The terms people with autism/ASD, autistic individuals, and on the spectrum are used interchangeably in this article. While person-first language is widely used in healthcare, many within the autism community prefer identity-first language as it better reflects their lived experience. As a psychologist, I always respect and use each individual’s preferred terminology.
This article is the first in a series exploring autism in adulthood, with a particular focus on diagnosis, presentation, and support strategies.
As a psychologist who regularly supports autistic adults, I’m often asked how autism presents in adulthood. While childhood autism is commonly understood, adult autism can be less visible—particularly in individuals who have developed coping mechanisms such as masking.
It’s important to note that each person presents differently. In many cases, adults with autism also experience physical health challenges, including hypermobility, Ehlers-Danlos Syndrome, dysautonomia, or immune dysregulation. Many also identify with the Highly Sensitive Person (HSP) construct, which shares sensory traits but not the social characteristics of ASD.
Masking, or camouflaging, refers to efforts by autistic individuals to hide or minimise their differences in social settings. This can involve mimicking neurotypical behaviours, scripting conversations, or suppressing self-soothing actions like stimming.
While masking can help individuals fit in socially, it often leads to exhaustion, anxiety, and burnout. Many adults only seek support when life transitions—such as becoming a parent or entering the workforce—make continued masking unsustainable.
Unfortunately, masking can complicate the diagnostic process. Even experienced clinicians may miss subtle indicators of autism if they are not familiar with how adults mask their traits. This reinforces the importance of thorough assessments by professionals with expertise in adult autism.
This is a common question among clients. Historically, Asperger’s Syndrome referred to individuals with autism who had average or above-average intelligence and no language delays. However, the DSM-5 now includes Asperger’s under the broader category of Autism Spectrum Disorder (ASD).
The term high-functioning autism is not a formal diagnosis but is often used informally to describe individuals who would have previously been diagnosed with Asperger’s. It’s important to acknowledge the controversy surrounding this label, as it may minimise the real challenges faced by individuals who appear to function well outwardly but still require support.
At Redman Gall Psychologists, we focus on each individual’s strengths, challenges, and support needs—rather than outdated labels.
Yes. In adults, autism can sometimes be misdiagnosed as:
Autism shares overlapping features with many mental health conditions, and masking can obscure core traits. Additionally, undiagnosed ASD can lead to secondary mental health diagnoses due to chronic stress and social difficulties. Many of our clients also present with co-occurring conditions such as Tourette’s, tics, PTSD, or eating disorders.
Differentiating autism from other mental health conditions requires a detailed and holistic assessment approach. This includes:
It’s critical to remember that autism is a neurodevelopmental difference, not a mental illness. With the right environment and support, many autistic individuals thrive academically, professionally, and personally.
If you or a loved one relate to the experiences described above, a professional autism assessment can provide clarity and open the door to tailored support.
At Redman Gall Psychologists on the Gold Coast, we offer comprehensive adult autism assessments by experienced psychologists who understand the nuances of ASD in adulthood.
👉 Book your autism assessment with Redman Gall Psychologists
National Autistic Society on Masking
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Existing clients can book your appointments online with our Psychologists Kelly, Sam, Mia, Gisele, Laura, Abbie, Emily, Blake, Justyce or Gemma. For bookings with Leia, please contact our admin team.
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