Can anyone recommend a service for private autism screening & assessment in NW England?

[Proteinpudding]

Hope this is ok to post. Having learned more about how autism can present in women over the last couple of years, I've been wondering whether I might be ND. I did contact the NHS self referral pathway in my area, but a month on and they haven't even managed to send the screening questionnaire - I know that they are short staffed and I'm not criticizing them but it's unlikely to be resolved soon. I've heard anecdotally that its around a 2yr wait for an assessment (if the screening indicates one is required obviously)

I'm lucky that I do have some savings that I could use, but having done some research I'm a bit wary of some organisations I've come across (including people recommending sites that will provide an online diagnosis from practitioner's based in America!) I know the process would be expensive so I'd want to be 100% sure that an organisation is legit and that if I diagnosis were made that it would be recognised. I'm anxious about whether I am autistic or whether I'm just not good with people/an introvert, and I'd hate to question the validity of any process.

I understand diagnosis isnt for everyone, for me I think it'd help my understanding, even if it turned out I wasn't ND.

Also I have reasons that involving family might be problematic, and if anyone has experience of this and the diagnostic process I'd appreciate hearing it. I have one living parent but they didn't live with us and contact was limited. I do get on with them but I think they'd see this as attention seeking and if the assessment resulted in no diagnosis I'd be mortified (about seeing them, I could accept it personally)

Sorry that was long but if anyone has any recommendations (or ones to avoid)/advice I'd really appreciate it.

Is Chester any good to you? I can recommend Axia ASD - I posted about my experience on another thread, which I'll link for you.

www.mumsnet.com/talk/neurodiverse_mumsnetters/4678869-has-anyone-had-an-assessment-with-axia-in-chester

Thanks @FrugalOddball ! Chester is a little far for me, but I'm willing to travel for a good service, as long as they will see people from outside their area.

Yes, they will see people from out of area (I'm in W Yorks). I would suggest 'shopping round' and finding a service you are comfortable with; for me it was definitely that one.

Connect to Autism

connecttoautism.org

Small point of order - a lot of folk (including a significant proportion of up-to-date professionals) have been revising the thought about male/female presentation, because it's more like early/late-diagnosed presentation instead; many (if not most) late-diagnosed men present exactly the same way as what's been called the "female" presentation of autism. That includes me, by the way, and was one of the main reasons that I hadn't begun to research it a couple of years earlier.

Anyway...are you set on an in-person assessment? My diagnosis was done online, with pre-screening questionnaires exchanged by email and then a lengthy interview by video call. My assessment was £800, and (from talking to other folk who went with more expensive services) was by no means lacking in quality or depth. PM me if you want the details (it's an individual Dr, rather than a large organisation, so I'm not sure it'd be OK to share an email address on here).

The male/female thing is something my assessor didn't agree with. Her take in it was that we all have to meet the same criteria for diagnosis, who while we may have different traits and presentations by the time you get to assessment stage it's largely irrelevant and the boxes that need ticked are that same for male/female.

Thanks both. I think what I mean by female traits is more of the masking and people pleasing with it, though I can see that could be applicable to both. Obviously I don't know if I have autism and I might not, but it's those aspects that I've heard more about in the last few years that have made me question it. I work in a job where social skills are important, which I would have previously thought meant I couldn't possibly be ND, whereas now I understand it may not be so black and white. I feel like I'm very good at understanding other people, I just study them intensely like they're a different species 😁

What might skew my view slightly is growing up I had an uncle who I later could see was definitely undiagnosed autistic (and his son, my cousin, was diagnosed at 5 and is very similar) My uncle fits the negative stereotypes of a man with 'mild' autism (sorry I'm not sure what terms are ok, I mean someone who lives independently but struggles) Eg he was socially awkward, known as a 'loner', was perceived as selfish because he talked about himself and things that upset him in long monotone monologues, he collected stamps and books about trains, he could be quite abrupt and short tempered, never asked anyone else how they were, seemed angry that women didn't want to date him. I made him sound awful, he wasn't, but I do think he really struggled without any help (he was in his fifties when I was a teen). So when for example someone describes 'obsessive interests' or 'prefers to do things alone' as an indicator, I think about him standing on train platforms in the cold and think that I don't compare!

