The Case for Autistic Self-Diagnosis

While the Autistic community tends to give a lot of pushback when people use language like ASD or spell out the acronym, I’ve noticed much more acceptance of the use of ADHD. I don’t think that’s okay. While there is less intense societal stigma with this neurotype than with autism, it still gets plenty of invalidation and shame.

Better options are the following two alternatives that hopefully we can get enough traction with to create a systemic shift. These alternatives are kinetic cognitive style (KCS), coined by Dr. Nick Walker, and variable attention stimulus trait (VAST), coined by Drs. Edward Hallowell and John Ratey, coauthors of ADHD 2.0. Both of these shift the focus from deficits to a whole person perspective that includes ample strengths. When I’ve shared these terms with clients, it’s almost as if they intuitively sense the innate accuracy of these terms.

If you are or you know anyone who is KCS/VAST, then you know full well that when it comes to an area of passion or interest, there is no shortage of attention. There is a plethora of attention, also known as hyperfocus. The perceived lack of attention shows up when there is a lack of interest. Both this neurotype and autism are interest-based systems, meaning that focus and attention are directly tied to engagement of interest. Kinetic, in KCS, and variable, in VAST, both refer to these differences in how attention is distributed. Attention stimulus in VAST refers to the impact of sensory and other input from the environment on a person. Both cognitive style, in KCS, and trait, in VAST, refer to this as a neurotype, rather than a disordered way of being.

Also, there is a transition component here that often gets missed. When a KCS/VAST person is deeply engaged with something, there’s a period of time required for them to disengage their attention, shift attention, and then reengage with something else. Monotropism is another way to describe this vortex of attention or singular focus and the need for transition time both into and out of that state. This focused attention can also be referred to as a flow state or hyperfocus. Both neurotypes are monotropic in nature.

But while there has been a lot of emphasis on the autistic neurotype, with seemingly less on KCS/VAST, I want to point out that these two neurotypes share a great deal of overlap. First off, depending on what studies you look at, research shows anywhere from 30–80 percent of Autistic people are also KCS/VAST. I’ve seen some people suggest that KCS/VAST belongs under the autistic spectrum umbrella. Both neurotypes have a sensory component, a social component, and executive function challenges, and they are monotropic.

There are also many other co-occurrences that people with these neurotypes deal with, including physical ones like Ehlers-Danlos syndrome (EDS), hypermobility, food sensitivities, postural orthostatic tachycardia syndrome (POTS), sleep differences, autoimmune conditions, migraines, and so much more. There’s also a greater likelihood of co-occurring depression, anxiety, bipolar, obsessive-compulsive, trauma/complex trauma, or what we call personality disorders, which are starting to be better understood as unique and creative behavioral responses to complex trauma.

One more thought about this neurotype. While KCS/VAST is commonly associated with low dopamine levels or having fewer dopamine receptors, this is not the whole truth. I first learned about this from Janae Elisabeth (she/they), a white Autistic researcher and ND advocate who is well known online as Trauma Geek. Rather than low dopamine being an innate trait, dopamine gets converted to noradrenaline and then adrenaline, which is associated with a stress response. Due to oppression, trauma, and being forced to focus on things that are not of interest (rather than on dopamine-producing interest-based activities), dopamine gets depleted in order to produce adrenaline.

Now let’s explore the importance of identification and especially the validity of self-identification. Gaining language for one’s neurotype(s) can be an essential part of self-knowing, self-validation, and dismantling internalized oppression. We will also learn more about how Autistic and KCS/VAST people present across sociocultural locations. The list I provide is intended to broaden our scope of what we previously thought autism was and wasn’t and to notice the similarities and differences with KCS/VAST.

Self-Identification and the DSM

I’m going to focus on autism in this section. Self-identification is absolutely just as valid for people with the KCS/VAST neurotype, and getting a KCS/VAST external identification is often more accessible than for autism.

The holy book of psychology that is intended to be a guide for mental health of all humans (I wish you could see my snarky smile in this moment) has eliminated a huge segment of the population: all racialized people, women, nonbinary people, transgender people, gender nonconforming people, intersex people, bi/gay/asexual/pan/queer people, poor people, and people in states of pleasure or neutrality. No wonder it’s a novel concept to the masses that someone can be Autistic and joyful, or Autistic and Black, or Autistic and poor, or Autistic and a woman.

