How relevant is diagnosis to our focus on adult autism? For a diagnosis of Autistic Disorder (classic autism) at least, the behavioral symptoms must be present before age three. Age of onset may be later for some of the rarer forms of autism. And the critical symptoms of some higher functioning forms of autism, notably Asperger’s, may not become clear until adolescence or adulthood.

Pediatricians and psychiatrists, in the past and perhaps sometimes today, may have been reluctant to pronounce a diagnosis of autism out of consideration for the parents’ feelings or because such a label was thought to close doors to service rather than open them. So many of today’s adults who probably had the symptoms of autism in early childhood were given other labels or described as having "autistic tendencies."

Autistic traits persist into adulthood, but with a wide range of outcomes. Some adults with autism achieve college degrees and function independently. Most diagnosed with classic autism do not develop functional language and communication and may have poor daily living skills throughout their lives. Some adults with autism who live without support may be reclusive or eccentric. Some may be labeled with obsessive-compulsive disorder, schizoid personality, simple schizophrenia, affective disorder, mental retardation or brain damage.

Those who probably had classic autism as children may suffer from general assumptions that they have a poor prognosis as adults. It may not seem to professionals and policy-makers that they are worth much in resources. In recognizing other subtypes of autism disorder, we may tend to overlook the needs of adults with the most distinctive and severe forms of the disorder.

By adulthood, in any case, symptoms of the disorder may be masked by the person’s life and treatment experiences, the effects of drugs, and her/his own efforts to cope with the disorder. Each person of whatever age should considered as a unique individual. This is especially true of adults who were diagnosed with autism as children. Their challenges cannot be understood purely and simply in terms of autism. On the other hand, knowledge of the autism and past treatments may help in assessing their abilities and challenges as adults and in considering helpful approaches—including adult versions of therapies and strategies that may have been mainly designed for children, but too recently for today’s adults.

In our view, far too little attention is paid to adult autism as a general category of disability or to individual adults who have the symptoms of autism. Yet adults with autism are said to have normal life expectancy. It would be prudent as well as humane to assess each person’s needs and abilities as part of individual plans for supports that will enable them to use their abilities, realize their dreams, and attain the best possible quality of life.

The Ontario Adult Autism Research and Support Network website is dedicated to the exchange of information about the needs of adults with autism spectrum disorders, and observations about the most effective forms of treatment and support.