Yet I skipped my work Christmas party to go to the hobby that I do four times a week without fail and where I can socialise without having to make small talk and was so relieved to do so....!

@xyhere how did you find the online process? My main worry about online is nuances. IF I have autism then I would assume it's subtle, and I'd be worried about things being missed. In my job I assess people (different sphere to this though) and assessing people online isn't seen as good enough (eg missing body language, people being able to fake being ok better on a screen then in person). So it seems a bit odd to me that something much more specialist like an ASD assessment could work online. But I'm open to learning more about it, I can't pretend to know enough about how those judgements are made to know what is relevant.

@Proteinpudding - the online process was...actually quite exhausting, but nowhere near as much as it would've been in-person. In terms of the steps, it's pretty easy - send the results of the RAADS-R and CAT-Q tests (multiple-choice), fill in a couple of pre-screening questionnaires (developmental history and sensory profile), and then it's a video interview (at least four hours long). All done within a couple of weeks.

For what it's worth...I do get the "subtle" concern. Thing is...to somebody who's got a lot of experience assessing and working with autistic people, it ain't that subtle no matter how long you've been blending in. I'm 45, and most people have a hard time believing that I'm autistic - my assessor said that I'm among the "best" at masking that she's ever seen (and that was with me trying not to mask...45 years is a lot of habit to break). But...and here's the kicker...after my developmental questionnaire she doubted that I was autistic, but she said it was clear as day that I definitely am within the first hour and the rest of the time was about clarifying details for the report.

Thanks @xyhere that's really interesting. I personally struggle with the idea of screening questionnaires (at least the ones I've seen that ask questions like - whether you notice quiet noises compared to most people, or whether you find it hard to know when it's your turn to talk on the phone). I worry that it's hard to answer them objectively without some bias about how you want to be perceived, especially as its fairly obvious which are more indicative of 'typical' ASD. And because I don't know what the baseline is - compared to what I assume friends at work would answer, yes, compared to friend I know who is diagnosed autistic and hyperventilates after a phone call even if she's prepped for it, definitely not. But then I'm probably overthinking it. As you say, experienced people in the field would be used to all of this.

Sorry for all the questions, but was there any indicator about what would happen if the assessment outcome was that you weren't autistic? Eg would you get any information about say, having some commonalities but it not meeting diagnostic threshold, or about why you might struggle in some areas? Its not that i'd jump to the next place and try and get a diagnosis of something else, I'm just a little afraid of putting myself out there and the possibility of getting a flat 'no'. I've thought about an assessment for a long time but wrangled over whether I'm a 'worried well' type. Id feel a bit silly if the outcome was just that I'm an introvert who is bad at small talk, but I have to be prepared for that possibility!!

NB I would be interested in your assessors details if that's ok, I am keen to look at all options.

Those are all the exact same concerns I had. The pre-screeners were very difficult for me, and it took me a good couple of days to finish them (including running it past my wife a couple of times). However, you generally get plenty of time to fill them out (measured in "weeks" rather than "days").

It's worth looking over the DSM-V diagnostic criteria - I had to do that and make notes on it beforehand. Not because I was trying to cheat the test, but because it gave a good translation reference in terms of determining what the questions were really about. It's also a kind of self-screening - it will show you which traits are required and which are optional. Yo Samdy Sam has a great video about it here, which tells you everything you need to know:

Interestingly, regarding your question about what would happen if the outcome was "no"...my assessor asked me that very question at the beginning, as well as "Why are you seeking this assessment?". They're not leading questions, and all reasons are valid; they're about working out what further support or assessment needs may be necessary if it turned out to be something else. All assessors I've encountered are qualified and experienced in treating/managing other conditions as well, so it's they'd offer you alternative paths forward.

I didn't mention it in mine (I really should've done), but one of my big concerns was that heavy masking - like in my presentation - shares an awful lot of characteristics with sociopathy; it's not the same thing at all, but when you remove the motivation behind them, they start to look quite similar. And, of course, the more you analyse your motivations, the less defined they become...and then paranoia and imposter syndrome set in and it's impossible to see the wood for the trees, as it were.

Of course, you also get a full report detailing both the outcome and how they arrived at it; as you'd expect with a condition that can present in so many different ways, it's not just a binary yes/no answer.