Consider the prevalence of misidentification or incomplete identification, oftentimes anxiety, depression, bipolar, obsessive-compulsive, trauma, personality disorders (particularly borderline for people assigned female at birth), and oppositional defiance or a conduct disorder instead of autism for unidentified Black Autistic kids. Consider too how much sheer lack of information or misinformation is out there; that waiting lists for assessments from psychologists and neuropsychologists can be upwards of a year (and they still may not know anything about nonstereotypical presentations); the enormous costs of assessments (they can cost upwards of $5,000, and those fees often are not covered by insurance); and that no one knows anyone better than they know themselves. Given all that: self-identification of autism is completely valid and just as valid as any medical or psychiatric identification.

It’s easy for me to get fired up about this. I’ve worked with so many clients over the years who’ve researched tirelessly about autism, only to finally work up the courage and finances to get an assessment and then be denied their Autistic identity. On top of the trauma of living as an unidentified Autistic person for potentially decades, they endure more trauma from the medical and psychology fields. By the time they make their way to my virtual office, having endured way too much, usually within the first hour of knowing them, I’m like: “It’s obvious to me that you’re Autistic!”

This may leave you wondering, “If the DSM is so problematic and incomplete, why bother labeling the neurotype at all?” Great question.

For some people, it’s the only way to get their support needs met. For others, especially later identified people assigned female at birth, who may have spent decades being invalidated in their challenges, blamed for their challenges, and isolated, receiving an Autism identification can be a full-on game changer. Having language for one’s neurotype can both be a profound relief or source of liberation and a source of tremendous grief, maybe even rage, and everything in between.

You mean it’s not my fault?

There’s a reason I am the way that I am?!

I’m not broken?!

Who am I, then?

The potential onslaught of thoughts and feelings can be deep and vast. At the same time, with language comes information, validation, access to knowing oneself, identification of support needs, and hopefully, getting those support needs met.

This is where we, ND-affirming, anti-ableist therapists come in to help them reframe their life through this new Autistic lens and help them identify and access the support they need. What this also means is that imposter syndrome is likely. In fact, I’ve known a lot of people, whether medically or self-identified, who navigate ongoing cycles of imposter syndrome. It’s hard not to in the dominant U.S. culture that labels any challenges we face as a moral failing based solely on our own efforts or supposed lack of effort. We get so accustomed to blaming ourselves that it’s easy to feel that “Autism is just an excuse.”

Oh, I feel the heartbreak in that statement. Both I and so many clients I’ve worked with over the years have echoed that sentiment. Talk about oppression in action. Part of my own unmasking journey has involved gaining access to my anger and rage, something I wasn’t allowed to feel or express growing up in my family of origin. Needless to say, anger and rage come to visit quite often these days, this moment being no exception. It’s a truly valid reaction, if I do say so myself.

Possible Qualities or Traits That Could Indicate a Person Is Autistic

The list that I’ve come up with to indicate whether a person is Autistic includes many qualities that could also apply to KCS/VAST. I’ll point out some differences along the way, and the reality is that there are way more similarities than differences between these two neurotypes. This list transcends what exists in the DSM and encompasses many nonstereotypical qualities.

For starters, there is no one way to be Autistic. When I read my first book about autism 15 years ago, this was true. It is still true today. As the saying goes, “When you’ve met one Autistic person, you’ve met one Autistic person.” We are a beautifully diverse neurotype. Also, autism is so much more than a particular subset of behaviors; it is a different bodymind. Lastly, given that only one tiny subset of the Autistic population is represented within the DSM and that by the time people reach adulthood they have often learned a multitude of strategies for existing within the neurotypical (NT) world, it is essential that we have a broader picture of what autism is. Please note: not everyone will identify with every one of these characteristics.

They report a lifetime of anxiety, sometimes depression too.

They report feeling different or misunderstood.

They have specific sensory needs, preferences, and aversions.

The sensory component of these two neurotypes is extremely important and can often be overlooked or downplayed. Each person, Autistic or KCS/VAST, has their own unique sensory profile that likely includes a combination of sensory seeking and sensory avoiding. I feel like Autistic people are more commonly known for their sensory overwhelm, while KCS/VAST people are more known for their understimulation. This is not entirely true, though, as both neurotypes can and do experience both. The sensory world can be a source of deep distress; it can also be a source of euphoria and joy!

