The conversation about the rise in adult autism may appear to be trending, but Dr. Avital Cohen, and much of the recent literature, advise not to over-interpret these figures, but rather, how we got there.
Autism and Autism Spectrum Disorder are the medical terms to encompass all individuals who meet a set of criteria of challenges related to social communication, restricted interests, and repetitive behaviors. Autism is a broader term, and some individuals may prefer it. “Spectrum” leaves room for “catch basket” parlance when folks like Elon Musk are lumped in with those who cannot communicate.
According to a recent JAVA Network Open Study, adult autism rates have risen by 175 percent over the last few years; those 26-34 years old have risen by 450 percent. In terms of metrics, Harvard Health (Dec. 3, 2024) found that approximately 2.2 percent of adults are on this spectrum. The Wall Street Journal confirmed, “This last decade surge is not a new phase vs. previously undiagnosed or unrecognized cases.”
Rate increases are also attributed to better research and social progress.
Cohen explained, “We really cannot quantify this number, but we know many individuals, especially women or high-masking individuals, were often not diagnosed or misdiagnosed when they were younger. Adult autism assessment requires a range of tools, including rating scales for the individual and someone who knows them well, as well as assessments to measure social interactions and other behaviors within the clinic setting. With adult assessment, the interview itself is one of the most important parts to help begin to understand an individual’s experience.”
Dr. Avital Cohen focuses on psychological testing, including autism, ADHD, and learning disorders.
Cohen also noted the advancement of female cases where medical providers initially had a very narrow view of autism. “Girls are socialized from a young age to learn the ‘rules’ of social interaction, and so some autistic women learned to be successful in their interactions initially but then began to struggle to continue to mask. They can know what is expected socially, but it doesn’t come naturally or comfortably. Societal demands have changed over time – social media, more people in crowded metropolitan areas, and other ways the world has transitioned, have made some of the challenges autistic people experience more significant.”
Since there is no cure, what’s the benefit of getting diagnosed? Cohen noted, “Acceptance and understanding of oneself – for many diagnosed adults share a sense of relief at finding out why certain experiences have felt more challenging and have new language to talk about their experiences. It can also help guide the types of therapies more likely to be helpful. There is no medication for autism. Also, common co-occurring issues can be anxiety and health challenges as well as ADHD.”
Cohen observed that the most common reason she sees adults seeking out an evaluation is when they have a child who is diagnosed and recognize similar traits in themselves. Most adults she sees for adult autism evaluations have average to above average IQs.
Dr. Cohen addressed masking in that some people are relatively content, not experiencing distress, and generally don’t seek answers. However, she questions whether someone who is masking is really “fitting in.”
She related, “They are having to expend so much effort, they are often exhausted and not able to keep it up long-term. They might have happiness in some areas of their life but struggles in others. I have seen individuals who have a partner who accepts and supports them, so their marital relationship isn’t where they are experiencing distress, but they are struggling with work or friendships.”
Insurance might cover testing with medical necessity. For self-pay, the cost range is $1,800 to $2,800 for a professional adult autism evaluation.
Dr. Avital Cohen is a licensed psychologist and the founder/clinical director of Peachtree Pediatric Psychology. She is an Army veteran who deployed to Iraq and earned a Bronze Star for her service. Currently, her clinical focus is psychological testing, including autism, ADHD, and learning disorders. While she focuses primarily on pediatrics, Dr. Cohen conducts autism assessments across the lifespan.
To learn more, Cohen recommends the book, “NeuroTribes,” by Steve Silberman.