My Autism Assessment, Age 40 (Pt. 2)

what will happen in the end?

For the first portion of this, please check out My Autism Assessment, Age 40.

When I last left you, Dear Reader, I’d agreed to take part in a formal autism assessment, which would be covered by my HMO. After submitting a battery of questionnaires and enduring two video interviews with the specialist who would be conducting the assessment and determining the findings, I was told that due to my “complex profile,” including my diagnoses of schizoaffective disorder, complex PTSD, and fibromyalgia/POTS, my already lengthy assessment would take even more time than the standard adult individual seeking out an autism assessment. A standard adult assessment tends to take several hours spread over several appointments; I gathered that it would typically take 12-15 hours for an adult with minimal differential diagnoses.

And adults are seeking out autism assessments and diagnoses in greater numbers than they used to. Due to factors like increased awareness and decreased stigma, changes in diagnostic criteria, and more widespread information due to social media and the internet in general, it’s not just kids who need an Individualized Education Program (IEP) who are getting assessed. In fact, I’ve heard from plenty of people who read Part 1 of this piece that they only realized their own likelihood of autism after their children were diagnosed—and while not everyone who has such recognition will go after a formal diagnosis, enough people do that they’ll do what I did and look for either a private or an insurance-covered assessment.

There has also been an increase in awareness about autism in adult women in particular. The podcast The Late Discovered Podcast is one significant example of the phenomenon that is adult women discovering that they are autistic after years of studies indicating that only 20-25% of autistic adults are women, while there are several reasons that the statistics are skewed: women and girls are often seen as better at masking and camouflaging; typically autistic traits are historically based on studies of boys and men.

I’ve received plenty of assessments and diagnoses in my life when it comes to my mental health and other conditions that could be considered elements of neurodivergence. But none of those evaluations have been as wildly in-depth as my autism assessment, which began in November, skipped a month while I was abroad, and then resumed with weekly or twice-weekly three-hour sessions involving interviews and tests of various kinds. I’ve had an IQ test (“Aren’t these outdated and shown to be biased?” I asked. “They’re still important,” Dr. P said), an academic test (I don’t know what knowing the distance between the sun and the earth has to do with any of it, but I can tell you right now that I still don’t know the answer), a math test (which I think I scored perfectly on except for one problem that involved a logarithm), and several tests that were specifically designed to look for autism.

One of these tests, which he called “the gold standard for autism assessments,” involved him walking to my table and unloading a baggie of contents onto the table’s surface. The items were seemingly random: a purple cube, a black shoelace, a fake pair of wire-rimmed spectacles the size of my palm, and a paper clip, among others.

When I saw the assortment of items, which to me seemed like they’d been picked up off the street and tucked into a baggie by a child for safekeeping, I asked, “Are you for real right now?”

“Yes,” said Dr. P. “Select five items.”