Not “Autistic Enough”?

I have found that one of my biggest challenges as a counselor has been that I see autism where others do not, so getting my clients, big and small, diagnosed, proves very frustrating for me and my clients. I think it’s part of my pattern recognizing and micro expression reading skills that raises a flag. But it leaves my clients being diagnosed as ADHD, or worse, possibly autistic but not autistic enough for a diagnosis.

These clients are facing the myth of not looking autistic enough. They do not necessarily have speech delays, obvious social difficulties or visible repetitive behaviors. But the reality is autism is generally much more subtle with only about 10 percent of the population meeting the common diagnostic markers of extensive and extreme challenges, which includes developmental delays, social and communication difficulties, and repetitive behaviors. Thankfully, research in 2025 from Princeton indicates that there are 4 categories of autism that have been discovered and most of the population have symptoms that are much more subtle. And these people have learned to mask or compensate for these challenges. This is especially prevalent in girls, gifted children and adults.

The common phrases I hear after psychiatric evaluation is, “they can make eye contact” or “they can have a conversation”. But that masking or those skills can make a person appear successful on the outside, but they will end up with sensory overload, social exhaustion, and anxiety. This can happen daily or at some point when they have a meltdown or completely crash. I also hear this after I have worked with a client for months and those skills are hard won and learned through empathy, compassion, and understanding why they struggle in those areas.

So, I’ll keep standing on my soapbox, advocating for my clients and others; we need to redefine the autism profile. We can’t just say someone isn’t autistic enough. That is simply not acceptable. Right now, they just don’t fit the current stereotype and it’s time for a change. We cannot leave people out in the world struggling without any understanding of why and without the necessary supports to be successful in this world.

New genetic study reveals 4 autism subtypes. Psychology Today. (2025). https://www.psychologytoday.com/us/blog/shouldstorm/202508/new-genetic-study-reveals-4-autism-subtypes