Late Diagnosis

When I attended speech-language therapy as a child, my primary goal was articulation of my /r/. There were no pragmatic goals assigned because daycare gave me a built-in group of peers whom I saw every day. My mother inadvertently laid out the social rulebook of how to mask with explicit instruction: “Say please and thank you like this, introduce yourself like this, smile like this, and don’t ignore others because that’s rude.”

Sure, I was quiet, had trouble concentrating in class, and found myself on the outskirts of friendships, but I thought everyone felt the same—that we were all just following the scripts that we had been taught, that all of us spent three times longer than expected thinking about completing homework assignments rather than actually doing them. It wasn’t until demands increased in community college that I began to recognize an important reality: I was more than a little different from my other peers, and I needed support to make it into our highly competitive field.

All of the coping strategies that had served me well previously didn’t cut it anymore. I was beginning to burn out, and so I began to seek help from the therapist I was seeing at the time. After myriad referrals and months of waiting, I was diagnosed with attention-deficit/hyperactivity disorder (ADHD)—and it wouldn’t be until I was administered an autism screener as part of gender-affirming care that I would be diagnosed with level 1 autism spectrum disorder (ASD). This combination of ADHD and ASD is known as AuDHD.

Looking Back: Acknowledging the Gift

During these early days of my diagnosis, as I looked back I recognized that in addition to being socialized in a culturally feminine way, I had been deeply impacted by how my symptoms had presented. This resulted in my late diagnosis, as the demands of life reached a tipping point. Although it took a while to receive my diagnosis, receiving it allowed me to reframe my past in a way that honored my neurodiversity—and to recognize all the gifts it gave me.

Looking Ahead: Exploring the Whys and the Ways

As a current communication sciences and disorders (CSD) graduate student, my neurodivergence has deepened my passion for research and for asking why we do what we do. It also allows me to view cases from perspectives that my neurotypical classmates may not share and has strengthened my empathy for people whose communication differs from society’s expectations. In this way, my diagnosis has given me a deeper understanding of just how important it is to have the whole spectrum of neurodiversity (and disability) represented in the field, as it helps us question commonly held assumptions and brings our practice closer to positively representing those we serve.

Practical Tips for Neurodivergent Students

I do want to recognize that being able to receive health services and get a diagnosis is something that not everyone can access, afford, find the time to do, or want to do. Additionally, I am only one neurodivergent individual, and what works for me may not work for you. As someone who progressed from spending 8 years completing my undergraduate degree to successfully presenting at ASHA Convention as a graduate student, I hope that sharing my journey and what I’ve learned may help a couple of you.

• Don’t be hard on yourself: It’s important to recognize that the systems built in the United States were created for neurotypical people and that navigating these systems as a neurodivergent individual will come with its own challenges. Take your time when you can celebrate the small wins. Slow progress is still progress.
• Find community: Chances are you’re not the only one going through what you’re going through—and being able to talk about the challenges you’re facing with others who can relate may provide some solace or a cheering section if that’s what you need! This could look like finding those who share diagnoses on campus, within your local community, or online. If you have a special interest or hobby, you can always join groups related to that. Community doesn’t always have to be focused around a diagnosis or label.
• Figure out what works for you; your path is your path: If you require more alone time to recharge, or if undergraduate school takes 8 years, there’s nothing wrong with that. We all travel our own journey, and as long as you feel content with where you’re at, that’s all that matters.
• Resources: If you’re struggling, reach out to the resources available to you. This may mean contacting campus health services, seeking accommodations through your campus for classes, finding a neuro-affirming therapist, or searching online for local resources. If any of these suggestions seem too overwhelming, try getting a trusted buddy or family member to help you. I’ve found that if health services on your campus can’t help you, they can usually point you toward those who can.
• Self-advocate and disclose on your terms: If you feel comfortable, let others know what you need to show up as your best self and/or how your diagnosis impacts how you navigate the world. This could mean telling them beforehand, informing them in the moment, or filling them in afterwards through whatever type of communication works best for you (e.g., verbally, text message, email). I’ve told multiple classmates about my diagnosis, how that manifests (e.g., need more alone time, am sensitive to sound, have trouble “reading between the lines”), and how they can best support me (e.g., still inviting me to hang out even if I decline, being straightforward with me rather than relying on me to pick up social cues).
• Your viewpoint is needed in the field: It takes all of us to make this field as inclusive as possible. The CSD discipline benefits from clinicians whose lived experiences reflect those of the communities we serve, including neurodivergent children and adults. As the disability rights saying goes, “Nothing about us without us.” As a neurodivergent future clinician, you have a unique position that allows you to consider both perspectives and to help bridge the gap in creating more neuro-affirming practices.

How To Be a Neuro-Affirming Peer

Communication is a two-way street, and trying your best to be a neuro-affirming peer is the first step to becoming a neuro-affirming clinician. Here are a couple of points to keep in mind as you interact with others—and remember, neurodivergence looks different in everyone.

• Shift your view of neurodivergence from something that is a deficit to something that is a difference. We need all types of people to deliver holistic patient-centered care.
• Recognize that people communicate in different ways and have different needs.
• Ask for clarification rather than making assumptions if you’re unsure of someone’s meaning or intent.
• Recognize that the neurodivergent clients we treat become neurodivergent adults and your peers. This doesn’t end in childhood.
• Have patience with those who take a little while longer and/or who communicate in different ways. Sometimes, understanding someone takes time.
• Advocate to make spaces more neuro-affirming by listening to the needs of those within the community and by supporting the change(s) that they want to see.
• Take time to educate yourself by exploring existing resources, webinars, and perspectives from neurodiverse clinicians.

By embracing our own neurodivergence and supporting it in our peers, we can collectively transform the CSD field into a more inclusive, patient-centered space. Our unique perspectives are not just personal assets—they’re essential tools for building a future where every voice is truly understood and valued.