Diagnosed as an Autistic Adult

Good morning

My name is Tessa Watkins my pronouns are they/them

and I’m autistic and an adult and I got diagnosed as autistic while being an adult so that’s why I’m up here

I’ve got Dr

Jessica Maher (she/her) with me today and we’re going to talk about the diagnostic process for adults seeking an Autism diagnosis

First, let me start with the reasons

I lump the reasons into two groups

The first group is the tangible and more public reasons

These reasons include actionable goals by disclosing your needs or diagnosis to someone

The second group of reasons are more private or personal

While parents seeking a diagnosis for their child is usually because their kid needs help in school or at home (which is a reason in group A), most adults seeking an autism diagnosis are initially looking for validation, which falls into the group B

But what happens is during their rabbit hole adventure is that they start identifying the underlying physiological needs that have been neglected and it can sometimes turn into needing access to accommodations that can only be provided by clinical diagnosis

Let’s take a look at Abraham Maslow’s hierarchy of needs

If you’re not familiar with it, it describes human needs and states that the needs at the bottom of the hierarchy must be satisfied before an individual can attend to a need higher up

The needs at the bottom are called deficiency needs while the ones at the top are called growth needs

The motivation to fulfill a deficiency need becomes stronger the longer it is ignored

For example, the longer you go without food, the hungrier you get

Meanwhile, the motivation to fulfill a growth need isn’t through deprivation but through desire and that motivation can become stronger once you engage in that activity

Maslow’s hierarchy is not linear, and that’s especially evident in autistic and neurodivergent people

For example, I learn very well through teaching

By talking and presenting about what I know, it helps me process the information even deeper

For me to stand up here and talk about autism, you might think I’ve reached transcendence because I’m trying to help others to self-actualize

If this was linear, you’d assume that I’ve achieved all the lower levels, but I definitely haven’t

I certainly still struggle with getting my physiological, social, esteem, and cognitive needs met on a daily basis

Let’s start with the physiological needs

I can hyperfocus so intensely that I forget to eat, drink, and use the bathroom

I say forget, but that implies that I knew about the information at some point and then didn’t, but that’s not what’s happening at all

My autistic brain will not send the signals for those needs while I’m hyperfocused

Sometimes when I’m at a natural stopping point for work, I’ll sit back in my chair and then realize I hadn’t felt anything else in a long while

I do one of those self-body scans to check for those feelings like hunger, thirst, full bladder, etc., and get nothing

It’s not until I stand up that my brain sends all those signals at once and then I look like a broken NPC trying to figure out which to do first

For what it’s worth, always use the toilet first

Hyperfocus can be a characteristic of autism, ADHD, or something else, and simply knowing that means I can figure out how to handle it so my physiological needs get met

If I didn’t know that, perhaps my hangry meltdown at the end of a workday would get me labeled as forgetful, irresponsible, and a jerk

Moving up to safety, you wouldn’t be here if you didn’t know autistic people struggled to gain employment

Having an unpredictable source of income threatens the safety need

For those of us who are employed, many workplaces are not neuroaffirming, meaning reasonable accommodations may be withheld unless you have a clinical diagnosis specifically saying you need it

Three years ago, my employer was discussing how to return to the office

Turns out, my lifestyle is called quarantine and I thrived working remotely from home

My productivity went up because I had complete control over my environment from temperature, to smell, to stimming without an audience

I wrote an email over 500 words long that explained my needs and how this felt like a reasonable accommodation and I’ve been working from home ever since

While my employer was nice enough to grant me these accommodations without needing proof of diagnosis, simply stating that I had one helped make my request seem credible

In a similar fashion, some family members won’t accommodate their loved ones without a clinical diagnosis, if you can believe it

I’m hard of hearing, I have a congenital condition that’s progressively taking away my ability to hear and I’m currently deaf of lower frequencies

I absolutely gaslight my family when they ask me what the sound is coming from the car or if thunder is rolling in because I can’t hear them no matter how loud

