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The Conundrum: Could it be autism? 

Have you ever thought that a seemingly functioning adult, who you know, might have autism?

You might have come to that conclusion based on seeing atypical communication, preferences, and behaviour (i.e. – Avoiding eye contact, being especially direct/abrupt, preferring e-mail to verbal conversations, and stimming). 

Thinking of talking with that individual about your speculation? There’s no definitive right or wrong way to do this. It’s a conundrum. You probably have good intentions and would like to help but is it your place? Knowing about his/her autism could cause him/her to get treatment that could be of assistance but you worry about how they’ll react. Before talking having such a personal discussion, ask yourself the following questions:

• How well do you know the individual and how helpful would it be?

• Would it cause too much pain or confusion?

• Do I think that that person would like to and should know this information? 

• What does that person think about autism, disabilities, labels, and stigma?

Be thoughtful and have empathy
It might be more appropriate, albeit possibly more painful, for a person with a closer relationship (i.e. – parent, spouse, sibling, child, very close friend) than a mere acquaintance or a colleague to have this conversation. People who are not close and/or who do not have a helping/advising relationship (i.e. – counselor or therapist) might not say anything. 

If you choose to have this conversation, be very mindful in your approach. It is possible that he/she has always felt different but does not think of himself/herself as having a disability. They could be offended by you bringing up autism in relation to him/her and could get defensive. In addition, realize the potential ramifications of a late diagnosis of autism. It might bring relief and understanding why his/her life has been the way it has. On the other hand, it could spark anger or a sense of being overwhelmed with the plethora of information about autism and systems of support 

Tips that you might find helpful
Consider how you would feel if someone wanted to have such a sensitive conversation with you. How would you like that person to approach that discussion? Treat others like you would want to be treated. 

Practicing with a close confidant and/or by yourself before you raise the subject could be a good idea. As would soliciting the help/advice of a trusted health professional. As well: 

• Be sure to be in a private area (i.e. – an office with the door closed). Do not initiate the conversation in a public area. 

• Prepare the person by saying you have something particularly sensitive to discuss. ( Do not just begin by saying, “I think you might have autism.”) Then, depending on how the person replies, say what you would like to say about autism.

• Discuss your knowledge/background on autism. This information, especially if it relates to direct personal experience (such as relative or close friend with autism), could be compelling as it would indicate that you do not randomly have this thought. However, recognize that autism manifests itself differently in people.

• Talk about autism as an increasingly prevalent intellectual and development disability that is marked by atypical communication and repetitive behavior. The person might not have a good understanding and think of autism as low-functioning. 

• Discuss pros and cons of a formal diagnosis. You can say that a diagnosis which may be thankful is critical for receiving useful treatment. However, be wary of mentioning treatment, as a person might be repelled by the suggestion of treatment and/or therapy. You can note that an evaluation can cost thousands of dollars. 

• List strengths. This will help to destigmatize autism and make the person less negative about the condition.

• Discuss famous people who have autism and say how their autism has helped them. A great example is Greta Thunberg. If she did not have autism, she very well might not have the courage to be so outspoken and influential about the world’s environment problems. Famous individuals could be inspirations as they prove people with autism can succeed.). 

• Pause/end the conversation at any time. Realize that this discussion could be difficult. If you choose this option, apologize and say that you were just trying to help. In addition, if appropriate, you could say that you would be happy to resume the conversation if he/she would like.

• Suggest expert help and resources. Offer to share autism related resources if the person agrees.

• Offer to share autism-related resources. Only provide resources if the other person agrees.
Helpful autism-specific resources include:

– Association for Autism and Neurodiversity (https://aane.org/

– Autism criteria of the DSM-5 (provided by Autism Speaks, which received permission of the American Psychiatric Association) (https://www.autismspeaks.org/autism-diagnosis-criteria-dsm-5)

– Autism Society (https://autismsociety.org/) 

– “The 9 Biggest Signs Of Autism In Adulthood” article (https://www.huffpost.com/entry/autism-signs-in-adult_l_6467cb11e4b0355739361c2b

– Books, magazines, articles, blogs, podcasts, movies, television shows, other organizations, and/or support groups about autism (The best type might partly be what the individual would be the most receptive to. As social workers have been trained to believe, the client is the expert about himself/herself.)

– Autism tests that people can self-administer online

Recognize this may be backfire
Everyone’s autism experience is different. They may feel badly that he/she could have autism but not have any of the associated strengths. They might feel terrible that autism has limited him/her, and hearing about famous people with autism might exacerbate those feelings. 

Know that there is no real right or wrong answer. Think carefully. Get advice and above all, tread lightly. Always be careful with what you say and how you say it. 

Miriam Edelman, MPA, MSSW

Disclaimer: The low-functioning functioning label is problematic, but it is used here for ease of comprehension. References available on request.

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