You are thirty-eight and have spent your whole life feeling that everyone else was handed a manual you never got. Group dinners drain you even when you have enjoyed them, hints go straight past you, your routines have barely changed in years and there are subjects you could talk about for hours. One day you read about Asperger's in adults and, for the first time, a lot of pieces fall into place.

It is not unusual. More and more people come across the word in adulthood, often after years of diagnoses that never quite explained what was going on. This guide covers what happened to the Asperger's diagnosis, how it shows up in adults, why so many people find out late and which test can guide you before you ask for an assessment.

What Asperger syndrome was, and what it is today

Asperger syndrome takes its name from Hans Asperger, a Viennese paediatrician who in 1938 described a group of children with very distinctive psychological characteristics, a few years before Leo Kanner's famous 1943 paper on autism. His most complete study appeared in 1944, but it only gained international recognition in the 1980s, which is when the label started to spread.

For years, diagnostic manuals used it to describe autistic people without language delay or intellectual disability. That changed in 2013. Since the DSM-5, Asperger's has been part of autism spectrum disorder (ASD), which the manual grades into three levels according to the support each person needs, and the WHO classification (ICD-11) has also folded it into the spectrum. As MedlinePlus, the health information service of the US National Library of Medicine, puts it, autism spectrum disorder includes what used to be known as Asperger syndrome.

In practice, an adult who would have been diagnosed with Asperger's in the 1990s is now diagnosed with autism, usually without intellectual disability. It is not something different: it is the same reality under another name.

Why the term is used less and less

There are two reasons. The first is that change in classification. The second has to do with Asperger himself. A study by the historian Herwig Czech, published in 2018 and based on archival documents, concluded that he accommodated himself to the Nazi regime, publicly legitimised its "race hygiene" policies, including forced sterilisations, and on several occasions actively cooperated with the child "euthanasia" programme. That is why many autistic people and many professionals prefer to talk simply about autism. Anyone who was given an Asperger's diagnosis at the time and identifies with it is, of course, free to keep using it.

Signs of Asperger's in adults

The NHS explains that the signs of autism in adults are similar to those in childhood, although many people have learned to adapt and they are not always noticeable. These are the most common.

In communication and relationships

  • You find it hard to talk to other people.
  • You spend more time alone than with other people.
  • You find it difficult to read facial expressions, gestures or tone of voice.
  • You take things literally and struggle with figures of speech and irony.
  • Making friends or keeping a romantic relationship has been harder for you than for others.

In routines and interests

  • You have fixed ways of doing things and changes to your routine upset you a lot.
  • Some subjects interest you intensely, to the point of spending hours on them.
  • You repeat certain movements that calm you, such as rocking or moving your hands or fingers.
Man carefully looking through the index cards in a filing drawer, a reflection of intense interests and an eye for detail

In the senses

The NHS also includes sensory differences: being very sensitive, or not sensitive at all, to light, sounds, smells, tastes or textures. A noisy restaurant or a shopping centre can overwhelm you long before it overwhelms the people with you. If sensitivity is what you recognise most, compare it with Highly sensitive person: what the evidence says and what may lie underneath as well.

The cost of masking

One of the keys to Asperger's in adults is masking: learning to copy what others do so as to blend in. According to the NHS, masking like this makes everyday life and relationships feel exhausting and stressful. It is more common in women, who tend to copy other people's behaviour, appear to cope well in social situations and show fewer repetitive behaviours, although men mask too. That is why, as the NHS acknowledges, the signs can be harder to see in women.

Why so many adults find out late that they have Asperger's

A late diagnosis is very common. The World Health Organization estimates that in 2021 around 1 in 127 people were autistic, and it points out that although the characteristics can be detected in early childhood, autism is often not diagnosed until much later.

The researchers Meng-Chuan Lai and Simon Baron-Cohen, of the Autism Research Centre at the University of Cambridge, wrote in 2015 about a lost generation: adults who were left out of classic autism diagnoses before the criteria were broadened and the idea of a spectrum appeared. Diagnosing an adult also has its own difficulties: sometimes there is nobody who can describe what the person was like as a child, the person has developed camouflaging strategies, and other conditions often cover up the picture. The authors warn that misdiagnosis is particularly likely in women.

The NHS confirms this from the other side: the signs are harder to see when there is anxiety, depression, an eating disorder or ADHD. It is not unusual to reach autism after years of treatment for one of those. If you want the bigger picture, we cover it in Neurodivergence in adults: what it means, signs and where to start.

What Asperger's is mistaken for in adulthood

Lai and Baron-Cohen note that, when assessing an adult, particular attention must be paid to anxiety, depression, obsessive-compulsive disorder and personality disorders, because they can look like autism or come on top of it. Two cases are worth looking at closely:

  • ADHD. The NHS points out that it is more common in autistic people, and the two can occur together. If, on top of everything above, you recognise yourself in the absent-mindedness and impulsiveness, the ADHD Test will help you see it.
  • Social anxiety. From the outside they look alike, because in both cases social situations are avoided. The difference lies in the reason: in social anxiety, the fear of being judged is in charge; in autism, the difficulty lies in social communication itself. They can also coexist, and the Social Anxiety Test helps tell them apart.

How to find out if it is Asperger's: the test and the diagnosis

An Asperger's test and an autism test assess exactly the same thing, because today they are the same diagnosis. The MyPsicoTest Autism (ASD) Test has 20 questions about what you have been like throughout your whole life, not just the last few months, and takes about six minutes. It measures three dimensions: social communication and interaction, sensory sensitivity and routines, interests and flexibility. It is inspired by the domains of two of the screening questionnaires most widely used with adults, the AQ and the RAADS-R scale, whose full name, incidentally, still includes the word Asperger. The result gives you an overall score and a score for each dimension.

A test does not diagnose. If your score is high, the next step is an autism assessment for adults with an experienced professional. According to Lai and Baron-Cohen, the process includes screening, interviews with you and, if possible, with someone who has known you since childhood, and an assessment of how you function day to day. The NHS advises starting with your GP.

Is it worth it at this stage? For many people, yes. The NHS points out that autism is not an illness and is not "cured", but there are ways of managing it and getting support, and the WHO notes that evidence-based psychosocial interventions can improve social communication and well-being. Putting a name to what is happening to you also helps you stop blaming yourself for what you find hard. The rest of the questionnaires are in the psychological tests catalogue.

If your result worries you or you want a professional assessment, you can talk to Xènia Capel Salcedo, a licensed psychologist (COPC reg. 14982), who offers a free first consultation call and online therapy from anywhere.

MyPsicoTest team · Updated: