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Hello,

I am awaiting my autism evaluation and have a question about the diagnostic criteria. I realize that it is somewhat subjective and based on the clinician's perception... but how likely is it that significant childhood trauma will exclude an appropriate diagnosis? I ask because I don't have anyone who can speak of my earliest childhood years before the traumatic incidences (all I have to go by is snippets of what my now-deceased grandmother told me about myself as a young child). I don't think I am traumatized by any of it, but I worry that it may be a red herring for the clinician. I do have a child and a sibling on the spectrum, so the genetic component is there.

Hi I'm new to this group too.

I can't really answer your question unfortunately, since I don't thoroughly understand the diagnosis process.

My clinician talked at length with my sister about early life experiences, but I don't actually know the specifics of what they talked about. I've never heard of an autism diagnosis being excluded due to trauma, however.

I went to a clinician experienced in diagnosing adult women on the spectrum. He asked my directly about traumas and I couldn't answer... I am traumatized by none of life and yet all of life. The next day I provided a long list (most sensory and social, with scale ratings of course). My clinician do not ask much about my childhood although I provided a list of memories and quotes from correspondence and yearbooks that I found. I provided living references he did not feel necessary to call. I was diagnosed as ASD and am one of about 30% of ASD women that are not ASD per the ADOS-2. As you suggest, there are not good standard diagnostics tools for women yet.

I have a niece who is ASD, my mother and grandmother likely is/was, my daughter likely is although the clinician said she is BAP, not ASD. Time will tell.

Welcome to WP!

Welcome to WP!

Hello there, can't help with the diagnosis part unfortunately. I was diagnosed at a young age. I think it depends on the clinician.
And welcome.

Thank you, everyone, for your replies. Against my better judgment, I made the mistake of discussing my upcoming evaluation with an extended family member. It kind of took me back to when I was awaiting my son’s evaluation and I felt very misunderstood because no one else was seeing what I was seeing, and was worried that the diagnosticians wouldn’t see it either (spoiler alert: they did, lol). So now, I am worried that MY diagnostician won’t see it, and will only see a tightly-wound introvert.

My evaluator told me that I hide my ASD much better than I think I do. I'm starting to understand that although my ASD feels so obvious to me, others can't see it. During and after diagnosis, I've stopped censoring myself and started explaining myself more and now folks are "seeing" it. It was always there, people!

Although I have the ASD diagnosis, my daughter does not --- similar to your concern, the psychiatrist said she's introverted: it's a choice that a highly-engaged child in the classroom sits apart from all her classmates at recess and lunch. It's awful, I hate it, but I'm getting her the help she needs anyway and we'll go for a 2nd opinion at some point. There are women in my ASD support group who've had to get second opinions. It stinks b/c it's like "digging" for the diagnosis --- but more often it's a failure in diagnostic criteria.

I have ASD, my BFF may have -or not. She is introverted and has had a greatly controlled life (incl. financial freedom) and therefore hardly any meltdowns or shutdowns. In the meantime, I am extroverted and have had less control and therefore have meltdowns... often. Yet, truly, I believe my BFF and I are at similar functioning levels (which look different b/c of varied external demands). I don't know that the medical community would see that.

Wishing you well as you ride this emotional roller coaster of evaluation. Hang in there.

Welcome to WP.

A good clinician will take any known or expressed trauma into account when evaluating data from an assessment and be alert to diagnostic overshadowing.

Its present to some degree in most cases anyway as being Autistic in a non Autistic world is traumatic for most. Adverse life events and experiences add another layer of trauma on top of this.

I have been involved in assessments for many years for children and young people and have yet to see a presentation that does not involve trauma in some form.

Update: I had my evaluation yesterday, and received a diagnosis. Even though it did not come as a surprise (truthfully, I would have never made the appointment unless I reasonably sure), having it be formal may take some getting used to. Kind of like buying a stiff new pair of the same of shoes I already have.