What Does Autism Spectrum Disorder Look Like in Adults? +2023

Shifra David imageImage Credit: Shifra David

“Growing up, I was always hailed as the ‘gifted kid,'” says Shifra David. She excelled in class, never had trouble studying, and got good grades. It had been her brother Diagnosed as on autism spectrum in early childhood but had intellectual challenges. Because Shifra didn’t, her parents never suspected she might be neurodivergent, too, she says.

But Shifra knew there was something different about them, especially when it came to socializing. “I felt like I missed that day of school,” they say—as if somehow everyone but them knew the rules of engagement for friendships. They had trouble reading social cues, didn’t understand cliques, and found it very difficult to maintain a consistent group of friends. From the outside they looked like a social chameleon, a temporary member of different social groups – but in reality, Shifra felt disconnected from her peers. This became clearer to them in high school. “I would try to overcompensate myself to fit in. And that took a really big toll on my mental health,” says Shifra.

In college, she saw a therapist and received her first diagnosis.

“Originally, [the therapist was] how yes, [you have] Depression and anxiety,” Shifra recalls. She had no reason to question that diagnosis — until she began taking courses in her speech therapy major, with a focus on childhood developmental disorders. When Shifra began to understand the diagnostic criteria for ADHD and Autism Spectrum Disorder, “I was like, ‘Oh wait, wait. I’ll do this.’

But the idea that they might have autism felt too overwhelming to bring to their therapist, so Shifra decided to “just focus on ADHD” and put off exploring further with autism. That worked for a while. But eventually, they were able to discover that they had symptoms that their ADHD treatments weren’t addressing — and the symptoms were interfering with their lives enough that they knew they needed more support. It was at this point that Shifra began talking to her caregivers about autism, voicing her belief that they may be on the spectrum.

Unfortunately, this monumental step did not bring immediate results. “It was a big boost to be taken seriously by practitioners,” she says — in large part, Shifra believes, because she doesn’t present herself in the way most people think of people on the spectrum.


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♬ Original sound – Shifra

Shifra saw three different therapists before one actually helped them get tested for autism.

The first psychiatrist suspected that Shifra had bipolar disorder and suggested mood stabilizers. “I felt like I was taking sugar pills — it wasn’t really doing anything,” they recall. The next therapist was quick to dismiss autism as a possible possibility, telling Shifra, “They make really good eye contact” and “They seem to have hit it off.” Shifra says they recall thinking, “That’s not the point .” (Not all people with autism present in the same way, and stereotypes about what autism is supposed to look like are a major reason people go undiagnosed.) Shifra was aware from her own studies and college courses that autism comes in many forms , which made her all the more determined to stand up for her own diagnosis.

When she went to see the third therapist, Shifra was determined to get tested: she brought with her a binder detailing her educational background and providing research and anecdotal experiences. “Please take me seriously,” Shifra told the vendor. And for the first time in a long time she felt heard.

Her therapist scheduled the test, which brought its own hurdles: the psychologist administering the test was absent for four months. But the tests Shifra needed were expensive, even with insurance coverage, and if they couldn’t do them before the end of the year, their insurance deductible would reset, leaving them with a higher bill. It took some scrambling, but ultimately the tests were conducted on New Year’s Eve 2021.

After 10 hours of testing, she was finally diagnosed as being on the autism spectrum.

“They did three tests. They did my ADHD testing, they did my autism assessment, and then they did a general comprehensive psychiatric panel as well,” she says. The tests totaled $1,000 after deductions, says Shifra — a price she says was well worth it.

Hearing the diagnosis confirmed by professionals confirmed what they had thought for years. Shifra says they felt relieved, like they could “finally respond to that part of my life that has always been confusing or frustrating to me.” But they were also unexpectedly sad, mostly because it had taken so long for anyone else to realize they weren’t feeling well. “People around me, teachers, parents, whoever, never really looked at me enough to know, ‘hey, there’s a fight here.'”

An official diagnosis has helped Shifra better support herself.

Many of the changes Shifra has described after receiving her official diagnosis might come across as minor – but the fact is that she has made significant changes to the quality of her life, which was only possible because her diagnosis gave her a better understanding of herself and the best Support has given their needs.

For example, Shifra says the diagnosis gave them more context to help them understand why they feel or behave a certain way in certain situations, which was useful for therapy. They have also found that an official diagnosis has helped them feel more comfortable and socially fulfilled. Knowing that her diagnosis was valid has allowed Shifra to embrace the fact that she is okay with having a smaller circle of close friends, for example. You have learned to focus on quality over quantity.

The diagnosis also helped Shifra in terms of self-care, which had previously been a struggle. “Even as a child I found it very difficult to brush my teeth because the toothpaste was too strong. And an electric toothbrush makes too much noise and is a very strange sensory experience for me,” says Shifra. “And now I’ve bought myself a mild toothpaste and a really quiet electric toothbrush.” She also began using noise-cancelling earplugs and sunglasses to control her sensory experience in overstimulating environments like the grocery store.


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♬ Original sound – Shifra

“Even something as small as finding a sunscreen that didn’t aggravate my sensory experiences” made a big difference, says Shifra. “It was all very small things that I never thought would have such a big impact on my everyday life,” they add, adding that all the advocacy was worth it. Having an official diagnosis served as a kind of green light for Shifra to make these small but “immensely” helpful adjustments.

“You know yourself best, and if someone is pushing back what you know about yourself, find someone else,” says Shifra. “Go until someone listens to you.”

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