Thinking of having an autistic assessment? Private or NHS ?

[Orchid90]

I’m thinking to start by going to GP, I know the waiting time are very long , if they even refer me

my partner has said a few time that I’m autistic, initially i thought he was not being serious. Over time , though, I read more and more about it and tbh it all just finally made sense. I always score high in the self tests I have done over the past few years .
I sort of decided I most likely am, but didn’t feel a diagnose would change anything .

However I had a terrible experience at work where I went for an interview, did a lot prep and also I waited years to go for it as I wanted to be sure I had developed the skills to do a great job. Put hours of thought into the presentation, I definitely had a great deal of passion about doing the role at best of my abilities.
i didn’t get it , it was very competitive , but what completely threw me off , and I haven’t recovered yet , is that the person who gave me feedback said my demeanour didn’t come through as passionate. She asked me if I really wanted the job . This could not be more different from what I felt and also it feels terribly unfair as I have colleagues that do a terrible job , they are lazy and yet they could selI themselves. The interviewer also said you should “ lie if you have to as they can’t check if you are lying anyway “. I can’t lie , it collides massively with my sense of justice . I will never lie, I hate it.
I then had a meltdown at work crying uncontrollably , just out of frustration as all my efforts went unseen and misinterpreted.

I had the same at school , thy always said to my mum that I was disinterested, lost in the clouds , yet when asked I did actually know the answers.

i know a diagnose will not get me the job , which I lost all confidence to apply now anyway, but it would make me feel less ‘wrong ‘ .

anyone has any advice on the best course of action ?

I went via the NHS (took 13 months from going gp to getting an outcome).
I wasn't bothered about getting a diagnosis because I felt it wouldn't change anything until I had a review of my personal independence payments (due to a physical disability) but I explained that my potential asd was probably getting in the way of me accessing health care when they repeatedlyasked why I wasn't having a specific treatment. The report came back making out I was lieing about my abilities.
At that point I decided a diagnosis probably could help me in this scenario. I spoke to the gp and he suggested an NHS one so the dwp cant say it wasn't a thorough assessment. He said he always advised private for speed except when its needed for education, health care and dwp because they are more inclined not to take into account a private assessment.
If you go private could you use a provider that works for the nhs as well. I used psychiatry-uk.com which do private assessment as well and had a very positive experience.

I went NHS, but our area wait times are not that long. I'm in South Yorkshire and from GP to diagnosis it was 4 months with the South and West Yorkshire Adult ADHD and autism diagnostic services. I know some areas are 6 years +

I know this is a mumsnet post, so we don't have all the details but from what you've explained about your school life it sounds more like ADHD.

The disinterest, head in the clouds sort of behaviour is typical inattentive ADHD presentation. If you've got school reports to back you up, or your mum is willing to explain the extent to which this affected your school life, and has now seeped into your adult life, I think you'd have a strong case for ADHD.

That's not to say you're not autistic as well, it's a huge comorbidity, and there's a lot of overlap in behaviour, it's the reasoning behind it that would determine whether you have one or the other, or both.

In my trust, you can't submit a dual referral, if you do, it get's automatically rejected, so you have to request one referral at a time and see each one through fully.

A lot of people have trouble with lying.

I am autistic+ADHD, and the thing is I can lie, I just can't lie sincerely. It's really easy to see through when I am lying. My completely NT partner can't lie at all, honesty is the best policy with him, and if somebody doesn't want him for being a straight laced, honest man, then they don't deserve him, which I think is absolutely fair enough.

Interviewers also give shoddy feedback often, even when it doesn't actually align with how you present. It's not an accurate reflection of how you actually presented, they will just make up an easy feedback answer as a way to explain why you haven't got the job when they've decided to offer it to somebody else.

If you're absolutely certain that the first diagnosis you want to go for is an autism diagnosis, then you'd be best reading about the autism diagnostic criteria, and seeing if you can write examples of how they impact your daily life, and how you've been disadvantaged because of them historically.

The UK Typically uses the ICD-11 model, however some clinicians may still refer to the DSM-5 for additional guidance.

ICD-11 Criteria (UK’s official standard)
Diagnosis requires both:
1. Difficulties in social communication & social interaction
Persistent differences in:

• social reciprocity (back-and-forth interaction)
• understanding non-verbal communication
• adapting social behaviour to context
• relationships, friendships, social rules
• These must appear across different settings and over time.

2. Restricted or repetitive patterns of behaviour, interests, or activities At least one of:

• repetitive movements or speech
• inflexible routines / strong need for sameness
• intense interests
• sensory sensitivities or sensory-seeking behaviours

✦ Symptoms must:

• start in early development (even if unnoticed)
• cause real-life difficulties
• not be better explained by something else

DSM-5 / DSM-5-TR Criteria (often used alongside) Very similar but split into two parts: A. Social communication & interaction differences (all three required):

1. Social-emotional reciprocity
2. Non-verbal communication
3. Developing/maintaining relationships

B. Restricted/repetitive behaviours (two required):

1. Repetitive movements/speech
2. Routines / insistence on sameness
3. Highly focused interests
4. Sensory differences

These challenges must have been present from childhood, have no other clinical cause, and cause significant disadvantage/disability in order to be diagnosable.

I would say that autism can be harder to diagnose as an adult, though it's not impossible, and my own psychiatrist and specialist occupational therapist involved in my adult diagnosis said that the wait times for autism diagnoses are typically shorter as most adults they see coming through their doors are there for an ADHD diagnosis, as autism is usually picked up much younger.

Here are the simplified UK diagnostic criteria for ADHD for the DSM-5:

Inattention – need 6+ symptoms (or 5+ if over 17)
Examples (simplified):

1. Careless mistakes / overlooking details
2. Difficulty sustaining attention
3. Not seeming to listen
4. Not following through on tasks
5. Disorganisation
6. Avoiding tasks that need focus
7. Losing things
8. Easily distracted
9. Forgetful in daily activities

Hyperactivity–Impulsivity – need 6+ symptoms (or 5+ if over 17) Examples:

1. Fidgeting or inability to sit still
2. Getting up when expected to stay seated
3. Feeling “on the go” / driven
4. Struggling with quiet leisure
5. Excessive talking
6. Blurting out answers
7. Difficulty waiting turn
8. Interrupting others
9. Impulsive decisions or actions

✔ Additional requirements (must all be true) To be diagnosed with ADHD: 1. Symptoms began in childhood Before age 12 (even if unnoticed or masked). 2. Symptoms occur in 2+ settings e.g.

• home
• work
• school
• social situations

ADHD cannot be diagnosed if problems only happen in one place. 3. Symptoms cause clear impairment Examples:

• struggling at work
• problems with time management
• relationships impacted
• chronic lateness, lost items, burnout

4. Symptoms not better explained by something else E.g., depression, anxiety, trauma, thyroid issues.

and for the ICD-11 framework:

• Persistent inattention
• OR hyperactivity-impulsivity
• OR both
• Present across settings
• Started in childhood
• Causing functional impairment

But UK psychiatrists still base diagnosis on the DSM-5, usually, because they're more specific.