How do you start the conversation with your GP about ASD referral and assessment?
One of the biggest concerns when we start to consider pursuing a diagnosis of autism is how to start the process. If you’re an adult, or if your child is in mainstream school and not obviously falling apart, people will often question why you want to seek a diagnosis at all, and may brush off or negate your concerns.
First, do some research. Know who, in your area, has experience with diagnosing girls and women on the spectrum, and have their details with you when you go. Groups like the Sisterhood of the Autistic Woman and Sisterhood of the Autistic Girl are very helpful here; if you say where you are, group members can often direct you to local specialists, with recommendations for those who are particularly helpful.
When you go to the GP to get a referral, the way you approach it may vary depending on how well you know the GP, and how you think they’ll respond.
If you feel very comfortable with your GP, you can take some information about the presentation of female autism and explain that this is something you see in yourself.
If you don’t know your doctor well, don’t think they’d be supportive of your interest in seeking an autism assessment, or if you really don’t feel comfortable discussing it, you may feel more comfortable approaching your doctor with a vaguer picture; perhaps explaining that, for example, you’ve been feeling anxious or distressed and out of place (which most of us have), have sought a recommendation, and would like a referral to this psychologist, please.
Is Asperger’s Syndrome the same as autism?
Short answer – it’s generally seen as a type of autism, though the terminology is considered out of date by many practitioners.
Prior to 1980 – when DSM-III came out, autism wasn’t a generally recognised diagnosis; children with autism were diagnosed as having ‘childhood schizophrenia’. Asperger’s was added to the DSM-IV in 1994, as a type of pervasive developmental disorder.
Since 2013, with the publishing of the Diagnostic Statistical Manual, 5th edition (DSM-5), the term “Asperger’s Syndrome” or just “Asperger’s” has been replaced with a broader term “Autism Spectrum Disorder”, which includes the previously separate diagnoses of Autism, Asperger’s and ‘Pervasive Developmental Disorder – Not Otherwise Specified’ [PDD-NOS]. All of these are now classified as autism, and a level is assigned according to capacity for independent living.
The World Health Organisation’s ‘International Classification of Diseases and Related Health Problems’ [ICD-10] retains Asperger’s as a diagnosis in the 2015 edition, under the umbrella term ‘Pervasive Developmental Disorders’. At the time of writing this, the plan for ICD-11 is to rename that umbrella term ‘Autism Spectrum Disorders’, and Asperger’s will be used as an ‘index term’ for Autism (a term used as a sub-type or synonym in the ICD classification) without being an official diagnosis any more.
My cousin’s best friend’s nephew is autistic, but he …
No. Just no. No comparisons.
Autism is diagnosed by the presence of a cluster of characteristics, but specific, observable behaviours are different for everyone, and any individual autistic person may or may not have them. An autistic person may or may not be able to speak, may or may not be able to make eye contact, may or may not have extreme over- or under-responses to sensory stimuli (compared with the average response), may or may not have visible stims or tics, but the fact is that autism is a difference in brain wiring, not a collection of behaviours. There are similarities, even if you can’t see them. Behaviours are an outward response to what’s going on in the environment and internally, but in many cases can be held in check for a time when we’re in public. This takes energy. Often, a lot of energy.
What is a stim or stimming?
The word ‘stim’ comes from the vaguely uncomfortable term ‘self-stimulating behaviour’. It’s a habit or action that people use to comfort, settle, or relax themselves. Hand-flapping is one example of this, but it can be as diverse as sucking a thumb or finger, stroking a toy, tapping feet or fingers, or spinning in circles. Stimming can also be more discreet such as nail bitting.
What is “ableism”?
This is a type of discrimination which favours people without a disability. Although the neurodivergence model of autism may reject the idea that it is a disability in and of itself, the societal expectation that everyone has a particular (NT) neurology creates disadvantage for those who don’t fit those expectations.