How to Get an Autism Diagnosis as an Adult: A Clear, Step-by-Step Guide

There’s a particular kind of exhaustion that comes from spending decades feeling like you’re a step behind everyone else — navigating social situations that seem effortless for others, processing sensory environments that feel genuinely overwhelming, and never quite understanding why certain things that should be simple just aren’t.

For many autistic adults, the answer has been there all along. They just didn’t have a name for it yet.

Here’s the direct answer: Getting an autism diagnosis as an adult involves finding a qualified specialist, completing a comprehensive clinical evaluation, and receiving formal documentation of the results. The process typically takes multiple appointments, may require gathering developmental history, and can cost between $2,000 and $6,000 — though insurance coverage varies. A formal autism diagnosis is the only pathway to legal protections, workplace accommodations, and clinically tailored support.

This guide walks through every stage of the adult autism diagnosis process — including why so many adults reach adulthood without one.

Why So Many Adults Are Getting Diagnosed Later in Life

Autism diagnosis in adults is more common now than ever before. According to a study published in JAMA Network Open, the rate of autism diagnosis in adults ages 26 to 34 increased by 450% between 2011 and 2022 (Harvard Health, 2024). It’s estimated that approximately 2.2% of people over age 18 have autism spectrum disorder (ASD).

Several factors explain why an autism diagnosis is missed in childhood:

Autism was historically narrowly defined. Older diagnostic criteria focused primarily on boys with severe presentations. Many adults — especially women, girls, and gender-diverse individuals — didn’t fit that narrow picture and were overlooked entirely (MGH Lurie Center for Autism / Harvard).

Masking and camouflaging. Many autistic people — particularly women — learn early to imitate neurotypical social behavior, suppressing or hiding autistic traits. This masking is exhausting and often leads to burnout, anxiety, and depression. Research published in PMC (2024) confirms that clinicians must account for masking when evaluating adults, as standard tools often miss it (PMC, 2024).

Misdiagnosis. Anxiety, depression, ADHD, OCD, and personality disorders share surface-level features with autism and frequently precede a correct autism diagnosis. Many autistic adults spent years receiving treatment for co-occurring conditions without the underlying neurodevelopmental profile being identified.

Cultural and generational factors. Adults who grew up before autism was well understood had far fewer pathways to diagnosis. As one participant in a peer-reviewed study published in PMC explained: “My parents had searched when I was a child… there were no answers in the 70’s” (PMC, 2023).

Why Get an Autism Diagnosis as an Adult? The Real Benefits

Before walking through the process, it helps to understand what’s actually at stake.

Legal protections and workplace accommodations. A formal autism diagnosis unlocks rights under the Americans with Disabilities Act (ADA). Under Title I of the ADA, employers with 15 or more employees are required to provide reasonable accommodations for adults with disabilities — including autism. These can include noise-canceling headphones, flexible scheduling, written instructions instead of verbal ones, and modified social expectations at work. You are not required to disclose your diagnosis unless requesting accommodations (Autism Speaks, 2024).

Access to therapeutic support. With an autism diagnosis, therapists can adapt their approaches specifically for autistic cognition. This includes CBT modified for autistic thinking patterns, sensory integration therapy, social skills groups designed for adults, and executive functioning coaching.

Vocational rehabilitation services. A formal diagnosis may make an adult eligible for state-funded vocational rehabilitation programs that provide counseling, job placement support, and career development services (Autism Speaks).

Self-understanding and reduced self-blame. Research published in PMC (2023) recorded the lived experience of autistic adults who received late diagnoses. Many described the diagnosis as validating and perspective-shifting. One participant, Lily, explained: “Since my diagnosis I’ve re-evaluated how my life is, I’m trying to re-vamp my entire life so that I’m making accommodations for myself knowing what I know now” (PMC, 2023).

How to Get an Autism Diagnosis as an Adult: Step by Step

Step 1: Start with Self-Reflection and Documentation

Before contacting any clinician, gather information about your own experiences.

