5 subtle signs you might have autism, according to a psychologist

• It's estimated that about one in 36 US children has autism.
• But some adults don't get diagnosed until they're in their 30s.

About one in 36 US children is on the autism spectrum, the Centers for Disease Control and Prevention estimates — but not everyone gets diagnosed in childhood.

Some people, especially women and gender-nonconforming people, are misdiagnosed for years. Many don't find out they're autistic until their 30s, or later.

To formally be diagnosed with autism, you must meet certain diagnostic criteria outlined in the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition.

But Carla M. Shuman, a clinical psychologist who works with many autistic and neurodivergent people, told Insider that autism was "way more complex" than how it's defined in the DSM-5.

"It isn't just people who don't make eye contact and have trouble socializing," she said. "That's why the DSM needs to keep evolving in the way that it builds its criteria."

Shuman outlined some of the major symptoms of autism, including the ones that aren't specifically mentioned in the DSM-5 but can be common among autistic people.

1. You frequently feel misunderstood and don't know what you did wrong

A common experience among autistic people is feeling like they're unintentionally offending people or committing a social faux pas, Shuman said.

"They find themselves being misunderstood by other people," she said.

For example, an autistic person might not realize that they're standing too close to someone or that they're doing all the talking in a conversation. Or they may feel passionate about a specific subject and not realize that others want to talk about something else.

2. You struggle with initiating and keeping up casual conversations

Shuman said the level of social difficulties varied from person to person because autism is a spectrum. But some autistic people may struggle to reach out to make plans or start a conversation.

This symptom can especially show up in social situations where "they're forced to be chatty, to make small talk at work parties or happy hours," Shuman said.

3. You feel agitated if your routine or plans are thrown off

Because inflexibility is a part of autism, Shuman said, disruptions in routines can make an autistic person "emotionally volatile over something that most people would adjust to."

Autistic people can struggle with emotional dysregulation, where they can experience meltdowns or extreme irritation when the unpredictable happens.

4. You have sensory issues such as noise sensitivity or aversion to certain textures

Other factors that can contribute to emotional dysregulation are sensory issues. While sensory issues are not recognized in the DSM-5 as autism symptoms, Shuman said almost all of her autistic clients struggled with them.

For example, she's had clients who wear noise-canceling headphones because they get overstimulated in loud, crowded environments, as well as clients who experience sensitivity to certain clothing textures.

5. You get exhausted from 'masking' or focusing on fitting in

Masking is acting a specific way to adapt to social cues — basically "playing a part in a play just to get by," Shuman said.

Generally, autistic women tend to "mask" more than men. While people who mask may fit in more on the surface with neurotypical people, deep down, they often feel overwhelmed, Shuman said.

"They get worn out a lot more easily. They end up losing a lot of energy because they're trying to do stuff that is not intuitive to them," she said.