The adult experience of being diagnosed with autism spectrum disorder: A qualitative meta-synthesis

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Kiehl, I., Pease, R., & Hackmann, C. (2024). The adult experience of being diagnosed with autism spectrum disorder: A qualitative meta-synthesis. Autism, 28(5), 1060-1074. https://doi.org/10.1177/13623613231220419

Publication date: 15 Feb 2024 Added to AutiHub: 28 Oct 2026 Type: Article Article language: English
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Authors

Publication authors
3
Autistic authors reported by the publication
1
  1. Ingrid Kiehl
  2. Ruby Pease
  3. Corinna Hackmann

Abstract

There is a dearth of research into the experience of adult diagnosis of autism spectrum disorder, and targeted research is needed to understand the needs of these adults. The aim of this coproduced review was to assess existing qualitative data on the lived experience of receiving an autism spectrum disorder diagnosis, identify recurring themes, and synthesize them into a visual model representing the journey through diagnosis. Using thematic analysis, we analyzed qualitative data from 24 studies of adult experiences of autism spectrum disorder diagnosis from PsycINFO, Embase, MEDLINE, and CINAHL. Thirty-two “descriptive” themes and three superordinate themes were identified. These themes represented how factors relating to identity and relationships are impacted by the diagnosis of autism spectrum disorder and the role of adaptation and assimilation. While the diagnostic process was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the diagnosis process explicitly considers needs in relation to: the impact of the diagnosis on identity, interactions with other people, choices regarding disclosure, and whether and how to make informed adaptations. Lay abstract There is little research looking at the experience of individuals diagnosed with autism spectrum disorder as adults. Adults diagnosed with autism spectrum disorder face different challenges than children, and more research is needed to better understand those challenges. For this review, autistic and non-autistic researchers looked at research on the experience of receiving a diagnosis of autism spectrum disorder as an adult. We looked for themes in people’s experience leading up to diagnosis, going through the diagnostic process, and living their life after diagnosis. We analyzed 24 studies and found three overarching themes that captured thirty-two themes describing the experience of diagnosis. The three overarching themes expressed issues with identity and relationships before and after the diagnosis and identified that the diagnosis of autism spectrum disorder in adulthood impacted people’s adaptation to and assimilation (i.e. the making sense of and internalizing the diagnosis) of autism spectrum disorder. While the diagnostic process itself was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences and had effects on identity and self-esteem. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the impact of the diagnosis on people’s identity and choices about telling others about their diagnosis, and whether and how people want to make adaptations, should be discussed and thought through in the process of diagnosis.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 29 Oct 2026 01:01.

Cited references
65
With a DOI
58
Without a DOI, from raw bibliography text
7
4 / 65 (6.2%) cited references include at least one author identified as autistic.
References with data to complete
5 / 65 (7.7%)
References with detected author names
61 / 65 (93.8%)
Without detected author names
4
Without a structured title
4
Without a stable identifier
7
References with raw author names still to review
3
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
217
From DOI or external metadata
217
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
3
76 / 217 (35.0%) names are linked to an author already present in AutiHub. 141 / 217 (65.0%) names are not yet linked.
Names linked to a person identified as autistic
8 / 217 (3.7%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 8 / 76 (10.5%). Distinct people identified as autistic: 8 / 198 (4.0%).
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