Rejected for assessment

Hi! This is a long one, so I can only apologise, but I am looking for some advice regarding being rejected for an assessment. I would like to add I am in Scotland, therefore right to choose is not an option.

To give some background, I am a 25 year old woman, and my dad and brother are both diagnosed with autism, my dad also has a brother who is diagnosed. My parents split up when I was very young, and throughout my childhood my dad faced an abundance of challenges due to being undiagnosed at the time and various other traumatic events, my mother was also violent to him and pushed him and his family out of my life, therefore I was not close to my dad for many years and did not know the family background. I was also subjected to neglect and abuse by my mother, and am no longer in contact with her, therefore sourcing people who can contribute to my childhood behaviours has been difficult.

I have received various different types of psychiatric treatment over the years, including different therapies and medication, none of which were particularly successful.

My mother used to always say I was “just like my dad” and it was one of the reasons she mistreated me. Since reconciling with him, we have discussed in depth how many similarities and challenges I share with both him and my younger brother. This lead to us questioning if I may also be autistic, as we were well aware it can run in families.

After spending the last few years researching everything I could about autism and having long discussions with my dad and brother about their experiences, I finally reached out to the GP for an assessment. The GP was supportive and I completed the AQ-10, which I scored high in, and compiled a document with a list of traits and challenges I have had since childhood, along with info regarding the genetic background. I was sent a follow up questionnaire from the local neurodevelopmental team, and filled it out as best as I could despite not having much info from my childhood.

From what my dad can remember of his time living with me in childhood, he could recount several instances of me having meltdowns over routines changing (e.g. him dropping me off at school instead of my mother when it was usually her who took me) and how he would watch me “arranging” things (e.g. lining up rocks in the garden, lining up toys).

I have an abundance of sensory issues, including;

-instances of vomiting because of food textures being “wrong” compared to how they’re supposed to be, and i cannot eat many foods due to their unpredictable nature texture wise.

-Sensitivity to sound which results in me having to cover my ears or remove myself from situations regularly.

-Extremely sensitive to touch and cannot stand people touching my skin as it feels agonising to me, like I am being rubbed with sandpaper.

I have also experienced an abundance of social difficulties throughout my life, which was particularly rough throughout primary school, as I could not bare speaking to people, would not speak unless spoken to and even then it was a hit or a miss.

I also misunderstood tasks in school a lot and would require further clarification regularly as I took things very literally resulting in mistakes, including several instances where I took writing topics far too literally and wrote essays on the entirely wrong thing, which was deeply embarrassing to me.

Along with all of this, I only had one friendship throughout the entirety of primary school, and it was not very consistent, with fall outs being a regular occurrence. My attendance was awful as I could not cope with the school environment for various different reasons, from the obvious social difficulties, to the pressure and expectation and also things such as seating plans unexpectedly changing and changes of teachers at the beginning of each new year.

By the beginning of high school I was extremely emotionally and psychologically exhausted with the world and trying to process and understand everything around me and began using drugs and alcohol to cope, beginning with alcohol around age 12 and drugs around 14. I also became addicted to opiates around the age of 16 or 17, as being “doped up” essentially was the only way I could cope with seemingly easy, basic human activities, such as going to school and appointments, and even just meeting up with friends, as even being around people I liked was uncomfortable for various reasons such as eye contact and being constantly aware of my body and not knowing whether I was saying or doing the “right” thing.

I was asked to leave school at age 15 with no qualifications due to my attendance, and have not lasted in any job longer than a few months without going into a severe state of depression and feeling extremely overwhelmed and trapped, because I cannot keep up or cope with the social aspect of workplaces, much preferring to work alone and be left alone, and I struggled to find a job like this, therefore I am now unemployed and have been for the past 6 years.

I have now lost every friendship I managed to make throughout my attempts at hiding my difficulties via drugs and alcohol and mimicking the behaviours and traits of others, and was often told by ex friends that I was too honest and harsh, despite not meaning to come across like this and often not realising I had done anything wrong until I was told, which in most cases was too late.

