Who Is Qualified to Diagnose Autism in Adults?

Dr. Amy Marschall is an autistic clinical psychologist with ADHD who specializes in working with children and adolescents sharing similar neurodivergent traits. She holds certifications in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and telemental health.

Language note: While preferences vary, research within the autistic community consistently shows a preference for identity-first language (e.g., "autistic person") rather than person-first language (e.g., "person with autism"). This article honors that preference.

If you suspect you might be autistic, seeking a formal diagnosis from a qualified professional can be an important step.

Who Is Authorized to Diagnose Autism in Adults?

Typically, autism evaluations for adults are conducted by psychologists or psychiatrists who have specialized training in autism assessments.

Continue reading to understand more about the diagnostic journey, challenges in identifying autism in adults compared to children, and how an evaluation might benefit you.

Professionals Conducting Autism Assessments for Adults

Psychologists and psychiatrists with expertise in autism are the primary professionals who perform these evaluations.

Additionally, certain mental health practitioners holding master’s degrees can acquire training in psychological assessments and autism diagnostics.

Finding a Qualified Autism Diagnostician for Adults

Many specialists advertise their services on professional directories, making it easier for prospective clients to find and select a suitable provider. Those experienced in adult autism diagnosis usually highlight this expertise on their profiles or websites.

Resources such as Neuroclastic offer directories of diagnosticians, and platforms like Embrace Autism provide validated online assessments and self-evaluation tools.

Neurodiversity-Affirming Organizations to Explore

Autistic Women and Nonbinary Network

Neuroclastic

Autistic Self Advocacy Network

Therapist Neurodiversity Collective

Embrace Autism

Inclusive Therapists

Understanding the Autism Diagnostic Process

Obtaining an autism diagnosis typically involves a comprehensive psychological evaluation that gathers detailed information about an individual’s developmental history, behaviors, symptoms, relationships, and challenges.

Child-Focused Tools Often Dominate Autism Diagnostics

Many diagnostic tools were originally designed for early childhood assessment and are not standardized for adults, limiting their applicability for those over 18.

What to Expect During an Adult Autism Evaluation

Evaluators use age-appropriate diagnostic tools, which may include:

• Diagnostic Interview: A thorough session where the clinician collects an extensive personal history.
• Collateral Interviews: Sometimes, input from parents or caregivers is sought to provide additional developmental insights, though this is optional and not always feasible.
• Autism Diagnostic Observation Schedule, Second Edition (ADOS-2): A set of structured tasks and observations tailored to assess autism-related behaviors, with adaptations for adults. Despite its reputation as a gold standard, ADOS-2 may yield false negatives, especially outside of cisgender male populations.
• Monteiro Interview Guidelines for Diagnosing Autism Spectrum, Second Edition (MIGDAS-2): A structured interview capturing history, symptoms, social interaction styles, and sensory needs.
• Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS-R): A self-report questionnaire evaluating diagnostic criteria for autism.
• Diagnostic Interview for Social and Communication Disorders (DISCO): A narrative-based structured interview exploring developmental and behavioral history.

Challenges in Obtaining an Autism Diagnosis as an Adult

Many specialists focus predominantly on diagnosing children or adolescents, which can limit access for adults seeking evaluation.

Referrals Often Lead to Pediatric Specialists

Resources frequently recommend developmental pediatricians or child-focused specialists, which may not suit adult diagnostic needs.

Insurance Coverage for Adult Autism Evaluations Is Limited

Health insurance often does not cover autism assessments for adults, or providers may not accept insurance due to low reimbursement or administrative challenges. Consequently, adults often face out-of-pocket expenses ranging from $800 to $5,000 in the United States.

High Out-of-Pocket Costs Pose Barriers

The financial burden of evaluations can be substantial, deterring many adults from seeking diagnosis.

Diagnosing Autism in Adults Presents Unique Difficulties

Some clinicians find it challenging to accurately identify autism in adults, leading to frequent misdiagnoses or false negatives.

Limitations of Assessment Tools and Biases

Standard diagnostic tools may not adequately account for masking behaviors or the diverse presentations of autism across different populations, including Black, Indigenous, People of Color, and non-cisgender individuals.

Is Pursuing an Autism Evaluation Right for You?

Given the obstacles to formal diagnosis, many autistic adults choose to self-identify based on personal research and symptom recognition.

The Rise of Self-Identification Among Adults

Self-identification means acknowledging autistic traits and experiences without having undergone a formal clinical evaluation.

Understanding the Impact of Autism Stigma

Fear of stigma and discrimination may discourage some from seeking a formal diagnosis, as it would become part of their medical record.

Considering Support Needs and Disability Status

Many autistic adults have disabilities and may require accommodations or financial support due to challenges in employment or independent living.

Official Diagnosis May Be Necessary for Accessing Services

To obtain certain supports, such as disability benefits or academic accommodations, an official autism diagnosis is often required.

Final Thoughts from VeryWell

If you believe you might be autistic, exploring content created by the autistic community can provide valuable insights. Deciding whether to pursue a formal diagnosis is a personal choice based on your individual needs. Qualified psychologists, psychiatrists, or other trained professionals can assist you in determining if an autism diagnosis is appropriate.

Explore more about living with Autism Spectrum Disorder:

• Conditions A-Z
• Neurodivergence
• Autism

References

1. Conner CM, Cramer RD, McGonigle JJ. Examining the diagnostic validity of autism measures among adults in an outpatient clinic sample. Autism in Adulthood. 2019;1(1):60-68.
2. Navarro-Pardo E, López-Ramón MF, Alonso-Esteban Y, Alcantud-Marín F. Diagnostic tools for autism spectrum disorders by gender: analysis of current status and future lines. Children. 2021;8(4):262.
3. Wigham S, Rodgers J, Berney T, Le Couteur A, Ingham B, Parr JR. Psychometric properties of questionnaires and diagnostic measures for autism spectrum disorders in adults: A systematic review. Autism. 2019;23(2):287-305.
4. Wei, S. Autism Screening Cost Without Insurance.
5. Kaufman NK. Rethinking “gold standards” and “best practices” in the assessment of autism. Applied Neuropsychology: Child. 2022;11(3):529-540.
6. Mallipeddi NV, VanDaalen RA. Intersectionality within critical autism studies: a narrative review. Autism in Adulthood. Published online November 24, 2021:aut.2021.0014.
7. Botha M, Dibb B, Frost DM. “Autism is me”: an investigation of how autistic individuals make sense of autism and stigma. Disability & Society. 2022;37(3):427-453.
8. World Health Organization. Autism Spectrum Disorders: Fact Sheet.

By Amy Marschall, PsyD
Dr. Amy Marschall is an autistic clinical psychologist with ADHD, specializing in working with neurodivergent children and adolescents. She is certified in TF-CBT and telemental health.

See Our Editorial Process | Meet Our Review Board | Share Feedback

Discover engaging topics and analytical content in Neurodivergence as of 13-12-2022. The article titled " Who Is Qualified to Diagnose Autism in Adults? " provides new insights and practical guidance in the Neurodivergence field. Each topic is meticulously analyzed to deliver actionable information to readers.

The topic " Who Is Qualified to Diagnose Autism in Adults? " helps you make smarter decisions within the Neurodivergence category. All topics on our website are unique and offer valuable content for our audience.