3 reasons an autism diagnosis can be missed

3 reasons an autism diagnosis can be missed... 

Meaning, you're autistic, you get evaluated, but the practitioner says you're not autistic.

1. Masking. 

This is because some traits are not observable and many practitioners rely too heavily on observation rather than interviews/personal accounts of the internal experience. This happens frequently in older kids/adults and has been noted more frequently in girls/women.

2. Autistic traits look different in everyone. 

There's a wide range of presentations of each trait (e.g. some people stim by flapping their hands, some by rocking in their chair, some by chewing their lips). And unfortunately, some practitioners don't look for or acknowledge less obvious presentations of autistic traits.

3. A surprising number of practitioners are not current in their understanding of autism or are not aware of the level 1, lower support needs presentation of autism.

Practitioners are technically required to stay up to date in order to retain their credentials to diagnose, but I have first-hand experience with one who didn't have very basic knowledge of the current diagnostic criteria. 

And believe it or not, the diagnostic manual that outlines how autism is diagnosed in the US (the DSM 5-TR) includes most of this in writing. Here's a screenshot with the relevant section highlighted for context... pause if you'd like to read it.

All that said... if you left an assessment without a diagnosis and feel it was missed, here is your permission (not that you need it) to seek out a second opinion...

But be sure to go into the process prepared so you can avoid running into the same problem again.