- About 1 in 36 US children are believed to have autism.
- But some adults don’t get diagnosed until they’re in their 30s.
- A therapist shared 5 common autism symptoms, from feeling misunderstood to an aversion to textures.
About 1 in 36 US children are on the autism spectrum, according to estimates from the Centers for Disease Control and Prevention (CDC) — but not everyone gets diagnosed in childhood.
Some people, especially women and gender-nonconforming people, are misdiagnosed for years. Many don’t find out they’re autistic until their 30s, or later.
In order to formally be diagnosed with autism, you must meet certain diagnostic criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5).
But Dr. Carla M. Shuman, a clinical psychologist who works with many autistic and neurodivergent people, told Insider that autism is “way more complex” than how it’s defined in the DSM-5.
“It isn’t just people who don’t make eye contact and have trouble socializing,” she said. “That’s why the DSM needs to keep evolving in the way that it builds its criteria.”
Shuman outlined some of the major symptoms of autism, including the ones that aren’t specifically mentioned in the DSM-5 but can be common among autistic people.
1. You frequently feel misunderstood and don’t know what you did wrong
A common experience among autistic people is feeling like they’re unintentionally offending people or committing a social faux pas, Shuman said.
“They find themselves being misunderstood by other people,” she said.
For example, an autistic person might not realize that they’re standing too close to someone or that they’re doing all the talking in a conversation. Or, they might feel passionate about a specific subject and not realize that others want to talk about something else.
2. You struggle with initiating and keeping up casual conversations
Shuman said the level of social difficulties vary from person to person because autism is a spectrum. But some autistic people might struggle to reach out to make plans or start a conversation.
This symptom can especially show up in social situations where “they’re forced to be chatty, to make small talk at work parties or happy hours,” Shuman said.
3. You feel agitated if your routine or plans are thrown off
Shuman said that because inflexibility is a part of autism, disruptions in routines can make an autistic person “emotionally volatile over something that most people would adjust to.”
Autistic people can struggle with emotional dysregulation, where they can experience meltdowns or extreme irritation when the unpredictable happens.
4. You have sensory issues such as noise sensitivity or aversion to certain textures
Other factors that can contribute to emotional dysregulation are sensory issues. While sensory issues are not officially recognized in the DSM-5 as autism symptoms, Shuman said almost all of her autistic clients struggle with them.
For example, she’s had clients who wear noise-canceling headphones because they get overstimulated in loud, crowded environments, and clients who experience sensitivity to certain clothing textures.
5. You get exhausted from “masking” or focusing on fitting in
Masking is acting a specific way to adapt to social cues; basically “playing a part in a play just to get by,” Shuman said.
Generally, autistic women tend to “mask” more than men. While people who mask might fit in more on the surface with neurotypical people, deep down, they often feel overwhelmed, Shuman said.
“They get worn out a lot more easily, they end up losing a lot of energy because they’re trying to do stuff that is not intuitive to them,” she said.
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