Volume and frequency are different

However, I also have an auditory processing disorder that makes taking in oral information quite a challenge and I’ve got tinnitus

Silence is so loud to me and I often mishear spoken words so a conversation with me can sometimes seem like it’s going in an completely random direction all because I thought you said a different word

Point is, I had all this going on before my diagnosis, and yet family got upset at me for “not listening.” Coworkers would refuse to answer clarifying questions because they thought they made the information obvious in a meeting

But with a diagnosis, it’s like a magical document I can point to and be like, “see? Somebody else recognizes this, so you should too

I’m not just making it up to get special treatment.” The special treatment being using live captions during a meeting so I can see the words to verify if I’ve heard correctly or to not get instantly mad if I ask them to repeat themselves

Next on the list are the social needs

Parents understand the challenge we have as autistic people with connecting and bonding with others

One of the most common questions I get are how to help their autistic kids make friends

The word autism comes from the Greek word, “Autos” meaning self

The counterpart is the Greek word “Allos” meaning other

Humans are inherently pack animals, we are “supposed to” need each other

Most humans are “allos” or “allistic.” However, there’s the group of us that don’t really need others in the same way, and we are autos, or autistic

But that doesn’t mean we don’t need others at all, and it doesn’t mean none of us want a connection

I’m happily married and we have a five-year-old daughter

I have people I call my friends and a local and online community where I’ve found a sense of belonging

There are plenty of people and places that don’t provide that, more so than the ones that do, so it’s a challenge to seek out the pockets of social acceptance and safety

After social are our esteem needs and this is where the bullying in school really affects us

Even if we have the safety net of our family and best friends, the bullying can really bring down our self-esteem

And… well… the general ableist society

So achieving all of those needs means filling deficiencies

Any accommodations we seek as disabled people is to help us with one of these

(I didn’t click on those)

division SC see that’s a thing I forgot to write clicking in my notes uh cognitive growth uh oh yep
Any accommodations we seek as disabled people is to help us with one of these

For us to thrive and grow, we need a solid foundation

Cognitive growth includes self-awareness, perhaps learning and understanding autism itself to understand why and how we are different and recognize it as not a moral failing

Our aesthetic need helps us appreciate the beauty in neurodiversity and the strengths that lie within

Our self-actualization need is when real actual self-care is a thing we can do and not just the 5 minutes of sitting in the shower

And finally Transcendence is the need we feel in helping others

Maybe you want to be a speaker at Dan Miller’s Disability & Mental Health Summit to help other undiagnosed autistics self-identify because you believe that’ll help them

I say you, I totally mean me

But could be you

All this to say, I believe self-diagnosis is valid, especially if your reason for seeking a diagnosis only falls within group B

However, if you need access to supports that only a clinical diagnosis can provide, I’ll give it to Dr

Maher here to share the reasons she’s seen patients seeking a diagnosis and to help explain what a competent autism evaluation looks like in her practice

Hi, I’m Dr Jessica Maher and I have been doing Comprehensive Psychological and neuroassessments for the past almost five years now with children’s —children, adolescents, and adults

