Have you ever thought about how it seems like autism is suddenly everywhere? Today, according to the CDC, around 1 in 32 children at age 8 are diagnosed with some level of autism spectrum disorder (ASD).

That number is high, and it has been growing; in 2020, it was 1 in 36. In 2010, it was 1 in 68. All the way back in 2000, it was 1 in 150.

A lot of different theories have been circulated to explain this rise, but the truth is likely quite simple: we just know what to look for now. It wasn't that long ago, after all, that what we now consider ASD was labeled as "Asperger's Syndrome", a term that was retired in 2013. More people feel more comfortable seeking a diagnosis for their children, or even for themselves.

There's growing awareness, not just of what ASD means, but of what people do to mask; the things formerly attributed to personality quirks. On top of all of that, more and more non-white people are being diagnosed, when formerly ASD was considered a white disorder.

ASD is broader than it was, and there's more awareness and willingness to seek a diagnosis and support.

Maybe you've always felt out of place. Maybe you're seeing more and more messaging about autism, and you're wondering if you fall on the spectrum. Maybe you're pretty sure you do, but you need an assessment to get access to assistance. Maybe you're seeking a diagnosis for your children, and wonder if you have it as well.

There are many, many different reasons why you might seek an autism assessment as an adult. The question is, where should you go to get that assessment here in Metro Detroit?

DISCLAIMER: This article is for informational and educational purposes only and should not be considered medical or psychological advice. The information presented here is not intended to diagnose, treat, cure, or prevent any mental health condition or replace professional therapeutic care. Every individual's experience with trauma and mental health is unique. Please consult with a qualified mental health professional, therapist, or healthcare provider to determine the most appropriate treatment approach for your specific situation. If you are experiencing a mental health crisis or emergency, please contact your local emergency services or crisis hotline immediately.

Signs of Autism Spectrum Disorder in Adults

First, let's talk about the signs and symptoms of ASD, the things you might feel as an adult, which could be pointing you in the direction of a diagnosis.

You might find it difficult to talk to other people and maintain conversations. Many people with ASD find it more comfortable not to talk when it's not necessary, find little value in small talk or socialization, and have difficulty keeping a conversation flowing.

Conversely, you might find it easy to overwhelm people with your current interests. One "stereotype" of ASD is developing special interests and hyperfixations. These are topics you're keenly interested in and could talk at length about, often ignoring social norms or the appropriateness of the conversational topic in doing so. If you find yourself being largely silent in conversation unless a specific topic comes up, it's a pretty clear sign.

You tend to prefer spending time alone. A lot of what we think of as "being introverted" can be attributed to some level of ASD. Since social situations tend to be stressful and exhausting, it's easier and more comfortable to spend time alone. You don't feel the sense of isolation the same way others might, or the drive to find ways to socialize.

You don't really understand nonverbal social cues. Things like facial expressions, gestures, and tone of voice convey a lot of meaning, but that meaning is somewhat lost on you. You've learned to understand the more obvious indicators, but you're still more likely to take things people say at face value rather than seek underlying meaning in the things they don't say.

You've developed fixed ways of doing things and feel distressed when they change. Whether it's a route you've planned through the grocery store, a set of processes you follow to handle daily tasks or the routines you've developed to handle responsibilities at work, you develop a system, and you stick with it. When things change around your system such that your system no longer works, you have trouble adapting to the change.

You exhibit physical behaviors as an output of energy and to gain a sense of comfort. Broadly called "stimming", this is a kind of physical outlet for excess energy, a way to soothe yourself when things are stressful, and manage sensory overload. Stimming can be larger and more obvious behaviors, like bouncing a leg, flapping hands, or snapping fingers. It can also be other kinds of behaviors, such as scratching or skin picking, rocking back and forth, rapid blinking, humming, chewing on items like pen caps, and more. There are many, many different kinds of stimming behaviors.

You find yourself to be very sensitive to things other people ignore. Some of the most common examples are the fluorescent lights in a typical office, the near-inaudible humming of equipment, and the presence of certain smells. You might also be sensitive to particular textures, tastes, and other sensory input.

You have been diagnosed with another condition, but it doesn't quite fit. Many people with mental health disorders that were diagnosed 10+ years ago find that the label doesn't quite fit. Maybe you've been diagnosed with anxiety or depression, or you have an eating disorder, or ADHD, or a learning disability. But whenever you look into the condition or talk to others with it, your experience doesn't quite line up. This is another reflection of how awareness of, and the definition of, ASD has expanded in recent years.

How Masking Hides the Signs

The list of signs and symptoms above are fairly clear, but they tend to be most obvious in children. Adults have a harder time, both in recognizing the signs in others, and in recognizing them in yourself.

The reason is masking. Masking is the term for the collective set of behaviors and mechanisms you use to either hide or adapt to the things you feel, the stresses you encounter, and the problems that arise.

• You might suppress stimming because you don't want to deal with the attention you get when people see you doing it.
• You might have scripts for conversations you have, patterns in your small talk, or established jokes you can tell as a way to navigate low-stakes social situations.
• You might mirror; copying the facial expressions, body language, and even the slang used by people around you, to better fit in.

