Happens When an Adult Wants to Be Evaluated for Autism?

When an adult is being evaluated for autism, the evaluator must use age-appropriate measures. These measures may include:

• Diagnostic Interview: Most psychological evaluations include a diagnostic interview, or an appointment during which the evaluator collects extensive, detailed history about the individual.
• Collateral Interviews: Sometimes, an evaluator will ask to speak to a parent, family member, or caregiver about the individual they are evaluating. A parent might be able to provide more detailed early developmental information that the client might not remember or think to share. However, some people’s parents might be deceased, or they might not feel comfortable involving the parent in their evaluation. Collateral information is not essential for an autism diagnosis, though some providers find this information helpful.
• The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2): The ADOS-2 is a series of tasks and observations used to determine whether an individual’s behavior and thought processes are consistent with autism. While parts of the ADOS-2 can only be administered to children, it has sections that can be administered to adults. However, although the ADOS-2 is sometimes referred to as the “gold standard” of autism evaluations, it often gives false negatives to populations other than cisgender boys and men.
• The Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2): The MIGDAS-2 is a structured interview that gathers information about an individual’s history, current symptoms, behaviors, social interaction styles, and sensory needs related to autism.
• The Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS-R): The RAADS-R is a self-report measure that assesses various diagnostic criteria for autism.
• The Diagnostic Interview for Social and Communication Disorders (DISCO): The DISCO gathers information about an individual’s development and behavior by gathering a narrative history of symptoms and differences. It relies on a structured interview format.
  

Barriers That Make It More Challenging for Adults to Receive an Autism Diagnosis

Many providers specializing in autism and who conduct autism evaluations specialize in working with children or teens.

Some Mental Health Professional Will Recommend Pediatric Doctors

In fact, many resources for finding a provider who can diagnose autism discuss seeking out developmental pediatricians or others who specialize in young children.

Health Insurance May Not Cover an Autism Evaluation for Adults

Often, health insurance policies will not cover autism evaluations for adults, or providers might not accept insurance due to low reimbursement rates or difficulty obtaining coverage for these evaluations. This means that clients must pay out-of-pocket, and in the United States, an autism evaluation typically costs between $800 and $5,000.

Out-of-Pocket Costs Are Very High

An autism evaluation typically costs between $800 and $5,000.

It Can Be More Difficult to Detect Autism in Adults

In addition, some providers struggle to identify autism in adults accurately. Many clients are misdiagnosed or get a false negative (meaning they are told that they are not autistic when they actually are).

Evaluation Processes Have Barriers

False negatives can occur because the assessments that evaluate for autism do not always account for masking or what autism can look like in various populations. Specifically, Black, Indigenous, and other People of Color are often overlooked in autism research, as well as those who are not cisgender boys or men.

Should You Get an Autism Evaluation?

Due to the barriers that make autism evaluations inaccessible to many adults, many in the autistic community have embraced self-diagnosing or self-identifying.

Many Adults Self-Identify as Austistic

What does it mean to self-identify with a diagnosis? This means that an individual has researched autism and identified with many symptoms and presentations, believing they are autistic but have not been evaluated by a provider.

Be Aware of Autism Stigma

Many autistic people face stigma and discrimination related to their diagnosis. Because of this, some may choose not to get an evaluation that would lead to the diagnosis being entered into their medical record.

Consider Any Disabilities You Might Have

Conversely, many autistic people are disabled and might require support, including financial resources, due to being unable to work full-time or in a supportive living environment.

To Attain Certain Services You May Need an Official Diagnosis

These individuals need an official diagnosis in their record in order to access services. Similarly, autistic adults who are in school might need a diagnosis in order to receive academic accommodations.

A Word From VeryWell

If you suspect you might be autistic, you can consume content created by the autistic community to see if these experiences resonate with you. The decision to get a formal diagnosis is personal and depends on your needs. If you feel that an official evaluation would benefit you, a psychologist, psychiatrist, or another qualified provider can help you determine whether or not you are autistic.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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8. World Health Organization. Autism Spectrum Disorders: Fact Sheet.

By Amy Marschall, PsyD
Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

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