Autism spectrum disorder is a lifelong neurodevelopmental difference in social communication and in patterns of behavior, interests and sensory processing. Diagnosis in teens and adults is based on a structured clinical assessment and developmental history. There is no medication for autism itself; psychiatric care focuses on co-occurring anxiety, depression, ADHD and irritability, with therapy, accommodations and support.
Stedfast Psychiatry provides diagnostic evaluation for autism in teenagers and adults and ongoing psychiatric care for the conditions that commonly accompany it: anxiety, depression, ADHD, OCD and sleep problems. We do not treat autism as something to cure. We help autistic people understand themselves, get the accommodations they are entitled to, and treat the conditions that are causing distress.
Symptoms of autism
- Difficulty with back-and-forth conversation or reading social cues
- Finding eye contact, small talk or group settings draining or confusing
- Feeling like you are performing or 'masking' in social situations
- Preferring routine and finding unexpected changes very distressing
- Deep, focused interests pursued with unusual intensity
- Sensory sensitivities to sound, light, textures, smells or touch
- Repetitive movements or self-soothing behaviors such as rocking or hand movements
- Taking language literally or difficulty with sarcasm and implied meaning
- Exhaustion or shutdown after social demands
- Lifelong sense of being different without knowing why
Causes and risk factors
Autism is highly heritable, with genetics accounting for roughly 80 percent of risk through many common variants and some rare ones; it often runs in families, and a diagnosis in a child frequently leads to recognition in a parent. Advanced parental age, prematurity and certain prenatal exposures add modest risk. Autism involves differences in brain development and connectivity that are present from early life. It is not caused by vaccines, parenting or diet; those claims have been thoroughly disproven. Autism is not a disease that develops but a neurotype that is present from the start, and the difficulties autistic people experience come largely from the mismatch between their needs and environments built for non-autistic people.
About 1 in 31 US children aged 8 was identified with autism spectrum disorder in 2022, up from 1 in 150 in 2000.
Source: CDC, Autism and Developmental Disabilities Monitoring Network
An estimated 2.2 percent of US adults, about 5.4 million people, are autistic, and most adults were never formally diagnosed.
Source: CDC, Journal of Autism and Developmental Disorders, 2020
Anxiety disorders affect roughly 40 percent of autistic adults, and depression affects 20 to 40 percent, far above general population rates.
Source: Meta-analyses, Lancet Psychiatry 2019 (Lai et al.)
Autism is diagnosed about 3 to 4 times more often in boys than girls, and girls and women are diagnosed later on average, partly because of masking.
Source: CDC; American Psychiatric Association, DSM-5-TR
How we diagnose it at Stedfast Psychiatry
Diagnosing autism in a teenager or adult requires a careful clinical assessment. We take a developmental history going back to early childhood, with input from a parent or someone who knew you as a child when possible, and a detailed account of current social communication, routines, interests, sensory experiences and masking. We use standardized tools including the Autism Spectrum Quotient (AQ) and the RAADS-R for adults, and when a formal observational measure is needed we use or refer for the ADOS-2. We screen for ADHD, anxiety, depression, OCD, social anxiety and trauma, which both co-occur with autism and can be confused with it, and we distinguish autism from social anxiety disorder, schizoid traits and personality disorders. For adults seeking workplace or academic accommodations, or for complex presentations, we coordinate with neuropsychologists for comprehensive testing.
Treatment options
Medication management
No medication treats autism itself, and we do not prescribe to make someone less autistic. Medication targets co-occurring conditions and specific symptoms. SSRIs such as sertraline or escitalopram treat the anxiety and depression that affect the majority of autistic adults, started at low doses because sensitivity to side effects is common. Stimulants or non-stimulants (atomoxetine, guanfacine) treat co-occurring ADHD, which affects 30 to 50 percent of autistic people, with guanfacine also helping irritability and sleep. Risperidone and aripiprazole are FDA-approved for irritability associated with autism in children and adolescents and are used cautiously with metabolic monitoring when severe irritability or self-injury is present. Melatonin helps the sleep-onset problems that are nearly universal in autism. We avoid unnecessary polypharmacy and review every medication regularly.