now my practice primarily I assess adults and a large number of adults that I assess are coming should be evaluated for autism so we see people coming into our practice for varied reasons when they’re coming for an Autism assessment it can be self-discovery validation sometimes it is just simply seeking a re-evaluation maybe they have already been evaluated as a child and they just need updated documentation to be granted access to supports and services maybe they re-evaluated because they were diagnosed with maybe ADHD as a child but something just didn’t click throughout their life and they now want to see might I me criteria for a diagnosis of autism maybe they’re seeking a second opinion thinking they were misdiagnosed we also see people who as Tessa had referenced are coming for documentation either because that documentation doesn’t exist because they were diagnosed decades ago or because they need new initial documentation of a diagnosis so that employers or administrators at their college or university can give them access to the supports and services and accommodations that they that they need to be the most successful versions of themselves so whatever the reason might be that brings an individual to decide that they want to seek an Autism diagnosis unfortunately there are challenges to finding a provider in the years that I’ve been doing this I don’t think a week has gone by where I haven’t heard you have no idea how long it took me to find you you have no idea how far I’ve driven to to get there we see people anywhere from a mile down the road to several hours away because they’re just aren’t a lot of providers who do autism assessments for adults and there are other barriers such as insurance maybe people finally found a provider but up they’re not in network with my insurance and I don’t have the means to pay out of pocket for all of itand as I had mentioned locations so we do see people from you know far and wide that come to our practice to be evaluated as an adult so once you’ve finally been able to make an appointment what is that going to look like so our practice conducts evaluations in two parts there’s the intake assessment appointment and then there is the testing appointment when the individual will come in another time for the actual direct testing I know this can be a very anxiety inducing stressful process so I do my best at the onset of the intake appointment to try to put people at ease and help them understand that there is not going to be a decision made or a diagnosis given or not given based on a single data point or test result or observation I say comprehensive and you will hear the word comprehensive over and over and over in in this session because it is just so important for people to understand that we take a comprehensive approach in this evaluation process and I will go into what that means for us so within the intake appointment not only are you going to do the standard forms that are done when you go to any new provider or physici but then we are able to complete an intake assessment We Gather background info all the way from birth and discuss educational background and Vocational background and social background and developmental Milestones history of presenting concerns how these concerns and what has been experienced throughout their life is has impacted them autism is a neurodevelopmental disorder so that means the onset had to have occurred in the developmental period of life I’m assessing adults I’m not seeing them in their developmental period so that’s why we take this comprehensive thorough background to see if these concerns and experiences have been present throughout their whole lives because if they are not and people they say well this just you know started happening a couple years ago and the diagnosis likely isn’t going to be autism but I will help you figure out why you’re experiencing what you’re experiencing we are also very aware that adults are likely going to present very differently than children with autism and that’s likely because they’ve had to learn compensatory strategies throughout their life to survive and be successful so that is something that I am acutely aware of and I take into consideration throughout this process and I ask information about what did this look like as a child what did it look like in school and with friendships and were there reports and discussions that teachers had with your parents and very often the answer is yes and then we get into that and what that looked like throughout the intake assessment I do clinical interviewing so clinical interviewing allows me to again delve deeper into what is being reported and presented to me we often see individuals who are coming in not just to have an Autism assessment but for other concerned areas as well so again going back to the comprehensive evaluation I can evaluate all concern areas that an individual is coming to us with so whether they also want ADHD or personality disorder depression anxiety PTSD that can be evaluated because we take the approach that if we look at all of the areas that you are experiencing separately and then I put all of that together to come up with a comprehensive view of each unique individual we know that that is going to lead to whether somebody is given a diagnosis or not and whether somebody is given a diagnosis or not is going to lead to access to different supports and services going to drive treatment and other post- diagnosis resources differently so we take this very seriously and we take very thorough approach we also offer consultation if a client should wish for us to discuss with either a family member or maybe their therapist or their PCP or their Med management provider if they complete a Hipp a release form we are able to consult with these other individuals who they already have a trusted relationship with and are able to gather more information from them as well again comprehensive we want to take as much information as possible in determining if an individual meets criteria for a diagnosis of autism or any other diagnosis so by having these different perspectives that also AIDS in making a determination of a diagnosis or not and then rating scales so rating scales are supplemental information related to each presenting concern because again it could be very stressful coming into the office needing to unload decades worth of experiences and how am I going to capture this in an hour two an hour and a half with this person I’ve never met before we know that we appreciate and understand that which is why this assessment process is done in multiple steps and we ga information from multiple modalities so that we can get as much information about an individual as possible so these rating skills we offer not only to the client themselves but we also afford the opportunity for them to pass it along to someone who knows them well whether it’s a spouse or a partner or a family member or sometimes even a therapist as long as they feel that that person knows them well enough and they trust them enough we will know receive that information and utilize that in our evaluation

