Neurodivergent Insights with Dr. Megan Anna Neff

What actually happens in an adult autism assessment, and is it worth it? In this deep dive, I sit down with Dr. Jess Hogan, a fellow AuDHD psychologist, to demystify adult autism, ADHD, and AuDHD assessments: where to start, what affirming assessment looks like, and the red flags to watch for.
This conversation is for late-identified and self-identified Autistic, ADHD, and AuDHD adults, and for clinicians who want to assess in a more affirming way.

TIMESTAMPS:
0:00 Why assessments feel so mysterious 
2:04 Should I get assessed? Benefits, identity, and imposter feelings 
6:24 Knowing your why: identity vs. disability services 
8:00 Where to start (and misdiagnosis vs. diagnostic overshadowing) 
12:35 Types of assessments: neuropsych, comprehensive, and ADHD-specific 
14:51 Why everyone's assessment experience is so different 
18:56 Private vs. insurance, and who can diagnose 
26:40 Masking, compensation, and non-stereotypical presentations 
32:36 Measures explained: CAT-Q, MIGDAS-2, DIVA-5 34:54 Questions to ask a potential assessor (and how to prepare) 
39:35 "You're not autistic": second opinions 
42:22 ADHD vs. autism assessments, and screeners vs. diagnostics 
50:02 Childhood history (and when parents can't help) 
55:17 AuDHD: when traits mask each other 
1:03:38 Leaving a bad-fit assessor, and the good enough therapist

In this conversation, we explore:
→ Whether an adult autism or ADHD assessment is worth pursuing
→ Misdiagnosis, missed diagnosis, and diagnostic overshadowing
→ Neuropsych vs. comprehensive vs. affirming assessment models
→ How masking and compensation strategies hide autism and ADHD from assessors
→ The measures used in affirming assessments (MIGDAS-2, DIVA-5, CAT-Q)
→ What to do if a parent can't (or won't) confirm your childhood history
→ How AuDHD traits cancel each other out during assessment
→ How to exit a non-affirming assessment process

About Dr. Megan Anna Neff:
Dr. Megan Anna Neff is an Autistic-ADHD clinical psychologist, founder of Neurodivergent Insights, and author of Self-Care for Autistic People and The Autistic Burnout Workbook. She creates research-grounded, identity-affirming resources for neurodivergent adults and the clinicians who support them.
Check out more at neurodivergentinsights.com
About Dr. Jess Hogan:
Dr. Jessica Hogan (she/her) is a Chickasaw, AuDHD, queer, cisgender, hard-of-hearing, and chronically ill licensed clinical psychologist practicing in Minnesota, California, and PSYPACT states. She is the founder of Neuron & Rose, a neurodiversity-affirming practice where she leads an assessment training program for doctoral students and postdoctoral fellows. She also runs The Divergent Clinician, where she trains clinicians in affirming autism and ADHD assessment. 
Website (Neuron & Rose): https://www.neuronandrose.com
The Divergent Clinician: https://www.thedivergentclinician.com

AuDHD and OCD overlap in ways that make all three hard to see clearly, and most of us don't get language for it until we've been confused by these patterns for years.This video is for AuDHD adults, late-diagnosed Autistic and ADHD people who suspect OCD might be in the mix, and clinicians working at the intersection. We walk through where they overlap, and how to begin teasing apart what is what — including practical questions you can ask yourself in the moment.📩 If you'd like to go deeper, here's the full article on ADHD, autism, and OCD: https://neurodivergentinsights.com/adhd-vs-autism-vs-ocd/In this video, we explore:→ Why OCD often gets missed when ADHD or autism are already in the picture→ How working memory shows up differently in ADHD vs OCD vs AuDHD→ The difference between ADHD compensation and OCD compulsion (and how they can spiral into each other)→ Why autistic people need routines — and how that's different from OCD avoidance→ A predictive-processing explanation of why familiarity matters→ How to tell an autistic ritual from an OCD compulsion (look for the logic)→ What shows up at the three-way intersection — sensory sensitivities, BFRBs, executive function strain→ A starting place for noticing your own patterns with curiosity instead of judgementOCD commonly co-occurs with both autism and ADHD, and clinical observation suggests rates may be higher for AuDHD folks specifically. The overlap with predictive processing, executive functioning, and sensory differences means this work benefits from both neurodivergent-affirming accommodations AND targeted treatment for OCD — not one or the other.

The autism rate in the U.S. has risen from 1 in 150 to 1 in 31 over the past two decades. But the story behind that number is far more nuanced than the headlines suggest. In this conversation, Dr. Megan Anna Neff and Dr. Donna Henderson walk through the history of autism in the DSM, the systemic shifts driving increased recognition, and why "epidemic" framing misses the point.
This video is for Autistic adults, late-diagnosed people, clinicians, parents, and anyone who has been asked "why is autism on the rise?" and wanted a deeper, more grounded answer to offer.

📩 If you want to go deeper on this topic, we have a visual guide and transcript available alongside this video on our website:https://neurodivergentinsights.com/episodes/why-is-autism-on-the-rise/

Two Autistic burnout authors in conversation for the first time. Dr. Megan Anna Neff sits down with Amelia Nagoski, co-author of Burnout: The Secret to Unlocking the Stress Cycle, to talk about what it means to complete the stress cycle when you're Autistic, alexithymic, and your body doesn't always tell you when it's stressed.
They cover the science of the stress cycle, why removing the stressor doesn't remove the stress, alexithymia and interoception, sensory-based ways to find safety, Autistic persistence as strength and risk, the link between autism and long COVID, and why collective care (not self-care) is the real path out of burnout.

When autism is identified first, ADHD can hide in plain sight, tucked behind the structure, the routines, and the focused intensity that autistic neurology creates. If you've been told your focus looks "fine" while you're quietly drowning in cognitive noise, half-finished tasks, and a nervous system that won't settle, this video explores what might be going on underneath.
This video is for AuDHD adults, late-identified Autistic people exploring whether ADHD is also part of their experience, and clinicians working with neurodivergent clients.
If you want to go deeper, I wrote a companion article that maps out all six patterns in detail:
https://neurodivergentinsights.com/adhd-hides-autism/
How autistic routines and structure can compensate for and hide ADHD distractibility

Why shutdowns and meltdowns get attributed to autism alone, missing the ADHD cognitive overwhelm

The difference between autistic inertia and ADHD task paralysis, and how both can operate at once

How special interests can mask ADHD novelty seeking (the "special interest solar system")

Why quiet, inattentive ADHD is especially vulnerable to being missed when autism is already known

How monotropism can look like excellent focus while ADHD fragments attention outside that channel

Defensive monotropic mode: when deep focus becomes an escape from ADHD overwhelm

Diagnostic overshadowing from co-occurring mental health conditions