What Comes After the Question?

If you’ve ever found yourself wondering if ADHD or autism might explain certain struggles or patterns in your life, and you’re now seriously considering getting assessed, this article is for you. Whether you’re quietly curious, gathering information before speaking to someone, or already planning your first appointment, what follows will help you understand what to expect, how to prepare, and the possible paths ahead.

If you’ve read my last article on imposter syndrome and the ways it can delay diagnosis, you’ll know how easy it is to talk yourself out of the possibility that you might be ADHD or autistic. That quiet voice saying “maybe” gets drowned out by all the reasons you can’t be: you’re doing fine at work, you’ve managed so far, you’re not struggling enough to count.

I’m not a doctor or a clinician, and nothing here is medical advice. What follows comes from my own research, my own ADHD and autism diagnoses, and from listening to hundreds of people around the world who have gone through the process of being assessed for neurodivergence. I’m sharing it so you can better understand what the journey might look like, not to tell you what you should do.

Here’s the truth: if you are seriously considering getting a diagnosis, there’s already something going on. Most neurotypical people never reach the point of questioning themselves in this way, let alone researching the process or reading articles like this. If you’re here, you’ve already crossed an important threshold, the point where curiosity becomes a need for clarity. Either that or someone has finally figured out your symptoms and set you on a path to discovery.

Even once you’ve decided, the process itself can be hard, especially if you’re ADHD, autistic, or both. It can mean filling in long forms that demand dates and details from years ago. It can mean tracking down old school reports or asking family members to recall childhood behaviours. Sometimes that means asking questions that feel awkward or intrusive, and not everyone will understand why you’re asking or want to help.

When I told my mum I was going for an ADHD assessment, she just said, “Don’t be silly, you are just like me. I’ve never understood other people, they are so boring.” Which, in hindsight, was unintentionally telling. ADHD is thought to be around 74% heritable according to twin studies, so it’s not unusual for more than one person in a family to share traits. Growing up in a neurodivergent household can also make those traits feel normal. If everyone communicates or behaves in a certain way, it becomes your baseline. A childhood that felt like a good fit for your needs can make it harder to recall certain difficulties later, even if those challenges were there. That sense of “this was just how things were” can blur memories and make it harder to see patterns of struggle until much later in life.

Later, when I shared the autism assessment questions with her, it opened up both of our eyes. We began to see our lives and our relationship through different lenses, revisiting events that had once been sources of frustration or misunderstanding.

One moment stood out. As a teenager, my parents once accused me of being on drugs because I looked “shifty” when they asked me directly. I wasn’t, but my face didn’t know how to react and my brain didn’t have a rehearsed answer. I froze. To them, that looked suspicious. To me, it was simply another time I’d been caught without a social script. Talking it through now, we could see how those moments were shaped by neurodivergence. For us, it became a positive and even healing conversation, but not everyone will have this experience. Some parents refuse to share information, perhaps because of shame, stigma, defensiveness, or simply not remembering. Those conversations can be as confronting as they are clarifying.

Even with support, memory can be a major barrier. Poor recall of childhood is well-documented in ADHD, and remembering what you want to say in the moment can be just as difficult. In everyday life, I often leave meetings wishing I’d remembered to mention something important. In a diagnostic interview, those gaps can mean the assessor doesn’t see the full picture.

One way to avoid this is to create a running list of anything that might support the diagnostic criteria (DSM-5 ADHD and DSM-5 autism). Mine became pages of notes on my phone: sensory quirks, social patterns, routines, shutdown triggers, behaviours from childhood, work habits, and moments of burnout. Add to it whenever something comes to mind and keep it somewhere you can access in the appointment. It isn’t cheating, it’s a practical way to work around the memory and executive function challenges that may be part of why you’re there.

In my case, the overall process was straightforward compared to most. Through my firm, I had access to private diagnosis, so I avoided the long NHS waiting lists. My ADHD diagnosis took a few months from start to finish, and my autism diagnosis was completed in roughly the same timeframe. I know this is a privilege. For many people, the same journey can take years, involve multiple false starts, and require persistence that is exhausting before the assessment even begins.

