The Neurotypical Autism Diagnosis

The Neurotypical Autism Diagnosis

Imagine that someone is colorblind, yet they have the job of identifying and detecting colors, and everyone around them thinks they are doing a great job getting all of the colors right. There’s no oversight or check by someone who sees in color. No one even thinks twice about it really. Imagine those people being trained by other colorblind people on how to detect colors. Wouldn’t that seem a bit backwards?

That is the prism through which we view autistic people as a society, and as many professionals do. They may only see “communication deficits,” but really they aren’t able to see into an autistic person’s brain, who may not think in the way a neurotypical person can follow. They can’t go into our brain and figure out what we are thinking and feeling. The idea that you can take a test, or someone (usually a neurotypical person) can assess your body language/tone of voice/very existence and then somehow know you are autistic,* is in some ways, rather ludicrous in the first place. But if that person has no firsthand knowledge of autism from an autistic person, then it is very much so.

In particular, the very “disorder” is defined as a social communication disorder. So, then why do non-autistic people think that you can diagnose someone from interviews/tests who literally has problems expressing their thoughts verbally in a neurotypical way (in a way that neurotypical people can understand)? You already have a barrier there, something that is inaccessible. Honestly I’m not sure I would’ve been able to speak so much during my interview for an autism diagnosis if my husband wasn’t there to elaborate on things. Further, many autistic people (myself included) have a hard time understanding and verbally expressing their emotions to others, and sometimes themselves (alexithymia). Therefore, we may not even know we are experiencing anxiety, or stress, or sensory pain. The fact that you have to be aware of your emotions to tell someone what you’re experiencing is a big problem, and likely part of the reason so many autistic people go undiagnosed through childhood and adulthood.

Diagnosis is largely based on neurotypical communication expectations, but many professionals are missing very important components – sensory hypersensitivities (or hyposensitivities) and alexithymia. Those are two giant barriers to actually getting diagnosed, as sensory overload makes it hard to think and verbally speak, while alexithymia makes it hard to recognize your emotions, especially in the moment (when a 2-second answer is expected). Although in general, diagnosing anything based on behavior is not great (if there are other methods, we should use them!), autistic people in particular are set up to get missed or invalidated by professionals. I could especially see this happening for children. There are a lot of autistic children (especially children raised as girls) who give the “correct” feedback that they think is expected of them, or don’t know how to describe their emotions.

I know that as a child, I thought I –

  1. made eye contact (I blurred my eyes or looked at people’s ears/noses/eyebrows)
  2. was good at conversation (to some extent I was since I watched people a lot, but couldn’t initiate or sustain a conversation with same-aged peers),
  3. didn’t have any difference in auditory processing from other people.

So how the hell would professionals have ever diagnosed me?

Any question would be answered like a neurotypical person.

Imaginary example:

  1. Do you have friends? “yes”
    • I had people I sometimes talked to at school, so those are friends right?
  2. Do you get overwhelmed? “no”
    • I didn’t know I was anxious or in pain
  3. Can you have conversations with other people? “yes”
    • I’m having a conversation with you right now!

I even found and took an autism quiz in 7th grade, very anxiously, thinking no, there’s no way I could be autistic. It had questions such as “do you make eye contact?” (answered yes), “can you make conversation?” (answered yes) and a few other things. I don’t remember the results to be honest, I just remember thinking, “yea there’s no way I have that, I’m just a weird kid” after I took it. It may have even been on the “threshold” of needing to look into a diagnosis, but I’m not sure.

Professionals, Remember This:

  1. Autistic people’s sensory experience does not equal behavior.
    • We can hide distress, pain, and anxiety.
  2. Autistic people’s emotional experience does not equal verbal expression or ability.
    • We often feel things in the moment that we cannot describe.
  3. Autistic people’s theory of mind does not equal results of experiments based on vaguely worded questions and tests, while assuming neurotypical type responses are the empathetic ones (i.e. the “right” answers).
    • Neurotypical people are just as bad, if not worse, at understanding what helps us.
  4. Autistic people’s experience of shutdowns/meltdowns does not equal “challenging behavior” or negative/spiteful intent to others.
    • Often it is stress from sensory overload and/or anxiety or frustration
  5. Autistic people’s body language/tone of voice does not equal neurotypical implicit intent or implications or emotion (read from a neurotypical perspective).

