As a therapist I was puzzled when some of my most hard working clients continued to struggle with their interpersonal relationships and emotion regulation. They would do their own research online, listen to podcasts, and read self-help books between therapy sessions. Not only were they attending individual therapy, but they would also be attending couples counseling, group therapy, and at times taking medication. Why despite all their efforts were they not meeting the goals they had for themselves?

Suddenly a light blub went off! Maybe they are neurodivergent.

We revisited my clients’ childhood experiences and we were able to see that their interpersonal difficulties pre-dated their trauma.

In addition, they had many sensory issues which could not be fully explained by trauma alone. Many had considered themselves to be a “highly sensitive person.” They would feel emotions that others around them experienced and were highly empathetic. If someone has empathy for others that surely that would be a rule out for autism right? (Wrong!!)

Often clients had a family member who was formally diagnosed as autistic but never considered this for themselves.

There is the false belief that if you are autistic you would have been identified by now. The image that comes to mind when we think of an autistic adult is Sheldon Cooper from Big Bang Theory or Dustin Hoffman in Rain Main. This is a narrow view of how autism looks. One reason for this limited view is that the diagnostic criteria and tests administered today were developed on boys. The traits in adults varies from those of children which means that many adults go undiagnosed. Adult women, nonbinary, gay, and transgender people are especially likely go undiagnosed.

Autism Check List

Samantha Craft developed this check list to help women explore an autism diagnosis (author Everyday Aspergers: A Journey on the Autism Spectrum.) I have altered the language to make it more gender inclusive. This checklist is not research based and not meant to replace formal testing rather it is a starting off point. There are many diagnoses with overlapping symptoms, and it can be helpful to meet with a therapist to help tease apart diagnoses.

Check all areas that fit with your experience. If each area has many statements checked, then it is worth exploring autism further with a therapist. Even if you think you have tons of self-awareness, It may be helpful to have someone who knows you well to look over the list with you as you may not have a fully accurate picture of yourself. You may have some areas with a lot of checks while there will be few checks in others. There is no cut off score to receive a diagnosis as this checklist is meant to help with self exploration. It can also be helpful to go over this list with your therapist to see their perspective.

Section A: Deep Thinkers

A deep thinker.
A prolific writer drawn to poetry.
Highly intelligent (This does not relate to IQ levels. Autistic individuals can have learning disabilities but can be highly intelligent about particular subject matters, and have an out-of-the-box thinking).
Sees things at multiple levels, including their own thinking processes.
Analyzes existence, the meaning of life, and everything, continually.
Questions place in the world.
Serious and matter-of-fact in nature.
Doesn’t simplify, everything is complex.
Often gets lost in own thoughts and “checks out” (blank stare). This can also be confused with dissociation.

Section B: Innocent

Naïve.
Causes significant discomfort when lying or not being 100% honest.
Finds it difficult to understand manipulation and disloyalty.
Finds it difficult to understand vindictive behavior and retaliation.
Easily fooled and conned.
Big feelings and/or often feels overwhelmed.
Feelings of not fitting.
Feelings of isolation – feels alone even with people.

Section C: Escape and Friendship

Survives overwhelming emotions and senses by escaping in thought or action.
Escapes regularly through fixations, obsessions, and over-interest in subjects.
Escapes routinely through imagination, fantasy, and daydreaming.
Escapes through mental processing.
Philosophizes continually.
Over analyzes interpersonal situations continually.
Had imaginary friends in youth.
Mimicking people on television or in movies (mannerisms, words, dialog).
Treated friends as “pawns” in youth; e.g., friends were “students” “consumers” “members.”
Makes friends with older or younger females more so than friends their age (often in young adulthood).
If you grew up as a cisgender female, feels more connected to men than women. When younger had mostly male friends.
Imitates friends or peers in style, dress, attitude, interests, and manner (sometimes speech).
Obsessively collects and organizes objects.
Escapes by playing the same music, reading the same book or watching the same thing over and over.
Escapes through a relationship (imagined or real).
Numbers bring ease (could be numbers associated with patterns, calculations, lists, time and/or personification).
Escapes through counting, categorizing, organizing, rearranging.
Escapes into other rooms at parties.
Cannot relax or rest without many thoughts.
Everything has a purpose.

Section D: Additional Attributes

Generalized Anxiety.
Traits of Obsessive Compulsive Disorder.
Sense of pending danger or doom.
Feelings of polar extremes – not much of a middle ground with emotions (depressed/over-joyed; inconsiderate/over-sensitive).
Poor muscle tone, double-jointed, and/or lack in coordination, often drops small objects. May have Ehlers Danlos Syndrome, Hypotonia, POTS syndrome).
Eating disorders, food obsessions, and/or worry about what is eaten.
Irritable bowel and/or intestinal issues.
Chronic fatigue and/or immune challenges.
Experiences multiple physical symptoms, perhaps labeled “hypochondriac.”
Searches for right and wrong.
Since puberty has had bouts of depression (may have PMDD).

