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Could I be neurodivergent?

LynnG

Hello all. I hope this is ok to post, I’m 47, female and at a point that I’m really trying to figure myself out properly. I’ve been looking into neurodivergence but have been put off my family members discounting it as “fashionable”. I’ve typed a (very long!) list of traits and wondered what you think? Does any of this resonate? Any advice would be appreciated.

  • Hyper focus on one thing and can’t rest until achieved, impatience, like an itch
  • Procrastination on big tasks
  • Very difficult to relax, brain on fire / fizzing
  • Research everything in huge detail
  • Detail focussed to the point of obsessive
  • Always tired. Have always fallen asleep in the afternoon since very young age, often on floor
  • High achiever at school
  • Often found myself sitting alone at school
  • Failed at uni, hated my time there, struggled to fit in, or to focus. Very few friends and even they didn’t become close
  • Tricky to make friends, very selective, hard work, tough at school/uni/work
  • Always called aloof or resting *** face
  • Cannot cope with fiction/imagination/visualisation
  • Never been a bridesmaid
  • Hide in bed, always have done, always exhausted, since very young/ afternoon naps
  • Untrusting of what people say to me, looking for nuance on what lies behind
  • Told that I “have to learn to take a joke”
  • “Lacks focus and direction”
  • Anxiety and depression diagnosed 2000 but was it really that?!
  • Addiction / teetotal since 2016
  • Dopamine seeking, impulse buys, snacking, scrolling
  • Feeling lost, haven’t found who I am but working on it now
  • Can’t concentrate on playing with kids /books etc have to be doing more than one thing
  • Rejection sensitive to the extreme
  • Like to stick to rules and get upset when others don’t, like queuing etc
  • Low self esteem
  • Horribly sensitive to loud noises, social settings, crowds, overwhelm
  • Can’t cope with people talking in class (either at school or as mature student)
  • Worry what others think of me constantly and adjust behaviour to suit
  • Converse with humour and charm to cover being shy/anxious - masking?
  • I appear very confident and outgoing
  • Can’t cope with changes in plans/christmas!
  • Emotional meltdown over seemingly small things
  • Repeat conversations over and over when alone, out loud or in head
  • Plan conversations, repeat out loud over and over
  • Not hyperactive at all
  • Don’t want anyone in my home - find this incredibly stressful
  • Perfectionism and perceived judgement if I’m not perfect
  • Blame myself for everything
  • Brain feels actually fizzing until I write something down, tick a box, achieve a task.
  • Used to cry constantly as a child, looked miserable in photos, became a family joke that I was grumpy
  • Felt choked up, like I couldn’t talk as a young child
  • Excitement from maths, countdown! New maths books
  • Capital cities and airport codes, almost thrilling
  • Would rather deep conversations than small talk.
  • Prefer one on one conversation to group
  • “Grumpy Bear” my childhood toy - given to me because I was always crying / grumpy - pigeon holed
  • I hate people making assumptions about me without even getting to know me
Parents Reply Children
  • in reply to Martin

    I agree that screening tests have to strike a balance, but that doesn’t make the RAADS-R more definitive.

    In principle, anyone could design a test that has 100% sensitivity: it would just flag everyone as potentially autistic. That would catch every autistic person, but only because it caught everyone else, too.

    Sensitivity (how good a test is at correctly flagging those who do get a diagnosis) has to be considered alongside specificity (how good it is at correctly flagging those who don’t). 

    In the study, specificity was only 3.03% - ie almost everyone who was not diagnosed as autistic also scored above the test’s threshold.

    Per what I said in response to your earlier reply, a lower-than-needed threshold wasn’t the issue here, because the non-diagnosed group had a higher median score.

    Hence the researchers' conclusion that, when used as a self-report tool, it had “no clinical value”.

  • in reply to Martin
    Martin said:
    That is because the RAADS-R cutoff  (>65) has been set, admittedly by the developers, at a ridiculously low level. I have an ASD diagnosis and scored 167. Had the testers set the cut off at a more reasonable level, say 100, the predictability of the test would, obviously, improve. Those scoring 65 and over have a 34.7% chance of receiving a clinical diagnosis. Increase the cut-off value and the test becomes automatically more predictive with no changes in the wording of the test.

    That doesn’t follow from the findings. Raising the cut-off would only make the test more predictive if higher scores were meaningfully associated with getting an ASD diagnosis. But the study found the opposite:

    • Median score of those who were not diagnosed as autistic: 154
    • Median score of those who were diagnosed as autistic: 138

    So the finding wasn’t that the cut-off was too low. It was that the RAADS-R didn't meaningfully separate the ASD and non-ASD groups. So raising the cut-off wouldn't have obviously improved its predictive value.

    Martin said:

    "Negative predictive value (NPV) determined that 100% of those who did not score above the threshold did not receive a clinical diagnosis", which is in itself useful. 

    The test is not at fault, it is the over-optimistic threshold level that most definitely is.

    The NPV was based on one person - the only one who scored below 65 - so I’d be cautious about placing too much weight on that.

    That also sits alongside their finding that there was only a 3.03% specificity in detecting the absence of ASD in those who didn't receive a clinical diagnosis.

    All of this explains why their conclusion was: “When used as a self-report tool, the RAADS-R had no clinical value.”

  • in reply to Bunny

    All such tests have to strike a happy medium between two non-complementary goals, including all autistic people and excluding all non-autistic people. No test can do both perfectly. The RAADS-R test cut off has gone for including all autistic people at the expense of not excluding all allistic people. In the paper the test identified 100% of the people who were subsequently diagnosed. I very much doubt that the AQ50, with fewer questions is in any way superior in this regard.

  • in reply to Bunny

    That is because the RAADS-R cutoff  (>65) has been set, admittedly by the developers, at a ridiculously low level. I have an ASD diagnosis and scored 167. Had the testers set the cut off at a more reasonable level, say 100, the predictability of the test would, obviously, improve. Those scoring 65 and over have a 34.7% chance of receiving a clinical diagnosis. Increase the cut-off value and the test becomes automatically more predictive with no changes in the wording of the test. "Negative predictive value (NPV) determined that 100% of those who did not score above the threshold did not receive a clinical diagnosis", which is in itself useful. 

    The test is not at fault, it is the over-optimistic threshold level that most definitely is.