*Note: This is not to say that there isn’t autistic body language or tone of voice to some extent. But there is as much variability between autistic people as there are between non-autistic people – so, a lot! My point is that how someone presents themselves to the external world is based on how someone grows up, what is expected of them, and what external pressures are put on them by society in general. Being an autistic cis white woman is likely very different from being an autistic trans black woman, for example, or any other different characteristics of a person. Your external pressures are different. And then there’s individual experiences of how you are treated and reacted to when growing up.

My point is that there is not one way to be autistic, just like there’s not one way to be neurotypical. Until professionals understand that, and until we have more autistic professionals in the field, an autism spectrum “disorder” diagnosis will simply be one box they’re trying to fit over everyone, no matter each person’s dimensions.

Self Diagnosis is Valid

Also, self diagnosis is valid. We shouldn’t have to try to access the inaccessible (through money/place/time/resources/implicit gender and race biases) to believe that our own experience of our existence is accurate and valid. My own diagnosis story was positive – but for many many other autistic people, it wasn’t. I was told I had done a “lot of research” and was immediately validated by the person who saw me, likely because I spent 6 months finding someone who has already worked with autistic adult women, after I read about autistic women’s experiences and heavily related to them. We are so scared of invalidation by professionals, unfortunately because it’s so common. If a professional invalidated you, know that the entire diagnostic system for autism is based on very little knowledge of autistic people. Self diagnosis is valid. Your experiences matter. We’ve been invalidated enough. It’s hard to do, but try to trust yourself. You matter.

13 thoughts on “The Neurotypical Autism Diagnosis

  1. Exactly! That’s what I was trying to say in my last post “Autism: A condition marked by external behavior not accurately representing internal events”. Except I do poorly at trying to explain things and probably the only thing people will understand is my chart. May I add a link to this post?

    Liked by 2 people

  2. Excellent discussion. I was diagnosed a few years ago at the age of 28. I was self-diagnosed and was seeing a therapist for anxiety and depression, then asked for a referral to a psychologist who had experience diagnosing adults. I recently started a blog focused on adult women on the spectrum. I hope to be a part of the conversation. I look forward to following you! =)

    Liked by 3 people

  3. I’m self-diagnosed, and it’s been the only thing that’s helped me make sense of my wonderful, different, misunderstood life, in large part because it’s drawn me to blogs like yours (and including yours) where I find happy mirrors and see I’m not the only one, after all.

    Liked by 1 person

  4. My first diagnosis was when I was interviewing for a PhD program in immunology at a top research university – a rather stressful experience. Two of the professors (both prominent immunology researchers and one was also a practicing rheumatologist) told me I was autistic and for some reason I completely ignored it; I think they were qualified to make the diagnosis even though they are not developmental psychiatrists. The rheumatologist even described me as being ‘severely disabled’. Unfortunately I was also subjected me to very blatant, quid-pro-quo sexual harassment during the interview process. I’m still having trouble processing the idea that people would knowingly put pressure on an autistic person in that way.

    I also experienced quite brutal sexual harassment as an undergraduate (graphic rape and death threats, lowering of a grade for not providing sexual favors). I hope things are better now, but what I have read of my alma mater not much has changed.

    Liked by 2 people

  5. Totally agree with you. I need to check my younger daughter to be evaluated too. She looks perfectly like neurotypical, but my gut tells me that she is in the spectrum too.

    Liked by 2 people

  6. I would love to know good resources for me to get so I understand and can be a soft loving place for my 7 year old grandson to land. Can you help? He is struggling with friendships and peers. He has directed hate to himself. I’d love to be able to help him realize how wonderful and unique he is and value those qualities. We have a special bond.

    Liked by 1 person

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