I am looking for resources or info on possibly diagnosing someone with autism in their mid-20s, not childhood. I am sure I may use some terms incorrectly, so please be kind. This young man would be what i consider “high functioning” as he successfully completed college and some grad school. He is often ‘passive’ in some situations, but he does not act like the Sheldon character on Big Bang, for example. But perhaps that is an incorrect stereotype.
He is going thru what looks like some failure to launch, but that combined with some other issues (in hindsight) have the family thinking perhaps autism is a possible Dx, in addition to long-standing treatment for depression and OCD.
Our googling brings up loads of info on Dx for younger kids, but it seems like adults are a whole different arena. I would love to hear what type of professional can evaluate this, and any other website, books etc that can be recommended in this situation. TIA!
No suggestions, but lots of good wishes for this young person. My brother was always “different,” and he suffered debilitating depression throughout adulthood. He happened to see a doctor about an unrelated health issue when he was in his late 50’s. The doctor had just been to a conference where autism in adults was discussed. He talked to my brother about his situation, and he definitely seemed to be on the spectrum. It provided my brother some solace to be diagnosed. He didn’t follow up before he passed away from a stroke. I do feel that had he been diagnosed years earlier, he might have been able to receive therapy that could have helped him to better cope with the world. Best wishes for this young man. I do think that there is a better awareness of autism in adults now than there ever has been. It may not be easy to find help, but I’ll bet the CC community has good advice.
My niece went through an evaluation in her 20’s that resulted in an Asperger’s diagnosis. She was in Michigan and went through something like the Bureau for Disabilities/Handicaps. I think it was also part of a job training program - she too was having trouble launching into a job.
I would also think that a Psychological/ Neuropsychological Testing office could do something like this. Just as an example, this is one in Michigan through U of M:
You will want to get testing done by a neuropsychologist. It can be quite expensive and insurance will not always cover it. I’ve found it best to call the neuropsych’s office and ask about what billing codes they use and then see if your insurance covers it.
Also ask what the testing will entail (you will want not only a dx, but recommendations) and when you can expect a written report. (Six week turnaround seems adequate. I’ve seen it take 6 months to actually get a written report).
My son was diagnosed with ASD late— at age 14. Asperger’s is no longer a diagnosis (this was 2015) but if it were, he would fall in that category. It was difficult to see growing up. He was a bit of a Sheldon Cooper in some ways, but also could blend in so it was not as obvious. He does have areas of focus that he excels in. It comes easy to him. He is above average in intelligence but not a genius. He struggled in middle school through hs because he was disorganized (executive functioning) and somehow in his mind if he doesn’t want to do something he had problems understanding consequences or caring in the moment about previous consequences. He was diagnosed in MN by a Dr who specializes in Autism at an Autism center. This is important and why he was diagnosed so late. His pediatrician never suggested Autism. We requested an evaluation in middle school and the eye seemed reluctant until I pushed the issue and then came back as not. As parents it was challenging to see his potential but be told no to learning disability and ruled out Autism not knowing much about it. We had him diagnosed Freshman year of hs by a Dr who specialized in Autism and finally things made sense. He didn’t do things to “push are buttons”. He really had a different way of thinking and it was difficult to detect when he was able to navigate the world for the most part. The diagnosis showed how some of his skill sets were above average and others far below. He could not tie shoes easily and many of his fine motor skills are that of a much younger child, he only got his drivers license this summer (age 21) after many specialized lessons. There were several different functioning areas that were tested.
The biggest take away is to go to an Autism specialist. It took my son a while to accept his diagnosis but now that we know it-we understand how to be better parents. Some things to look back on, (remembering all ASD diagnosis do not look the same) Childhood meltdowns that are more extreme than typical? Sensitivities to textures/noise/light/smells? Socialization challenges? Pain tolerances? (I’ve seen both sides of this-sometimes high, sometimes low tolerance) Fixation on interests? Unusual coping mechanisms? Strong black/white thinking? Overwhelmed?
Good luck with your friend in looking for answers for her son. My son now embraces his Autism diagnosis and is in his senior year of college. I’ve leaned so much about Autism and it is really difficult to learn about it on tv—many good shows that have a lot of obvious stereotypes and are still good, but sometimes make it seem like Autism is very obvious when first meeting the person and for my son it is not. If your friend’s son has made it all the way through college without a diagnosis, he may be similar. There may be a different diagnosis though, like OCD or executive functioning issues or depression or a combination.
I think his failures and depression have as much to do with being viewed as “different” and struggling to fit in as normal.
I won’t try to downplay “rising to the occasion” but I think it may be more beneficial in the long run if the family (and the young man himself) focused more on doing/living what makes him happy, and focusing less on doing things a “normal” person his age should be doing.
