Private non-diagnosis

I’ve seen a few posts from people who’ve been given a non-diagnosis on the NHS. And the advice either seems to be to pursue a private diagnosis or self-identify. 

My non-diagnosis story is a little different. Whilst on the NHS waiting list, I decided to sell my car and pursue a private diagnosis. It cost £1,750. I had one zoom call which lasted about an hour and a half and another one with a different clinician face to face. They asked for no supporting paperwork but I sent in reams of stuff.

I had a feedback session recently, with the first clinician from the zoom call. She very matter-of-fact started the feedback with “So, we don’t think there’s enough evidence to meet the diagnostic criteria”. I shutdown from there. I didn’t know what to say or ask. I wanted to burst into tears or end the call immediately. I stayed on for about 10 minutes unable to look at the screen. She kept on talking but I couldn’t take in much of what she said.


Sadly, I know it might seem unlikely they’ve got it wrong when I’ve paid for the privilege. But from what I could take in during the feedback session (which wasn’t much as I was so distressed!) the reasoning was so outdated. Apparently there was evidence of non-verbal communication use (I nodded to say yes). I could have a brief two-way conversation. I didn’t have any motor peculiarities (when I’d explained in writing my possible stimming is tweaking my arm and leg muscles or constantly moving my toes and ankles when anxious or overstimulated, which would be obviously unseen on a zoom call or under a desk!). My examples of hiding behind and copying older siblings wasn’t unusual (which is something I inexplicably kept bringing up in the zoom call, when it’s only one example I’d previously thought might be a sign of my lifelong masking behaviour).

I’m waiting on the full report. They won’t tell me more before that’s issued in a few weeks. If it explains things in a better way, then fine. But I doubt it will. I feel like the hope I’d had has gone that other people might need to start listening to me and stop telling me I’m like everyone else. My individual struggles aren’t taken seriously. Other than my parents, everyone I’ve told is like “at least you can move on now” as if it’s nothing! But this possible diagnosis was going to make sense of things. It was going to be life affirming. 

But, one of the big things I’ve always said is I don’t want to encroach on the autistic community. My son is autistic. And I know not everyone is a bit autistic. I either am or I’m not. But, I was hoping I would get a diagnosis to make sense of my whole life, instead I’m left with even more of a puzzle. Either I’ve somehow been misdiagnosed or I’ve had lifelong depression (the only alternative she gave), which explains the burnouts and shutdowns that have occurred throughout my life in different unsuited environments.

I don’t suppose anyone else has a similar experience or words of advice?

  • To be honest, I went with someone who could assess me quickly. I tried to ask a few questions about their experience, and they confidently emphasized that they have lots of experience and follow the gold standard ADOS-2 assessment criteria (and not much more). They implied I could look up the clinicians before each appointment. But it was only after the non-diagnosis came back that I realised I wasn't even given their names. I asked after the feedback session and they got very defensive about the fact I'd paid for an assessment, not a diagnosis. They did at least tell me their job titles. But I don't know how to check if they specialise in autism masking. I doubt they'd tell me any more now. 

    I was dreading them concluding I'm not autistic. But I was hoping and expecting they'd conclude I'm autistic, just because it's made total sense to me as soon as I've thought it could be and scored above the thresholds on any pre-diagnostic test I did. I know I have a problem with thinking other people intuitively know what's in my head and agree, when they don't have a clue. 

    Saying that, I actually thought the face to face session might point more towards me being autistic. I'm really intrigued to see what their conclusion was from the tests conducted in it (e.g. making a pattern out of triangle pieces and describing the frog book). When I walked out of that session I thought they must conclude I am. But maybe they saw something neurotypical in me in how I answered them?

    I guess I'll need to wait for the report to see how they've come to the conclusion they have.

    Thanks all for giving me the confident to push back if it doesn't make sense to me though.

  • Can I ask, did you go with someone who specialises in Autism, and has experience of diagnosing females? That’s crucial when choosing someone that you are paying to see.

    I feel the whole thing was too short, and not thorough enough. You cannot see someone’s whole body via video call either. You could be doing anything below. 
    hmm, so you nodded and had a bit of to and fro conversation. They deem you not ‘Autistic enough’, and you believe them? 
    Honestly. How many adults say they are autistic, and go to be assessed for the fun of it? It’s because they know they are.

    Dont be disheartened. Wait to read your report.

    I do understand how you must be feeling. Just know that there are people out there who look at everything. People who aren’t focussed on if you smile or make a joke,  but are focussed on what you don’t say. There’s no rules for assessing adults, but they shouldn’t be using out of date criteria suited to a stereotypical boy aged 11!

  • Thanks for this. I’ll revisit it all when I get the report back.

  • I find the instances of 'yes/no' decision making in autism diagnosis so very infuriating. Where in the diagnostic criteria does it say that autistics cannot use non-verbal communication? Answer, nowhere! Autistics have problems with communication, verbal or non-verbal, the exact form that this takes varies from person to person, but it does not mean that we cannot communicate. 

    For people over the age of about 12 the reported traits and difficulties, reported by the person him or herself and possibly a parent or partner, should take absolute precedence over mere observation by a clinician. 

  • Private or not, misdiagnoses or missed diagnoses can occur.  How long did you spend in the face to face?

    There are a few of possibilities: either they got it wrong or you meet some, even many of the criteria, but not all, and/or something else explains your experience. 

    Wait till you get the report. If you feel there's anything they missed out, go back to them with it. They may give that further consideration. They are saying there sn't "enough evidence". That doesn't necessarily mean there isn't enough evidence which exists, it may just mean there wasn't at that time enough evidence available to them.

    If you feel they did get a complete picture, then the questions I'd be asking are where did/did you not meet the criteria. You could for instance have a sensory processing disorder exactly like autism, even if you aren't autistic. Understanding that might help you regardless. I'd also be asking what they do think the problem is and then consider whether you think that that could explain the ins and outs of your experience. If it does, then it will still have been money well spent as you'll come away with information you can use and no further need to wonder what's wrong.

    If on the other hand you think that they aren't considering evidence that they should or your symptoms don't seem adequately explained by their report, you might need a second opinion. 

    I do find the nodding business at bit strange. My report said my body language was fairly well integrated with my speech and I didn't stim when I was in there, but there was still ample evidence I'm autistic and hitting all the criteria. Failure to nod isn't a criteria in itself, I'm sure many of us manage that.