If you're here, you might be wondering whether you are autistic. Maybe you've connected deeply with the experiences of others who have been identified as autistic, or perhaps you've always sensed that you experience the world differently?
Understanding the autism 'diagnosis criteria'* can be an empowering step toward your self-discovery.
*note that this blog uses medical model language from the DSM-5-TR that I detest, but for the purposes of attempting to strike a balance between affirming language and medical model language, I will use the words 'diagnosis', and 'criteria' in this blog.
The unique path to identification for women
Autism has often been portrayed in a way that centres on young boys, leading to a significant under-diagnosis in adults — particularly women and those assigned female at birth (AFAB).
The traditional view has missed the diversity of how autism can ‘look’, especially in women, who often excel at "masking" or "camouflaging" their traits to fit in with societal expectations in a neurotypical world. This ability to adapt, though remarkable, can sometimes delay or complicate the journey.
No, we don’t all flap our hands and love looking at trains!
For women and AFAB folk, masking can involve mimicking neurotypical social behaviours, which might make their autistic traits less visible to others. Understanding this can lead to a more accurate and affirming recognition of one’s unique neurodivergent identity.
Understanding the criteria for an autism diagnosis and assessment
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) has 5 criteria for identifying autistic neurotypes. I’ve re-worded the ‘criteria’ because medical model language sucks, and used questions because I like questions….
A. Are there key differences in social communication and social interaction across
various contexts?
B. Are there distinctive patterns of behaviour, interests, or sensory experiences?
C. Is there 'evidence' from childhood? (this is why we need informant data!)
D. Are there impacts in important areas of functioning? (such as mental health- it doesn’t have to affect your work or social life actually!)
E. Does an intellectual disability better explain the differences?
Criteria C, D and E are not really exciting, so I won’t cover it here.
Criteria A - Key differences in social communication and interaction
Let’s explore these areas and how they might resonate with your own experiences, especially if you're an adult woman.
Criteria A includes different approaches to social-emotional reciprocity, nonverbal communication, and forming and maintaining relationships.
All three of the bullet points below must be seen in order to be identified as autistic.
Social-Emotional Reciprocity
You might notice that you approach conversations differently, perhaps preferring deep, meaningful exchanges over casual small talk. You may also find that you have a strong focus on particular topics and enjoy sharing them. We often hide all of this, so it’s more obvious when we’re stressed or burnt-out!
Nonverbal Communication
You may have a distinct way of expressing yourself nonverbally. For example, eye contact might feel uncomfortable, and you might express emotions in ways that others find unique. This doesn’t mean you lack emotion—it just means you express it differently. In fact, autistic folk are deeply empathetic and sensitive people!
Relationships
You may prefer smaller, more intimate connections over larger social groups. You might have a deep, loyal bond with a few close friends, but find larger social settings draining or confusing. It doesn’t mean that you have no friends, but it could mean that maintaining connections is not as easy at times… I notice that I rely on sending lots of memes to friends. We’re often straight-shooters who are quite direct, but will often mask this.
Criteria B - Distinctive patterns of behaviour, interests, or sensory experiences
This autism 'diagnosis criteria' is characterised by unique routines, specialised interests, and a distinct sensory profile.
Only two of the four bullet points below must be seen in order to be identified as autistic, plus they might've been seen in the past ('historically'), but not now:
Repetitive Movements and Speech (Stims)
We often move our body in different ways to regulate, sooth, distract, when we’re excited, etc. Stimming is not just about flapping your hands. It could be listening to the same song on repeat, or reading the same book. It can look really subtle in some women, such as tapping teeth together, fiddling with a ring, twirling hair, etc.
Routines and Rituals
You might find comfort and joy in maintaining specific routines, and disruptions might feel challenging. This could be something like eating the same foods (‘same foods’) or following a particular daily schedule that brings you a sense of calm and predictability. Check out my blog on this! This is not a big issue for all autistic people actually. Autistic folk who also have ADHD might notice the interplay of these two neurotypes!
Focused Interests (SPINS)
You might have passionate and intense interests that you dive deeply into, and these interests can bring you immense satisfaction. They might change over time, or you might have a lifelong love for a particular subject. I’ve always loved plants and cats! Sometimes our SPINS (special interests) blend into socially acceptable areas like helping others (like psychology haha).
Sensory Sensitivities
Your sensory experiences might be more intense or muted compared to others. You might be highly sensitive to certain sounds, lights, or textures, or you might seek out specific sensory experiences that bring you comfort. Sensory sensitivities might be something you’ve learned to manage, but they’re a vital part of your experience.
What to expect during an autism assessment
You can expect a thorough and supportive process designed to provide reliable and valid results. Questionnaires, a semi-structured interview, observations, and data collection from loved ones is used to paint a comprehensive picture. Sessions are conducted via videoconferencing, typically using Zoom, to ensure accessibility and comfort.
The atmosphere is intentionally casual, with the aim of making you feel as safe and at ease as possible.
Before the interview, you’ll be asked to complete 7-10 online questionnaires, background assessment forms, and an autism assessment form.
Additionally, you’ll have the opportunity to share any relevant reports or reflections, and your loved ones, referred to as ‘informants,’ will be asked to complete an online questionnaire to provide insights.
The interview itself is a 2-hour session, where the goal is to explore your experiences in a conversational and informal manner.
By the end of the first hour, I am able to determine on the spot if you are autistic.
This allows us to spend the remaining time exploring your questions, discussing targeted recommendations, and addressing any concerns you may have.
After the assessment, a report will be generated and emailed to you. You’ll have the opportunity to review the report and suggest any changes if necessary.
Ready to take the next step in your autism assessment and diagnosis?
My approach is deeply rooted in empathy, compassion, and a keen curiosity about each individual’s unique experience. I provide a warm, collaborative and insightful environment where your story can unfold with support and understanding. My passion lies in supporting women, non-binary, and trans individuals who often go undiagnosed due to historical diagnostic frameworks and sociocultural stereotypes.
Together, we will explore the autism diagnosis criteria through a collaborative and transparent process, ensuring that you feel seen and validated.
Check out my autism assessment page or contact me to book your assessment in when you're ready.
Your Neurodivergent Psychologist,
Amy
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