I have had lifelong repetitive physical behaviours since childhood, such as cracking my thumbs all day long, rocking back and forth, shaking my legs, rubbing my feet together. I have done each of these things, every day, pretty much all day unless I am in public and physically can’t, as far back as my memory goes.

I also have “rituals” I have done my whole life, such as eating each meal in an order that only makes sense to me, and I cannot do it any other way.

The reason I explain all of this, is because my assessment was rejected despite explaining all of these things as best as I could on the follow up form I was sent out after the AQ10. I am not saying I am autistic, and I did explain on the form that I have faced significant trauma which may contribute to at least some of my difficulties, however I have made an abundance of progress with said trauma and have in recent years overcame my opiate addiction and broke out of many, many unhealthy cycles that were implemented on me by my mother.

They sent me a letter in response to my questionnaire saying the only signs of autism they could see were emotional dysregulation and social difficulties, and reiterated that autism is categorised with these along with sensory issues and intense lifelong interests. I have had several, intense lifelong interests including;

-Music, I still to this day listen to the exact same songs on repeat all day long that I did back then, and can listen to the same song 30+ times in one day.

-Movies, which again, I can and do watch the same specific movies over and over again all day long, the exact same ones since childhood, it has never changed.

-An intense interest in perfume, cosmetics and fashion and the history of all three, I collect perfume and vintage makeup books and various other things in relation to this. 

They did not mention any of the sensory difficulties I have, nor my special interests other than saying of my “interest in beauty” that it was perhaps just because I “wanted to be seen as perfect” as I told them I masked heavily in my teen years by covering up my appearance to fit in and forcing myself to conform to a certain beauty standard even if I did not personally like it, because I just wanted to be like other girls so I wouldn’t get bullied. My interest in the history of fashion, cosmetics and perfume is unrelated to this and I loved these things way before I started making myself look a certain way to fit in.

They stated that they looked at my records from baby-toddler years, and that my speech was regarded as developing slowly, I was noted as a fussy eater and had significant sleep issues during my developing years, but everything else was considered normal therefore they did not expand further.

They also did not mention the genetic background of my father and brothers diagnoses, my paternal grandmother also has ADHD which was noted on the form. I also gave my dad as a contact so he could provide him with more info, on what he could remember of my childhood as well as his family background, they did not contact him.

They stated they felt that my emotional and social difficulties were perhaps because of trauma and told me to attend the mental health team instead. Which I have, many times, for a decade now, which has 90% of the time been unsuccessful for me. The medications have not worked nor have the several rounds of CBT, exposure therapy and occupational therapy.

They also stated that they felt my need for routine and predictability was “personal preference” despite explaining that I have regularly had meltdowns and outbursts, often leading to self harm via hitting my head off of walls and such, over plans changing and details being left out. This has caused conflict with others and lead to ostracisation from peers several times throughout my life. I also explained it takes me weeks, even months to prepare for things like appointments and outings as it feels disruptive to my usual routines, doing something I don’t usually do every day, which causes me immense anxiety and can cause panic attacks and meltdowns. It felt quite insulting that they considered this a personal preference, especially considering I have physically harmed myself and been through significant distress due to such experiences. If it was a preference, I would prefer not to be that way, as it is painful to me and blatantly inconvenient to those around me. 

Again, I am not saying I am autistic, I am not a doctor, but I feel like their dismissal of me may have been a bit unjust, and am feeling a bit at my wits end with it all. The reason I was seeking a diagnosis is because I have spent all of my life feeling different and being ostracised, and have not been able to get the education I deserve nor hold down employment, I feel like I have been allowed to fall through the cracks and now I am stuck on the outside of society. I was not necessarily seeking diagnosis for support from the NHS and such, as I know neurodivergent people are consistently failed in this department, but more so to allow me to access the accommodations I need to perhaps return to education or work. Has anyone else been or known anyone in a similar situation? Did you seek a second opinion and were successful? As I am unsure if it is worth trying to do anything about or just accepting the neurodevelopmental teams judgement. Thanks x 

