Why more adults than ever are being diagnosed with autism

Mint

26-05-2025

More U.S. adults than ever before have autism, and many are being diagnosed not as children, but in later years.
While the data don't pinpoint how many people are over age 18 when diagnosed, clinical psychologists say many more adults are seeking evaluations for autism than a decade ago.
'We have adults reaching out every week," said Paige Siper, chief psychologist at the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai in New York.
Overall, the rate of autism in people 18 or older more than doubled between 2011 and 2019, from 4.2 per 1,000 to 9.5 per 1,000, according to an analysis of Medicaid data published in the journal JAMA Psychiatry in 2023.
Researchers saw the most rapid growth in adults between the ages of 26 and 34, according to a study, published in the journal JAMA Network Open in 2024, that analyzed U.S. health records and insurance claims for more than nine million individuals a year from 2011 to 2022. That group's rate of autism increased from 0.7 per 1,000 people in 2011 to 3.7 per 1,000 in 2022.
Some of this growth comes from autistic children aging into adulthood.
For adults seeking evaluations for the first time, scientists attribute the rise to a variety of factors.
Social media has increased awareness of autism. Autism has shed the stigma it used to hold. The definition of the condition has expanded over time to include a broader range of behaviors. And some parents who have children diagnosed with autism then recognize their own challenges and seek out evaluations, said Michelle Gorenstein-Holtzman, a clinical psychologist who works with adults at the NewYork-Presbyterian/Weill Cornell Medical Center and the Center for Autism and the Developing Brain.
Three years ago, before she joined, the center did one adult autism evaluation a month. Now Gorenstein-Holtzman does two a week.
People diagnosed as adults typically don't have severe communication challenges or intellectual disabilities, clinical psychologists said. But they have struggled socially, and show subtle repetitive behaviors like rocking in a chair, or nearly obsessive interests in certain topics. They often have other continuing mental-health conditions, such as anxiety, bipolar disorder or ADHD.
Many are highly educated, and some have successful careers, though some have been in and out of jobs.
Many are women whose autism was missed when they were children, said Catherine Lord, a clinical psychologist and autism researcher at the David Geffen School of Medicine at UCLA. About three times as many boys are diagnosed with autism as girls, partly because some of the behaviors psychologists look for are less pronounced in girls, and partly because researchers have been trained to better recognize the condition in boys.
Growing up, Sonia Chand said she felt out of touch with her peers and judged by teachers and therapists. 'I was made to feel like I was the bad kid," she said. 'I wasn't trying to act up in a bad way. I was just trying to fit in."
Sonia Chand and her parents, Kishan Chand and Krishna Pahuja, looking at photos together.Growing up, Chand said, she felt misunderstood and rejected by her peers, teachers and therapists.
In sixth grade, she was diagnosed with depression, prescribed lithium and flagged at risk for suicide. At age 20, after a new therapist had heard her story and referred her for an advanced neuropsychological evaluation, she was diagnosed with Asperger's in 2002. Now 42, she works as a therapist herself, runs marathons and hosts a podcast in her free time.
At the time Chand was diagnosed, Asperger's syndrome was considered a developmental disorder in which people had trouble with social interactions but didn't have language delays or cognitive impairments associated with autism.
Autism first appeared as a distinct diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, a standardized classification system for mental disorders, in 1980. Initially, the diagnosis required children by age 2.5 years to exhibit a narrow set of behaviors that typically applied only to those with severe disabilities.
Each subsequent edition of the manual has broadened the definition of the condition, said David Mandell, director of the Penn Center for Mental Health at the University of Pennsylvania.
In 2013, Asperger's and other developmental disorders were included under the category of autism spectrum disorder, which acknowledged varying levels of severity—and helped to pave the way for more diagnoses in adults.
Chand now works as a licensed professional counselor and hosts a podcast..
Holden Thorp, editor in chief of the Science family of journals, was in his 50s when a psychologist evaluating senior administrators at Washington University in St. Louis, where he was provost, told him he was autistic in 2016.
Thorp had established himself as a research scientist, climbed the ranks of university leadership and served as chancellor of the University of North Carolina at Chapel Hill.
'A lot of things came together all at once," Thorp said, ranging from his habit of staring at a wall when people were talking to him to student evaluations that said he was 'a great teacher" but 'very monotone."
Now, he tells classes on the first day that he's on the spectrum and explains that expressive intonations or big arm gestures are a challenge. 'That was very liberating," he said.
Some adults welcome the diagnosis as a way to make sense of the challenges they have faced all their lives.
'When I started in the field, everyone's vision of autism was more like Rain Man," said Gorenstein-Holtzman. 'Now, I think people have more ideas of what autism could look like."
Write to Nidhi Subbaraman at [e-mail]