11/30/2021
“It costs us NOTHING to affirm the identity of clients who come looking for answers.”
SUCH an important + informative thread from Joel Schwartz!
It is well beyond time for folx to get with Neurodivergence + start affirming Neurodiversity. It’s not some bandwagon or trend— it’s our identity, our community, and our real lived experience.
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[screenshots of tweets by Joel Schwartz, . image text:
Thread about why most assessments are ableist, why so many psychologists do bad autism assessments, and why informed assessment is essential. 1/x
It all starts with our training, which is steeped in DSM, medical model ableism. ADHD, autism, etc are inherently bad things, maybe the worst things because they really can't be fixed with psychological tools. All of this is implicit in training, through ableist messages. 2/x
So when someone comes to us looking for an Autism diagnosis, we are trained to be comprehensive, to do "rule outs" for everything else. This leads to 2 immediate consequences 3/x
1. Immediate bloated comprehensive assessments that take time and cost $$$$$.
2. Setting us up for invalidation of lived experience by trying to find ANY OTHER explanation of for the experiences we are seeing. 4/x
So despite there being any wisdom or clinical evidence to do so, psychologist forums are littered with questions like, "Can I diagnose Autism or ADHD if there is a personality disorder/trauma/other mental health condition." 5/x
Even a cursory sit with some reasoning would obviously answer YES! Neurodivergence is not a rule out, it is an umbrella under which all other diagnoses fall. If a neurotypical person can have CPTSD, depression, NPD, BPD, bipolar, etc, then so can any neurodivergent person. 6/x
But because ableism against neurodivergence is so key to our training and we literally get zero training in the lived experience of neurodivergence, we go back to the whole "rule out" stuff. 7/x
informed assessment does the opposite. Instead of ruling out something icky, we start with the position that neurodivergence is fine and can exist among any other condition and culture. Neurodiversity informed assessment also assumes lived experience is valid. 8/x
In informed assessment, we LEAD WITH LIVED EXPERIENCE instead of denying it, or assuming the person doesn't know. We collaborate together as co-searchers for the truth, to explain the lived experience instead of relying solely on tests normed on neurotypicals. 9/x
When we lead with lived experience, and assume competence of our clients, the assessments become much quicker and easier (and cheaper). Instead of spending a ton of time trying to disprove our clients wrong, all we need is enough confirmatory evidence to prove them right. 10/x
And if that evidence isn't there, no harm, no foul - we keep looking. It costs us NOTHING to affirm the identity of clients who come looking for answers. 11/x
Ultimately, this is why I barely trust any assessment psychologist to accurately identify neurodivergence. They just don't get it. Their model is wrong, and therefore everything coming from the model is wrong. 12/x
It is why we hear countless stories of neurodivergent folks spending a ton just to be denied an accurate identification. It's theft. It's injustice. It's denial of agency and identity. It is, or least should be, against our ethics. 13/x
But until we understand how deeply ableism and the harms of the medical model are embedded in our training, only the few renegade neurodivergent psychologists who have done antiableism work will get it (proud ADHDer here). 14/x
Which means until there is systemic change, assessment of neurodivergence won't be accurate for the majority. And ultimately this is why self diagnosis is valid, and often MORE valid than psychological assessment. 15/x
There is hope. 5 years ago, I was the only neurodiversity informed psych I knew. I now run a Facebook group of over 9K mental health professionals who want to learn. And I've many neurodivergent psychologist friends. I get training inquiries all the time. Things r changing. 16/16
pls r/t my fellow advocates
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