Make a list of traits or patterns that have been consistently challenging across your lifetime (not just recently)
Talk to parents, siblings, or childhood friends who may remember early behaviors
Review old school report cards, which often contain observations about communication or social behavior
Note any prior diagnoses you’ve received, including anxiety, depression, ADHD, or learning disabilities

Self-reflection is not a substitute for professional evaluation, but it gives you a foundation for the clinical conversations ahead. Online screening tools like the Autism Spectrum Quotient (AQ) are sometimes used for initial self-reflection — but these are not diagnostic tools. A formal autism diagnosis can only be made by a qualified clinical professional (Autism Speaks).

Step 2: Talk to Your Primary Care Provider

The most accessible first step is making an appointment with your primary care physician (PCP) or a healthcare provider you already see.

Your PCP can:

Conduct an initial screening to rule out other medical conditions
Provide a referral to a specialist who evaluates adults for autism
Help you navigate insurance and documentation requirements

Be specific in this appointment. Describe the patterns you’ve noticed, how long they’ve been present, and how they affect daily functioning. Bring your self-reflection notes. If your doctor is unfamiliar with adult autism presentations, ask directly for a referral to a psychologist or psychiatrist who specializes in ASD in adults (Medical News Today, 2025).

Step 3: Find a Specialist Who Evaluates Adults for Autism

This is where many people hit their first major barrier. Not all clinicians who diagnose autism are experienced with adult presentations.

Who can diagnose autism in adults:

Psychologists — particularly recommended because they receive more clinical training and exposure to conditions with early childhood onset, which is required for an ASD diagnosis (ADDitude Magazine)
Psychiatrists with ASD specialization
Neuropsychologists
Trained clinicians at autism centers affiliated with universities or hospitals

How to find a qualified provider:

Use the Autism Speaks Resource Guide and search by zip code
Contact the Autism Speaks Autism Response Team
Ask your insurance provider for in-network specialists who evaluate adults
Check with local autism organizations and support groups for recommendations
If local access is limited, virtual assessment options are increasingly available and accepted for adults, though not all insurance plans cover telehealth evaluations (PMC, 2024)

Key questions to ask any potential provider:

Do you specialize in adult autism evaluations, or primarily children?
What assessment tools do you use for adults?
What is the estimated timeline and cost?
Do you accept my insurance?

Step 4: Complete the Intake and Paperwork

Once you’ve scheduled an evaluation, you’ll typically complete extensive intake paperwork before your first appointment. This may include questionnaires about:

Current daily functioning and social communication
Sensory experiences
Developmental history (to the extent you know it)
Previous diagnoses and mental health history
Repetitive behaviors, special interests, and routines

Some providers also invite a family member, partner, or close friend to contribute observations — particularly about your childhood behavior. This collateral information can be valuable when developmental history is limited (Neurosparkhealth.com).

Step 5: Undergo the Clinical Evaluation

An adult autism evaluation consists of multiple assessment methods. Unlike a blood test or imaging scan, there is no single “autism test” — the diagnosis is built from a comprehensive clinical picture.

What the evaluation typically includes:

Clinical interview: The core of the assessment. The clinician will ask about your current life — how you communicate, your sensory experience, your social interactions, and your daily routines. They’ll also explore your childhood development, early behaviors, and how you moved through school and relationships. Sessions typically run 1.5 to 3 hours (Neurosparkhealth.com).

Standardized assessment tools: The most commonly used instruments in adult autism evaluations include:

ADOS-2 (Autism Diagnostic Observation Schedule, 2nd edition) — considered one of the most comprehensive measures available
ADI-R (Autism Diagnostic Interview-Revised) — used when informant history is available
Autism Spectrum Quotient (AQ)
Social Communication Questionnaire
Adaptive Behavior Questionnaire

Research published in PMC (2024) notes that clinicians must account for masking, gender differences, and the limitations of tools normed primarily on male populations when evaluating autistic adults — particularly women and gender-diverse individuals (PMC, 2024).

The evaluation must meet DSM-5-TR criteria: To receive an autism diagnosis, the evaluation must confirm that symptoms were present from early development (even if not identified then) and that they affect current functioning across multiple areas. The evaluator uses diagnostic criteria from the DSM-5-TR to guide this determination.

Step 6: Receive Results and a Formal Report

How results are shared varies by provider. Some clinicians offer diagnostic impressions at the end of the final evaluation session; others schedule a dedicated feedback appointment.

