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Questioning autism self-diagnosis - "a little bit autistic" p.2

Follow-up to "Autism v. ADHD & comorbidities"

Because I liked some content about autism on twitter, Twitter is feeding more more content related to autism. That's how I stumbled upon embraceautism.com, which self-hosts a variety of autism self-assessment tests and discusses their reliability and accuracy.


Here are some of my scores from the tests hosted there:

ASQ (Autism Spectrum Quotient): 28
  • Scoring range: 0–50
  • Threshold score: 26↑
    • Scores 26 or greater indicate you might be autistic
    • Lower scores mean you likely are not
  • 80% of autistic people score 32 or higher
  • Most non-autistic males score 17 on average
  • Most non-autistic females score 15 on average
RAADS-R (Ritvo Autism Asperger Diagnostic Scale-Revised): 91

Social relatedness: 55
Language: 4
Sensory/motor: 18
Circumscribed interests: 14

All scores of
65 or higher are indicative of autistic traits. However, since no single test is conclusive, the RAADS–R alone can’t conclusively indicate whether you are autistic. Nevertheless, in the table below are general interpretations of various total scores on the RAADS–R.

Score
Interpretation
25
You are not autistic.
50
Some autistic traits, but likely not autistic (yet some autistic people score as low as 44.
65
The minimum score at which autism is considered.
90
Stronger indications of autism, although non-autistics may score as high.
130
The mean score of autistic people; strong evidence for autism.
160
Very strong evidence for autism.
227
The maximum score autistic people acquired in Ritvo’s seminal paper on the RAADS–R.[9]

CAT-Q (Camouflaging Autistic Traits Questionnaire): 124
Compensation: 34
Masking: 40
Assimilation: 50

A total score of 100 or above indicates you camouflage autistic traits. But other than knowing the threshold, it can be challenging to make sense of your scores. It may be helpful to compare your results to the average scores of autistics and non-autistics.

(Opting not to include the related tables for reference because it would get kind of lengthy.)



The way I interpret these results is that I have some autistic traits(?)1 and may be (a little bit) autistic. Or near the cluster or on the edge of. Technically, I'm scoring high enough on these assessments to be considered potentially? autistic, but kind of on the cusp of. Even though the website authors discuss the reliability of the tests, I still wonder if I score high on the social relatedness and masking portions because of strong introversion and social anxiety.2 I wonder if any slight hypersensitivity to sensory stimuli is because of ADHD. I do hyperfocus on some topics or some stimuli3 but I identify more with having varied, rotating interests than narrow, persistent interests.

This reminds me of how hesitant I have historically been to apply the label "ADHD" to myself, though I relate greatly to the material about ADHD / ADD that has grown over time on the internet. There is such overlap between ADHD and anxiety symptoms (and indeed I believe they can feed into each other).

In college, my twin sister and I sought out a neuropsych assessment with sliding scale assistance from a local clinic in Pasadena, both to seek out better insight into abstruse academic difficulties and investigate the possibility of academic accommodations. In the long report the proctor discussed what I've always deigned to call a "tentative" diagnosis of ADHD:

"In addition, results of the Brown ADD Scale completed by Ms. Chong and her
sister yielded clinically significant elevations across a number of scales. Ms.
Chong's responses yielded a Total Score in the highly probable range for ADD
Her sister's responses yielded clinically significant elevations on all of the scales
and yielded a Total Score indicating that she sees Ms. Chong as experiencing
symptoms that are in the highly probable range for ADD."

"Highly probable" was probably not enough for me to feel conviction in a diagnosis.4 I never let myself believe it fully; I didn't want to feel like a scam or a con artist. I wasn't sure I believed the rationale/evidence presented. The assessment was done as part of an internship -- what if the proctor felt pressure to deliver an argument so we could justify academic accommodations? What about how I might have been significantly sleep deprived on the days the assessment was carried out? What if the questions on the questionnaire are subjective?

My resolution to the ambiguity was to absolve myself of the label. The label and the exact neurobiological mechanisms underlying my behavioral conditions did not matter (whether it was dopamine- or anxiety-related)5-- what mattered to me was the fact that I felt I could relate to ADHD content and symptomatology and therefore it was a useful lense to view myself through on occasion. I could not declare myself as having ADHD with confidence, but I could at least say I felt ADHD-adjacent. The more material I read about ADHD, however, and the more I self-identified with the condition, the more my stance on whether or not I actually have ADHD has shifted (to where I am still probably a little reserved about making any declarations, while simultaneously strongly identifying as someone with ADHD :shrug:).



In trying to understand whether or not I can self-identify as autistic, and if I can, should it just be "a little bit autistic", I've gathered the following quotes to help me understand and think about the topics...

Is Everyone A Little Autistic?

"For all humans, there are a number of different cognitive abilities in which we can excel or lack, we are all somewhere on the spectrum of human capability. Most neurominorities tend to have big differences between the peaks and the troughs, known as the ‘spiky profile’, it’s a defining feature of neurodivergence – diverging from a statistical norm, a diverse profile rather than all average scores. The ‘cut off point’ for how much difference is significant and warrants diagnosis tends to be two standard deviations but this can be blurred by an individual’s background history and environmental factors."

"The degree to which neurominority conditions overlap, go undiagnosed or misdiagnosed due to the holistic approach needed is well explored by Professor Amanda Kirby. It is entirely possible that a person who relates to the concept of everyone being a little Dyslexic, is actually an undiagnosed Dyslexic themselves, or has a similar pattern to their profile without having quite met the threshold of significant difference."

"There are undoubtedly many undiagnosed and misdiagnosed neurodivergents all around us, they may not have struggled with the exact same difficulties but are still in need of finding their community and understanding themselves better."