Masking can be intentional, something you do because you recognize an abnormality you want to address or hide. Or, it can be unintentional, a learned set of responses to common points of friction in your life. Often, it's a combination of both.

Unfortunately, masking (especially unconscious masking) makes it harder to look at yourself objectively and recognize that you may be experiencing the symptoms that would lead you to an ASD diagnosis. You might recognize that your workplace is stressful, but not why. You might have suppressed your stimming and attribute it to "mild ADHD". You might feel like a prior diagnosis is accurate, and you just have an atypical presentation.

Why You Should Consider Seeking an Adult ASD Diagnosis

Maybe you feel like even if you have ASD, you've managed it well, or it's too mild to be worth worrying about. Maybe you're masking effectively, potentially even from yourself. Maybe you just don't see the benefit in adding a label to your life. Why should you consider seeking an assessment and diagnosis for ASD as an adult?

One of the biggest reasons is simply that you might not even realize how much stress you've been under.

Once you undergo an assessment and receive a diagnosis, you can work towards ways to make your life easier. You can build an awareness of what things trigger stress in you, how to recognize negative behaviors, and how to handle the sources of stress that you would otherwise just have to grit your teeth and bear.

You can also work on "unmasking". Unmasking is the release of the masking mechanisms you use, particularly when they're covering up your authentic personality or causing stress themselves. Masking itself can be highly stressful and lead to increased risk of burnout.

• You can finally have an explanation for why you are the way you are and why you felt the way you have in the past.
• You gain an explanation for strange events and interactions you formerly didn't grasp.
• You gain more awareness of yourself and your surroundings, and can take steps to improve your quality of life.
• You can have "proof" you can use in cases where someone took your masking at face value and doesn't otherwise believe you.

There are some tangible benefits to a diagnosis, as well.

One is the potential for accommodations. Accommodations don't have to be significant; even things like allowing you to use a non-disruptive fidget device, use headphones in a noisy environment, or free you from certain unimportant social obligations can be a huge quality-of-life boost for you.

The understanding you gain about yourself can also empower you to self-advocate, adjust your expectations, and adapt to the way you feel most comfortable.

If you have or plan to have children, knowing your own state of mind is beneficial as well. It can help you and your spouse prepare for the challenges you can face in parenthood, and help you watch for signs that your child also has ASD.

An ASD diagnosis can also open up doors for treatment, both for the ASD itself and for any co-occurring disorders like anxiety, depression, PTSD, sleep issues, eating disorders, substance use disorder, and more.

An ASD diagnosis as an adult opens up doors, fosters understanding, and can resolve long-standing conflicts and issues you've experienced.

Where to Find an Adult Autism Assessment in Metro Detroit

There are quite a few options throughout Detroit for seeking an adult ASD assessment.

Henry Ford Health is the first one most of you will think of; after all, they're the largest health network in southeast Michigan. Indeed, they do offer adult autism assessments.

One option is to schedule a complete neuropsychology evaluation. This evaluation will involve a sequence of three appointments. The first is an intake appointment where you submit your medical history and talk to a doctor about your concerns, issues, and goals. The second is a testing appointment, which evaluates you across numerous different potential psychological disorders, including autism spectrum disorder. Third is the feedback and results appointment, where you get your results and plan your next steps.

The other option is to talk directly with GROW, the Henry Ford Health Generational Resilience Opportunity and Wellness Center for Autism and Intellectual and Developmental Disabilities. Yes, that's a mouthful. GROW is a specialized center for generational autism and developmental disability treatment, and can be an exceptional choice.

Independent providers are a second option. The Autism Alliance of Michigan maintains a list of providers, including psychiatrists, psychotherapists, mental health centers and facilities, and others who provide adult autism assessments in the greater Detroit area. You can explore those options and contact any who seem promising.

The Autism Society of Greater Detroit has a similar list of resources and providers who have come highly recommended, though not all of them are specialized in autism spectrum disorder. This can also serve as a secondary list for services ranging from eye care to surgery for people with ASD who might not do well in a normal doctor's office.

Finally, you can contact us. At BMC-Troy, we're proud to offer a complete range of services for both childhood and adult autism spectrum disorder. While we don't typically perform the initial diagnostic assessment, we're often the next step after one. For those who have received a diagnosis, we offer:

• Comprehensive diagnostic evaluations to guide treatment recommendations and identify co-occurring conditions
• CBT adapted for people with ASD
• Skill building for social communication, emotional regulation, executive function, and more
• Coaching for parents and caregivers
• Identity exploration and late diagnosis support
• Medication management for co-occurring disorders and cases where medication is appropriate

An adult ASD assessment is not a pass or fail test. It's an evaluation of who you are. It's a way to understand yourself and your mind, and a way to open doors to ways that you can improve your future. And a diagnosis is a starting point, not an endpoint.

If you've received an ASD diagnosis, whether recently or years ago, and you want help figuring out what comes next, we'd love to work with you. You can fill out our new patient packet here on our website directly, or if you prefer, you can call our office to schedule an appointment or just ask questions at 248-528-9000.