There are eight senses that are essential: in addition to sight, sound, taste, touch, and smell (to which not all humans have access), we also have three more. Proprioception is about knowing where we are in space, where our body ends and the air or environment begins. Deep pressure, containment, and touch can help us access this knowing. Interoception is inner body awareness, which includes cues like hunger, thirst, need to rest, need to eliminate, or any other body sensation. Vestibular is connected to the inner ear and balance and is accessed through rhythmic movements like rocking, swaying, or spinning.

They have some degree of discomfort, confusion, and/or anxiety when it comes to being social with other humans.

Autistic people have their own unique communication style, including body language, that is often misunderstood by non-Autistic people, For KCS/VAST people, it’s less that they don’t understand NT communication, but more that their tendency toward having many thoughts at once and taking in so much at once makes them more likely to miss certain cues or communication.

They can be easily overwhelmed and when they are really distressed or overwhelmed they may melt down, shut down, explode, implode, or self-injure.

This looks different person to person and across the two neurotypes. While this is certainly not true of everyone, there seems to be a trend (based on how the binary genders are socialized) that assigned male at birth (AMAB) people tend to express their distress more externally and seemingly, more obviously. Oftentimes, assigned female at birth (AFAB) people tend to internalize more often, making their struggles seem invisible to others. Self-harm, such as cutting, counts in the meltdown category. Racial identity and racism also directly affect how people are allowed or not allowed to express their overwhelm.

Certain things just don’t make sense to them, and they don’t know why. Alternatively, things that are obvious to them may be not at all obvious to others.

They may or may not make eye contact.

For some Autistic people, eye contact is actually more distracting than it is connecting. Possibly due to less synaptic pruning, Autistic people take in vast amounts of information at any given moment, and it is too much to filter. Not making eye contact can provide less input, which often results in more focus.

They are easily distracted or have a hard time staying focused, specifically when something isn’t interesting to them.

They have some sort of movement, sound, or other behavior that they engage in repetitively that helps them feel more relaxed, present, engaged, or safe. This is called stimming and is an essential part of self-regulation.

Stimming is a wonderful thing! It’s a part of Autistic innate brilliance that the bodymind knows how to regulate itself as needed. Stimming can be fun, playful, creativity enhancing, relaxing, or energizing. There are endless ways to stim! A lot of people are trained out of their more visible stims as a way to appear more NT or less “weird,” which is really sad. The more well-known Autistic stims are rocking and flapping, but they can be big movements or barely visible.

Both neurotypes stim, but oftentimes it’s referred to as fidgeting for KCS/VAST.

It is my perception that stimming has more stigma associated with it, while fidgeting is somewhat more socially acceptable. That said, there is still plenty of judgment out there about engaging in repetitive movement. White supremacy prefers people to have “quiet hands and bodies.” Ick!

They may seem really intense or deep. Small talk may be a struggle.

They may report a history of feeling disconnected from other humans, lonely, or misunderstood and have a deep longing for connection with others.

They need alone time.

They are extremely passionate about certain topics or areas of interest. This is sometimes referred to as special interests/SPINs, but that can have a condescending connotation, so I choose to say passions.

Autistic people may have the same passion for years, even decades. Their depth of knowledge about the topic is likely profound and nuanced. It’s common for KCS/VAST people’s passions to change more frequently. These are not absolutes by any means. Due to oppression, many KCS/VAST people get accused of “not following through,” “losing interest too easily,” or “jumping from thing to thing.” Whether long term or short term, these passions are not just valid but important and vital to that person’s aliveness and well-being.

They prefer routines and can seem rigid.

A primary difference between the two neurotypes is that Autistic people tend to crave sameness, predictability, and knowing what to expect. KCS/VAST people, on the other hand, tend to crave novelty as part of producing more dopamine for their brain. This is also why their passions may change more frequently, because once the novelty wears off a passion may no longer be as interesting.

They may relate to the terms highly sensitive person or empath.

Within the Autistic community, there are mixed opinions on whether or not highly sensitive is its own neurotype, or if it is a more socially acceptable label for someone who is actually Autistic. Some are adamant that not all Autistic people are highly sensitive, while others argue that using the label highly sensitive is a way to avoid the social stigma associated with autism. Similarly, with the term empath, some Autistics believe that word is a way of coding social stigma with a lofty spiritual label.

No matter how much self-growth work they’ve engaged in, some things just don’t change.