  • Thank you - I’m sorry you’ve experienced something similar  in your family too. My son is getting some support at the moment (a small amount but he is getting on well with it)  - but I think he does undoubtedly live with some consequences of spending all those years in school unable to speak. He’s a truly amazing person - kind, wise, loving - and I’m amazed he’s emerged from what was a very difficult time in education without being bitter or angry etc - he’s a wonderful person and I’m incredibly proud of him. I lost count of the times I was told that the Ed psychs sent to see him were “newly qualified” and the turn over of staff was very quick - so that probably didn’t help! He did however have one great Senco at secondary school and she was amazing - she got him an EHCP in place and was supportive with getting the diagnosis of autism. We’ll never forget her and will always be grateful to her as she really connected with my son and did all she could to help him. 
    I totally agree with you that the vast increase in young people with mental health issues is not at all helped by lack of good help and support in the school years - and just by society in general not being more caring and supportive of children. We live in a complex, competitive and in many ways unhealthy society - and children are often ‘sinking rather than swimming’ as they try to navigate it all.  

  • It’s not just Forth Valley. Stirling and Tayside health boards have both axed their adult autism services. I’m in the Glasgow area, but I don’t know what the state of adult autism services are here.

    As I’m too old to wait years for an NHS assessment and too mean to spend a couple of grand to go private and essentially be told what I already know, I have decided simply to self-identify as autistic.

  • Interesting you mention endocrine issues. I checked my hormones 2 weeks ago (privately) just see, and 3 are outside the normal range by quite a bit, others a bit marginal.

    Is this common? I'm assuming stress is the main cause.

  • Wow that is truly shocking, I had no idea they were doing stuff like this which just shows my ignorance. It’s horrifying the complete lack of regard they have for those who are only realising they may be autistic later in life, I’m assuming they see it as “well you’ve went this long now, i’m sure you can manage”. What they don’t realise is the immense amounts of trauma and psychological problems that can arise as a result of being autistic, not knowing, and not having any support. The world can be a dark place for those of us who are considered different. 
    I was actually quite taken aback by some of the things they said on the letter they sent back to me, particularly about my need for routine and predictability just being a “personal preference” despite explaining the fact I have physically harmed myself and lashed out at others over it as far back as my memory goes! It felt like they were definitely just trying to gloss over a lot of what I said in order to cherry pick specific things they could relate back to trauma so they didn’t have to assess me and could just fob me off back to the MH services, who have also consistently failed me over the years.

    It’s an exhausting battle to fight and I think, like you, I might just go down the route of saving up for a private assessment. Things with the NHS have actually gotten so bad I’ve considered looking into private health insurance several times recently, as I’ve also been fighting a losing battle trying to get help for endocrine disorders as that’s another aspect of the NHS, like majority of it at this point, that is being scarcely underfunded. 

  • Wow your son’s situation sounds so similar to that of my younger brother, my dad and his wife had so many of the same struggles with being passed around from supposed professional to supposed professional, and what we all know now were so many glaringly obvious autistic traits yet no one noticed! As much as we’re all used to it, it still never fails to shock me how many professionals, like you say, lack even the most basic training in these things. So many people allowed to fall through the cracks by the systems that are supposed to protect them, and then they wonder why the NHS is so filled to the brim with people having mental health crises down the line. I’m so sorry you and your son have had to go through that, and I can only hope he is much better supported now, although it’s sad that parents like yourself and my dad are forced to do the job of supposed professionals. 

    You’re so right, human brains can only tolerate so much, especially in a society that feels like it was not made for those with any kind of difference, be it anxiety, autism, trauma and everything in between. Sometimes we have to do what we have to do to get by in our darkest moments and it’s shocking that in this day and age people are still judged for that instead of offered much needed help and support to get better and find better ways of coping. Professionals aren’t much better with supporting that kind of thing either! 

  • Sorry to to read of your struggles.

