A little reassurance before we meet

Thinking about having an autism assessment can feel daunting. You might be wondering what I’ll ask, whether you’ll know how to answer my questions, or whether you’ll be able to explain experiences you’ve struggled to put into words for years.

I’m a consultant psychiatrist with extensive experience working with neurodivergent people, and it’s an area I’m genuinely passionate about. I feel privileged to help people better understand themselves and make sense of experiences they may have struggled with for much of their lives.

I also believe that an assessment should feel like a conversation rather than an interrogation. My aim is to create a welcoming space where you feel comfortable being yourself, asking questions and talking openly about your experiences.

In fact, someone once told me that they hadn’t expected me to have a Scouse accent! I’m not quite sure what they were expecting, but it was a lovely reminder that we’re all individuals, and you can’t always tell what someone is like from their professional title.

So, before we get started, here’s a little about me and what you can expect when you meet with me at Somerville.

Before your assessment: A little preparation

Before your appointment, I’ll send you some questionnaires to complete. Some are designed to help me understand your experiences, while others may ask about your development, childhood and the way you’ve experienced the world throughout your life.

Some questionnaires are ideally completed by someone who knows you well, such as a family member or friend. Their perspective can sometimes provide helpful additional information, particularly when we’re exploring childhood experiences or things you might not have noticed about yourself.

However, please don’t worry if you don’t have someone who can complete these questionnaires, or if you’d simply prefer to complete them yourself. That’s absolutely fine.

You might also find that there are questions you can’t answer, or that some questions don’t seem to fit your experiences. I expect this! Not everyone can remember their childhood in detail, and not everyone has access to someone who can provide information about their early development.

Answer what you can, as honestly as you can. Anything you’re able to share will be helpful, but please don’t put yourself under pressure to complete everything perfectly.

The questionnaires are just one part of the assessment. They don’t tell the whole story, and they certainly don’t replace the opportunity for us to talk.

Meeting with me: What will it be like?

One thing I hope you’ll find reassuring is that I’m just a person, too!

I work from home, so our appointment will take place in a relaxed home-working environment rather than a traditional hospital or clinical setting. You can call me by my first name, and there’s no need to worry about being overly formal.

You might occasionally hear one of my dogs in the background. I do my best to keep things quiet, but dogs don’t always appreciate that they’re supposed to be working from home!

You may also meet my St Bernard, Barbie. She’s very well behaved, although she occasionally snores rather loudly.

Why do I allow her to join us? Well, firstly, she’s amazing. Secondly, she has a remarkable ability to open the door and let herself in, so sometimes she makes that decision for me!

If Barbie or any of the dogs becomes distracting, I’ll make sure they’re settled somewhere else. The aim is for you to feel comfortable and for us to have the space we need to talk.

I also keep the gate locked, so unexpected deliveries shouldn’t interrupt us. The road is generally quiet, although if your appointment is on a Wednesday morning, you might hear the bins being collected.

I mention these little details because I think it’s helpful to know what to expect. An assessment doesn’t have to feel intimidating or overly clinical. I want you to feel that you can settle in, be yourself and focus on what matters to you.

Will I have enough time to explain everything?

Absolutely. We allow up to two hours for the assessment.

That might sound like a long time, but these appointments often fly by! Autism assessments involve exploring a range of experiences, and it’s important that we have enough time to understand your individual story rather than rushing through a checklist.

We’ll talk about the difficulties you’ve experienced, the things you find challenging and the ways you experience the world. We might explore your social experiences, communication, sensory sensitivities, routines, interests, relationships and childhood experiences, depending on what’s relevant to you.

We’ll also consider the ways you’ve adapted to different situations and whether you’ve developed strategies to manage difficulties that other people might not see.

For some people, these experiences have been present for as long as they can remember. Others have spent years trying to understand why certain situations feel harder for them than they seem to for everyone else.

You might have spent a long time masking your difficulties, trying to fit in or working out how to navigate situations that don’t come naturally to you.