Psychotherapy and support
Cognitive behavioral therapy adapted for autism, with concrete language, visual supports and attention to sensory factors, is effective for anxiety and depression in autistic teens and adults. Therapy also helps with understanding the diagnosis, reducing the cost of masking, building self-advocacy, managing burnout and navigating relationships and employment. Social skills groups benefit some teens. Occupational therapy addresses sensory needs. We connect patients with autism-affirming therapists, vocational rehabilitation services, support groups and, for students, disability services offices for accommodations under Section 504, an IEP or the ADA.
What to expect
The diagnostic evaluation is typically 90 minutes, sometimes across two visits, in person or by video, and we will ask you to complete questionnaires beforehand and, if possible, to have a parent or long-time partner share observations. You receive a written summary of the diagnosis, suitable for accommodation requests. For ongoing care, follow-ups are every one to three months depending on medication needs. Telehealth is available across Florida and South Carolina and many autistic patients prefer it, since it removes travel, waiting rooms and sensory load.
When to seek help
Consider an evaluation if you have lifelong social difficulty, sensory sensitivities and a strong need for routine, if treatment for anxiety or depression has helped only partly, if a child or sibling has been diagnosed and you recognize yourself, or if you are experiencing autistic burnout: exhaustion, loss of skills and withdrawal after prolonged masking. Seek urgent help for a teen or adult in crisis; autistic people have elevated rates of suicidal thinking, and if you are having thoughts of suicide, call or text 988. Many autistic people find texting 988 easier than calling.
How autism presents in adults
Adult autism rarely looks like the stereotype. Many autistic adults make eye contact (sometimes too much, because they learned to), hold conversations by following learned scripts, and have close relationships. What they describe is the effort it takes: analyzing social situations consciously that others navigate automatically, exhaustion after socializing, confusion about unspoken rules, intense interests that provide joy and regulation, sensory overload in restaurants, offices and stores, and distress when plans change. Many have a history of being called shy, odd, rude, intense or 'too sensitive.' Women and people assigned female at birth often mask more thoroughly and are more likely to have been diagnosed with anxiety, depression, borderline personality disorder or an eating disorder before anyone considered autism.
Co-occurring conditions
Most autistic adults have at least one other psychiatric condition, and these are usually what bring them to a psychiatrist. ADHD co-occurs in 30 to 50 percent and both can be diagnosed together. Anxiety disorders, especially generalized and social anxiety, affect about 40 percent. Depression affects a third or more, often related to isolation, masking and unemployment. OCD, eating disorders (including ARFID driven by sensory sensitivities), sleep disorders, epilepsy and gastrointestinal problems are all more common. Alexithymia, difficulty identifying and describing one's own emotions, affects about half of autistic people and complicates both diagnosis and therapy; we adapt our approach accordingly.
Differential diagnosis
Several conditions can be confused with autism in adults. Social anxiety disorder, schizoid and avoidant personality traits, OCD, ADHD with social difficulty, complex trauma, and the negative symptoms of schizophrenia all overlap with aspects of autism. The distinguishing features are onset in early development, the presence of restricted interests and sensory differences, and the pattern of social communication difference rather than fear or disinterest. A thorough developmental history is what separates them, which is why we invest the time.
Living well as an autistic adult
The most effective interventions are often environmental: a job that matches your strengths and sensory needs, predictable routines, sensory tools, clear written communication, and relationships with people who accept directness. Reducing unnecessary masking lowers the risk of burnout. Connecting with other autistic adults, in person or online, is consistently described as one of the most valuable outcomes of diagnosis. Regular sleep, exercise and time with special interests are regulating, not indulgent. We treat the conditions that cause suffering and support the life that fits.
