I Think I’m Autistic, But....

Does this sound like you?

• You make friends easily but find it impossible to meet the demands of maintaining close relationships.

• You have no trouble with understanding facial expressions, but people tell you they are fine even though they look sad.

• You enjoy strong sensory input such as loud music or big hugs.

• You don’t relate to ‘black-and-white’ thinking - you believe that most topics have more nuance.

• You’ve done quizzes on autistic traits but felt that the questions weren't clear enough.

Many people assume autism always looks a certain way, but the reality is much more complex.

If you've ever wondered whether you might be autistic but felt like you didn’t fit the mould, you’re not alone. In fact, taking the autism criteria literally may be due to rigid thinking – an autistic trait in itself!

Let’s address some common misconceptions about autism to help you better understand whether an autism diagnosis might apply to you.

Can I be autistic with good eye contact?

Put simply, yes. Eye contact is just one part of nonverbal communication, and there may be other nonverbal communication behaviours that are difficult for you to express or interpret.

Many autistic people also mask difficulties with eye-contact with strategies such as:

• Making short glances

• Practicing in the mirror

• Making intense eye-contact, to the point where others find it jarring

Expectations and comfort with eye contact varies between culture and personal preference, even amongst allistic (non-autistic) people. Within the nonverbal communication domain, autistic people may also struggle with interpreting or using facial expressions and other body language, however autistic people may mask by researching or carefully copying others' nonverbal communication, and they might end up more in-tune with these subtle mannerisms than allistic people.

Can I be autistic without social issues?

If you’re introverted, feel that you do not need to make friends, make friends easily but prefer to spend your free time with only one person, or don't feel pressured to conform to social norms - you may believe you do not have social issues.

However, autism always involves some form of social difficulty, even if it doesn’t feel like a personal issue. These difficulties manifest in the way an autistic person understands, processes, or responds to social interactions. In short, whether or not it feels like a ‘problem’, autistic people will generally have a hard time navigating and adapting to the ever-changing demands of what is expected in relationships, group settings, or the general public, without facing exhaustion.

Even if an autistic person does not feel lonely or distressed by these challenges, the differences in social interaction styles still exist. Socially ‘successful’ autistic people still navigate the world differently than their allistic peers.

Can I be autistic without experiencing meltdowns?

Not all autistic people have visible meltdowns - but that doesn’t mean they don’t experience distress or shutdowns. Meltdowns are typically intense, emotional responses to overstimulation, frustration or change, but they can look different depending on the person.

Instead, you may experience intense internal distress that is not outwardly observable, or wait until you are in a safe environment before releasing your emotions.

You may also experience verbal shutdowns, withdrawal or freezing. Often autistic people will have heightened emotional responses to changes, perceived injustices or sensory triggers, but these responses aren’t always visible to bystanders.

Can I be autistic without having sensory issues?

Sensory processing differences are part of the autism diagnostic criteria, but they don’t always look the way people expect. Many people assume sensory differences means disliking loud noises or bright lights, but sensory profiles vary widely. Sensory sensitivity can encompass both an over-responsiveness (hypersensitivity) or under-responsiveness (hyposensitivity) to sensory input.

Most autistic people will have a mixture of responsiveness, where they avoid certain sensory experiences and seek others. These preferences may change greatly depending on mood, energy levels or simply whether they have control over their sensory environment. For example, you may be okay with making loud noises yourself but feel irritated when others do.

Some autistic people with comorbid ADHD or dissociation-related symptoms may not notice sensory sensitivities immediately. This may come at the cost of burnout in the long run, and unexpected emotional build-up after experiencing sensory overwhelm.

So I could be autistic?

If you’ve been thinking, “I think I’m autistic, but…”, you may have been misled by stereotypes or the idea that autism only looks one way. The truth is, autism is a spectrum - not in the sense of ‘mild’ to ‘severe’, but in the sense that each autistic person presents differently depending on their individual symptomology.

Many autistic adults don’t recognize themselves in diagnostic criteria because:

• They have masked their differences for years

• They compare themselves to stereotypes that do not reflect the full spectrum

• They have adapted or accommodated to their behaviour without realising

• They have comorbidities (e.g. ADHD) which alter how their symptoms present

If you resonate with the experiences discussed in this blog, it may be worth exploring autism further. It may be beneficial to seek formal assessment, talk about your symptoms to a psychologist or to other autistic people, or simply reflect on how you navigate the world differently.

At Psychwest, we understand the nuances within the autism diagnostic criteria, and can help you explore your symptoms in a safe, supportive environment. Whether you’re considering an autism assessment or just want to talk through your experiences, our team is here for you. Reach out now to engage with one of our experienced psychologists.

Adult Autism Assessments: What to Expect

If you or a loved one is considering an autism assessment for an autism diagnosis but feeling overwhelmed about where to start, this guide is here to provide clarity on the process and what you can anticipate.

Autism Assessment & Diagnosis Process for Adults

Clinical History/Interview

The assessment process usually begins with some exploration of your background, encompassing health, development and significant events. Assessors will inquire about your primary symptoms of concern during this phase.

Formal Assessment

Following the background examination, the assessor conducts a thorough assessment to delve deeper into your symptoms. Two commonly used assessments are the ADOS-2 (Autism Diagnostic Observation Schedule-Second Edition) and the MIGDAS-2 (Monteiro Interview Guidelines for Diagnosing Asperger’s Syndrome).