process okay so once the intake is done we schedule individuals for testing so they come back for another appointment that is going to be several hours long and that’s largely dependent upon are we just looking at assessing autism are we looking at other areas as well because we want to have enough time to do all of the assessments that are necessary to provide the in each individual with as many answers as

possible excuse me the multiple perspectives again can go connect with the rating scales consultation with trusted others those allow not only for us to have the individuals self support of their own experiences but also to see what they how it’s impacting different contexts and different areas of life or how others are viewing them and again we take every piece of information and it is valued but it is not one piece of information is never going to determine whether a person meets criteria for a diagnosis or does not meet criteria for a diagnosis so the test appointment always consists of an IQ measure not only does that allow us to have a baseline of an individual’s cognitive ability because we want to make sure that what an individual is experiencing is not due to cognitive deficits because that is going to have us rule out other diagnosis but with an Autism diagnosis specifically I have to indicate if that’s with or without accompanying intellectual impairment and way for me to determine that is through an IQ assessment we do the [ __ ] 2 which is a standardized measure for assessing autism it’s long been considered the gold standard in autism assessment and it allows a lot of opportunity for structured social interactions observations and various other measures for to gather information as to whether or not an individual is going to meet criteria for a diagnosis of autism within that testing appointment if there are other co-occurring disorders that they that an individual thinks are present I will also do direct assessments on those as well there can be so much overlap with many of these diagnoses so it is important to directly assess all of what an individual is experiencing so that I can most accurately provide a diagnosis psychology is not an area where we can do blood tests and x-rays or brain scans to say y or no just like your PCP might be able to do so again taking the comprehensive approach and taking all these data points and pieces of information is going to allow me to have the opportunity to make the most accurate diagnosis possible and it’s going to allow me to differentiate between these other areas of concern if that is you know true of that individual client and sometimes the answer is you meet criteria for all of the above and sometimes an individual doesn’t meet criteria for an Autism diagnosis but it is my job to account for what you’re experiencing in whatever way is most accurate and that can lead to people feeling invalidated not feeling seen or heard but at the at the intake appointment I try to explain that that my job is to help you on this journey find answers those answers may not be what you thought they were but I am going to do my best by gathering all of this information to help you find the answers that most accurately depict what you have experienced throughout your life because that’s going to help Drive treatmentfind access to resources supports and services and also help with the you know journey of self- exploration or self-acceptance or the acceptance of those around us as Tessa had so nicely discussed

So I wish I knew all that before I went to get mine

Before I get into what my evaluation looked like, I first want to explain my reason for seeking one

In September 2018, my neighborhood book club chose The Rosie Project by Graeme Simsion

It’s a fictional love story featuring a white autistic man named Don Tillman who is a professor of genetics

While reading this book, I related to Don so hard

At one point in the book, Don is out to dinner with a friend to learn social etiquette and his friend says, “Don, I’m impressed, but changing to meet someone else’s expectations may not be a good idea

You may end up resenting it.” Now the book is told in first person by Don, so we have insight into what Don is thinking

Simpsion wrote, “I didn’t think this was likely

I was learning some new protocols, that was all.”

My first thought after reading that is…

Exactly!

I’m not intending on changing, I’m just learning about the human rules of engagement

I was excited for the book club meeting that month because I was elated to find a book with a character I related to

Not just any character, but the protagonist!

The desired love interest!

