What to expect during an autism assessment with Amy

If you're here, you might be wondering whether you are autistic, or you already self-identify as autistic, but would like confirmation and validation.

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?

What does an autism assessment look like?

The first thing I want to say is that your comfort is my main priority. I mean this in a very genuine way. I understand that by the time someone sees me for an assessment, they are likely to be anxious. So I see it as my job to create a space for you that is calm, respectful, warm, and where you will feel safe. I do whatever I can in my power to create that for you, whether it means you don't want to (or can't) do any questionnaires before hand, want your camera off (as long as I can see you for 10 mins at the start, and 5 at the end), want to lay down in bed at the same time, eat, etc.

I do autism assessments the way I wish my own autism assessment was done. I see assessments like therapy- I use a therapeutic approach to them. There are no trick questions. I am not trying to 'catch anyone out'. It is not clinical. Your comfort is key to me.

I see plenty of folk who are likely to be auDHDer, smart, and high maskers, so don't worry- I get you.

I am intentionally casual, with the aim of making you feel as safe and at ease as possible. 

If you have a disability that means that we need to modify anything, I will do that for you- if you struggle to type, have a vision or hearing impairment, FND, CPTSD, or a learning disability (for example) we can make modifications for you. Please note I am not able to provide assistance to those with an intellectual disability however, as I am not skilled in making accomodations in that way (yet!)

I've written some info below to help you hopefully feel more comfortable with what to expect. Please also refer to this page for detailed info: autism assessment page 

Before the Interview

Once you have selected a date and time that suits you, my admin assistant (Brie) will send the following:

1. Client intake form (we already have your name and email, but will ask for your DOB, address, mobile, pronouns, and an emergency contact name and number). You can upload or email other reports, etc, if you want to (not necessary)

2. Service agreement (states our policies and so on)

3. AI tool consent (I struggle with writing due to having Ehlers Danlos Syndrome, so use AI)

4. Consent to liaise with others (only if you want me to)

5. Assessment form (your expectations, goals, anything to make it easier for you, background questions (living situation, physical and mental health, family, developmental milestones, education, employment), MIGDAS form (stims, spins, sensory, routines, communication, social, emotional, burnout).*you don't have to fill this out prior to if you don't want to.

6. Autism tests/questionnaires (Brie will then send you links to complete questionnaires). if you don't want to do them, you don't have to- we understand. Questionnaire suck for autistic folk- as a collective, I think the majority of us hate them!

7. Informant questionnaire (Brie then directly emails your loved ones with a questionnaire-

   (if this too tricky, we can speak about this in session with me- don't worry!) It's so common that our parents, family, etc, can't provide helpful data because:

   1. They are autistic too, and not aware

   2. They think there is "nothing wrong" with my child/sister, etc

   3. Due to trauma, you're estranged from them

   4. They think of Rainman or toy trains when they think of autism

   5. They have passed away, or not able to fill them out (I see lots of women and AFAB folk in their 40s, 50s and beyond),

The 'Interview'

We then have our 2 hour 'interview'/session together. You will be emailed a zoom link- this is a dedicated and secure zoom room. In the 2 hours, I can be flexible to suit your needs. How I approach this depends on how much info you have given me before hand, but my typical structure includes:

1. Clarifying what I can do to make the interview comfortable for you

2. Clarifying what you want in our time together (some people give me a lot of data before hand, so we can use the session to talk about NDIS, resources, talk about autistic burnout, masking, etc)

3. Clarifying if you identify as autistic or not, and why not/why

4. Clarify a few background areas (eg- I might need more data in addition to what you have given me on your health, mental health, etc)

5. Do the MIGDAS with you (or only ask some parts of the MIGDAS, depending on how much you have written before hand)

6. I will then share test results with you (I can screen share if you would like)

7. We then (usually!) have time to talk about key resources or supports you need (this is only if I have enough information to make a 'diagnosis').

After the Interview

1. On the day of your session, I will email you key resources as a starting point (relevant to you), and key blogs of mine to read

2. 4 weeks later (sometimes up to 6 weeks), I email you your full report

3. I can see you for a small handful (1-3) therapy sessions after to support you/put you on the right track too

4. I know many lovely and openly auDHDer/ autistic psychologists to refer you to for ongoing support- these are all affirming and SAFE people.

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.

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 auDHDer Psychologist,

Amy