Before you go further, it’s worth asking yourself why you want a diagnosis. What do you hope it will give you? Is it clarity, access to treatment, legal protections, or the relief of having a name for what you’ve been experiencing? How do you imagine your life might change once you know, and how might it stay exactly the same? These questions aren’t meant to trip you up, but to anchor you. And it’s important not to second-guess your answers in the hope of “getting it right.” Trying to game the system might get you a piece of paper, but it can leave you wondering if the result is real, which can make imposter syndrome worse. It can also mean you don’t get the help you actually need. If your difficulties aren’t ADHD or autism but something else entirely, an inaccurate diagnosis could delay access to more effective treatment.

I can say with certainty that my life is so much better after diagnosis. It’s definitely been a journey, one that I’m still on. I will be sharing more in future articles about what happens after you have the answers. But even with the challenges, the shift in self-understanding and the ability to work with my brain rather than against it have been worth every step.

It’s also worth knowing that the official diagnostic criteria for both ADHD and autism were originally developed from research on boys and men. As a result, the tools and questions used in assessments may still lean towards identifying the more “classic” male presentation. This can mean that women, girls, and people who don’t fit those patterns are more likely to be misdiagnosed, under diagnosed, or told they don’t meet the criteria despite significant struggles.

If you’re a woman or present differently from the traditional stereotype, it can help to familiarise yourself with research on the female autism phenotype (Hull et al., 2020) and gender differences in ADHD presentation (Quinn & Madhoo, 2014). Understanding how masking, camouflaging, and internalised symptoms show up can help you recognise your own experiences in the language of diagnostic criteria, and to share examples that make sense in that framework. This isn’t about “gaming” the process, it’s about making sure your reality is visible within a system that wasn’t originally designed with you in mind.

Now that we’ve looked at the “why” and how to prepare, let’s talk about what actually happens when you decide to go ahead. ADHD and autism assessments share some similarities but also have important differences.

If ADHD is your starting point, the journey usually begins with a GP appointment where you talk about your symptoms and how they affect your life. They can refer you to a local ADHD service, or in England you can use the Right to Choose pathway to select an NHS-approved external provider. Waiting times vary widely: in some areas, the wait is over a year, and in others, several years.

Assessments typically include a detailed clinical interview (often the DIVA-5), questionnaires, a review of your childhood history, mental health screening, and, if possible, input from someone who knew you as a child. Screening tools like the ASRS are often used early in this process. They are useful for flagging whether an in-depth assessment is warranted, but they don’t confirm diagnosis on their own. In the general population, many people who screen positive will not meet the full criteria; in a specialist clinic, where the base rate is higher, a positive screen is more likely to reflect a true diagnosis.

If medication is recommended, the NHS will arrange a titration phase to adjust dosage, which can also involve waiting lists.

Privately, you can refer yourself directly. The process is similar in content but usually much quicker, often within weeks or a few months. Some providers include titration in the initial cost; others charge separately. In England, some GPs will agree to a shared care agreement to take over NHS prescribing once your dose is stable. In Scotland, this is not currently offered, so you would need to continue paying full private prescription costs indefinitely.

If you’re seeking an autism diagnosis, the steps are similar in some ways to ADHD, but the tools and focus areas are different. Waiting times can be long — in England, the median wait to first appointment is over nine months, with many people waiting more than two years.

You may be sent questionnaires for you and someone who knew you in childhood. The full assessment usually includes a developmental history interview, observations, and sometimes structured tools such as the ADOS-2. Screening tools like the AQ-10 may be used early on to determine whether a full assessment is recommended. As with ADHD screens, a positive AQ-10 result is not a diagnosis in itself and can produce false positives in the general population. In a specialist clinic, however, a positive result is more likely to align with a later confirmed diagnosis.

Privately, you can refer yourself directly. The steps are similar, but timeframes are shorter, often weeks to a few months. Private reports are generally accepted for workplace adjustments, but some NHS services will not automatically add a private diagnosis to your records without their own assessment. Costs for private adult autism assessments typically range from around £800 to £2,000 depending on the provider, length of the assessment, and whether follow-up sessions are included.