    The NHS in Scotland does sod all for autistic adults unless you are severely autistic and have learning difficulties. My GP was brilliant and referred me to the local NHS team. I was put on the waiting list and told that it might be more prudent to seek a private assessment due to the waiting times. I was lucky that I could scrape together the cost of going private. Some health boards are cutting back on adult autism assessment. One that I know of is Forth Valley which sent out a letter to all on the waiting list to sorry but they are not assessing adults anymore and to either self identify or go private. There was a public climbdown after STV news and papers got interested after a very public petition.

    My GP wrote to the NHS team asking what support would be offered and they wrote back to me to say 'we are a diagnostic service only' and signposted me to the autism charities for help and support. I found them to be not very supportive. So it seems us 'latelings' are left to fend for themselves

  • You sound very switched on and informed to me - I think you’ll do a good job of persisting with this by the sound of it! I never cease to be amazed how many ‘professionals’ seem very badly informed about the complexity of autistic people and how they present. A lack of good training is probably at the heart of it in many cases. There’s no excuse though ultimately- because it’s their job after all! My youngest started with Selective Mutism when he started school - and wasn’t diagnosed as autistic until he was 10. I knew very little about autism when he started school - but looking back with what I know now it seems ridiculous that he wasn’t identified much earlier by the ‘professionals’ who had contact with him in those early years. He had so many obvious traits of autism - and yet saw so many Ed. Psychs. to help with his Selective Mutism but none of them mentioned autism until I finally clicked that he was autistic! So all in all I’m pretty cynical about so called experts in these things! So we have to be informed ourselves, and do the research ourselves - to prevent us suffering from the incompetence of poorly trained ‘experts’! 
    And by the way - I’ve always used alcohol to help cope with my anxiety. I have been lucky really in that I have a low tolerance to alcohol so could never drink large amounts - it just made me feel really sick and ill to drink more than 2 glasses - it just didn’t suit me physically, my body just can’t deal with it. So that’s prevented me from drinking a large amount. Plus I’m very anxious about taking any drug (even presciption medication) due to health anxiety - I’ve only ever tried marijuana and didn’t like the way that felt either. But I can totally see why autistic people would turn to anything that helps - because life can feel unbearable sometimes, and we do what we can to help make it bearable don’t we? 

  • Thank you so much for your reply, after speaking to people on here I will definitely be going back to my GP to request a second opinion. 
    Adding in the local health authority is a good idea too and I’m grateful for your advice, it’s sad we have to go to these extents just to be listened to though. It definitely doesn’t sound extreme to add in local MPs as my dad had to go down a similar route when desperately trying to get adequate help for my younger brother, he has been back and fourth with complaints and the health board and everything in between for years now due to the problems my younger brother has faced when accessing help. He even had one supposed professional disputing my brothers diagnosis because “he could make eye contact”, despite the fact autism is a spectrum, and many autistic people can make eye contact, though it does not mean it is not painful and extremely uncomfortable in the process, which for my brother (and my dad and myself) it is. My dad was hoping things might’ve been easier for me with the system due to the fact I am an adult, but it seems not. 

    I definitely think you could be correct with a little bit of discrimination on their end due to my history with drug abuse, I don’t want to make assumptions, but I feel it could be because of stereotypes and biases where many people, including professionals, can see people with autism as being “childlike”, or at least having a “childlike innocence”, not seeing them as autonomous, complex, multifaceted human beings who are capable of many different things, even including unhealthy things such as abusing drugs and alcohol in a desperate attempt to mask, fit in and get through life. My dad actually went through the same thing with drug and alcohol abuse, for the exact same reasons I did when he was in his teens and early twenties, and I think that’s probably why he went under the radar until he was a lot older (and sober) too, and also just due to the lack of knowledge of autism back then, which unfortunately seems to somehow still be a problem all these years later. 

    There definitely is a massive funding issue too, which is not the fault of the NHS but the government, and unfortunately they are consistently allowing so many people to fall through the cracks, left without support, diagnosis and treatment for so many different conditions, but then complain that many people cannot work. The irony of it all. 

