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Am I Too Old for an Autism Diagnosis? Working with older autistic clients.

Key points:

Why getting diagnosed as autistic at any age can be life-transforming


People are increasingly being diagnosed with autism in adulthood


Older adults sometimes question whether it is worthwhile seeking out a diagnosis


An autism diagnosis later in life can help people gain awareness about their past


An autism diagnosis later in life can help people identify their autistic needs and change their behaviours to meet their needs


I work with clients from their late teens into their late seventies. One question some of my older clients ask, particularly those over the age of sixty, is whether there’s any point in accessing an autism diagnosis at their age. After all, they’ve already lived an entire life without knowing.

The reality is, living with undiagnosed autism is challenging. Most undiagnosed autistic adults, particularly older adults who grew up in an era of ignorance and lack of acceptance around autism, camouflage their autistic traits heavily.

Older autistic women
Adult autism therapy

Camouflaging, or masking, involves hiding the traits that are most likely to reveal you as autistic and hiding the levels of anxiety and discomfort you experience in social situations and as the result of sensory or emotional overwhelm. Camouflaging is linked with mental health issues, including anxiety, depression and suicidality1. Whilst these older adults have got through life, it’s often been tough to do so.

Receiving a diagnosis offers the potential of a life where you recognise and respect your needs as different and valid. It allows you to re-evaluate past experiences, which might include being bullied and ostracised for being different, which is so commonly experienced by autistic people2. And it allows you to access the correct type of support from friends, colleagues and in therapy.

Some of my clients who have received a diagnosis later in life have shared the impact of their diagnosis with me.

Mandy, 62, told me, “I have truly never felt the way I do now. It’s as if I’ve been waiting all my life for something and now I have it. It’s down to feeling validated and understanding all these parts of my past which have been a mystery up until now”.

Sarah, 74, described the change in her life since being diagnosed as autistic. “I don’t really have the words to describe how the diagnosis has changed my life. It’s everything. I can breathe easier. I’m kinder to myself. I’ve stopped putting myself out there all the time for my adult children and I take time for my interests. I feel like I can make this phase of my life one of the best”.

Anthea, 76, told me, “I didn’t tell a soul I was going for a diagnosis. I was terrified about the whole process. I thought people would think I was ridiculous at my age. I thought I was ridiculous! But knowing I’m autistic is the single best thing I’ve ever done. I’m finally learning to be kind to myself. To accept myself. And that’s huge, after a whole lifetime of thinking I’m a failure”.

A diagnosis at any stage in life doesn’t always provide what autistic people might expect, particularly concerning accessing post-diagnostic support, including therapy. In addition, accessing a diagnosis isn’t always easy. But, as my clients’ experience above reveals, it creates a significant shift in perspective, which leads to self-awareness and supportive changes in behaviour. If the question holding your client back is, "Am I Too Old for an Autism Diagnosis?", you can help them explore what they would benefit from a diagnosis and what their concerns are about seeking out a diagnosis.

If you are a therapist who is used to seeing older clients, it's very likely that you've worked with autistic clients even if both you and they have been unaware of it. Particularly in the case of adult female clients, it's often the case that they have gone through their lives being under or misdiagnosed. Perhaps you've found yourself working with older autistic clients who haven't engaged well with therapy. Without being aware of their autism, you might have wondered why there are aspects of therapy which haven't met their needs. Being able to discuss the potential benefits of being diagnosed as an older adult, in addition to being able to explore the types of issues which might come up as the result of increasing awareness could be an important part of your client work as older adults are increasingly exploring the possibility of being autistic.


Are you an older person who’s questioning whether they might be autistic? If age is the factor stopping you from seeking a diagnosis, don’t let it.1. Beck, J. S., Lundwall, R. A., Gabrielsen, T., Cox, J. C., & South, M. (2020). Looking good but feeling bad: “Camouflaging” behaviors and mental health in women with autistic traits. Autism, 24(4), 809-821.

2. Neil Humphrey & Judith Hebron (2015) Bullying of children and adolescents with autism spectrum conditions: a ‘state of the field’ review, International Journal of Inclusive Education, 19:8, 845-862, DOI: 10.1080/13603116.2014.981602

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