Launching for him may not mean the same as it might mean for “normal” young adults in his situation. He might be happy with a different lifestyle, but may be uncomfortable expressing his desire for something different.
I have a friend who lives a very scaled back life as far as the normal college/career/marriage/kids/suburban home, but also very full. Both his parents have advanced degrees, his father was a professor and his mother spent a career in finance. He has an advanced degree, but lives in low-income neighborhoods, has never owned a car, works p/t at two different places as well as other occasional and/or contract employment and would be described as under-employed by many people. He’s a voracious reader. Is both a public facing person and is very happy being alone. His personality is … let’s say quirky, full, engaging, rewarding.
Now in his late 50s, he is very happy with his life. When he was younger, his family/friends always pushed him to “do more, be more, change” and that put him at odds with many of his loved ones. Once he dictated how he planned to live and what made him happiest, and they accepted that decision, he’s been as happy as a lark. Never married, though he’s had girlfriends here and there. No children. Not career focused or IRA driven or “goal oriented”. Simply enjoying the hell out of his life.
If the young man in your life is intelligent enough to graduate and self-aware enough to be high functioning, I think it’s time to allow him to choose his path. Some gentle guidance and mapping may be helpful. Some therapy from a counselor accustomed to working with neurodiverse people may be helpful. And open-ended understanding and acceptance from his family will definitely help. Let him be him, and relieve the pressure of hoping he “overcomes” his neurodiversity and becomes someone else.
Every case is different. My brother could have used some assistance early in the game. His story is long and sad, but the moral is that diagnosis and targeted therapy when he was younger “may” have helped him to be happier with himself.
Thanks for your reply! One of the challenges is that he does not seem to have any of these markers. He was a good student and no behavior/discipline issues, so that is probably why no red flags were raised. I think he is smart enough that he could cover any executive functioning or disorganized habits and still get good grades. He probably never learned good study habits because he didn’t “need” to and he most certainly never learned to advocate for himself. In hindsight that is probably more due to the potential autism Dx holding him back from understanding how to ask for help.
No meltdowns, a very, very compliant child. Probably too compliant, which is not good, but at the time, everyone is so happy to say what a good kid he was. The only thing that we can recall is he did not want to start preschool and the first month was rough separating from mom. We chalked that up to social anxiety/shyness.
I agree - and I keep remembering the CC wisdom of loving the “kid on the couch.” I don’t think we are trying to turn him into something he is not. For sure there was some confusion over why a kid everyone thought was so gifted is not setting the world on fire currently.
But the goal is to be self-sufficient and happy/content. His family would be fine if he chose to become a bartender (as he has mentioned in passing), or go into a trade, despite advanced degrees in math. Truly, as long as he can sustain himself. The issue is, he is not even getting himself together to get a FT job with benefits. He seems paralyzed, which is why there is now the discussion that perhaps a Dx of autism would explain a lot of his challenges, and if so, he may need some other therapy/counseling beyond the current depression therapy.
Sometimes young adults (autistic or not) are so conditioned to be a student and all that that entails that they have a hard time moving to another category of performance, working. Like a major roadblock moving forward.
My teen nephew is on the spectrum. He is a terrific kid and we are so used to him that we sometimes forget that others see him as atypical. He is doing well in high school and will likely be fine in college, and in any job where he can work independently. His struggles are with understanding the social world around him.
When I stop to think about it, the main things that stick out are:
He doesn’t read people well, and is often unaware of how things will make others feel. He tends to hurt people’s feelings by being blunt and he has trouble making friends.
He can get obsessed with his favorite subjects, and doesn’t understand why others do not share his level of interest.
He handles it much better now, but he has extreme frustration about many things in the social world that don’t make sense to him, for example, rules, etiquette, and people’s behavior/feelings in general. His frustration about these issues caused countless meltdowns until he was about twelve.
I hope that you can find the right professional to help your relative. Unless he has difficulty with relationships, I would look beyond autism. However, I’m not sure the exact diagnosis matters as much as practical measures that would help him function better and be happier/more comfortable in his own skin. Best wishes!
my S is on spectrum and graduated college in 3 years and has his first job, but EF issues were a concern in the past. His biggest issue is social. He talks about inappropriate stuff, and will ramble on about technical thiings that noone cares about. He never cared about attending social events , but I think his “lack of friends” is finally getting to him. he talks very monotone . Also extremely honest and with no filter, has caused issues in the past.
This is such a beautiful post that captured high functioning asd so well. It describes one of my kids so perfectly. I would cry at the pediatrician’s office out of frustration for so many issues in her younger years, but no one ever mentioned asd. When she was finally dx’d at 14, the np recommended not telling her because she also suffered from depression and she thought she would get fixated on it in a negative way. Now in her third year of college, she is making friends with other neuro-divergent kids and has diagnosed herself and is feeling good about who she is and how she fits in.