Section E: Social Interaction

social interaction when you're autistic.

Friends (or you) have ended the friendship suddenly. You may feel confused about why they ended the relationship.
Difficult time making friends.
Feels more connected to animals than to people.
Tendency to overshare.
You may later feel embarrassed about telling a stranger more details than you meant to.
Highly suspicious of others’ motives when they try to connect with you.
Raised hand too much in class or didn’t participate in class.
Had more instances where you spoke impulsively when you were younger compared to your peers.
Eager to talk about yourself or your interests. You don’t always give space for the other person to interject or contribute.
Brings subject back to self in a conversation.
Comes across at times as narcissistic and controlling (is not narcissistic).
Often sounds eager and over-zealous or apathetic and disinterested.
Holds a lot of thoughts, ideas, and feelings inside.
Feels as if they is attempting to communicate “correctly.”
Obsesses about the potentiality of a relationship with someone, particularly a love interest or feasible new friendship.
Confused by the rules of accurate eye contact, tone of voice, proximity of body, body stance, and posture in conversation.
Conversation are often exhausting.
Questions the actions and behaviors of self and others, continually.
Feels as if missing a conversation “gene.”
Does not have a thought-filter.
Trained self in social interactions through readings and studying of other people.
Visualizes and practices how they will act around others.
Practices/rehearses in mind what they will say to another before entering the room.
Difficulty filtering out background noise when talking to others.
Has a continuous dialogue in mind that tells you what to say and how to act when in a social situation.
Sense of humor sometimes seems quirky, odd, inappropriate, or different from others.
As a child it was hard to know when it was your turn to talk.
Finds norms of conversation confusing.
Finds unwritten and unspoken rules difficult to grasp, remember, and apply.
As a child able to play alone or entertain themselves for long periods of time.

Section F: Finds Refuge When Alone

Feels extreme relief when they don’t have to go anywhere, talk to anyone, answer calls, or leave the house but at the same time will often harbor guilt for “hibernating” and not doing “what everyone else is doing.”
One visitor at the home may be perceived as a threat (this can even be a familiar family member).
Knowing logically a house visitor is not a threat, but that doesn’t relieve the anxiety
Feelings of dread about upcoming events and appointments on the calendar.
Knowing they have to leave the house causes anxiety from the moment they wake up.
All the steps involved in leaving the house are overwhelming and exhausting to think about.
They prepare mentally for outings, excursions, meetings, and appointments, often days before a scheduled event.
OCD tendencies when it comes to concepts of time, being on time, tracking time, recording time, and managing time (could be carried over to money, as well).
Questions next steps and movements, continually.
Sometimes feels as if they are on stage being watched and/or a sense of always having to act out the “right” steps, even when they are home alone.
Telling self the “right” words and/or positive self-talk (CBT) doesn’t typically alleviate anxiety. CBT may cause increased feelings of inadequacy.
Knowing they are staying home all day brings great peace of mind.
Requires a large amount of down time or alone time.
Feels guilty after spending a lot of time on a special interest.
Uncomfortable in public locker rooms, bathrooms, and/or dressing rooms.
Dislikes being in a crowded mall, crowded gym, and/or crowded theater.

Section G: Sensitive

Sensory sensitivity.
Sound – bothered by loud noises– will cover ears to block out loud sounds.
Touch - tags in clothes bother, seams in socks have to be just right, particular about fabrics in general, being comfortable is the most important consideration when it comes to clothes.
Dislikes being touched/hugged or likes deep pressure from a weighted blanket/feeling tucked in.
Smells – over sensitive. Gets migraines due to strong smells.
Taste - picky eater, disgusted by the texture of some food, cannot have food touching.
Sight - too much visual input can feel overwhelming. Fluorescent lighting can feel distressing.
Flicks/rubs fingernails, picks scalp/skin, flaps hands, rubs hands together, tucks hands under or between legs, keeps closed fists, paces in circles, and/or clears throat often.
Sensitive to sounds, textures, temperature, and/or smells when trying to sleep.
Adjusts bedclothes, bedding, and/or environment in an attempt to find comfort.
Dreams contain a lot of emotional content. They can experience more emotional range in their dreams than they do in real life. They are often vivid, complex. Dreams of things outside of her awareness.
Highly intuitive to others’ feelings.
Highly empathetic, sometimes to the point of confusion.
Takes criticism to heart.
Questions if they is a “normal” person.
Highly susceptible to outsiders’ viewpoints and opinions.
At times adapts their view of life or actions based on others’ opinions or words.
Recognizes own limitations in many areas daily, if not hourly.
Becomes hurt when others question or doubt their work.
Views many things as an extension of self.
Fears others opinions, criticism, and judgment.
Dislikes words and events that hurt animals and people.
Collects or rescues animals (often in childhood).
Huge compassion for suffering (sometimes for inanimate objects/personification).
Sensitive to substances (environmental toxins, foods, alcohol, medication, hormones, etc.)
Tries to help, offers unsolicited advice, or formalizes plans of action.
Questions life purpose and how to be a “better” person or understand themselves and grow.