Many times, unidentified Autistic and/or KCS/VAST people are long-term clients who may be on a perpetual journey to try to change who they are. They may be deeply invested in the narrative that “This is a me problem, and if I just try harder, I’ll be ‘normal’ like everybody else.” They may change therapists multiple times to try to find someone who can finally help fix them. They may try to induce their therapist into believing their narrative; together you may find yourselves in cahoots with their belief that they are “broken” and you can be the hero they’ve been searching for. Turns out, you just might be! But not in the way they anticipated. You may be the person to finally help them accept that they aren’t broken, they’re Autistic and/or KCS/VAST!

They have a hard time with executive functions such as being on time, managing all the different responsibilities of life/home/adulthood (e.g., cleaning, laundry, groceries and cooking, bills, scheduling appointments), staying organized, advocating for themselves, navigating new situations, and so on.

Sometimes called “adulting” for people who are adults. Both neurotypes have varying difficulties with this. For kids this is most often obvious with things like the state or disarray of their room or challenges at school.

The more they heal from trauma, the more sensitive they become.

Let’s use an example of a particular loud sound, say a siren. With trauma work, one would suppose that over time the sound of the siren and the memories associated with it would get integrated into the system and be less disturbing. The person may never like or have an affinity for that sound, but the trigger may diffuse or get easier to tolerate. For Autistic and KCS/VAST people, healing from trauma can make the unwanted loud sound even more difficult to deal with. Healing and unmasking can increase sensitivity, not lessen it.

They may be easily influenced, a “chameleon” becoming like the others in their environment.

When I learned this, it was a total lightbulb moment for me. It was what I needed to move beyond the perpetual (not cyclical at the time) imposter syndrome in my self-acceptance as an actually Autistic person. This is especially common in high-masking AFAB folx. They can feel that they have a diffuse sense of self or lack a sense of self, but it can also make them really adaptable. It is often not something that is done consciously, and it can very much be a survival strategy. You may hear clients refer to “becoming who the environment expects them to be.” This can be a form of code switching, is tied to intersectionality, and is about passing as “safe enough” or “normal” in the presence of dominant sociocultural identities. It is deeply tied to masking.

Regulating emotions can be really challenging.

Perhaps they tend to feel a lot and frequently, and their emotions seem to shift quickly.

They may not know what they are feeling; it can feel more like a “jumbled internal indecipherable” landscape, also known as alexithymia (there’s a lot happening inside, but I don’t know what it is or why I feel it).

They may experience heightened sensitivity to injustice, also known as justice sensitivity.

In children, this can present behaviorally as inflexibility in the face of real or perceived injustice, especially with siblings, peers, or people in positions of power. It can also present as deep distress over injustices like climate change, racism, homophobia, transphobia, eating meat, animal abuse, or abuse of any kind.

In adults, it may be more visible through activism and investment in social justice. Again though, there is deep distress over injustice, deep empathy for the abused planet, people, or beings on the receiving end of injustice, and a profound internal drive to make right what is wrong, unfair, and unjust.

They may be very sensitive to rejection, whether actual or perceived, or fear of possible rejection, also known as rejection sensitivity dysphoria (RSD).

This is being more talked about lately with KCS/VAST, though it’s definitely a lesser known but important attribute of this neurotype. Rejection can signal a threat response and be a very real source of trauma.

They have pattern recognition.

They tend to notice trends and connections among things or ideas and have a way of weaving together past, present, and future.

They are curious about their neurology and find themselves wondering if they might be Autistic or KCS/VAST.

Just as straight and cisgender people don’t tend to question their identities or spend months if not years researching queerness or transness, learning everything they possibly can, losing sleep over it, maybe even talking to every person who will listen about it, neither do neurotypical people when it comes to their neurotype. It just is. It’s not a question.

They tend to like or connect more easily with or gravitate toward other Autistic or KCS/VAST people.

They have family-of-origin members who are also Autistic or KCS/VAST.

There is definitely a genetic component here. It’s common for one person to be identified and then suddenly many others in the lineage get identified, too. Sometimes a child gets identified and then there is a trickle-up effect. Or an adult will get identified, then discover their child(ren) shares their neurotype, or siblings, parents, and other relatives.

As you read through this list, even more ideas may come to mind. Whether you are Autistic or KCS/VAST or love people who are, there may be aspects of who you are or relate to that didn’t make it onto this list. These aspects are just as valid! Here is a great place to remind you of the wisdom and insight with which you came to this article.

Adapted from Neurodivergent Somatics in Therapy: An Anti-Oppressive Model for Whole Person Care, Copyright © 2026 by Nyck Walsh. Used with permission from W. W. Norton & Company, Inc.