I understand how it feels to have doctors and therapists dismiss your concerns that you may be autistic. For example, “no, there’s no way you’re autistic because:

• you would have been diagnosed as a child, or

• you have empathy for people

• you use humour sometimes

• you make eye contact with me sometimes

• you are employed

• you have a romantic partner”

Comments like these often accompany a refusal to refer for assessment; it’s awful. There’s a regrettable amount of ignorance and stereotyping toward autistic adults in the medical community.

Instead, I approach the assessment process with an open mind, treating clients with dignity, compassion, and trust. There’s always more to learn, and I try to keep up with relevant recent research as well as regularly participate in a variety of communities for autistic adults. I view and (try to) discuss neurodiversity from a stance of empowerment, acceptance, understanding, and respect. Unfortunately, a key part of a formal assessment is to seek a medicalized diagnosis, and given current definitions, the DSM-5-TR criteria focus on “deficits” and “disorders” which is negative and disempowering. I try to only include a minimal amount of medicalized language, but it’s a balance. I encourage you to view a diagnosis as just one part of your journey of self-discovery.

There can be significant value in seeking a thorough assessment for adults who suspect (or are fairly sure) that they’re autistic. Some people are happy with a more casual ‘self-diagnosis’, which is understandable. Why adult autism assessments can be of value:

Autism is complex to diagnose due to the likelihood of co-occurring conditions and the challenge of a differential diagnosis:

There are many conditions that often co-occur with autism: approximately 50% of autistic people have alexithymia, ~30% have ADHD, as well as possible histories of trauma, OCD, anxiety, bipolar disorder, and so on. Only a thorough diagnosis will detect this

These numerous similar conditions can lead to misdiagnoses, if the assessment isn’t thorough and conducted by a psychologist with substantial relevant expertise

The above assumes the clinician you’re working with is open-minded enough to even consider assessing an adult, which many are not

Medical staff are more likely to believe that an adult is actually autistic if you’re officially diagnosed, thus taking things more seriously in relation to accommodations or related health concerns (this is an ugly truth about the stereotypes and ignorance related to autism and their continued prevalence in the medical system, particularly for late-diagnosed adults and women)

Access to academic or work accommodations—aiding sensory sensitivities and/or executive functioning issues

Increased sense of confidence in understanding your own experience and identity (vs imposter syndrome)

Some adults in the autistic community without an official diagnosis say that they feel periodic self-doubt about whether or not they are autistic. An official diagnosis can help reduce this doubt and help people feel they are “allowed” to make/ask for more accommodations for their neurodiversity. This diagnostic validation leads to concrete, positive changes for many people

Allows a person to more accurately focus their efforts toward acceptance where necessary and change where possible

Get specific about what social issues, sensory difficulties, comorbidities, strengths/weaknesses and so on are present

Modify your environment (home, work, relationships, etc) in a more targeted way to better accommodate for your needs

Help people close to you better understand your differences and needs