Section H: Sense of Self

Feels trapped between wanting to be themselves and wanting to fit in.
Imitates others without realizing it.
Exhibits codependent behaviors (often in young adulthood).
Adapts self in order to avoid ridicule.
Rejects social norms and/or questions social norms.
Feeling good about self takes a lot of effort and work.
Switches preferences or behaviors based on environment and other people.
Did not care about hygiene, clothes, and appearance before teenage years and/or before someone else pointed these out.
“Freaks out” but doesn’t know why until later.
Youthful sounding voice. People assume they are younger than they are.
Trouble recognizing what others looks like and/or has occurrences or difficulty recognizing or remembering faces.
Feels significantly younger on the inside than on the outside (does not view themselves as an adult).

Section I: Confusion

Had a hard time learning that others are not always honest.
Feelings seem confusing, illogical, and unpredictable.
Confuses appointment times, numbers, and/or dates.
Expects that by acting a certain way certain results can be achieved, but realizes in dealing with emotions, those results don’t always manifest.
Spoke frankly and literally in youth.
Jokes go over their head.
Confused when others ostracize, shun, belittle, trick, and betray.
Trouble identifying feelings unless they are extreme.
Feels hate and dislike intensely. Uncomfortable with the level of intensity.
Feels sorry for someone who has persecuted or hurt them.
Personal feelings of anger, outrage, deep love, fear, giddiness, and anticipation seem to be easier to identify than emotions of joy, satisfaction, calmness, and serenity.
Difficulty recognizing how extreme emotions (outrage, deep love) will affect them and challenges transferring what has been learned about emotions from one situation to the next.
Situations and conversations sometimes perceived as all or nothing.
The middle spectrum of outcomes, events, and emotions is sometimes overlooked or misunderstood (all or nothing mentality).
A small fight might signal the end of a relationship or collapse of world.
A small compliment might boost them into a state of bliss.

Section J: Words, Numbers, and Patterns

Likes to know word origins and/or origin of historical facts/root cause and foundation.
Confused when there is more than one meaning (or spelling) to a word.
High interest in songs and song lyrics.
Notices patterns frequently.
Remembers things in visual pictures.
Remembers exact details about someone’s life.
Has a remarkable memory for certain details.
Writes or creates to relieve anxiety.
Has certain “feelings” or emotions towards words and/or numbers.
Words and/or numbers bring a sense of comfort and peace, akin to a friendship.

Section K: Executive Functioning & Motor Skills

Simple tasks can cause extreme hardship.
Learning to drive a car or rounding the corner in a hallway can be troublesome.
New places offer their own set of challenges.
Anything that requires several steps, dexterity, or tasks requiring experience may be anxiety provoking.
The thought of repairing, fixing, or locating something can cause anxiety.
Cleaning self and home may seem insurmountable.
Many questions come to mind when setting about to do a task.
Might leave the house with mismatched socks, shirt buttoned incorrectly.
Have dyslexia and/or dysgraphia.
A trip to the grocery store can be overwhelming.
Trouble copying dance steps, aerobic moves, or direction in a sports gym class.
Has a hard time finding certain objects in the house but remembers with exact clarity where other objects are; not being able to locate something or thinking about locating something can cause feelings of intense anxiety (object permanence challenges), even with something as simple as opening an envelope.

While this checklist is not research based is it a good starting off point to explore with a therapist. There is formal testing that you can obtain to receive an “official” diagnosis. However, it is often challenging to find a therapist that is up to date on current research in testing adults for autism. Most tests are normed on boys which can lead women, nonbinary, and trans clients to not receive a diagnosis. At times, it can be additionally challenging to receive a diagnosis if you are gifted as well.

I do believe that self diagnosis is valid and one does not have to have formal testing done to claim this identity. However, there are many overlapping diagnosis that can be tricky to tease apart so it can be helpful to have a neurodivergent affirming therapist to help you sort out what is going on for you and how to get you where you want to be. Feel free to contact me if you want a free consultation to see how I may help you put the pieces together.

Do not give up hope to find answers.

Dr. Christine Henry is a neurodivergent licensed psychologist specializing in trauma, grief, highly sensitive people, ADHD, adult autism, and religious trauma.

Unexpected Traits of Autism