The overarching aim of this PhD thesis is to contribute towards a reframing of the way we understand and assess autism, including autistic play, away from a deficit-focused perspective, towards a neurodiversity-informed perspective. This is important for helping us to understand how to improve autistic people’s wellbeing and improve the way diagnostic assessments are carried out in ways that better cater to autistic people’s needs. To address the overarching aim, I conducted two qualitative, interview-based studies involving stakeholder consultations: the Clinician Study and the Autistic Play Study.

The Clinician Study focuses on the perspectives of professionals’ who work in a multidisciplinary autism team on neurodiversity-affirmative autism diagnostic assessment. Guided by a ‘neurodiversity-affirmative autism diagnostic assessment’ framework I present in this thesis, my analysis revealed the importance of a holistic, balanced, person-centred assessment that is strengths-and-needs-led. This study contributes to the existing literature by highlighting what a neurodiversity-affirmative diagnostic assessment could ‘look like’, thus giving insight into ways in which diagnostic practices could be improved in ways that align with the neurodiversity paradigm and have the potential to support autistic people’s wellbeing.

The Autistic Play Study focuses on autistic adults’ perspectives and experiences of play and diagnostic assessments that include play. This study is split into two results papers: Autistic Play Study Play Experiences and Autistic Play Study Play Assessment. Through adopting a balanced rather than deficit-focused interpretive lens, the Autistic Play Study Play Experiences paper builds on the existing neurodiversity-informed literature concerning autistic play, for example, by highlighting the importance of flow. The Autistic Play Study Play Assessment paper provides new insights into how autistic adults view diagnostic assessments including play, which has implications for improving the way these assessments are conducted. For example, the findings highlight the importance of adopting a personalised or individualised approach.

As a whole, the findings of this thesis highlight the importance of adopting a balanced approach in understanding and assessing autism and autistic play, considering variability of autistic experiences, and the importance of understanding and assessing autistic play specifically. This thesis also presents an updated ‘neurodiversity-affirmative autism diagnostic assessment’ framework which could guide clinical practice.