Autistic traits in adults: what they mean and when they are more

You leave parties early because conversation takes more out of you than it seems to take out of others. You like fixed routines, and when a plan changes at short notice it takes you a while to readjust. A topic can hold you for weeks until you have read everything about it. At some point someone says, half joking, that you have autistic traits, and the remark stays with you: what does that mean, and does it mean anything?

What autistic traits are

The phrase describes characteristics that also occur in autism, only on their own or in a milder form: finding small talk hard work, preferring routines, very absorbing interests, unusual sensitivity to noise, light or touch. In the population these characteristics are not simply present or absent. They are spread continuously: most people have a few of them to a small degree, some have more, and a few have a great many. A large twin study in the United States showed this (Constantino & Todd, 2003), and a Swedish twin study found that the upper end of this spread and a diagnosis of autism share largely the same hereditary influences (Lundström et al., 2012).

Autistic traits are therefore not a label you either have or do not have. They describe where you sit on a scale on which everyone sits somewhere.

Traits are not the same as a diagnosis

For a diagnosis of autism spectrum disorder (6A02), the WHO's ICD-11 requires more than the presence of such characteristics. The difficulties with social communication and the restricted, repetitive patterns of behaviour have to be persistent, have to have begun during development, and have to be marked enough to cause significant impairment in personal, family, social, educational or occupational life. Some people compensate for a long time with great effort, so the impairment only shows when demands increase.

Three questions help to separate traits from a possible diagnosis:

• How many areas are affected? A liking for routine on its own is different from routine, social exhaustion and sensory sensitivity together.
• Since when? Autistic characteristics are present from childhood, even if nobody noticed them at the time. Something that only begins after a crisis or an illness often has a different cause.
• What does it cost you? The question is not whether something is hard for you, but whether it noticeably limits your life or can only be managed at the price of constant exhaustion.

How autistic traits can show in everyday life

Adults who are looking into the question often describe the following. Single points say little, because many people without autism recognise them too. The pattern is what matters.

• Small talk costs you more energy than a technical discussion, and after meeting people you need time alone.
• You sometimes only understand irony, hints or unspoken expectations afterwards.
• You have worked out rules for conversation, such as when to make eye contact or how long to talk about yourself.
• Fixed routines make you feel secure, and last-minute changes throw you off.
• Your interests are deep and lasting, and you enjoy talking about them at length.
• Certain noises, bright light, smells or clothing labels bother you more than they bother others.

If sensory overload is the main issue, the article autism or highly sensitive sets out where the two differ. How autism can look in women in particular is covered in autism in adult women.

What questionnaires on autistic traits measure

The best known questionnaire is the Autism-Spectrum Quotient (AQ), with 50 statements. In the original study around 80 per cent of autistic adults scored 32 or more, compared with around 2 per cent of the comparison group (Baron-Cohen et al., 2001). A review covering almost 7,000 adults without a diagnosis found an average of about 17 points, slightly higher in men than in women (Ruzich et al., 2015).

A high score is a reason to look more closely, not a diagnosis. A low score does not rule autism out, particularly in people who compensate a great deal. What a screening measures and how it differs from a clinical assessment is explained in our guide to autism tests for adults.

Autistic traits in the family

Research finds milder autistic characteristics more often in the parents and siblings of autistic people than in the rest of the population, for example a preference for routine or reserve in social contact. This is known as the broader autism phenotype (Sucksmith et al., 2011). If your child or a sibling has been diagnosed and you recognise yourself in parts of the description, that is not unusual. It does not automatically mean that a diagnosis applies to you as well.

When an assessment makes sense

A professional assessment is most worthwhile when the characteristics affect several areas, have been there since childhood and are a noticeable burden: at work, in relationships or through ongoing exhaustion after social situations. Overload that does not improve with a holiday is also a reason to take the question seriously. If, on the other hand, you recognise a few traits, live well with them and mainly want to understand how you work, a structured screening can already sort out a great deal.

What our screening adds

Our autism screening covers the four areas that autistic traits are about: social communication, routines and interests, sensory processing and your development in childhood. That shows you not only whether your answers stand out, but in which areas. You receive the result straight away and free of charge. The detailed paid report interprets your pattern area by area, oriented to ICD-11, and gives you a basis for a conversation with a professional. Only a professional can make a diagnosis.