For many adults, there has always been a quiet sense of being different. of working harder than others to navigate social situations that seem effortless for everyone else, of feeling perpetually out of step with the world in ways that are difficult to articulate. Some people spend years masking those differences, putting enormous energy into appearing “normal,” while quietly carrying the exhaustion and confusion of not understanding why connection, communication, or sensory experience feels so different for them than it seems to for others. If this resonates, you are not alone, and answers are available. More adults are seeking autism spectrum disorder assessments than ever before, driven by growing awareness and a reduction in the stigma that once kept so many people from asking the question.
At Old Town Psychology, we provide comprehensive adult autism assessments in Alexandria, VA, conducted by licensed psychologists with specialized expertise in ASD. We also have immediate openings, so you do not have to wait months to begin to fully understand yourself.
What Is Autism?
Autism Spectrum Disorder (ASD) is a form of neurodivergence that affects social communication, sensory processing, behavioral patterns, and the way a person relates to and experiences the world. The word “spectrum” is significant; autism presents in an enormous range of ways, and no two people with ASD are alike. Some individuals have significant support needs across multiple areas of life. Others are highly capable in many domains while experiencing specific and persistent challenges in social interaction, sensory sensitivity, or flexibility around routines and transitions.
In the United States, autism affects approximately 1 in 45 adults, and a substantial proportion of those individuals have never received a formal diagnosis.
ASD is highly heritable. Research suggests that genetics account for approximately 80% of cases, and it is not uncommon for adults to seek assessment after a child or other family member receives a diagnosis and the description resonates deeply with their own experience.
Undiagnosed ASD in adulthood can result in years of feeling misunderstood, marginalized, or quietly out of place in ways that have never had a clear explanation. Many adults who eventually receive an ASD diagnosis describe a profound sense of relief; not because the diagnosis changes who they are, but because it provides a framework that finally makes sense of a lifetime of experiences.
Signs and Symptoms of Adult Autism
Autism in adults can look quite different from the presentations most commonly associated with childhood ASD. Many adults, particularly women and those with higher cognitive ability, have spent years developing strategies to mask their autistic traits, making the condition less visible but no less present. As a result, many adults reach midlife or beyond before the picture becomes clear enough to seek a formal assessment.
You may want to consider an adult autism assessment if you recognize yourself in any of the following:
Social communication and relationships:
- A persistent, lifelong sense of being different from others, of not quite fitting in, even when you are trying your best
- Difficulty understanding unspoken social rules, subtext, or the expectations of social situations that others seem to navigate intuitively
- Finding social interaction draining, confusing, or requiring conscious effort and mental rehearsal, when others do not seem to need
- A history of difficulty making or keeping friends, even when a genuine connection was wanted
- Frequently feeling misunderstood, as though what you mean and how it lands are consistently out of alignment
- Difficulty with eye contact, either finding it uncomfortable to sustain or having learned to perform it in ways that feel unnatural
Masking and identity:
- A sense of performing “normalcy” in social situations and consciously studying and mimicking how others behave in order to fit in
- Exhaustion following social interactions that others find energizing or neutral
- A feeling of having a “public self” that is fundamentally different from how you experience yourself privately
- Difficulty knowing what you actually feel, want, or prefer in the absence of external cues
Sensory sensitivities:
- Strong aversions to specific sounds, lights, smells, textures, or physical contact that others do not seem to notice or mind
- Being told that you are too sensitive, too loud, or too quiet, or finding certain sensory environments overwhelming when others are comfortable
- Seeking out specific sensory experiences for regulation or comfort
Repetitive behaviors, routines, and interests:
- A significant reliance on routines and rituals, with distress or disorientation when they are disrupted, even by minor changes
- Difficulty transitioning between activities, tasks, or environments
- Intense, focused interests that consume a significant portion of attention and that others may find unusually narrow or deep
- Repeating words, phrases, or sounds, either internally or aloud, as a form of self-regulation
Broader patterns:
- A history of being described as quirky, intense, literal, or socially awkward in ways that have never been explained
- Difficulty with flexibility in thinking, problem-solving, or adapting to unexpected changes
- Having been diagnosed with anxiety, depression, or other conditions that have not fully accounted for the breadth of your experience
What to Expect During an Adult Autism Assessment
At Old Town Psychology, adult autism assessments are conducted using a careful, comprehensive, multi-method approach. We do not rely on a single tool or a brief screening. We gather information across three domains: clinical interview, objective testing, and standardized rating scales, and integrate the findings into a single, cohesive evaluation. Here is what the process looks like:
Clinical Interview
Your assessment begins with an in-depth clinical interview conducted by one of our licensed psychologists. This conversation covers your developmental history (including childhood experiences, even if you were not assessed at that time), your social and communication experiences across your life, sensory sensitivities, behavioral patterns, relationships, and the specific concerns or questions that brought you to seek an assessment. Where relevant, information from a family member or partner who has known you for a long time can add valuable context to the developmental history portion of the evaluation.
