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In a conversation with Lisa Dent, Dr. Megan Anna Neff, a clinical psychologist practicing in Oregon, explores the indications of undiagnosed autism in adults. With her expertise, Dr. Neff highlights key signals that may suggest an individual has undiagnosed autism and discusses potential behavioral patterns exhibited by individuals on the autism spectrum.

Why many Autistic Adults go undiagnosed

First, it’s essential to understand that the diagnostic criteria for autism have evolved significantly over the past 30 years. For example, those born before the mid-1990s had very low chances of being identified as autistic during childhood because it wasn’t well known how Autism presents.

If people like Dr. Neff, who is now 41, were to be diagnosed back in the ’80s or ’90s, it’s doubtful they would have met the criteria. Back at home, the traits they exhibited may have been dismissed as shyness, perfectionism, or emotional sensitivity, rather than recognized as part of the autism spectrum.

Awareness and understanding of autism

Today, there’s a great improvement in awareness and understanding of autism, especially among adults who were previously undiagnosed. Dr. Neff highlights a few signs that adults may want to look out for in themselves. These include:

A feeling of being alien. This is a common experience where individuals feel out of place or disconnected from others. It can manifest as a sense of not quite fitting in, as if you’re observing the world from a different perspective. Many describe this feeling as being like an outsider. This sense of alienation often goes unrecognized for years, especially in environments that don’t account for neurodivergence.

Another common sign is difficulty with social cues. Dr. Neff explains that for ASD adults, social cues are not automatically processed in the same intuitive way as they are for others. Yes, they can pick up on social signals, but they do so analytically rather than instinctively.

For instance, Dr. Neff describes how she recognizes when someone crosses their arms, but it’s not an instinctual understanding—it’s based on logic and prior knowledge. So crossing arms for an ASD adult could mean a cross-out, as in X.

In contrast, her spouse (neurotypical) intuitively picks up on body language, like eye movements, to gauge emotions. The challenge presented by social cues’ difficulty is that it creates a feeling of being disconnected from the social “conversation” happening around them. It’s as if there’s an entire layer of communication that they aren’t fully tapped into, which can contribute to that pervasive sense of being “alien.”

Other common traits of ASD adults 

The other issue common with ASD adults is the need for extended recovery time due to sensory overload. Because many autistic individuals experience heightened sensitivity to their environments—whether it’s noise, lights, textures, or social dynamics—they often find themselves easily overstimulated. This can lead to exhaustion after everyday activities that others might find routine.

Social events, for example, may require hours or even days of recovery. It’s not about being antisocial—it’s about how much energy is drained simply by processing all the incoming stimuli. In most cases, autistic adults need more rest, solitude, and downtime to function well. Without this understanding, it can be easy to feel confused or guilty for needing what seems like “too much” rest.

In reality, it’s a vital part of self-care. Other signs mentioned by Dr Neff are a preference for Direct talk rather than small talk, and ASD adults prefer clear, direct communication.

A diagnosis can bring clarity

Dr. Neff suggests that if these traits significantly impact your daily life—your relationships, work, energy levels, or sense of identity—it might be time to explore a formal assessment. A diagnosis can bring clarity, validation, and access to helpful resources. But even without a formal label, simply recognizing your neurodivergent traits can be a powerful step toward self-understanding and creating a better life for you.

If you resonate with many of the traits described—feeling out of place, struggling with social cues, needing more downtime than others—it may be worth exploring further.

For those in Illinois, Illinois Autism Center is a valuable resource offering diagnostic services, support, and guidance for adults seeking answers. You don’t have to navigate this journey alone—help is available, and clarity is possible.