Expert: Paul Johnson - 4/4/2010

Question
My sister and I are 4 years apart, I being the younger. While in elementary school my sister was diagnosed as having a speech impediment and a learning disability but nothing otherwise. I understood she was different but never thought anything of it, I even understood her abnormal speech better than our mother, who would often give me a questioning look and I'd have to explain what she was trying to ask/say.
My mother questioned the diagnosis often and brought up the topic with me a few times in the last year or two. In one of these conversations we brought up the fact that she had a lot of quirks that had been overlooked in childhood, or didn't stand out as much.
Along with speech problems(poor annunciation, difficulty finishing some sentences, long pausing, vague trailing sentences she expects you to fish for her.)and difficulty learning she also has some really strange behaviors around the house, some that even myself and my mother were unaware of.
She repeatedly slams kitchen cabinets quickly to gain attention of people in the next room, and  some times yells gibberish while doing it, then when she has the attention she has nothing to say. when asked why she was doing it, she wont answer. It's hard to explain really, it looks like she's trying to gain attention while others are having a conversation, but maybe she's just frustrated she can't really take part in the conversation properly and that's why she interrupts it...
She CANNOT handle being yelled at and will break down immediately into tears and start yelling. even a normal scolding for not doing what she was told would result in tears on some days. Simple sibling rivalry in the house would often result in aggressive behavior, many times that entailed her striking our brother repeatedly(though not hard)for being annoying or doing something she didn't like(changing the TV station or having it too loud.)
My mother has always had a hard time getting her into the bathtub. I had to run her baths for her as a child because she was scared of the hot water. Even now it's a fight daily for her to take a shower. she has to be told over and over and she gets upset and will sometimes cry because she doesn't want to take a shower or bush her teeth.
She has an amazing memory, she can remember tiny events for years before and doesn't understand when others don't remember the specifics of the same events when she brings them up.
She's good at games and computers and has even joined Facebook with my parents to play Mafia Wars

And the strangest what while my mother and I were cleaning out her room so she could change rooms we found TINY scraps of papers she cut out, some of them had words written in her little child-like hand writing, other where words cut out of magazines, along with tiny pictures of food, clothing, and other odd objects. She couldn't or wouldn't explain to our mother what they were for or why she did it.

After discussing all of this we both wondered if she was autistic.
If it could have been overlooked when she was a child.

I was wondering if any of this sounds familiar to someone who's schooled on the subject. I've tried some research but it's hard to find instances of adults diagnosed with autism and because I was younger I don't remember her childhood symptoms and wasn't even alive for some of them.
any comments would help. I'm wondering if my parents she have her taken to a specialist again and how much, if at all it would help.

Answer
Hey Elle,

Thank you for your interesting and challenging question. Yes some of the symptoms mentioned in your question sounds like Autistic like behaviors, however I do not see a strong pattern that would lead to an out right diagnosis from your description. I think the possibility of your sister being Autistic is fairly good. She has symptoms of a few other diagnosis that I choose not to go into here because of the difficulty making diagnoses over the computer.

The part of your question that drew my greatest interest is when you spoke about how there isn't much information about adults being diagnosed with Autism. I am one such individual, my support group is full of members that are almost all diagnosed as an adult. When A person is diagnosed as an adult with being on the Autism Spectrum of Disorders, they have some fairly mild symptoms coupled with a powerful coping mechanism that are naturally self taught. Your sister is likely talented at learning how to cope with her deficits. A better question I think to ask about her is how she was able to avoid the detection of her deficits for twenty four years and what is it about her now that has exposed these behaviors to the scrutiny of psychological evaluation?

For me it was the repeated failure at work where previously I was successful. So at the age of 46 I and others were viewing deficits in me that went previously ignored or misunderstood.

Go to websites that explain symptoms of adults with autistic behaviors and have her examine it because if she does not think this is a possibility, she will not look into it.

You can place adult features and Autism in a search engine and find these behaviors. When I did this, it blew me away how many symptoms I had of High functioning Autism.

I would love a follow up report after she examine these behaviors more,