[UPDATED] CHAPTER 5: HOME ASSESSMENT PART 2 - DIFFERENTIAL DIAGNOSIS

Assessing autism without self-erasure, using history, co-occurrences, and culture to ground your truth with clarity and confidence.

Autistic traits may be enough to ground identity, but the DSM adds three more hurdles—criteria C, D, and E—that shift the focus from traits to context. This chapter reframes those requirements, showing how they often reinforce ableist assumptions while still shaping medical diagnosis. Criterion C asks whether the traits were present in childhood; Angela explains how masking, trauma, and biased parental memories make this nearly impossible to prove but emphasizes that autism isn’t something you “develop” later—it’s been there all along. Criterion D demands “clinically significant impairment,” which usually means proving your differences made life harder for you or inconvenient for others. And criterion E rules out intellectual disability as the full explanation, though Angela notes that autism and intellectual disability often overlap.

To help you work through these layers, she introduces a detailed Personal History Questionnaire. It covers co-occurring conditions, family traits, school experiences, sensory differences, emotional regulation, masking, burnout, and more—inviting you to record your story in your own words. Alongside this, the chapter highlights the broader picture: autism connects not only to medical comorbidities but also to cultural traits and identities like LGBTQIA+ experiences, left-handedness, synesthesia, and altered reactions to medications or substances. The message is clear: differential diagnosis is less about proving you belong and more about equipping yourself with a comprehensive understanding of your history. By the end, you’ll have raw material to argue your case—whether for a professional evaluation or simply for your own clarity—and a deeper grasp of how your life story ties into autistic culture.