Am I “Autistic Enough” to Count as Autistic?

Neurodiversity exists on a spectrum — so where do we draw the line?

Neurodiversity exists on a spectrum — so where do we draw the line?

Photo by Gavin Biesheuvel on Unsplash

Welcome to the third entry in Autistic Advice, a semi-regular column where I respond to questions about neurodiversity, Autism acceptance, and disability rights from Autistic people and their allies. You can anonymously send me questions via my Curious Cat askbox.

Before we dive in, a bit about me: I am a 32-year-old Autistic psychologist who didn’t realize they were on the spectrum until their mid-20’s. My whole family is full of people with Autism-spectrum traits, and I have been active in the Autism self-advocacy community for about six years. On Medium, I’ve written extensively about my experiences, and the experiences of other adult Autistics whom I’ve interviewed for various projects. Though I am a research psychologist, I am not a therapist, and this column should not be treated as therapy.

My letter today is from someone who wants to know how to make sense of the idea of Autism being a “spectrum.” If many people exist somewhere on the Autism spectrum, they ask, how do we know who counts as actually “Autistic”? They write:

How does one differentiate between a person who displays a few autistic traits, and a person who is actually on the autism spectrum?

I’ve noticed I have some autistic traits, like difficulty in socialising, a tendency to deeply engage with certain topics of interest, and laughing at unusual times. I’ve also noticed Autistic traits in some others around me.

I’m wondering, where is the line is drawn between neurotypical and neurodiverse?

Anonymous

Thanks for this question Anon! It gets to the heart of a common misconception many people have about Autism, as well as many other mental disabilities and disorders. People want to believe the psychologists and psychiatrists are objective, and that they have created air-tight, consistent rules for who “counts” as having a particular diagnosis. In reality, a single person can wind up with a variety of competing diagnoses, all for the exact same symptoms. Psychiatrists do not have high inter-rater reliability; they often disagree on who “counts” as having a particular diagnosis.

People also tend to think diagnostic categories are real, easily measurable things. Actually, mental disorders are slippery, ever-changing clusters of symptoms and traits that tend to go together, but don’t always, and have been given any number of names throughout history.

Autism, for example, used to be considered a form of childhood Schizophrenia. Back then, kids with any kind of psychotic symptoms would get an Autism diagnosis. More “high functioning” kids didn’t get Autism diagnoses at all, because they belonged to a separate category entirely (Asperger’s Syndrome). Today, kids with psychosis might instead be labeled Bipolar, or Oppositional-Defiant, or something else entirely. At the same time, kids who would have gotten an Asperger’s diagnosis in the past would instead get an Autism diagnosis today, because the two categories have been combined.

I bring all this up to show that the definition of Autism has shifted dramatically over time, and the people who get counted as “Autistic” are very very different today than they were a few decades ago. Even now, the definitions continue to shift, as researchers become more aware of Autistics they used to overlook, such as women and people of color. The definitions and diagnostic tools will continue to change, adding some new folks, excluding some others.

This is why, as I have written before, I support Autistic self-identification. The supposedly “objective” assessments of Autism that are available to us are not objective at all. The categories psychiatrists and psychologists treat with so much reverence were invented by human beings with biases and limited knowledge, and have been proven to have flaws dozens of times. Experts have attempted to draw the line between “Autistic” and “not Autistic” in all kinds of places, and whenever they do so,some people who are suffering and need help get left out.

So, to answer your first question, Anon, about how to differentiate between “Autistic” and merely “on the spectrum,” I’d throw a question right back at you: why differentiate? What is the benefit to taking something that is fuzzy and complex and exists in a whole rainbow of colors, and trying to reduce it to simple black and white?

I don’t see the value in thinking categorically about things that actually exist on continuums and spectrums. When we draw a line in the middle of a spectrum, we reduce the beautiful, brilliant diversity of our world, and our understanding of complex topics is much worse for it. This is also true of things like measuring personality, by the way. Most of us are just far too complicated and unique to easily sum up.

You’re Probably Not an Introvert (or an Extrovert)
Statistics, psychology, and the limitations of identity labelshumanparts.medium.com

There is no blood test for Autism, or brain scan, or single gene we can look for, or objective measure that gives a definitive answer. All we have are flawed assessments created by non-Autistic mental health professionals, and the observations and critiques written by Autistic people themselves.

When someone comes to me wondering if they are Autistic, I always have the same advice: read writing by Autistics. Watch videos by Autistic people. Try out resources designed for Autistics, like Ear Defenders, stim toys, and weighted blankets. Join an Autistic community space, whether that’s a virtual meeting, an in-person one, or a social media hub. Explore the possibilities, and focus less on discovering objective “truth,” and more on finding what helps you feel more happy, connected, and whole.

I don’t believe in drawing an arbitrary line in the sand and saying a sufficient number of traits (or intensity of traits) makes someone categorically Autistic, especially considering that many undiagnosed Autistics have been forced to hide their more obvious traits for decades. If you have some Autistic traits but not others, it’s possible you have generalized anxiety, PTSD, OCD, social anxiety, or ADHD. Look into those disorders and their communities too. See if there are resources that are useful to you there. You can be promiscuous — we won’t get jealous. A lot of us have multiple conditions anyway. Or feel at home in multiple mental health communities, if you prefer.

As your question acknowledges, Autism is a spectrum. Or as others have written, a sundae bar with a variety of toppings. If you are somewhere on the spectrum, you’re on the spectrum; you don’t have to be the most intensely Autistic person around to count. Even if you actually have a “sister condition” like ADHD, you might still feel at home among Autistic folks, and if that’s the case, you belong too.

I have said this many times, but people need the reassurance very often: if you feel at home in the community, if you benefit from resources designed by and for Autistic people, if you recognize you share common interests with us and you want to fight alongside us for greater disability justice, you belong in the neurodiverse community. Full stop. Don’t let anyone tell you otherwise.

You can use whatever words for yourself you feel most comfortable with, Anon, or you can just enter neurodiverse community spaces without claiming a label. You don’t owe anyone proof, and you don’t have to be “Autistic enough” to matter and belong here. We are stronger together. We’re a big, diverse rainbow, and you are welcome inside it.

…

Want to ask Autistic Advice a question? Submit via the Curious Cat box here.