There is no single way to be autistic, and I want to understand your experience, rather than trying to fit you into a stereotype of what autism looks like.

You don’t need to have all the answers before you arrive. Sometimes, talking through an experience helps you recognise patterns that you hadn’t previously considered.

And if you need a break halfway through, that’s absolutely fine. Two hours is a substantial amount of time to concentrate and talk about personal experiences, so we can pause whenever you need to.

What if I don’t know how to answer a question?

This is something people often worry about, and I want to reassure you that it’s completely normal.

You might struggle to remember a particular experience, find it difficult to describe how you feel in certain situations, or be unsure whether something is relevant.

You might even find yourself thinking, “I don’t know if I do that,” or “I’ve never really thought about it before.”

That’s okay.

You don’t need to know what I’m looking for, and you don’t need to work out whether something is an autistic trait before telling me about it.

My role is to ask questions, explore your experiences and help us understand what they might mean. Sometimes I’ll ask for examples or approach a question in a slightly different way if that helps us explore it together.

There are no marks for giving the perfect answer. Being open about what you do and don’t know is much more helpful than feeling you need to give a particular response.

Will I receive a diagnosis at the end?

In many cases, I’m able to give you an answer about the diagnosis at the end of our appointment.

I appreciate that people often come to an assessment having spent months or even years wondering whether they might be autistic. Waiting for an answer can feel significant, and I understand why you may want to know the outcome as soon as possible.

However, a responsible assessment sometimes requires a little more time.

There may be information I’d like you to send me after the appointment, or I might feel it’s important to discuss your assessment with the multidisciplinary team (MDT) before reaching a final conclusion.

This isn’t necessarily a reason to worry. It simply means I want to make sure I’ve considered the information carefully and reached the most appropriate conclusion.

I won’t rush a decision simply to provide an answer on the day.

If I arrange additional time to complete your assessment, you won’t be charged for that extra time. I want to make sure there’s enough opportunity to consider your assessment properly, without you having to worry about unexpected additional fees for the time I’ve arranged.

What if I don’t meet the diagnostic criteria for autism?

An important part of my approach is recognising that everyone’s experiences are different.

You may identify strongly with autistic experiences, have spent considerable time researching autism, or have found that an autism diagnosis seems to explain many aspects of your life.

Those experiences deserve to be taken seriously, regardless of the outcome of your assessment.

However, not everyone who experiences difficulties associated with autism will meet the diagnostic criteria for an autism diagnosis. Sometimes, other explanations may better account for what you’re experiencing. Sometimes, the picture is more complex, and several factors may be contributing to your difficulties.

My responsibility is to assess your experiences carefully, consider the relevant diagnostic criteria and reach a conclusion that reflects the information available.

The purpose isn’t simply to confirm or rule out autism as quickly as possible. It’s to help you better understand yourself and, where possible, identify what might help you moving forward.

Whatever the outcome, your difficulties are real, and you deserve to have them understood.

A final word: You don’t need to be anyone other than yourself

If there’s one thing I’d like you to take away from this blog, it’s that you don’t need to prepare a perfect version of yourself for your assessment.

You don’t need to rehearse your answers, remember every detail of your childhood or know how to explain every difficulty you’ve experienced.

You can tell me when you’re unsure. You can ask me to repeat a question. You can take a break. You can explain things in your own words, even if they don’t come out quite as you intended.

And if you need a little time to think, that’s fine, too.

My aim is to provide a thoughtful, individualised assessment in which you feel listened to and taken seriously. I want to understand not just the difficulties you experience, but also the person behind them.

Whether you’ve suspected you might be autistic for years or have only recently started exploring the possibility, I hope your assessment feels like an opportunity to understand yourself a little better.

And if Barbie happens to join us for a snooze along the way, I hope you’ll feel at home enough to smile about it!

At Somerville, the aim is to help you feel heard, understood and supported throughout your assessment.