Standardized Rating Scales
You will also complete standardized self-report measures that assess autism-related traits across multiple domains. These instruments are specifically designed for adults, capturing how autistic traits present in adulthood rather than relying on child-focused frameworks that may not accurately reflect adult experience.
Objective Psychological Testing. We administer research-validated assessment tests that provide objective data to complement the interview and self-report measures. The testing battery at Old Town Psychology for adult ASD evaluations includes:
- ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition): The gold standard in autism assessment worldwide, the ADOS-2 is a structured observational instrument that allows our clinicians to directly assess social communication, reciprocity, and behavioral patterns in a standardized way. The ADOS-2 includes modules specifically designed for verbally fluent adolescents and adults, making it appropriate and clinically meaningful for adult evaluations.
- WAIS-5 (Wechsler Adult Intelligence Scale, Fifth Edition): A comprehensive measure of adult intellectual functioning across verbal comprehension, perceptual reasoning, working memory, and processing speed. Understanding your cognitive profile is an important part of interpreting ASD presentations in adults, particularly in distinguishing ASD from other conditions and understanding how cognitive strengths and challenges interact with autistic traits.
Comprehensive Report
Once all data has been gathered and analyzed, your psychologist will prepare a detailed written report that integrates the findings across all sources of information, provides a clear diagnostic conclusion, and explains the results in practical, accessible terms.
Adult Autism Assessment Results
After your evaluation is complete, we schedule a dedicated feedback session to walk through the findings with you in full. This is not a brief conversation. It is a structured appointment in which your psychologist reviews what the assessment found, explains what the diagnosis does or does not mean, answers your questions, and ensures you leave with a genuine understanding of your results, not just a report you have to interpret on your own.
Regardless of whether the assessment results in a diagnosis of ASD, you will receive specific, tailored recommendations based on your individual profile. These may include guidance on therapeutic support, strategies for managing sensory or social challenges, workplace or academic accommodations, referrals to specialized resources, or recommendations for further evaluation if other conditions are indicated.
Research consistently shows that adults who receive an ASD diagnosis report meaningful benefits: a clearer framework for understanding their own experience, relief at having an explanation that fits, greater self-compassion, and more targeted access to support. Whatever the outcome of your evaluation, our goal is to ensure you leave with more understanding than you arrived with and a clear sense of what comes next.
As a full-lifespan, one-stop practice, Old Town Psychology also offers therapy, ADHD assessments, comprehensive evaluations, and a range of other services, so if your needs extend beyond the autism assessment itself, everything you need is available under one roof.
"We brought our daughter in for testing and the OTP team was amazing. They were so kind, caring and great with children. My daughter is shy and takes a little time to warm up when first meeting someone new. The Doctor was patient and encouraging and my daughter had a wonderful time. They also provide fast results and meet with you to explain everything in the report. I would definitely recommend them."
"Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met."
"Excellent service, knowledgeable staff, incredible responsiveness, diligence and follow through -- we feel lucky we found such a great therapy practice. We cannot recommend them highly enough!"
“My daughter took WISC-V test there and we are very pleased with our experience. They are professional, patient and wonderful throughout the entire process. My daughter had such a great time that she hardly felt that was a test - she even asked when she could take it again. I would highly recommend them to whoever needs child IQ testing services.”
“I took my children here for TAG testing. Both of my kids actually enjoyed their assessments. I was very pleased with the time and care taken to assess my children, the thoroughness of the report, and the fact that there was a follow-up session to discuss any questions that I had relative to the assessment included. Also-- the tea selection in the waiting room is top tier :)”
“Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met.”
Take the Next Step
You have spent long enough wondering. An adult autism assessment at Old Town Psychology can provide the clarity, self-understanding, and framework you have been looking for, without a six-month wait. We maintain immediate availability for new assessment clients, so you can begin the process now.
At Old Town Psychology, we are proud to serve the Northern Virginia, DC and Maryland community with expert, individualized psychological care for children, teens, and adults at every stage of life.
To schedule an adult autism assessment or to ask any questions, contact us today.