Unfortunately, I was not able to share my excitement that evening

At the meeting, I heard some neighbors and friends say things like, “I don’t know why he thought like that” but with a tone that expressed sympathy

These people did not relate to Don, instead they described him as if he was in the uncanny valley, something that looked and acted human, but not quite and it made them feel uneasy about it

Because of this, I detected that this was not a safe place to announce how I related to Don, because my elementary school experiences taught me that I would be discussed like how Don was being discussed in that room—pathologized

And I don’t blame the book club members, this is what they’ve been taught about autism

But immediately, my first experience with autism in the real world was that autism is not good, and that if I want to be liked by people, I shouldn’t be autistic

I should change my behavior to meet their expectations

That was the protocol after all

With that experience under my belt, it wasn’t until a year later I sought talk therapy for depression

I had attributed it being post-partum and assumed it unrelated to any long-term mental health condition or disability

The following April after learning more about autism, I finally decided to tell my therapist that I thought I might be autistic or ADHD and they gave me the contact information for a Neuropsychologist should I ever want to pursue it

I sat on that information for another 2 months before I finally scheduled an appointment through their website

I waited not because I was afraid of being right, but because I was afraid of being wrong

At least if I was autistic, I’d have something that explains me

If not, I’d have to keep looking and looking is exhausting

If I was autistic, I could say I am the way I am because I was born this way

(That is page 3)

If not, then I felt like the only other answer was childhood trauma, which meant that I am the way I am because of what happened to me

If I wasn’t autistic, then I’d have to admit that people I loved were villains in my story

I’d have to live with the idea that there could have been a version of me that wasn’t like this

My sense of identity needed me to be autistic because I was not coping with the reality of my upbringing

The night before my scheduled evaluation, I took every online test available

I spent hours on the computer trying to convince myself that I was autistic

That spending the money to get evaluated would be worth it

Before bed, I cuddled up to my husband while I doom-scrolled on Facebook and came across a meme that said,

“If you’re trying to convince yourself that you’re autistic, stop

Neurotypicals don’t do that.”

“If you’re trying to convince yourself that you’re autistic, stop

Neurotypicals don’t do that.”

I immediately held that up in his face and asked if it’s true, if he ever thought he was autistic

His eyes rolled so hard as he confirmed he never thought he was autistic, and that just blew my mind

Is it autistic of me to have the strong desire to know if I’m autistic?

The next morning, I felt like I had the energy to run a marathon and for anyone that knows me, I can’t even jog a 3k

My FitBit recorded my heart’s beats-per-minute as being in the fat-burn zone for two hours and I was barely moving, maybe walking fast as I struggled to remember everything I needed to bring (everything being myself, being dressed, car keys, house keys, phone, and wallet, it’s not like I needed to bring anything special)

I thought I was masking well, but my husband was legitimately concerned because he asked if I was okay to drive

I sat down in the hallway and thought to myself, if I am autistic and autistic people stim when they’re anxious, maybe I should try stimming

So I began to rock back and forth on the floor of the hallway

It felt silly at first, like I was pretending, but it also felt… good

Like I was a digital compass that needed to be moved around to recalibrate

Maybe there is something scientific about that but I don’t know

When I got to the doctor’s office, I was not tactful at all

I’m sure they’re used to meeting people like me, but I showed up and blurted out how anxious I was and was immediately met with calm people with warm smiles

I couldn’t see their smiles, we all wore masks, but I could see they were smiling by how their cheeks were raised up and squishing their eyes a little

I forgot to introduce myself and state why I’m there, but that’s pretty typical for me

I spent 30 minutes being interviewed

I don’t remember much only that I could not sit still in the chair

I changed positions frequently and that may be because I’m autistic or pansexual so not really an identifier for me

For the next six hours, I sat in a little room with someone and they tested various neurocognitive functions

For some of the tests, I felt like I did a great job

Visual-spatial memory, nailed it

Mental arithmetic though? I asked to just skip it after they read the question because I could not do it

Like, I still use my fingers to count and multiply by 9

(Papers)

I’m great at understanding a problem and manipulating numbers to design an algorithm, that’s why I work professionally as a programmer, but awful at executing it mentally… which is also why I work professionally as a programmer because I just tell machines what to do

