“I get exhausted trying to read the room.” “I never know what to say in conversations.” “A sudden change of plans sends me into a panic.” “I know a certain subject inside and out.” — If these kinds of traits have been causing difficulties well into adulthood, it may be a sign of ASD (autism spectrum disorder).
ASD is a characteristic of how the brain works — closer to an inborn trait than a disease. By understanding your own characteristics and adjusting your environment, the difficulties of daily life can be significantly reduced.
Keldsen Family Clinic is a family-oriented clinic offering both Psychosomatic Medicine and Internal Medicine, a 1-minute walk from ‘Oizumi Yubinkyoku’ bus stop, accessible by Seibu Bus from Oizumi-Gakuen Station. We are open on weekends and holidays and also offer telemedicine. “Going to a clinic feels a little scary” — we’d love to help you take that first step.
About Developmental Disorders
Developmental disorders (neurodevelopmental disorders) are an umbrella term for conditions caused by innate differences in brain function that can lead to difficulties in behavior, communication, and learning. Common examples include ASD (autism spectrum disorder), ADHD (attention-deficit/hyperactivity disorder), and LD (learning disabilities).
Developmental disorders are increasingly understood not as “diseases” but as “neurological traits.” While these traits are present from childhood, the degree to which they cause difficulties can vary depending on the demands of different environments and the roles one is expected to fill.
In recent years, there has been a growing number of adults receiving an ASD diagnosis for the first time. As social communication demands become more complex after entering the workforce, or when facing new life stages such as marriage and parenting, many people become aware of their traits for the first time. In some cases, a visit for depression or anxiety leads to the discovery that ASD is part of the picture.
These traits can also serve as strengths. The ability to explore topics of interest in great depth, to identify patterns and regularities, and to follow rules with integrity can be powerful assets in the workplace and in research. A diagnosis is not a “label” — it is a tool for understanding your own traits and creating an environment that works for you.
What Is ASD?
ASD (Autism Spectrum Disorder) is a developmental trait characterized by distinctive patterns of social communication and strong preferences, focused interests, and repetitive behaviors. As the name “spectrum” implies, the way these traits present and their intensity vary widely from person to person.
According to the DSM-5-TR and ICD-11, the main diagnostic criteria for ASD include two core domains:
- Social communication and interpersonal characteristics: Difficulty reading others’ feelings and intentions, challenges with conversational give-and-take, and distinctive use of nonverbal cues such as facial expressions and gestures
- Restricted, repetitive patterns of behavior, interests, or activities: Strong preferences for routine, reliance on established patterns, deep interest in specific topics, and sensory sensitivities or reduced responsiveness
A diagnosis is generally considered when these traits have been present since early development and cause significant difficulties in daily life. ASD without intellectual disability includes what was previously known as Asperger’s syndrome.
Features of Adult ASD
Even when traits are not noticeable during childhood, difficulties may begin to surface after entering the workforce.
- Not knowing what to say during casual conversation or meetings at work
- Difficulty understanding jokes, sarcasm, or reading between the lines
- Strong stress from sudden schedule changes or unexpected instructions
- Extremely detailed knowledge of — or intense focus on — areas of interest
- Heightened or reduced sensitivity to light, sound, touch, and other sensory stimuli
- Feeling drained after social interactions; needing time alone
These traits may also lead to secondary conditions such as depression, anxiety disorders, and adjustment disorder.
ASD Traits and Symptoms
The characteristics of ASD tend to appear across three areas: social communication, preferences and interests, and sensory processing.
Specific Symptom Examples
Social Communication Traits
- Difficulty with casual conversation and small talk
- Taking words literally (difficulty understanding sarcasm and metaphor)
- Difficulty making eye contact, or maintaining eye contact that feels too intense
- Challenges reading others’ facial expressions and emotions
- Conversations that tend to become one-sided
- A tendency to guide conversations at one’s own pace
Preferences and Interest Traits
- Preference for established routines and set procedures
- Strong stress from changes in plans
- Deep interest and knowledge in specific subjects
- Particular attention to the arrangement and order of objects
- Repetitive behaviors (such as hand-flapping or rocking)
- Preference for stability over change
Sensory Traits
- Heightened (or reduced) sensitivity to sound, light, smell, touch, and taste
- Discomfort with certain fabric textures
- Fatigue in noisy environments
- Strong preferences for — or avoidance of — certain food textures and flavors
- Distinctive responses to temperature and pain
The degree of difficulty varies greatly from person to person, and many individuals with ASD thrive in their areas of strength. Rather than viewing these traits as shortcomings, finding ways to build on them is an important perspective.
Managing and Supporting ASD
ASD is not something to be “cured.” The focus is on understanding your traits and creating an environment that works for you. If secondary symptoms such as depression, anxiety, or sleep difficulties are present, those are addressed through treatment.
1. Medication
There is currently no medication that directly treats ASD itself. However, the following medications may be used to address co-occurring symptoms:
- SSRIs: For depressive symptoms, anxiety, and obsessive-compulsive tendencies
- Anti-anxiety medications: For short-term use when anxiety is severe
- Sleep medications: When insomnia is significantly affecting quality of life
- Low-dose antipsychotics: For significant irritability or aggression, as determined by a specialist
Medication is used to manage co-occurring symptoms — it does not change the traits themselves.
2. Psychosocial Support
- Psychoeducation: Understanding ASD traits, as well as your personal strengths and challenges
- Social Skills Training (SST): Practicing communication patterns and strategies
- Cognitive Behavioral Therapy (CBT): Developing coping strategies for everyday challenges together
- Counseling: Deepening self-understanding and self-acceptance
At Keldsen Family Clinic, we take the time to listen carefully during consultations and coordinate with specialized support services when needed.
3. Strategies for the Workplace and School
- Ask for instructions in writing (email, chat) rather than verbal-only communication
- Request that schedules be shared well in advance
- Avoid multitasking; create an environment where tasks can be tackled one at a time
- Discuss the possibility of a quieter, lower-stimulation workspace
- When appropriate, request reasonable accommodations
A medical certificate or explanation of your traits can serve as an important tool for communicating your needs to your workplace or school.
4. Strategies for Home Life
- Communicate schedule changes early, using written notes or visual aids
- Respect the need for personal space and time alone
- Be mindful of sensory sensitivities (quiet spaces, adjusting lighting, etc.)
- Don’t dismiss areas of interest or passions
- Family members should also make time for their own self-care and seek their own sources of support
5. General Self-Care
- Know your traits: Take stock of what you find easy and what you find difficult
- Plan for fatigue: Build in rest time after social interactions
- Maintain a sleep routine: Disrupted sleep can intensify sensory sensitivities
- Manage sensory input: Use tools that work for you — noise-canceling headphones, sunglasses, and similar aids
- Have trusted support: Whether it’s a doctor, a counselor, or a peer community
ASD is not something to be “cured” — it is about learning to live well with your own traits. Rather than struggling alone, please feel free to reach out to Keldsen Family Clinic. We are a 1-minute walk from ‘Oizumi Yubinkyoku’ bus stop, accessible by Seibu Bus from Oizumi-Gakuen Station, open on weekends and holidays, and also offer telemedicine.