Many autistic people have co-occurring conditions that can both complicate our experiences and also mask an ASD diagnosis.
While an autistic persons’ life includes more than Autism, it is important to focus on our autistic traits during an evaluation, and not those of co-occurring conditions. Since common medical practice is to separately diagnose and treat comorbid conditions, this can lead to a missed Autism diagnosis if the crises of the comorbid conditions are more visible than underlying autism.
I’m breaking down the DSM-5 assessment, so autistic people can prepare for an evaluation and explain their traits to a practitioner. The DSM-5 isn’t the only autism assessment, but its emphasized traits are present in other tools. We’ll take a look at each criterion with examples. (I’m not a licensed professional. DSM-5 info is at CDC.gov.)
• DSM-5 E checks if “these disturbances are not better explained by intellectual disability or global developmental delay. To make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.”
• The DSM also states, “Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.”
• The DSM looks at if ASD is accompanied by “a known medical or genetic condition or environmental factor, another neurodevelopmental, mental, or behavioral disorder, and/or catatonia.”
• Common comorbid intellectual disabilities: Dyslexia, dyscalculia, dysgraphia, Social (Pragmatic) Communication Disorder, executive function disorder, etc.
• Common comorbid genetic/environmental conditions: Ehlers-Danlos Syndrome, Chronic Fatigue Syndrome, Fibromyalgia, Sensory Processing Disorder, etc.
• Common comorbid neurodevelopmental/mental/behavioral conditions: ADHD, dyspraxia, epilepsy, OCD, BPD, Bipolar Disorder, anxiety, depression, etc.