If you receive a formal autism diagnosis, documentation typically includes:

A written report summarizing assessment findings
Formal diagnostic classification
Specific recommendations for supports, accommodations, or follow-up care
A summary that can be shared with employers, insurers, or other providers

What if the evaluation doesn’t result in a diagnosis? Many adults still find the evaluation process valuable. A thorough assessment may identify other contributing conditions — such as ADHD, anxiety, or sensory processing differences — that explain long-standing challenges and open pathways to appropriate support.

Cost and Practical Considerations

Getting an autism diagnosis as an adult comes with real logistical challenges that are worth knowing in advance.

Cost: Adult autism evaluations typically range from $2,000 to $6,000. Not all providers accept insurance, and even those who do may have limited coverage for comprehensive evaluations. Always verify with the provider and your insurer before scheduling. Some clinicians and centers offer sliding-scale fees (Harvard Health).

Wait times: Depending on your location, wait times for adult autism evaluations can range from several weeks to more than a year. Limited availability of adult-specialized providers is one of the most commonly reported barriers to access (SPARK for Autism).

Identity adjustment: A formal autism diagnosis can bring profound relief — but also grief, particularly for adults who reflect on decades spent without the language or support they needed. One participant in PMC‘s qualitative research, Diana (diagnosed at age 50), described: “It was a huge relief that there’s a name for it, and it encompassed all of my traits” (PMC, 2023). Working with a therapist who understands autism is strongly recommended during the post-diagnosis period.

After the Autism Diagnosis: What Comes Next

An autism diagnosis in adulthood is not an endpoint — it’s a starting point.

Immediate next steps may include:

Reviewing your ADA rights and requesting any relevant workplace accommodations
Connecting with a therapist who specializes in autistic adults (CBT, ACT, and coaching are all evidenced-based options)
Joining autistic adult communities and peer support groups — research consistently shows that social connection with other autistic adults improves well-being
Exploring occupational therapy for sensory or executive functioning support
Informing your healthcare providers so that other care (including mental health treatment) can be adapted appropriately

Conclusion: The Process Is Real — and So Is What’s on the Other Side of It

Getting an autism diagnosis as an adult takes time, persistence, and often money. The barriers are real. But the research on what changes after diagnosis — access to support, clarity about yourself, legal protections, and the ability to ask for what you actually need — is equally real.

For many adults, a formal autism diagnosis doesn’t change who they are. It changes how they’re able to live.

At Epic Minds Therapy, we understand that adults with autism need support that goes well beyond what a childhood-focused system was designed to offer. Our team works with individuals across the autism spectrum — at any age, at any stage — to build individualized plans based on each person’s actual life, not a generic diagnostic category.

Here’s our invitation: Don’t wait for another year to pass wondering. Connect with the Epic Minds team for a conversation about where you are, what you’re navigating, and what support could look like for you — right now.

👉 Reach out to Epic Minds Therapy today. — Serving families and adults across North Carolina.

❓ Frequently Asked Questions

Q: Can adults actually be diagnosed with autism? A: Yes. Autism can be diagnosed at any age. According to research published in JAMA Network Open, adult autism diagnoses in people ages 26–34 increased by 450% between 2011 and 2022. Many adults were simply not diagnosed in childhood because autism was less understood, or because their presentation didn’t match the narrower diagnostic criteria in use at the time.

Q: Who can diagnose autism in adults? A: Autism in adults can be diagnosed by psychologists, psychiatrists, neuropsychologists, and trained clinicians at ASD specialty centers. Psychologists are often particularly well-suited for adult autism evaluations because of their training in conditions with childhood onset. Primary care physicians can conduct initial screenings and make referrals, but they do not typically provide a formal autism diagnosis.

Q: How long does an adult autism evaluation take? A: Most adult autism evaluations take multiple appointments over several days or weeks. Individual clinical interview sessions typically run 1.5 to 3 hours. Depending on the provider’s availability and your location, the full process from scheduling to receiving your written report may take weeks to months.

