this post was submitted on 08 Nov 2023
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My doctor ordered me a pack of forms and questionnaires to request an assessment for adult autism. In amongst the medical histories and self assessments, this question stuck out;

it is important to know that not everyone who is referred to our service will have a diagnosis of autism confirmed. In the space below, tell us how you think having an autism diagnosis confirmed, or not, might impact on you and your life

What's going on here? Do you get asked this for other conditions? We're a community that typically struggles to read between the lines, so I could be way off, but this feels grudging to me. It's a question that says - what's the point of us even offering this service, and why are you so special that we should waste our time on you?

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[–] [email protected] 0 points 1 year ago (1 children)

I'm reading it more in the direction of, "If we're on the fence/think your case is borderline, make your argument for why we should go ahead and give you a positive diagnosis." or a negative one if you're there at the behest of someone else and are hoping for negative.

But it may also be the kind of question that helps them get a feeling for how you currently perceive your life in relation to your perceived but currently undiagnosed condition. Which can be informative. How you talk about it may even carry indicators in some instances.

[–] [email protected] 0 points 1 year ago (1 children)

Oh that's all reasonable information to ask for. And I hadn't considered the possibility of someone filling it reluctantly at a doctor's request, so thanks for that. But the format of the question rubs me the wrong way.

"Bearing in mind that our resources are limited, and that you might be mistaken, write a persuasive speech about why you, in particular, merit our attention". I'm (I think) decently able to express myself. I'm not great at self-advocacy, but I can grit my teeth and do it anyway. Not everyone filling this form will have those advantages. It feels like a barrier for people to self select out of the process, and I have to wonder if was clinicians or administrators that put it there.

[–] [email protected] 0 points 1 year ago* (last edited 1 year ago) (1 children)

Are you paraphrasing in your quote how you perceived the question? Or does it literally say that somewhere else on the page?

I don’t think that the intent of the question in the photo exists with the intent to blow off patients who the doctors feel are wasting their time or something; it’s almost certainly there to determine the mindset of the prospective diagnosee, and is probably worded specifically to elicit a response such as yours.

I think you should answer it honestly; if you feel it was designed to push you away then explain your analysis. The fact that you even saw it this way could possibly be helpful to them in diagnosing a condition that is almost entirely reliant on the patient externalizing their experiences accurately.

(I can’t say if it would make them lean one way or another towards a positive diagnosis.)

[–] [email protected] 0 points 1 year ago

Oh no, that was my perception in my words. If there was anything so explicitly hostile I would have taken a picture of that instead.

Some context for my reaction - it has a cover letter that mentioned the high demand on the service and 24+ month wait times. Health service provision here (the UK) is highly politicised (as it is everywhere), and services are always under pressure to cut their wait lists. The application pack came in separate sections for standardised assessment forms, and one for admin details like contact numbers and medical history. This question was in the admin section.

I appreciate your point of view though, and it's a reasonable possibility. I'll keep it in mind when I fill it out.