Social Communication and Relationships
- Difficulty understanding and navigating implicit social expectations, social cues, and unspoken rules.
- Difficulty initiating, maintaining, or appropriately ending conversations and social interactions.
- Differences in conversational reciprocity, including difficulty balancing speaking, listening, and responding to others.
- Difficulty interpreting sarcasm, indirect communication, figurative language, or ambiguous social messages.
- Relationship conflict or misunderstanding related to differences in communication style, expectations, or social needs.
- Social isolation, loneliness, or difficulty developing and maintaining meaningful relationships.
- Emotional distress related to feeling misunderstood, rejected, excluded, or disconnected from others.
- Difficulty recognizing or communicating personal boundaries and interpersonal needs.
Sensory Processing and Overload
- Distress or functional impairment related to sensitivity to noise, light, touch, textures, smells, crowds, or movement.
- Sensory-seeking or sensory-avoidant behaviors that interfere with daily functioning or participation.
- Difficulty recognizing early signs of sensory overload and identifying appropriate strategies to prevent escalation.
- Increased irritability, anxiety, withdrawal, shutdown, or reduced functioning when experiencing sensory overload.
- Difficulty recovering emotionally or physically following prolonged or intense sensory demands.
- Avoidance of environments or activities due to anticipated sensory discomfort or overwhelm.
Emotional Regulation and Distress
- Difficulty identifying, labeling, expressing, or communicating emotional experiences and needs.
- Difficulty regulating emotional responses when demands exceed available coping resources.
- Rapid escalation of distress in response to frustration, sensory overload, unexpected changes, or interpersonal stress.
- Difficulty returning to baseline following intense emotional experiences.
- Meltdowns, shutdowns, or significant withdrawal associated with overwhelm or difficulty communicating distress.
- Difficulty recognizing internal emotional or physiological cues associated with escalating distress.
- Limited access to effective coping strategies during periods of heightened emotional arousal.
Transitions, Flexibility, and Change
- Significant distress or dysregulation in response to unexpected changes in routines, plans, expectations, or environments.
- Difficulty shifting attention or transitioning between activities, tasks, or settings.
- Difficulty tolerating uncertainty, unpredictability, or situations without clear expectations.
- Strong reliance on routines, structure, or predictability to support emotional regulation and functioning.
- Anxiety or emotional dysregulation associated with transitions or changes in expectations.
- Difficulty considering alternative approaches when an established plan or routine is no longer feasible.
- Increased distress when preferred activities are interrupted or unavailable.
Executive Functioning and Adaptive Skills
- Difficulty initiating tasks despite understanding expectations and possessing the skills needed to complete them.
- Difficulties with organization, planning, prioritization, sequencing, or time management that interfere with daily functioning.
- Working-memory difficulties that contribute to missed steps, forgotten instructions, or incomplete tasks.
- Difficulty breaking complex or multi-step tasks into manageable components.
- Inconsistent functioning across home, school, work, and community settings depending on environmental demands and available supports.
- Difficulty completing activities of daily living independently without appropriate structure, prompting, or environmental supports.
- Difficulty estimating how long tasks will take or allocating sufficient time to complete responsibilities.
- Difficulty maintaining routines or completing responsibilities when external structure or reminders are limited.
Masking, Camouflaging, and Burnout
- Chronic exhaustion associated with sustained social masking, camouflaging, or efforts to meet perceived social expectations.
- Difficulty relaxing or behaving authentically due to ongoing monitoring of social behavior.
- Emotional distress associated with feeling pressure to suppress or modify natural communication, sensory, or behavioral patterns.
- Loss of access to previously manageable skills during periods of prolonged stress, exhaustion, or high environmental demand.
- Increased sensory sensitivity, irritability, emotional reactivity, or withdrawal following sustained social or environmental demands.
- Difficulty recognizing the impact of chronic masking or overextension on emotional well-being and functioning.
- Identity confusion related to distinguishing personal preferences, needs, and values from learned strategies used to navigate social environments.
School and Academic Functioning
- Difficulty navigating transitions, unstructured settings, group activities, or changes in classroom expectations.
- Sensory sensitivities within the school environment that interfere with concentration, participation, or emotional regulation.
- Executive functioning difficulties affecting assignment completion, organization, planning, or time management.
- Social stress related to peer conflict, bullying, exclusion, misunderstanding, or difficulty forming friendships.
- Difficulty communicating academic, sensory, social, or emotional support needs to teachers and school personnel.
- Need for individualized accommodations, predictable routines, or environmental modifications to support academic functioning.
- Difficulty maintaining academic performance when environmental or social demands exceed available coping resources.
Occupational Functioning
- Difficulty understanding open-ended instructions, implicit expectations, or unclear workplace responsibilities.
- Sensory or social demands that interfere with concentration, emotional regulation, or work performance.
- Occupational exhaustion or burnout associated with sustained masking and high-demand work environments.
- Difficulty with task switching, prioritization, organization, or transitions between workplace responsibilities.
- Communication misunderstandings or interpersonal conflict related to differences in communication style with supervisors or coworkers.
- Difficulty identifying and communicating workplace support or accommodation needs.
- Reduced occupational functioning when expectations are unpredictable or environmental structure is limited.
Family and Caregiver Concerns
- Parent-child conflict related to routines, expectations, demands, transitions, or differences in communication styles.
- Caregiver uncertainty regarding how to respond effectively to meltdowns, shutdowns, or periods of significant distress.
- Difficulty distinguishing intentional noncompliance from overwhelm, communication difficulties, or a mismatch between demands and available skills.
- Family stress related to differing expectations regarding routines, independence, communication, or behavior.
- Caregiver difficulty identifying environmental or sensory factors contributing to behavioral or emotional escalation.
- Need for increased autonomy and independence while maintaining appropriate safety, structure, and support.
- Family members experiencing difficulty adapting communication and expectations to the individual’s needs.
Identity and Self-Understanding
- Emotional difficulty processing a new, unexpected, or later-in-life Autism diagnosis.
- Shame, low self esteem, or negative self concept related to feeling different or experiencing repeated social difficulties.
- Difficulty identifying and understanding personal strengths, needs, preferences, and support requirements.
- Questions regarding identity, belonging, authenticity, and one’s sense of self.
- Difficulty accepting neurodevelopmental differences and integrating Autism into one’s understanding of self.
- Need for increased self advocacy skills and ability to communicate accommodation or support needs.
- Difficulty recognizing personal strengths and viewing differences through a balanced and non-deficit-based perspective.