Q: How much does an adult autism diagnosis cost? A: Comprehensive adult autism evaluations typically range from $2,000 to $6,000. Insurance coverage varies significantly — some plans cover part of the evaluation, others do not. Always verify coverage with your insurer and ask your prospective provider about payment options, sliding-scale fees, or financing.

Q: Is there a free or low-cost way to get tested for autism as an adult? A: Some autism centers affiliated with universities or hospital systems offer evaluations at lower cost or on a sliding scale. State-funded disability and vocational rehabilitation programs may also provide pathways to evaluation for qualifying individuals. Your state’s Medicaid program may cover autism-related assessments — eligibility and coverage vary by state.

Q: Does getting an autism diagnosis affect my employment? A: In the United States, the ADA protects against employment discrimination based on disability. You are not required to disclose your autism diagnosis to an employer. If you do choose to disclose, you may request reasonable accommodations — such as flexible scheduling, modified work environments, or written communication preferences — which employers with 15 or more employees are legally required to consider.

Q: Can I get an autism diagnosis online or via telehealth? A: Virtual autism evaluations are increasingly available for adults. While telehealth assessments have improved access — particularly for adults in rural areas or those with limited local specialist availability — not all insurance plans cover telehealth evaluations, and not all clinicians conduct the full assessment process remotely. Research on the validity of fully remote adult autism assessment is still developing (PMC, 2024).

Q: What happens if I don’t meet the full criteria for autism? A: A thorough evaluation often identifies other relevant conditions even when a formal autism diagnosis is not given — including ADHD, anxiety disorders, sensory processing differences, or other neurodevelopmental profiles. These findings can still guide targeted support and treatment. Many adults find the evaluation valuable regardless of the outcome.

📚 Sources

Harvard Health — Autism: The Challenges and Opportunities of an Adult Diagnosis (2024) https://www.health.harvard.edu/mind-and-mood/autism-the-challenges-and-opportunities-of-an-adult-diagnosis
MGH Lurie Center for Autism / Harvard Adult Autism Health — Getting an Autism Diagnosis as an Adult https://www.adult-autism.health.harvard.edu/resources/getting-an-autism-diagnosis-as-an-adult/
Autism Speaks — Autism Diagnosis as an Adult https://www.autismspeaks.org/adult-autism-diagnosis
Autism Speaks — What Are My Rights as an Adult with Autism? https://www.autismspeaks.org/tool-kit-excerpt/what-are-my-rights-adult-autism
PMC / NIH — Diagnosing Autism in Adults: Clinically Focused Recommendations (2024) https://pmc.ncbi.nlm.nih.gov/articles/PMC12724529/
PMC / NIH — What Does Receiving Autism Diagnosis in Adulthood Look Like? Stakeholders’ Experiences (2023) https://pmc.ncbi.nlm.nih.gov/articles/PMC10251666/
Medical News Today — Getting an Autism Diagnosis as an Adult: Where to Begin (2025) https://www.medicalnewstoday.com/articles/how-to-get-autism-diagnosis-as-an-adult
Cleveland Clinic — How to Pursue an Autism Diagnosis as an Adult (2024) https://health.clevelandclinic.org/adult-autism-diagnosis
ADDitude Magazine — How to Get Tested for Autism: Adult Autism Diagnosis Advice https://www.additudemag.com/how-to-get-tested-for-autism-adult-diagnosis/
SPARK for Autism — Getting an Autism Diagnosis in Adulthood https://sparkforautism.org/discover_article/autism-diagnosis-adulthood/
Neurosparkhealth.com — How to Get an Adult Autism Diagnosis in 6 Clear Steps https://neurosparkhealth.com/assessment/how-to-get-an-adult-autism-diagnosis
Prosper Health — How to Get Tested for Autism as an Adult https://www.prosperhealth.io/blog/how-to-get-tested-for-autism-as-an-adult
Autism Toolkit of Georgia — Seeking an Autism Diagnosis as an Adult: Pros and Cons https://www.autismtoolkit.org/resource/seeking-an-autism-diagnosis-as-an-adult-pros-and-cons/
Gold Heart ABA Therapy — Late Autism Diagnosis: What It Means for Adults https://goldheartaba.com/resources/late-autism-diagnosis-what-it-means-for-adults/