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Supporting Late-Identified Autistic and ADHD Clients


woman sitting on a couch in a therapy session

Being late-identified as autistic and/or having ADHD comes with a unique set of challenges and experiences that differ significantly from those identified earlier in life. This article explores the distinctive needs of late-diagnosed adults and provides practical strategies for offering neurodiversity-affirming support.

What Are the Unique Challenges?


1. Identity and Self-Perception


Late-diagnosed adults often grapple with a shift in their self-identity. They may have spent years feeling "different" without understanding why, leading to feelings of confusion, frustration, and relief upon receiving a diagnosis. Exploring their identity and helping them integrate this new information about themselves is essential. Importantly, the goal is to help late-identified clients build a positive sense of self and connect with what it means to be neurodivergent.


Many late-identified adults may also have a series of other mental health diagnoses that might no longer feel accurate or relevant once they understand they are neurodivergent. Being late-identified can therefore mean shedding other labels or identities and revisiting past experiences through a new lens. This process can sometimes be healing, but it may also bring up grief, resentment, and anger for clients who were not identified until later in life.


2. Masking and Burnout


Many late-diagnosed adults have spent a lifetime masking their traits to fit societal norms, leading to significant mental and physical exhaustion. Understanding the concept of masking and its impacts is important for providing appropriate support to late-identified clients. While masking may have its benefits at times, it is linked to autistic burnout, a debilitating condition that affects many autistic individuals.


Help clients identify when and why they mask their traits. Encourage them to embrace their authentic selves and create environments where they feel safe to do so. This might involve working on self-acceptance and finding supportive communities. Keep in mind that some individuals in minority groups may not have the privilege or safety to unmask in public spaces without an increased risk of victimisation. This is a nuanced issue, so it’s important to balance the client’s safety and psychological well-being.


3. Navigating Relationships and Others’ Perceptions

Being late-identified can present challenges in existing relationships. Clients may feel dismissed by significant others or may not feel safe disclosing their neurodivergence. It can be confusing for the client and those around them when they receive a late-life diagnosis, as others’ views of Autism and ADHD are often challenged. This is a common theme that warrants holding space for, ensuring we are creating a safe and supportive environment for these discussions.


Practical Strategies for Support


1. Psychoeducation


Educate clients about Autism and ADHD from a neurodiversity-affirming perspective. It’s helpful for clients to recognise not only the disabling aspects of their diagnoses but also the strengths these neurotypes bring. Providing information on how their neurodivergent brain works can empower them to better understand themselves and develop effective management strategies.


2. Individualised Therapy Approaches


Tailor therapeutic approaches to meet the specific needs of neurodivergent adults. There is no one therapy that is inherently affirming or non-affirming (besides ABA, which is not affirming); rather, it is how therapy is applied, with an understanding of neurodivergence, that makes the difference.


3. Building Self-Advocacy Skills


Encourage and support clients in developing their self-advocacy skills. This includes understanding their rights, advocating for their needs, and setting boundaries to protect their mental health.


4. Building Strategies for Executive Dysfunction


Many late-identified adults struggle with executive functioning tasks such as time management, organisation, and planning. Traditional methods may not suit Autistic and ADHD individuals, so it’s important to find systems that are sustainable and align with their neurotype.


5. Sensory Processing Support


Work with clients to identify their sensory profiles and develop strategies to manage sensory needs. Sensory processing can often be an unknown contributor to stress, overwhelm, burnout, and mental health challenges in autistic people. Many autistic adults may not have realised how much they have been masking or tolerating sensory discomforts. Part of this process involves helping them understand their unique profile and becoming comfortable accommodating themselves.


6. Connecting with Other Neurodivergent People


Encourage clients to connect with other neurodivergent individuals. Support groups, both in-person and online, can provide a sense of community and understanding that is invaluable. Connecting with others who share a similar neurotype can enable more natural and authentic social communication, increase a sense of belonging, and reduce isolation.


Conclusion


Supporting late-diagnosed Autistic and ADHD adults requires a nuanced and compassionate approach. By understanding the unique challenges of being late-identified and providing tailored, evidence-based strategies, we can empower our clients to lead fulfilling and authentic lives.











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