After all that, the only part dedicated to autism from my point of view was a questionnaire at the end

The questionnaire I received was the Autism Spectrum Quotient, or AQ Test, and it is only 50 questions

For each question, you get four options to choose from: definitely agree, slightly agree, slightly disagree, and definitely disagree

There is no room for, “I don’t know”, “it depends,” or “I have no opinion on the matter.” So for the flavor of autistics that require accuracy in communication, we’re already nervous that we’re going to answer incorrectly because we can’t possibly choose an option that 100% fits every situation that is asked about

For example, one states, “I like doing things spontaneously.” How am I supposed to answer that truthfully? When I’m sensory seeking, hell yeah let our impulses drive our behavior! Definitely agree

But in the morning after I first wake up? I forget my meds if something interrupts my routine

Definitely disagree

Zero spontaneity for me before 10am

One of the questions is about whether or not other people frequently tell me that what I’ve said is impolite despite believing they’re wrong

Like, Saer, that requires me to talk to people and for those people to feel comfortable enough to tell me that I’m coming off as rude

I often come across as aggressive without knowing it so no, they don’t frequently tell me I’m being impolite because they’re being polite

Another one the questions asks if you notice small sounds when others do not

I don’t know if other people noticed the small sounds and are just ignoring it, or filtering it out, or have already made a remark on it before I entered the room

(Can anyone else hear this projector because it’s loud? It’s why I had to take my shoes off)

This requires me to know what other people are thinking

It also requires me to be able to hear and identify if the noise is occurring outside my skull because again, I’m partially deaf and have tinnitus so there is always noise going on in my head

One of the weirder questions asked me if I knew when it was my turn to speak… but only when I was talking on the phone

How many people here have phone calls these days? I still physically raise my hand to express my interest in talking, even on Zoom calls

Some people are even like, “it’s okay to interrupt me,” and my heart skips a beat because I just cannot

Another question is about whether or not I can easily imagine what a character in a story looks like when I’m reading

I mean, that depends on the writer’s ability to describe the character, does it not?

I fully recognize, now that I’ve reached some aspects of self-actualization and self-acceptance, that the purpose of these questions went right over my head

To me, I thought too deeply about the questions, wanting to be 100% honest and 100% accurate because, as we know, I had put a lot of stock in finding out if I’m autistic or not and this was seemingly my moment of truth

How do I represent myself in these 50 stressful questions? It still perplexes me that the questions don’t ask what it really wants to know

My communication style is direct, straightforward, and blunt

That’s a rather common characteristic of autism

So if you’re trying to find out whether or not I’m good at mental visualization and imagery, I’m an adult, tell me the definitions of aphantasia and hyperphantasia, give me a few examples, and then let me tell you where I’m at on that spectrum

Don’t hide the intent behind some vague question about characters in a book

What do you think?

So Tessa is not the first person that I’ve heard talk about those challenges and she’s certainly not going to be the last

how I approach it is I make it known to each person that the rating scales again are one piece of information and because they’re not standardized as the other assessments are

I can talk it through with you so yes do they result in a score sure but I’m the one taking that information

