3.2. Describe the difficulties surrounding the diagnosis of autism in relation to; formal diagnosis, the range of different diagnoses on the spectrum.

One of the challenges of getting a formal diagnosis is that there is no single medical test to diagnose autism. It is not like a blood test where it can be shown one way or another whether an individual has a condition or not.

Instead, it involves this comprehensive evaluation process, and even then there is a subjective element to the process, which means given the same information, one medical professional may diagnose autism, whilst another does not. Also, symptoms can range from very mild to severe and may go unnoticed or be misdiagnosed.

Autism is a “spectrum” disorder because of the wide variety of type and severity of symptoms patients can have. Some individuals with ASD may be entirely unable to speak, while others may have rich vocabularies and are able to talk about specific subjects in great detail. Some may have significant cognitive impairment, while others may have average or above-average intelligence.

This wide range of symptoms and levels of impairment makes diagnosis a challenge. Furthermore, many autism symptoms can overlap with symptoms of other disorders. For instance, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and certain language disorders can have symptoms similar to autism, which can complicate diagnosis.

Previously, several conditions like Autistic Disorder, Asperger’s Syndrome, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), and Childhood Disintegrative Disorder were separately diagnosed. With the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, these have been folded into one umbrella diagnosis of ASD, but there’s still debate over whether this change has improved the clarity or accuracy of diagnoses.

It’s also important to mention that autism has historically been underdiagnosed in females. Many assessment tools and diagnostic criteria have been developed based on male presentation of autism, which has led to a skewed understanding of how autism might look different in females. As a result, many women and girls go undiagnosed or are diagnosed later in life.

Finally, because autism diagnosis is so complex, it results in long waiting times to be assessed.