    Thank you so much for your kind words, it definitely is a long process, but thankfully I am very stubborn and will not give up on finding peace haha! 

  • I did take these in the lead up to me deciding whether I should seek a diagnosis or not, I can’t recall my exact results but know I scored very high in each as I remember discussing it with my dad and partner, and I actually scored higher than my dad who is diagnosed haha, as he took them too just out of curiosity. I actually didn’t think to present this as evidence and now wish I had, but I will retake them and keep records of each one to take to my doctor when requesting a second opinion. That was great advice, thank you!  

  • If you have not taken them, I would do the RAADS-R autism test, plus the autism camouflaging test and the systematising quotient, they can be found online. Also look at the ICD-11 diagnostic criteria for autism diagnosis. it is the manual most used in the UK, see how your own traits and history can be fitted into its necessary sections. The more information you can present the better, in my opinion.

  • Gosh - it’s very concerning to read this - the traits you describe very much reflect autistic traits so it seems extremely surprising that they won’t properly assess you for autism. How strange. If I was in your position I would definitely be requesting a second opinion. Do everything in writing so you have a record of everything, when emailing them you could copy in your local Health Authority. Don’t give up. If things get to the complainants stage further down the line  I know it sounds extreme but occasionally in the past when having difficulties getting my son support I copied in my local MP to emails and they were surprisingly supportive and helpful. 
    Part of me wonders if other aspects of your story regarding drug and alcohol issues you have had is making them discriminate against you in some way? Because the traits you describe definitely point to the possibility of autism. I’m really sorry - you deserve better. I think funding issues might also mean that authorities might be trying to reduce the amount of diagnosis for neurodiversity issues. It’s hard to know why this has happened to you but I really wouldn’t just give up if you feel you really are autistic ( or might be). In my past experience we often have to be persistent when dealing with the authorities and health boards etc - they’re meant to help us but they are often overstretched and underfunded and therefore try to reduce their workload and costs. 
    I’m very sorry you had an abusive mother - it’s a hugely difficult thing to experience and I hope you can now move forward and heal from that. It’s a long process - but I hope you can find peace after so many difficult experiences that you’ve had. 

  • Thank you so much for your reply! 

    I genuinely has been so validating to see these comments from others saying the same thing, as I was so close to just accepting what the professionals said and leaving it at that, despite feeling deep down that they had got it wrong. 

    After posting this and speaking to my dad, I think I am going to return to my GP and ask if there is any other services I can attend for a second opinion, and bring my dad with me to the GP appointment as he is diagnosed himself and can help me explain better. If they can’t provide this I think saying up for a private assessment will be the only way, which is disheartening but needs must. 

    Thank you again for your help, I greatly appreciate you and all others who have commented! 

  • Thank you for your comment! From what you and others have said, I think a second opinion is definitely going to be my only choice. It’s been very validating to know it’s not all in my head! 

    Im so sorry you’re going through all of this exhaustion, I know exactly how you feel. It’s so tiring having to fight a system that is constantly working against you, and like you, I was forced on an abundance of meds that made me feel worse for many years as a teenager as no one seemed to know what else to do with me.

    I’m glad you have your therapist, and hopefully they would be able to provide you with support and back up if you were to go through something similar to me with the rejection of an assessment, so you would not have to go through it alone and could have someone help you fight it. However, I really hope that I have just been one of the unlucky ones and you do not have to go through this. 

    Thank you again for your comment, and I hope everything goes well for you too, this community is always here if you need any support! 

  • Thank you for your comment! 

    It’s really validating to hear this, when I was researching about autism the past few years, I had read many times that women were not taken as seriously, and often misdiagnosed with other conditions. I actually already have several diagnoses from my teenage years, as I think the mental health professionals I was working with just could not figure me out, so they labelled me with the easiest things they could think of, and gave me a plethora of medication that did not work for me, and various types of therapy that in a lot of ways made me feel worse despite my best efforts to comply and do as they are asking of me. 