Outlook
Autism is lifelong and does not need to be outgrown or cured. With accurate diagnosis, treatment of co-occurring conditions, accommodations and self-understanding, autistic teens and adults build successful lives on their own terms. The adults we evaluate most often describe the diagnosis as a relief: an explanation that replaces years of self-blame. That is where good care begins.
Frequently asked questions
Can adults be diagnosed with autism?
Yes. Many adults, especially women and people who learned to mask, were never evaluated as children, and a diagnosis in adulthood is common and valid. The evaluation uses your developmental history, current experiences, standardized questionnaires and clinical observation. Adults seek diagnosis for self-understanding, to explain why anxiety or depression treatment has not fully worked, to access workplace or academic accommodations, or after a child's diagnosis. We provide written documentation.
Is there medication for autism?
No medication treats autism itself, and we would not want one that did. Medication treats the conditions that often come with autism and cause real distress: SSRIs for anxiety and depression, stimulants or non-stimulants for ADHD, melatonin for sleep, and in some cases low-dose aripiprazole or risperidone for severe irritability. We start low, go slow, and avoid stacking medications, because autistic people are often sensitive to side effects.
What is the difference between autism and social anxiety?
Social anxiety is fear of judgment in social situations by someone who reads social cues normally. Autism involves a difference in how social communication works, often from early childhood, along with sensory differences and a preference for routine. Many autistic people also develop social anxiety from years of difficult interactions, and the two are frequently confused. The developmental history and the presence of sensory and routine features usually distinguish them, and treatment differs.
What is autistic burnout?
Autistic burnout is a state of exhaustion, reduced functioning and loss of previously held skills after prolonged masking and exceeding one's capacity, often at life transitions such as starting college, a new job or parenthood. It can look like depression and is sometimes misdiagnosed as such. Recovery involves reducing demands, sensory rest, dropping masking where safe, and accommodations. We recognize it, treat any co-occurring depression, and help patients reduce the load that caused it.
Can the evaluation be done by telehealth?
Yes, in many cases. A diagnostic interview, questionnaires and the developmental history can be completed by video, and we serve patients across Florida and South Carolina. Some evaluations, particularly those requiring the ADOS-2 or comprehensive neuropsychological testing for formal accommodation purposes, are better done in person, and we will tell you which applies. Ongoing medication and therapy visits work well by telehealth.
Is an autism evaluation covered by insurance?
A psychiatric diagnostic evaluation is covered by most major insurance plans and Medicare as a specialist visit; an extended evaluation may be billed as two visits. Our self-pay rate for a new evaluation is $185, with additional time billed when needed. Full neuropsychological testing, if required, is billed separately and often needs prior authorization. Ongoing psychiatric care and therapy are covered as outpatient mental health.
Do you treat autistic teenagers?
Yes. Our child and adolescent providers evaluate teens for autism and treat the anxiety, depression, ADHD, sleep problems and irritability that often arise or intensify in adolescence. We coordinate with schools on IEPs and 504 plans, involve parents, and plan for the transition to adult services, which is a common gap in care. Teens who were diagnosed young and those being evaluated for the first time are both welcome.
What accommodations can an autism diagnosis provide?
At work, the ADA entitles you to reasonable accommodations such as written instructions, a quieter workspace, noise-cancelling headphones, flexible scheduling or remote work. In college, disability services can provide extended time, reduced-distraction testing, note-taking support and housing accommodations. We provide the documentation these require. A diagnosis can also open access to vocational rehabilitation services and, for some adults, Medicaid waiver programs.
Where to get treatment for autism spectrum disorder
Evaluation and treatment for autism spectrum disorder is available at every Stedfast Psychiatry office and by video across Florida and South Carolina.
Related conditions
If you are thinking about harming yourself, call or text 988 now, or go to the nearest emergency room. This page is educational and does not replace an evaluation. Clinical content reviewed by Dr. David Husted, board-certified psychiatrist.