How is Autism Diagnosed?

Since there is no definitive way to diagnose ASD, and no standards for diagnosis after childhood, the ways that people are evaluated later in life varies by provider. Though many states have laws requiring health insurance cover ASD testing and treatment, most have age limits on the requirements, and there are no federal mandates beyond Medicaid coverage. Due to this lack of standards, as well as a plethora of misinformation, many providers refuse to diagnose ASD past a certain age, such as 5 or 10.

Practically speaking, all of these factors combined mean that individuals missed in early childhood face an uphill battle to receive any assistance. Insurance requires an official diagnosis before covering any treatment, while often not providing an opportunity to get the diagnosis. It can be especially difficult for individuals with atypical presentation or low support needs to gain a diagnosis for a variety of reasons - they may be misdiagnosed, unable to afford the evaluation, unable to find a provider that will give the evaluation, et cetera. Additionally, the tests that are used are largely looking for signs that are observed in typical 'male' development, which presents differently than those with 'female' development. The tendency to 'mask', or adapt to disguise autistic traits, is much more prominent in those that experience 'female' development. Combine that with the nature for literal interpretation, existing tests can return negative results for autists that have developed these abilities through conscious effort.