I always wondered if we had done the right thing, but she recently told us how she would not have been able to handle that label at that point in her life. Who knows really. I think it might have been best to know in early childhood and got the right kind of therapies.
She’s got some gross motor issues and is now learning to drive.
Failure to launch might not be related to an autism spectrum diagnosis. I recently read an article about Japanese young men that never leave their bedrooms (the Japanese have a name for them, hikikomori), which seems like an extreme case of failure to launch. I can’t find the article I read but here is one that talks about failure to launch or Peter Pan syndrome .
Our neighbor from across the court has an adult daughter that failed to launch. Went to university and then came home and hasn’t left since. Doesn’t work. I don’t know all the details but it seems like the longer one finds themselves in this pattern, the harder it might be to break out of it.
Is it possible that he has ADD-inattentive not autism? Not everyone is hyperactive. I never got a real diagnosis for my younger son, but most of his school issues seemed to stem from disorganization, not being an aural learner at all. He’s in the Navy now and lives with post-its reminding him of what to do. Especially making sure he has all the parts of his uniform!
My other kid is likely high function autistic. All the markers like sensitivities, somewhat anti-social, fixated on things. Luckily his quirks are well accepted in his field of computer programming and while he’s messy at home I think his mind is orderly!
Is he interested in getting assessed? If he is, that’s great, but it may take a really long time to get in with an expert (around here over a year waiting list.) But even if he doesn’t want to get assessed, it may be useful to think of him in your own mind as being “neurodiverse” or “spectrum adjacent.” In my own extended family, only one member has an actual autism diagnosis, but it’s clear that many traits run in the family. I suspect at least a handful of us would qualify for the diagnosis if we went to the trouble of getting formally evaluated. By the way, none of us have ever been behavior problems, quite the opposite! (Meltdowns are loud, why would we want to do that? Better to just get the situation over with as fast as possible so others will leave you alone.)
@MACmiracle and I seem to have a similar path with our children. It can show up differently depending on child. It was amazing to see my son being evaluated by an expert. She (the expert) understood and recognized behaviors we explained and had a list of questions in I think 4 different functioning areas to make a diagnosis. Not all ASD looks the same. For my son it is a hidden disability. Some tv shows dramatize the physical appearance that doesn’t show up in all cases. Some on the spectrum struggle with eye contact, that has never been a problem for my son. Some portray as walking/talking differently. My son does seem to walk quickly and louder than some-my d says he walks with a purpose. He is annoyed by slow walkers. I think ASD is more difficult for pediatricians/teachers to help diagnose since they blend in physically. I think many of the kids could sense his differences but either chose to just avoid him if he wasn’t their style or look out for (protect, be kind to) him and just recognize that was who he was/is. The kids probably understood him more than the adults.
There really is something about physical appearance and level of disruption. A pretty, quiet, clean girl tends not too raise red flags, even if they walk around like a bull in a china shop. Lol.
My college D had meltdowns which responded to an SSRI, but my youngest is an avoider. Meltdowns aren’t fun but at least they make you pay attention. You are forced to work on the relationship. It’s not always been easy but we have a great relationship. I’m more worried about my avoider as she approaches college and adulthood. I took her for a psychiatrist for an adhd evaluation when she was maybe 8. I nearly fell out of my chair when the psychiatrist said she strongly suspected autism. I didn’t take it seriously because she was so well-behaved and compliant. My pediatrician didn’t make any suggestions regarding therapies either. As social and academic demands increased and became more complex through the teen years, the weaknesses became more obvious.
This was our son too! Sharp dresser, nice, clearly intelligent. He could fake his way through in the elementary years, but middle school/hs were rough until diagnosis and then he still had issues that didn’t magically become better but we understood that he wasn’t doing things to “push our buttons” and that he really did have a very different way of thinking in some areas. Based on tv portrayals–“The Good Doctor”, “Atypical” and my new favorite netflix “Extraordinary Attorney Woo”, it seems like those with ASD all have physical quirks that make if obvious that they are on the spectrum. That is not the case with my son.
If you don’t already know about the Sunflower Program check it out. It helps identify people with hidden disabilities to airport staff and other locations. We received a free lanyard from the MSP airport in case my son needs to travel. That airport and many in the country have been trained to identify these people in this subtle way and understand that they may need more attention. The state of MN also has a place on the drivers license to self identify ASD. It is an option. My son chose to put it on his license and it can be removed. After we discussed the option, he decided it would be good to have on there in case he were pulled over by a police officer and his behavior was not typical.
OP-Good luck. I hope your friend is able to find some answers.
