Connecting the Dots

The Assessment Minefield

How much did you or a family member pay for their diagnosis of Diabetes? Your cousin’s Schizophrenia? Zero dollars, right? Then why does it cost between $2,000 and $5,500 to get assessed for Autism Spectrum Disorder and AD(H)D? That’s what you’ll pay if you don’t want to wait one to three years for an OHIP- covered assessment. Where can you even get one of these mystical ‘free’ assessments? The only professions allowed to diagnose a neurodevelopmental disorder are doctors, psychiatrists, nurse practitioners, and psychologists. And surprisingly few members of these professions have the specialized knowledge to do neurodevelopmental assessments. While most ASD assessments are done by psychiatrists and psychologists, AD(H)D assessments are more likely to be done by your primary care provider.

If you’re ready to sprint through the minefield and get straight to being assessed, scroll to the end of this article to a list of agencies that conduct OHIP and fee-based assessments in Toronto or resources provided across Ontario and Canada by Autism Ontario, Autism Canada, and the Centre for AD(H)D Awareness Canada.

Back to the minefield. What happens once you’ve decided to get on the wait list or fork out the money? Will the assessment be accurate? I hate to say it, but adult diagnoses, particularly for adult women, are hit and miss. There are pitfalls other than gender. What if you don’t have a family member who can accurately describe the early years of your life? Maybe your parent is also neurodivergent and thought that childhood behaviours that fit all the DSM-V criteria were ‘normal’. If you can’t demonstrate that you showed signs of Autism or AD(H)D before the age of five, it’s unlikely you will get a diagnosis.

So you stuck it out and got (or didn’t get) the diagnosis, what comes next? There may be someone, somewhere, who felt disappointed to be diagnosed with ASD or AD(H)D as an adult, but I haven’t met them. Every client I work with has experienced tremendous relief when their gut knowledge was confirmed by the medical establishment. Which raises the opposite scenario. What happens if you don’t get the diagnosis? You may feel undermined. Your old, unhealthy narratives are reinforced. Instead of being able to say ‘I have a finely tuned nervous system that picks up on minute changes in temperature and noise’ you go back to ‘I’m oversensitive and drive everyone around me nuts’. Instead of ‘My brain lacks dopamine and has a wildly inconsistent ability to concentrate so I’m going to need unconventional strategies like body doubling to achieve my goals’ you go back to ‘I’m lazy and I’ll never accomplish anything’.

Pursuing an assessment is not without risk. It’s up to you to decide if you can tolerate it. If you can, the benefits are worth it. A diagnosis legitimizes perceptions, experiences, and behaviours that might before have seemed ‘quirky’, ‘weird’, ‘negative’, or ‘irresponsible’. A diagnosis gives you a language to use when you explain your quirks to family members, partners, colleagues, employers, physicians, teachers, and yourself. This language can help you self-advocate. Human rights legislation and workplace policies are a resource you can use for protection. You can ask other people to change to accommodate you, instead of being the contortionist always trying to fit into the neurotypical mold. It might help you find your coterie.

So you made it through the assessment minefield and now you have it. It’s written on a piece of paper staring up at you. Autism Spectrum Disorder or Attention Hyperactivity Deficit Disorder. Or both. Now what?! A diagnosis is only the first step in understanding how your uniquely neurodivergent brain works. You have years of unlearning to do. There is a lot of past harm to unpack. You have a wonderful opportunity to look at the world through new eyes. You have choices to make. Do I keep masking? Do I ask if I can wear noise-cancelling headphones at work? Do I tell my family? What do I tell my family? Is this the right job for me? Am I living in the right neighbourhood? The right climate? Should I get a dog?! (That last one was a bit random, but yes, you should definitely get a dog.)

If you have self-diagnosed, you may have similar questions. Why go through the process of sorting it all out alone when someone at Scattergram can help you navigate this new terrain? We’ve done it many times, with many other people. And maybe gone through it ourselves. You made it through the assessment minefield, but we can help you avoid stinging nettles and find hidden berries you didn’t even know existed.

Author: WebM2

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