    I had hoped with recent surges in awareness of women being left behind with autism, and also ADHD diagnoses would maybe have reduced my chances of this happening at least a little bit, especially as my GP was very supportive of me seeking a diagnosis, but it seems not. 

    I think a second opinion is definitely going to be the way to go. Thank you again for your help! 

  • Thank you for your reply! 

    That was definitely how it felt, when I read the letter they sent me, I was thinking the entire time, can autistic people not be traumatised too? From the research I’ve done, I actually thought that was quite a common occurrence, and I have read studies that have stated autistic people can be at a higher risk of traumatic things such as abuse, so it certainly left me confused that they felt I could not be considered for an assessment due to having trauma. 

    Also, don’t apologise for asking, I’m happy to answer! My younger brother is actually from my dad’s second relationship, he has been with his current wife for around 16 years now, so my mum just had me and my dad haha, after he left when I was around 6 it was just myself and her for many years. My mum was a very troubled woman with an abundance of her own issues, definitely a lot of childhood trauma.

    Myself, my dad and her GP as well as some of her own family members attempted for many, many years to get her to accept psychological help as she desperately needed it, to which she would either refuse, or accept and then refuse to work with psychologists she was sent to. I held a lot of empathy for her despite her violence and inability to be a parent to me, as I was really the parent in our relationship since childhood, and spent many years trying to help her and encourage her to get the support she needed, however there came a time when I could not keep trying to force the mother daughter relationship that was not going to happen, nor for her to get the help she did not want.

    Myself and my dad were certainly very confusing for her and she could not seem to understand the way our brains worked respectively, and like you say, I think a lot of this was probably down to an abundance of misunderstandings and miscommunication, and I think a lot of frustration that we wouldn’t act or think the way she wanted us to, as there have been many others in both my dads life and mine who have also grown frustrated with us, and I personally have faced types of abuse from others too as a result of this. 

    I definitely will keep checking this website, as everyone here has been so supportive already! I think second opinion certainly seems the way to go.

    Thank you again for your comment!

  • * your ( not you mr) 

  • I’m sad to read about you mr experiences. You really have been let down and you should be able to access an assessment. I would definitely get a second opinion. If it’s an option, change / re register at a different doctors surgery altogether or save up and get a private assessment if possible. Wishing you luck! 

  • Your story is sad and I think it’s worth to seek second opinion. 
    your story also makes me think that I’m very much likely to get rejected too, but in such case I would have left it as it is, because I barely find energy for life, so I’m too tired to complain, appeal, seek any other opinion. I only hope to not be forced on meds anymore. My therapist understands me better than anyone else, I fear I will be left alone again when the sessions are over.

    i wish you all best and just treating. 

  • You are describing textbook autism traits. They are more overt than mine are/have been and I am diagnosed with ASD. The assessors appear to be ill-informed at best, incompetent at worst. Complain formally and ask for a reassessment with other assessors. Unfortunately, there seems to be a greater tendency for women to be fobbed off with alternative diagnoses than men are. It is very poor.

  • Hi,

    Wow! There was certainly a lot to unpack there! 

    I'm sorry to hear your situation. It does sound to me like the "professionals" are trying to suggest "she has traits similar to autism that can be easily explained away as trauma". Have they not considered trauma occuring as a consequence of autism? Heredity has to play a part, surely.

    Sorry if it's personal, but do you think that having to cope with an autistic husband, son, potentially daughter, had a baring on her violent temperament? Don't feel obliged to answer btw. I am in no means condoning your mum's actions.

    Most, if not all, autistic people suffer conflicts due to misunderstanding or miscommunication. This can breed anger and resentment. Apologies about being analytical, but it's something to consider.

    Plus, ask for that second opinion. Nothing to lose, everything to gain.

    Oh, and keep checking up on this site. It can sometimes make that tangled web a little easier to detangle! 

    WinkHeartThumbsup

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