Can autism be diagnosed at any age?

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My friend has been diagnosed with ADHD. She thinks she’s also on the autism spectrum but has learned to mask so well that it’s very unlikely she would get a diagnosis now. Is that true? Surely if you are autistic then it can be picked up at any age, even if it presents itself differently. A lot of the traits she attributes to autism however can also be attributed to ADHD. Such as being overwhelmed by strong smells etc.

[mod. note - merged with the earlier thread "Asperger Diagnosis In Adulthood"]

Yes, autism can be diagnosed at any age. In fact the majority of people on the spectrum are diagnosed in adulthood. Only I was diagnosed in childhood, because my experience has to be unique.

The usual issue is that the older you are, the worse the access to information about your early life is and the more likely that other diagnoses will camouflage it

I was told the offical autism diagnoses had to be made before I turned 21. Since autism is a developmental disability that occurs before 21 the only way the so-called experts could know that I had autism before I turned 21 was for me to be tested before 21. After I was offically tested at 20 I was told that I had Asperger's Personality due to having Schizoid Personality Disorder & I had nothing on the autism spectrum; my paperwork stated this as well. That was several thousand bucks of my parents hard-earned money well spent My psychiatrists & GP type docs state that I have autism. However I can not qualify for any programs or services specifically for autism due to me failing to be offically diagnosed when I got tested at 20. Autism services have stated that I had to be tested & diagnosed before 21. At least Social Security Disability accepts my autism diagnoses as well my other various disabilities.

In theory, yes.

In practice there are bias like it mostly affects males and is a childhood affliction.

A possible analogy is the calling of balls and strikes in baseball.
Even at the top MLB level there are some umpires that were notoriously bad at calling balls and strikes.

I have many signs of autism, including stuff that people would call savant skills.
I've found I socialize much more easily if I present in different gender than that which I was assigned at birth.

I can relate to parts of that, I was diagnosed near the end of high school. Prior to that, I had little idea I was neurodiverse and even now I've been told by most people that they would have no idea I was on the spectrum if I didn't tell them. If I remember, I can ask the therapist who diagnosed me sometime how difficult it is to diagnose adults.

Recently went through the diagnosis/assessment process.

It took roughly 5 hours and was full of tests, interviews, questionares etc.

They really lean into interviewing you about your life experience. There was also some things that I didn't even think were relevant, like explaining what was happening in a picture book. Apparently I described every single detail, which was consistent with "bottom up thinking"

I think any professional psychologist has the tools to diagnosis adults. I might just ask them a lot of questions before hand.

A lot of that is because they don't want to hand out a diagnosis due to social pressure of there being this "epidemic" of "overdisagnosis." It probably is less common for there to be enough autistic traits to qualify for disability on that basis alone if it weren't caught earlier, but I definitely think it happens. It's one of the reasons why I think it was so dumb to combine all those disagnoses into one diagnosis to rule them all without doing the work to demonstrate that they are all the same thing, just having some variation in appearnce.AS in particular arguably should have been grouped with ScPD as that's been the historical use of the term before it was added to the DSM, getting rid of it created a massive gap for those that were showing adequately clear traits early enough for AS, or late enough for ScPD.

Autism in adults, especially Autism in adult women, is not as well understood as Autism in children. Knowledge varies a lot depending on the clinician.

Your friend should try and find a clinician with knowledge and experience in assessing women. These people are sometimes hard to find.

Autism and ADHD are common co-occurring conditions. This is unofficially known as AuDHD. We have a thread about living with AuDHD. She might be interested in taking a look at it to see if she relates to what is being described.

AuDHD = Needing routine/structure but struggling to achieve it?