Autism is often misunderstood, especially in adults who were never diagnosed as children. Many psychologists simply don’t have the right training to recognize autism in adults, particularly in women and those with low support needs. This lack of awareness makes it frustratingly difficult for many people to get an accurate diagnosis.

In this article, we’ll explore why so many psychologists struggle to diagnose adult autism, what this means for those seeking answers, and how to find the right professional for an evaluation.

The Lack of Autism Training in Psychology Programs

One of the biggest reasons why so many psychologists don’t diagnose adult autism is that their training programs don’t prepare them for it.

Most psychology students take just one general class on abnormal psychology. In that entire course, autism may be covered for only a single session—and usually, the focus is on children with high support needs. Adults with autism, especially those who mask their symptoms, are rarely discussed.

Even after graduation, many psychologists continue to rely on outdated information, especially if they were trained decades ago. Unless they make an effort to stay updated on autism research, their understanding of the condition may remain stuck in the past.

Limited Hands-On Experience with Adult Autism

Psychologists gain real-world experience through practicum placements and internships, but these often focus on traditional therapy, testing, or working in hospitals, schools, or clinics. While they may encounter autistic individuals in these settings, most training is centered on children with significant support needs.

For someone pursuing a Ph.D. in psychology (which is usually required to diagnose adult autism), training experiences vary widely. Some may have little to no direct exposure to autistic adults with low support needs.

For psychiatrists, the situation is even worse. Autism is barely covered in their medical training, which means that many mental health professionals lack the experience to properly assess adults for autism.

Outdated Language and Misconceptions About Autism

Another issue is that many professionals still use outdated terms and ideas about autism.

The autistic community has moved away from terms like:

Asperger’s Syndrome (now included under Autism Spectrum Disorder)
High-functioning and low-functioning (which oversimplifies autism)
“A little autistic” (autism isn’t a sliding scale of “more” or “less”)

However, many psychologists still use these outdated terms simply because they were never educated on the preferred language and evolving understanding of autism.

In addition, some therapists and doctors refuse to test for autism based on incorrect assumptions. They may say things like:

“You can’t be autistic because you make eye contact.”
“You have friends, so you’re not autistic.”
“You’re an adult, so you don’t need a diagnosis.”

These ideas are completely false and show a deep misunderstanding of how autism presents in adults. Many autistic adults have learned to mask their traits to fit in, which makes it even harder for professionals who don’t specialize in adult autism to recognize the signs.

The Problem with Standard Autism Tests

Even if a psychologist offers autism assessments, they may rely on tests that were designed for children. Many commonly used screening tools under-identify adults or aren’t appropriate for assessing autism in those who have learned to mask.

Diagnosing autism isn’t as simple as a right-or-wrong test. It requires clinical judgment, understanding of social nuances, and awareness of sensory issues—all of which many professionals lack experience with.

Why Finding the Right Psychologist Matters

Because of these issues, your experience with autism assessment can vary drastically depending on the psychologist you see.

Some professionals may be overly skeptical or dismissive. Others may believe they can diagnose autism simply by using a checklist, even if they lack real-world experience with autistic adults.

The best way to ensure a proper evaluation is to find a psychologist who specializes in diagnosing adult autism.

How to Choose the Right Psychologist for an Autism Evaluation

If you’re seeking an autism diagnosis, here are some key things to look for in a provider:

Experience with adult autism – Not all psychologists are trained to diagnose adults. Look for someone who has specific experience in this area.
Familiarity with autism in women and low support needs – Many professionals only recognize classic autism traits seen in young boys, which can lead to missed diagnoses in adults.
Updated knowledge and terminology – Avoid psychologists who use outdated terms like Asperger’s or high/low functioning.
Understanding of masking and social adaptation – Autistic adults often learn to hide their traits, and a skilled psychologist will recognize this.

It may take some time to find the right professional, but it’s worth it to get an accurate diagnosis from someone who truly understands autism in adults.

FAQs

1. Why do so many psychologists struggle to diagnose adult autism?

Most psychology programs provide minimal training on autism, and what they do teach is often focused on children. Many professionals simply don’t have the experience needed to recognize autism in adults.

2. Why do some doctors refuse to test for autism in adults?

Some therapists and doctors base their understanding of autism on outdated stereotypes. They may not recognize the ways that autistic adults mask their traits to fit in, leading them to dismiss valid concerns.

3. What should I do if a psychologist says I don’t have autism, but I believe I do?

If you feel strongly that you may be autistic but were dismissed by a psychologist, consider seeking a second opinion. Not all professionals are knowledgeable about adult autism, and it’s important to find someone who specializes in it.

4. What’s the best way to find a psychologist who diagnoses adult autism?

Look for a psychologist with specific experience diagnosing autism in adults, especially those who understand how autism presents in women and individuals with low support needs. Reading reviews and checking their credentials can also help.

Conclusion

Getting diagnosed with autism as an adult can be a challenging process, largely because many psychologists aren’t properly trained in recognizing it. However, finding the right provider—one with experience and up-to-date knowledge—can make all the difference.

If you suspect you may be autistic, don’t let outdated information or uninformed professionals discourage you. Keep searching for a specialist who understands adult autism and can provide a thorough, accurate evaluation.

Need an Autism Evaluation?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.