Sometimes the question is more complicated than “Am I autistic?”
It may be: Which parts of my experience might be autism, and which might have another explanation?
You may already have several diagnoses. Autism may have been suggested alongside ADHD, anxiety, trauma, obsessive-compulsive experiences or longstanding mental-health difficulties. Perhaps different professionals have offered different explanations over the years.
These are situations in which formulation and differential diagnosis matter particularly strongly.
Autism can coexist with other difficulties
Finding evidence of anxiety, ADHD or another mental-health difficulty does not in itself rule autism in or out. Autistic people can experience other neurodevelopmental and mental-health conditions, and some experiences can look superficially similar while having different underlying explanations.
Looking at patterns across a lifetime
One useful question is not simply whether a particular behaviour or difficulty is present, but when it emerged, what seems to drive it, and how it fits with the rest of the person’s development.
For example, social withdrawal can have several possible explanations. Routines or repetitive behaviour may also mean different things in different contexts. Unusual sensory or perceptual experiences need to be understood rather than automatically attributed to one diagnosis.
That is why our assessments draw on developmental history, current experience, direct observation and wider clinical history rather than relying heavily on one questionnaire or test.
Our clinical and research experience
Both Illumina psychologists have experience across autism assessment and complex mental-health services. We discuss every assessment jointly and explicitly consider competing explanations where they are relevant.
Dr Jess Stock and Dr Dan Stevens are co-authors of the paper “Determining unmet need: clinical relevance of suspected neurodivergence in first-episode psychosis”, published in BJPsych Bulletin. The research examined autism and ADHD in a first-episode psychosis service and reflects our broader interest in the intersection between neurodevelopment and complex mental-health presentations.
Occasionally, a question may fall outside our own expertise. Where specialist input would genuinely improve the assessment, we can discuss whether consultation with another professional would be useful.
What we are trying to achieve
Our aim is not to produce the diagnosis that somebody expected when they arrived. It is to arrive at the explanation that best fits the available evidence and to explain our reasoning clearly.
Whatever the eventual diagnostic outcome, the assessment should provide something useful: a coherent account of how we have understood your experiences and practical recommendations about what may help next.