I’m the one interpreting it

I’m the one writing the evaluation report

so let’s talk about it

let’s have a conversation about different contexts why this is hard for you everything is diagnostic every piece of information is important throughout this process so that’s the approach that I take in trying to help these people’s mind that sure I know these are flawed I didn’t make them maybe someday I can come up with a better version but this is what we have now but I am going to use it as a tool and if that that tool leads us to more interviewing fantastic again the more information the better is going to help me I also know and I explained to people you are not going to be able to capture decades worth of information in any throughout this whole process it’s just not possible but we’re going to do our best to capture as much as we can so at the end of the entire process an individual is either going to get a diagnosis of autism or they’re not that can lead to lots of thoughts and feelings now our practice does offer what we call feedback sessions so once an individual has their their report with their information we do offer for them to come in and you know ask any follow-up questions get any clarification often times it’s just simply let’s talk more about these resources and recommendations that you provided so I know what to do next but when an Autism diagnosis isn’t given again as I had mentioned earlier I do my best to explain that doesn’t mean I’m invalidating your feelings or I’m not seeing you or hearing you I just had to account for what you’re experiencing in a different way than you thought it might be and that’s because of our DSM our Diagnostic and Statistic Manual if a person doesn’t meet criteria I can’t give diagnosis so I will explain throughout the report if you don’t meet criteria or even if you do I’m going to explain how I got to each decision because I know that having whatever answers you might get are going to lead to this self-acceptance or more understanding for family friends co-workers employers Etc knowing that if I do to give a diagnosis of autism that is going to be what some people consider to be their golden ticket to getting the access to the supports and services and accommodations that they need and deserve and so this is never taken lightly and we take it very serious because we know the ramifications and the answers that we give are going to lead people in One Direction or another or maybe multiple directions if there are multiple diag given we know that a diagnosis can result in access to supports and services that they may not get if they aren’t given a diagnosis of autism but again it is my ultimate goal to give you the most accurate diagnosis based on observations test results reports consultations rating skills all of the above so that when you go forward you find the best road for treatment or services or just better understanding yourself and having the most meaningful life going

forward I think I need maybe so I am so much better off knowing I’m autistic I’d love to have been able to say that a self-diagnosis was enough for me but I think after spending my childhood and young adulthood as a people pleaser I needed outside validation learning about autism through Don Tilman in The Rosie Project was my self-discovery I found someone like me representation is important after I got my diagnosis I started paying acute attention to my own behavior specifically I would tune in when I felt uncomfortable and started digging into why even if it was just a little one of my challenging areas is hygiene I find it difficult through shower consistently well one day I was in the shower and I absolutely hating the experience I realized it was because the water pressure felt like it was taking my skin off I hadn’t noticed that before not really not consciously anyway I would just avoid the water and only use it when I needed to but I was essentially debugging these areas in my everyday life this is the process of becoming self-aware I still struggle with self-acceptance and self-love some days I find myself dancing in the kitchen to the music in my head and I think to myself I love how autistically silly I am I bet neurotypicals don’t have random dance parties by themselves because I stereotype them as super serious people I guess but then there are the days where the depression and the PTSD Take the Lead moments where I feel feel like my daughter deserves the best and that the best is someone that isn’t disabled like me because the N typical parent wouldn’t be so forgetful incompetent easily confused or frustrated I’ve accepted that I’m all of those things on those days I feel like maybe some people were right in that I shouldn’t have had a kid because maybe I’m not cut out to be a parent there are plenty of people out there that can that believe that if I can’t take care of a child of all a child’s needs by myself that I shouldn’t be a parent and I can’t even take care of my own needs let alone a vulnerable innocent child what if having a disabled parent is inherently traumatic for her and in my self-acceptance journey I know I’m not 100% independent but all of that doubt is the depression talking and depression only wants to kill you the thing that brings me out of that spiral is something my husband said my daughter doesn’t want the perfect parent she wants me and yes for a while I believed I tricked her into loving me and that was a whole thing but being on the receiving end of unconditional love while also being autistic showed me that this beautiful child loves an autistic person so maybe I should too and that’s all I have for y’all today so let’s dive into the questions

so I did just want to touch on when you, an individual, gets their evaluation report we always include recommendations resources and some of them when an Autism diagnosis is given maybe you know recommendations to access service the office of vocational rehab rehabilitation OBR to have vocational or career planning as Tessa had mentioned you know employment can be difficult recommendations for service coordinator to help assist with finding access to Autism Services through the county resources for the adult autism waiver suggestions for follow up with their employer or educational institution to discuss appropriate appropriateness of supports and services as well as you know that ultimate documentation for the employees or educational institutions to provide the modifications accommodations that are necessary for success