"Is everyone disabled? No. Can the degree to which you are disabled change throughout your life? Yes. Whilst the phrasing might be a little awkward it is for this reason that someone might actually refer to themselves as a little bit Autistic. To give an example I have a Dyspraxic colleague who often wonders if she is also Autistic. This could be because there is some overlap between the two conditions, but it could also be that she is actually Autistic but not in a way that has ever warranted further investigation, most likely because as a female her need to withdraw to decompress from sensory overwhelm was typed as "introverted". If we move beyond narrow definitions, she identifies as neurodiverse, with experiences and traits that make her feel aligned with a broader range of experiences than one diagnosis can explain."

"In the same way that functioning labels harm both those who are perceived as “high” or “low” functioning by making assumptions that ultimately limit them and seek to define them in an overly simplistic way, we are becoming too attached to diagnostic labels instead of looking at people as individuals. Legislatively, diagnosis is not the criteria for legal support. Worldwide, disability is legally defined by the extent to which one experiences difficulty, not the label one has been given - this is important for employers to remember when deciding on accommodations and adjustments."

Comments on Isn't Everyone A Little Bit Autistic? video, which by itself is worth a watch

  1. "I think one scenario you are missing is that one can feel exactly that: a "little bit" autistic. I can really relate to a lot of the things you describe, and I don't know whether the shortfall between your experiences and mine is because I've spent so many decades learning to negotiate a life in this society that I've learned skills which have mitigated my underlying experiences, or whether it is that I don't understand what autistic people experience. [...] I've often thought I'm "partly" autistic, or have several "traits" that seem to fit, and it's not with any intention or desire to offend or dismiss people's experience. It comes from confusion at the terminology and at the vast range of experiences and not knowing where I fit in, but being certain that trying to get a diagnosis would be very difficult. I do feel disadvantaged in some areas of life, but there may be other reasons. It's a journey." - pyschoprosthetic
  2. 'There is arguably some merit to the concept of being "a little bit" autistic, but the devil is in the details. When we talk about being autistic we mean a bunch of distinct aspects, such as disability - both social and intrinsic (the whole of the world we live in is not construed and thus not all disability is social), neurological type (the "broad autistic phenotype") and identity. It is clear that in terms of neurological type one can be "a little bit" autistic - there seems to be no clear-cut distinction between those who meet diagnostic criteria for autism and their non-disabled but still not neurotypical relatives. That's because autism is still primarily a clinical category defined by deficits and needs which need to be addressed in order for an individual not to be hindered by them. [...]

    As there is little in terms of therapy or medicine to aid autistic individuals - especially those diagnosed later in life - the biggest benefit of being diagnosed that I can think of (and I do take in to account various kinds of aid) is understanding oneself better, being provided a "roadmap" of typical autistic deficits which helps one to navigate one's way out of the vicious circle of failure and self-accusation, and also - the community of people who share similar experience and their ways to cope. All this comes with identifying oneself as autistic - on the basis of formal diagnosis or otherwise.

    Now, to my mind the question is: whether we allow the identity to be a spectrum in the sense in which the diagnostic category isn't one, but in which the neurological type is one. It's a question about which aspects of autism we chose to define our identity - those which relate [t]o disability or others. What I find problematic about defining the identity by social (or better societal) disability - which seems to be the thinking behind a lot of what I see being said about neurodiversity - is that it has the potential to be doubly exclusive: first towards those who feel that they are like the greatest component of their disability is intrinsic and not societal, and second - those who cope with their autistic traits but do not meet diagnostic criteria for a disorder/don't seek clinical diagnosis for some reason.

    Plus, defining one's identity by societal disability/oppression - which is very real and demands addressing in it's own right - doesn't seem to me like the best way to built a positive and independent identity, but rather a reactive and dependent one, an understanding of ourselves in opposition to the neurotypical society. I understand why it seems intuitive to concentrate on challenges and disability - this is what brought the majority of us to the "autistic" [t]able in the first place. But I think the way for the future is to work towards an understanding of "being autistic" which transcends that perspective. And I think the only way to achieve this kind of self-understanding is to include those who aren't (as of today) disabled, but share the neurodivergence. They may not need the label but we might need them. So, to recapitulate my point: not everyone's a little bit autistic, but it may be wise to allow certain people to be "a little bit" autistic.' - M. Ch.

Footnotes
  1. Still kind of squeamish about declaring this with confidence.
  2. Or do I have strong introversion and anxiety because of undiagnosed autism :shrug_kaomoji:
  3. Stimming with sunlight and music are great hits for me. I have been known to zone out just lying on the floor listening to music for hours, and to brush my teeth for upwards of 15 minutes while ruminating or spacing out. Is that just anxiety or OCD?
  4. Does a neuropsych report count as a diagnosis, or can you only be diagnosed by a doctor?
  5. Especially because I was hesitant to try out medication or substances and preferred to seek out therapeutic support for coping skills/mechanism.


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Xx_j0s3_xX

Xx_j0s3_xX's profile picture

i got 36 at hte first one i got diagnosed this week wis asbergers :P


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Xx_j0s3_xX

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i got 36 at hte first one i got diagnosed this week wis asbergers :P


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xXd0ntGetAfr4id_.Yuki1Xx

xXd0ntGetAfr4id_.Yuki1Xx's profile picture

ASQ - 40
---
I'm trying to convince my parents 2 take me 2 a psychologist, not having a specific diagnosis is making my life very difficult, =[


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Angered_cat

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How can I do this test?


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xXkf100Xx

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i got a score of 48 and i was diagnosed at the age of 3


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