The ADOS-2 is a practical assessment that provides a controlled environment for an assessor to observe symptoms of Autism and can be particularly valuable for those uncertain about how their symptoms impact them.

The MIGDAS-2 is a flexible semi-structured interview, which is preferable for those well-acquainted with their symptoms.

At PsychWest, we currently use the ADOS-2 for both child and adult assessments.

After the main assessment, your assessor may screen for additional conditions that could influence your symptoms, such as ADHD, CPTSD (complex post-traumatic stress disorder), or mood disorders.

References

Assessors often seek input from family, partners or close friends to gather observations. References can be provided in person using the ADI-R or a semi-structured interview, over the phone or in written form. School reports can serve as supplementary information for adults.

Report and Feedback

After gathering information, your assessor should compile this into a report and provide a feedback session.  This session aims to address next steps, potential funding options, and answer any questions you may have.

Who can diagnose autism?

Psychologists or psychiatrists who have had relevant training and experience with autism can diagnose and provide support through the assessment process. If you are seeking assessment, ensure that you let the practice know so that they can direct you to the correct practitioner and you can start the assessment process right away.

It is recommended that you research the assessment processes of available practitioners to make an informed decision. PsychWest is currently accepting appointments for autism assessments and combined autism/ADHD assessments.

What should I do now?

Given the typical waiting lists for autism assessments, take this time for reflection. Whether awaiting an assessment date or contemplating the need for assessment, consider how autism might explain your history and current symptoms.

Embarking on an autism assessment journey can be daunting, but understanding the process and being informed about available resources will help you navigate this important step toward understanding and support.

Start the process today by contacting PsychWest here.

What is Autism?

Autism: Where to Start

Autism is a developmental condition that originates in childhood and is likely to continue into adulthood. Autism begins before the age of three and occurs in all racial, ethnic and socioeconomic groups. It is more common, however, in males.

Little is known about the cause of autism, but some factors have been identified that may make a child more likely to develop autism. These are environmental, biological and genetic.

Autism is characterised by a number of behaviours and differences. People with autism may behave, communicate/interact with others and learn in ways that are different to most people. They have difficulties in the areas of language/communication, social awareness, monotropic mindset, information processing, sensory processing, repetitive behaviours and neuro-motor differences.

Common Symptoms of Autism Include

Social Communication and Interaction Skills

Some common signs or symptoms in the area of social communication and interaction skills include:

• Avoids or does not keep eye contact

• Does not respond to name by 9 months of age

• Lack of facial expressions by 9 months of age

• Does not share interests with others by 15 months of age

• Does not notice others are hurt or upset by 24 months of age

• Does not join in with play with other children by 36 months of age

• Does not role play by 48 months of age

• Children with autism can become non-verbal, or they can be fully verbal.

As older children and adults, it can look like:

• Difficulty engaging with and maintaining friendships/relationships

• Difficulty communicating in social contexts

• Differences with pragmatics (appropriate use of language)

• Prosody (rhythm) of speech

• Difficulty assimilating or adapting to changing environments

Restricted or Repetitive Behaviours or Interests

This can look like:

• Lining up toys or other objects

• Repeating words/phrases over and over

• Playing with toys the same way every time

• Can become upset by changes in routine

• Has obsessive interests

• Hand flapping/body rocking or spinning

• Sensitive to certain smells, touch, tastes or sounds

Other Characteristics

• Delayed language skills

• Delayed movement skills

• Delayed learning or cognitive skills

• Hyperactive/impulsive or inattentive behaviour

• Epilepsy or seizure disorder

• Unusual eating or sleeping habits

• Gastrointestinal issues

• Unusual mood or emotional reactions

• Excessive anxiety and worry

• Lack of fear or more fear than expected

• Effects on body control and movement eg. clumsiness

Why Autism is a Spectrum

The spectrum does not equate to the severity of the condition, which is a common misconception. The spectrum relates to the diverse range (spectrum) of related neurological conditions or abilities. The abilities of people with autism can vary significantly. Some autistic people require more support than others to live their daily lives. Every autistic person presents differently. The saying “if you have met one autistic person, you have met them all” does not stand for this condition. For example, all autistic people will have some type of difficulty with social/communication AND restricted/repetitive behaviours or interests, but to different and varying degrees.

How Autism Affects Daily Life

Autism can affect people’s daily life in different ways - it really depends on the individual and what they have difficulties with. One person could be non-verbal and another person could have an intellectual disability. Some people with autism will never be able to live independently while others can live an independent lifestyle.

How Autism is Diagnosed

In order for someone to be considered autistic, they must have difficulty in multiple categories spanning the spectrum. There is no medical or blood test that can be administered to make a diagnosis. Clinicians (GP’s, Psychologists, Psychiatrists and Paediatricians) look at the child’s (or adult’s) full developmental history and behaviour to make a diagnosis. It often involves more than one specialist, some standardised assessments, behavioural observations and comprehensive interviews.

Difference Not a Deficit

In recent times, the viewpoint that autism is a deficit or disability has been criticised. Many experts are encouraging society to embrace autism as a difference, whilst at the same not underestimating the difficulties this group that experience. The acceptance of difference can go a long way to improving the lived experience of those with autism.

If You Are Concerned

Lachlan at PsychWest is available to assess for and diagnose autism in all ages. Click here to learn more about the assessment packages at PsychWest.