Adult autism assessment

Am I Autistic?

Some of my clients reported that autism was not discussed during their ADHD assessment (this refers mostly to assessments completed by psychiatrists).  Moreover, some clients tell me their enquiry about Autism was dismissed with comments such as “you are too talkative to be autistic” or “you can maintain eye contact, so you can’t be autistic”. 

 Below are listed criteria adapted from Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-:

Autism Spectrum Disorder

  1. Differences in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history:
  1. Differences in social-emotional reciprocity
  2. Differences in nonverbal communicative behaviours used for social interaction,
  3. Differences in developing, maintaining, and understanding relationships,
  1. Repetitive patterns of behaviour, interests, or activities, as manifested by at least two of the following, currently or by history:
  1. Stereotyped or repetitive motor movements, use of objects, or speech (like stimming)
  2. Likeness of sameness and adherence to routines, or ritualized patterns of verbal or nonverbal behaviour
  3. Special interests  that are high in intensity or focus
  4. Hyper- or hypo reactivity to sensory input or strong interest in sensory aspects of the environment
  1. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
  2. Symptoms cause challenges in social, occupational, or other im­portant areas of current functioning.
  3. – It is not due to intellectual disability.

Please note that DSM-5 is very “deficit” oriented, this is unfortunately the language that is used in the whole manual. Fortunately, most psychologists now focus on the differences that Autistic brains come with, seeing them as something unique and beautiful. Acknowledging that all neurotypes have unique strengths, interests, and needs is called using a “neuroaffirming approach”, which I talk about more in my blog post.

“How common is co-occurring ASD+ADHD?

Estimates of co-occurring ASD+ADHD vary widely. Generally, it is considered that the majority of individuals with autism also have ADHD symptoms. However, in some studies the proportion of children with autism who also have clinical symptoms of ADHD is reported to be as low as 14% while other studies report it to be up to 85%.4,7 Similarly, clinically elevated levels of autism symptoms have been noted in 18% to 67% of children with ADHD.1,8,9”

(source: https://www.autismspectrum.org.au/uploads/documents/Fact%20Sheets/Factsheet_Autism-and-ADHD_20171113.pdf )

From my research and conversations with colleagues, there is no consistency in the data provided. One of the reasons for it is that it is only since 2013 (DSM-V release) that a dual diagnosis is allowed. Previously it was not an option to have both 🙂

The other issue is the methodology used for this kind of research. The information I have gathered indicates that the coexistence can be as high as 70%.

It is important to keep in mind that autism presents very differently from the image we might have because of the media (think Sheldon Cooper from The Big Bang Theory).   Currently, the prevalence of autism is estimated at 2% of the world population, which means that there are 160 million autistics around the world.  I am sure you know someone who presents with these features; however, due to lack of widespread knowledge, they have often just been labelled as “weird” or “quirky”.

Gender differences

DSM-5 indicates that Autism is diagnosed four times more often in boys than girls. It also states that girls “may go unrecognized, perhaps because of subtler manifestation of social and communication difficulties”. This is well explained in this short pdf: https://www.autismspectrum.org.au/uploads/documents/Fact%20Sheets/Aspect-Research-girls-and-women-on-the-autism-spectrum.pdf

If you are uncertain, speak to your or our psychologists and get curious.

Here are some questionnaires I would recommend to complete as a starting point: 

I encourage my clients to get assessed! Research indicates that obtaining a diagnosis (even in adulthood) can lead to anxiety reduction, as well as a better understanding of your identity.