Dr. Mary Doherty:

I will first address the benefit of an adult diagnosis. It is absolutely life changing. I cannot stress enough how much it can change somebody's life for the better after years or possibly decades of not understanding ourselves to suddenly realise that this is the reason that things are challenging in settings that do not seem to be difficult for other people. A perfect example is that as I speak, I am constantly aware of the noise in the background from what I assume is the air-handling unit. It feels like heavy traffic. I need to try very consciously to filter that out although naturally I cannot. It is there constantly. Understanding that makes such a difference. Understanding how communication happens for autistic people in a very different way from non-autistic people is important. It is equally effective but different. Understanding those differences makes such a difference.

I have lost count of the number of autistic adults who have been recurrent and heavy users of mental health services and then finally get an autism diagnosis or other neuro-diversion diagnosis and for the first time in our lives find good mental health. To realise that we are perfectly good autistic people and not broken neurotypicals is absolutely life changing. It is becoming much more common. Because of the increased visibility, that has snowballed and people recognise themselves. Like me, many people are recognising they are autistic after the diagnosis of a child. Even that has changed so much from ten years ago when my son and I were diagnosed. Back then I realised quite quickly during the assessment process, and when speaking to the professionals we were dealing with at the time, that there was absolutely no talk of autistic parents or autistic adults. It is wonderful to see how that has changed.

Regarding employment, we really need an access-to-work scheme as exists in the UK. That really keeps autistic employees in employment when otherwise they might not. It helps people into employment. Very many autistic adults spend far too much energy masking and camouflaging their autistic traits and trying to pass as non-autistic. It is exhausting to have to do that. There are many autistic employees in all fields. Every sector has autistic people, but most people do not disclose. While we need to support autistic people getting into work, we really need to support those existing autistic people in all sorts of sectors. That will help to bring more autistic people into work. Who is better positioned to mentor an autistic young person entering employment than somebody who is successfully working in that field? We see that in Autistic Doctors International all the time as we support our junior doctors from medical students into foundation year training and through the training schemes.

Regarding how we deal with the demand for adult diagnosis, we definitely need to do more research. Earlier I referred to a study from Sweden which showed that 20% of new patients presenting to mental health clinics when screened may have been autistic. We need to replicate that work here for sure. Similar work has been done on ADHD which has sparked an ADHD programme and we need to do the same here for autism. At the moment I am involved in some work by UCD on the mental health needs of autistic adults.

Regarding replicating what is happening in the UK, we need to address from the start the difficulties and challenges being found in the UK, where most autism diagnosis has been done in specialist services which are absolutely inundated. That may or may not be the appropriate route to take here. We need to take what has happened in the UK and build on that, and we have the opportunity to do that.