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From what I know about the autism spectrum, a lot of people who were diagnosed later in life (not during childhood) didn't "seem autistic" until adolescence or young adulthood. Of courses, they had symptoms all this time but it didn't become obvious until later.

Why is that? Do you have some articles/youtube videos that I could read/watch to learn more about this (English or French)?

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    $\begingroup$ I'm by no means an expert, but you have to remember that there are degrees of severity. Of course willing to be corrected, but I would suspect that those cases where it is identified later, are generally cases where it is not of extreme severity. (Though in some rare cases it may be) $\endgroup$
    – Eff
    Commented Dec 16, 2018 at 15:22
  • $\begingroup$ @Eff You will need to define "severity" in order for your statement to be correct or not. But yes, the doctors tend to qualify those autistic people that are detected later as "Hight functioning". $\endgroup$
    – Ælis
    Commented Dec 16, 2018 at 15:28
  • $\begingroup$ Well, for example in terms of cognitive empathy. Consider two groups: (1) individuals diagnosed early with autism, and (2) individuals diagnosed late with autism. My prediction is that group (2) has higher cognitive empathy on average. [Cognitive empathy can be approximately measured with a battery of tests that assess ability to interpret emotion] $\endgroup$
    – Eff
    Commented Dec 16, 2018 at 15:32
  • $\begingroup$ @Eff This doesn't answer my question but is still an interesting theory, thank you $\endgroup$
    – Ælis
    Commented Dec 16, 2018 at 15:38
  • $\begingroup$ Well, I didn't write an answer, either. It was simply a comment regarding something to consider. However, I would say that it is at least plausibly related to the true answer. If something is less severe, it is less likely to be discovered, and hence it will not be as likely to be discovered and diagnosed early in life. $\endgroup$
    – Eff
    Commented Dec 16, 2018 at 15:43

3 Answers 3

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It is important to remember when reading this question and answer is that Autism Spectrum Disorder (ASD) does not develop in adulthood, but symptoms can change for individuals over time because learning occurs.

Symptoms of ASD come in all shapes and forms because this is a spectrum disorder and therefore people present somewhere on a spectrum, often referred to as from low functioning to high functioning.

To answer the question directly, people who present symptoms later in life, as you say, often do present those symptoms in childhood but they aren't noticed by the adults in the child's life until it becomes a real problem for the individual.

As an example, interpersonal skills are learned during childhood. It is perfectly acceptable for children to be at slightly different stages during development with regard to interpersonal skills. Some children will be more advanced then others. Interpersonal skills can be difficult for people with ASD to grasp and so someone with high functioning Autism can take longer to develop these skills, if they are developed at all. So that would potentially not show up until later when the other kids have developed these skills and the child with undiagnosed ASD has not.

Often, 30+ years ago, before we had more advanced treatments and assessments children would 'fall through the cracks' and be labeled as gifted, rather then as having high functioning ASD. This would explain why some people who are highly successful in adulthood are diagnosed in adulthood rather then childhood. People with high functioning ASD often have a savant type qualities, meaning they are very skilled in some specific area. The diagnostic criteria (DSM) has been amended over the years which would account for some adults being diagnosed now, as they may not have qualified before the DSM changed the criteria.

This would be an interesting study to read to understand social interaction among children with high functioning ASD: Bauminger, N., Solomon, M., Aviezer, A. et al. J Abnorm Child Psychol (2008) 36: 135. https://doi.org/10.1007/s10802-007-9156-x

This article discusses changing symptoms (Behavioural) in youth and adults with ASD.

This might be a good book for you to read together a good understanding of ASD in development, which might give you a better understanding as to why people can go undiagnosed until adulthood. Handbook of autism and pervasive developmental disorders, 2nd ed.

In conclusion, There are many reasons that someone might not be diagnosed until later in life, and autism is a spectrum which means people have many different symptoms that range on a vast scale.


References

Bauminger, N., Solomon, M., Aviezer, A. et al. J Abnorm Child Psychol (2008) 36: 135. https://doi.org/10.1007/s10802-007-9156-x

Shattuck, P.T., Seltzer, M.M., Greenberg, J.S. et al. J Autism Dev Disord (2007) 37: 1735. https://doi.org/10.1007/s10803-006-0307-7

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More of an opinion based answer- the symptoms become more distinguishable from kids and adolescent behaviour when you age.

Restless behaviour, stimming behaviour, echolalia etc. can be confusing with typical childish behaviour.

Failing to organise things, fine motor skill problems, making clutters, forgetfulness etc. can be easily confused with adolescent and early adult behaviour.

But when the patient is adult, say 20 or 30 years old, yet having unusually childish behaviour, lack of social understanding, various skill deficits (and given that the patient fail to 'mask' hard enough); the neurodevelopmental anomalous pattern gets some more visibility.

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The reason autism is sometimes only visible later on life is that it is interpreted as something else. It is therefor undiagnosed

Like the gorilla in the middle of the basketball court in that famous video, is visible, but not seen.

One of the reasons for this is lack of information available to the public or even misinformation.

Also there often moral condemnation of those who are inconvenient or who do not fit in. Condemnation that is often internalized

Understanding of autism has changed radically in recent decades.

Forth, it is genetic and often adults become aware that they are autistic when their child or nephew or niece is diagnosed

Fifth, there are so many autists undiagnosed that any increase of awareness means more people of all ages will be diagnosed, and as there are more adults than children...

Autists often assume that their internal struggles are normal and erroneously believe that non-autists have the same problems. Their autistic traits can be invisible to them.

Autistic traits were visible when they were children, however instead of being diagnosed as autistic they were diagnosed as bad children.

The parents were blamed because real life autistic behaviour was seen as inappropriate behaviour therefore the parents must have not taught them correctly. An early theory was that it was caused by cold and unfeeling mothers.

Autism is seen as what Rain Man had, or those non-verbal white male 4yo children you would sometimes see in documentaries.

God help them if they are non-white, female or older than 4yo.

Until recently even most psychologists knew little about autism unless they were studying autism.

Even among experts autism is a moving target, with massive changes between DMS-IV and DMS-5 with autism and ADHD now allowed to be diagnosed together and several separate diagnoses being absorbed under the ASD umbrella.

Until recently a lay person had little hope of having decent information.

This is changing as more information about autism becomes widespread.


Resources

Changes in the Concept of Autism - Francesca Happé CBE

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