What are the signs of autism in adult men?

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Each autistic person is different, and this diagnosis exists on a broad spectrum. Knowing a person is autistic reveals very little about their behavior or personality. But a person’s culture can influence how their diagnosis manifests. As a person matures into adulthood, they may seek culturally accepted ways to meet their sensory and cognitive needs.

The main signs of autism in adult males are the same as in all other groups but may manifest slightly differently. They include:

• Differences in nonspeaking communication: A person might not pick up on nonspeaking cues or may not give typical nonspeaking signals. For example, they might not smile in situations where others do or might not be able to tell when another person is bored, afraid, or uncomfortable.
• Differences in social-emotional exchanges: A person may follow different cultural scripts for interaction. They might have difficulty making eye contact, talking quickly and extensively about their interests, not recognizing another person’s emotions, or not initiating social interactions.
• Differences in understanding relationships: A person may find relationships difficult, be uninterested in having relationships, or find it difficult to share interests with another person. For example, a man might not want to date or have difficulty attracting romantic partners.
• Restricted and repetitive interests or behaviors: Autistic people become intensely focused on their particular interests but often only have one or two. For example, an individual might obsess over video games or gardening, spending all of their time doing or talking about these things but have few other interests.
• Repetitive movements: Autism can cause someone to make stereotyped, repetitive movements that look like twitches or stimming. These movements can also be verbal. A person might repeat things they hear under their breath, obsess over lining things up, or have unusual patterns of movement.
• Sensory differences: An autistic adult may be sensory-seeking or sensory-avoidant. They can also be both. For example, an individual might be very sensitive to noise or engage in stimming, such as chewing their nails, tapping fingers, or flapping their body.
• Inflexibility and resistance to change: A person may depend on routines or sameness. For example, they might do things the same way every day, be uncomfortable traveling or going to new places, or become anxious when facing routine disruptions.

Learn more about the signs of autism in adults.

What is autism?

The definition of autism is evolving and remains the subject of political and sociological debate. The American Psychiatric Association defines it as a developmental disorder that causes deficits in communication, relationships, and emotion.

However, autistic adults and neurodiversity advocates usually focus on autism as a different way of doing things and not necessarily requiring treatment. Instead, they believe autistic adults need accommodations. They may also need support for symptoms, just as non-autistic people need support.

Autistic and non-autistic people agree that autism causes differences in:

• communication
• interests
• patterns of interaction
• responses to sensory input
• support needs

Signs of autism that are present in childhood can evolve as a person develops.

Other signs of autism that an adult may have noticed earlier in life include:

• stress at school
• difficulty complying with social norms
• difficulty making friends
• feeling different or like they didn’t fit in
• feeling overwhelmed by things that did not seem to bother others, such as ambient noise
• frequently being corrected by adults for interacting or playing in the “wrong” way

Autism must be present in childhood for a person to get a diagnosis. This does not mean they have to seek a diagnosis in childhood, though. Instead, a clinician may focus on symptoms that were present in childhood and attempt to rule out any other causes, especially if symptoms are new.

A clinician may ask about childhood experiences, talk with others who knew the person during childhood, and ask about current and past symptoms.

Clinicians make the diagnosis based on symptoms, so it is important for a clinician to get an accurate overview of all the symptoms a person has or had.

Clinicians use a range of assessments to test for autism. These tests cover symptoms, their severity, and how they affect a person’s life. The gold standard for assessing autism is the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2).

As part of the evaluation, a clinician will typically test for other diagnoses that may explain symptoms, such as dyslexia, attention deficit hyperactivity disorder, or depression. This can take many hours and involve multiple assessments.

A person may need to pay a large sum for the diagnostic process if insurance does not cover it. For this reason, some adults self-diagnose based on the diagnostic criteria, though this practice remains controversial.

Autistic adults have long advocated for a different approach to autism, labeling it a neurodivergence rather than a disease. Under this model, autism poses both challenges and opportunities. Many of the challenges come from cultural norms and a refusal to accommodate rather than anything innate to autism.

Being autistic often involves embracing the diagnosis. Many autistic adults highlight the power of viewing autism as an identity rather than a disease.

Symptoms and medication

There are no specifically approved medications for autism, and having autism does not require medication. Instead, a person might take medication to deal with symptoms. Examples include:

• medications to manage anxiety
• antidepressants if a person experiences depression
• antipsychotic medications for repetitive behaviors and aggression, if other interventions do not help

Education

Autism self-advocates emphasize the importance of people around those with autism learning to accommodate a wide variety of neurotypes. Many behaviors deemed “symptoms” or “abnormal” are not harmful with accommodations.

For example, not making eye contact is morally neutral, and a person can have relationships and communicate even if they do not make eye contact. Accepting this form of communication can help people feel included.

Educating oneself about autism, as well as about a person’s disability and employment rights, may help. Consider joining an autism self-advocacy organization or support group and learning as much as possible about this type of neurodivergence.

Therapy

Psychotherapy includes treatments that can help a person master new skills, cope with the challenges of living with autism, and more effectively advocate for oneself. Couples counseling may also help with managing relationship issues.

Some therapies focus on helping people modify their environment to be more accommodating, such as minimizing sensory distractions.

Some people also find support from occupational therapy, which focuses on developing life skills, effectively managing emotions, and maximizing strengths.

Autism can take many forms and may change throughout a person’s life. No single definition or list of symptoms applies to all autistic people. Moreover, the meaning of autism itself is in flux, and the stigma has lifted in some places.

Men who think they may be autistic can get the most accurate information by consulting a clinician specializing in adult autism.