Once your assessment is complete, you’ll usually receive a written report explaining the outcome, along with any recommendations for treatment, support, or adjustments. If you receive a diagnosis, the next steps can include medication (for ADHD), referrals to occupational therapy or counselling, workplace or study adjustments, and signposting to resources or support groups.

If the outcome is inconclusive or you don’t meet the criteria, it doesn’t erase your experiences. You may still be offered guidance, strategies, or referrals that can make a difference. Sometimes it’s about finding the right support, whether or not there’s a formal label.

Post-diagnosis can be a stage of huge relief, mixed emotions, or both. There’s often a period of rethinking your past through a new lens, and figuring out how to work with your brain instead of against it. This is where the real change can begin — and where future articles in this series will explore how to navigate life after diagnosis and turn that understanding into action.

For many people, being assessed for one neurodivergent condition leads to the discovery of another. Research shows that 50–70% of autistic individuals also meet diagnostic criteria for ADHD, and at least one in ten people with ADHD will also receive an autism diagnosis, particularly when assessments are thorough and symptom overlap is explored in detail. In broader terms, around 50–80% of people with any one neurodevelopmental condition will also meet criteria for another.

When a person meets the criteria for both autism and ADHD, it is often referred to as AuDHD. While not a clinical diagnosis in itself, the term is widely used within the neurodivergent community to describe the lived experience of having both.

ADHD and autism can interact in complex ways. In some situations, the impulsivity, distractibility, and novelty-seeking of ADHD can temporarily mask the slower processing, sensory sensitivities, or social communication differences often seen in autism. In other cases, traits can amplify one another, for example, ADHD’s executive function challenges combining with autism’s need for structure can make changes or disruptions especially difficult to manage.

This interaction can impact diagnosis. Sometimes ADHD is identified first because its outward symptoms are more visible or disruptive, while autism traits remain partly hidden behind coping strategies. In other cases, autistic traits are noticed first, while ADHD symptoms are overlooked because they are assumed to be part of autism.

It is also common for autistic traits to become more apparent once ADHD is diagnosed and treated. ADHD medication does not cause autism, but by reducing ADHD-related restlessness or masking behaviours, it can make underlying autistic traits easier to recognise. This happened in my own case: my psychiatrist screened for both ADHD and autism during my initial assessment, and both came back strongly positive. He suggested we focus on ADHD first, and I was formally diagnosed and started treatment. Over the next year, as ADHD symptoms became more manageable, autistic traits stood out more clearly, leading to a later autism diagnosis.

These diagnoses are based on clusters of behavioural and functional traits, not on clear-cut biological markers. While there is some evidence of overlapping patterns in brain structure and connectivity, neuroscience has not yet mapped a definitive “ADHD brain” or “autistic brain”, and it’s not clear exactly how or why these conditions co-occur so often. For now, the diagnostic groupings describe patterns of struggle and support needs, rather than distinct and fully understood biological categories.

A diagnosis can open the door to targeted treatment: ADHD medication, sensory accommodations, and strategies for executive functioning. Psychologically, it can dismantle years of self-doubt, reduce internalised shame, and give language to experiences you’ve never been able to name. Socially, it can make self-advocacy more effective, shifting the conversation from “fitting in” to “making it fit.”

If you are standing at the edge of this decision, know that you are not alone. Whether you take the next step now or later, the very act of questioning means you are already listening to yourself in a way that matters.

There are many supportive spaces where you can talk through your thoughts and hear from people who have been where you are now. Facebook groups, Instagram communities, and Discord servers can be a good place to connect with others who are exploring or have gone through the diagnostic process. These conversations can offer reassurance, practical tips, and a sense of belonging while you decide what is right for you.

If this article has helped you picture what the process might look like, I’d love to hear your thoughts. Share your experiences in the comments or pass this along to someone who might be quietly wondering the same thing. And if you’re ready to explore what comes after diagnosis, stay tuned — future pieces will dive into life beyond the assessment and how to make that knowledge work for you.

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