Enabling positive lives for autistic adults

A quick guide for social workers

Autism is a lifelong developmental difference that can have a profound impact on an adult's quality of life.

Having good person-centred conversations exploring strengths and differences can empower autistic adults to make informed decisions about their care and support.

This quick guide is for social workers who support autistic adults and is based on research evidence. It does not cover referral and assessment for a diagnosis.

Working together

Autistic adults experience a wide range of differences in their communication, use of language, social interactions and emotions. About half also have a learning disability.

Some autistic adults show a marked discrepancy between their IQ and their ability to plan and perform daily activities, and this can mean their need for support is underestimated. The way that autism affects a person can also vary over time and in different situations.

Think about what this might mean for:

Social work support

  • allow sufficient time to build relationships and develop communication that can support the person to process information and make decisions
  • maintain continuity wherever possible
  • work together to develop a personalised plan, based on an accurate picture of the person’s strengths, wishes and needs, including any sensory differences.


  • find out how the person prefers to refer to their autism
  • explain any technical terms you are using
  • check the person’s understanding of what you have said.

Support from others

  • liaise with local specialist autism services to find out about any current or previous support the person has had
  • find out what support might be available from the person’s friends and family
  • consider what their family and friends might need to know about autism in order to provide appropriate help.

Two figures, one wearing an official pass around their neck

Identifying care and support needs

Autistic adults may need additional support in some or all of the following areas:


any autistic adults have sensory sensitivities, for example to smell, taste, light, colour or noise, which can cause anxiety or even physical pain.

Be aware of the person's sensory sensitivities when deciding where to have conversations and when planning support. This is particularly important if reviewing or considering a residential placement. See the checklist in the further information section.

An icon indicating someone affected by their environment


Around 70% of autistic people have at least one physical or mental health issue, including anxiety disorders, epilepsy and attention deficit hyperactivity disorder (ADHD), but these are often unrecognised.

Consider whether the person may have any additional health needs and offer them a referral if needed (for example, to their GP). Offer advice and encouragement to follow a healthy lifestyle (for example, eating a balanced diet and exercising regularly).

An icon showing someone having a health check


When an autistic adult becomes distressed it may be because of:

  • a physical or mental health problem
  • the person’s social or physical environment (including sensory sensitivities)
  • communication difficulties
  • changes in the person’s routine or circumstances.

Consider whether any of these areas may be affecting the person’s behaviour and what changes or support may help.

An icon showing tickboxes for health, environment, communication and changes to routine

Risk of victimisation

Autistic adults may be at greater risk of misunderstanding the behaviour of others because of difficulties with social interaction and communication.

This can also make them more vulnerable to exploitation, bullying or harassment.

An icon showing someone alone and vulnerable

Tailored support for fulfilled lives

Access to personalised support and specialist interventions can help autistic adults build on their strengths and reduce isolation.

Social workers can:

  • Find out about local and national sources of information and support for autistic people and their families.
  • Be sensitive to issues of sexuality and recognise the importance of developing personal and sexual relationships.
  • Provide advice, encouragement and support to help people access information and services, including activities in the community that may support social opportunities, a healthy lifestyle or employment.

Specialist support

Find out what specialist services exist in your area and what they offer. Discuss with the person whether they would like to seek access to tailored support and advice or available interventions which may include:

  • structured leisure activities, including individual or group exercise.
  • life and employment skills
  • support with parenting
  • anti-victimisation support
  • social opportunities
  • anger management and challenging behaviour programmes.

Social workers can make a difference to autistic adults by working with and alongside them. Good social work can enable autistic adults to get the assistance they need to manage how autism affects them.

Godfred Boahen, British Association of Social Workers

Further information

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This content has been co-produced by NICE and the social care institute for excellence (SCIE). It is based on NICE’s guideline on enabling positive lives for autistic adults.