As I explained to my new occupational therapist, my goal here wasn’t what it would have been as a child: I wasn’t seeking a therapeutic program to address a potential DCD diagnosis. Rather, since I’d found my autism diagnosis to be helpful by giving me boxes with labels into which I could put parts of my life for easier reference and examination; suddenly I had an autism box, and an anxiety box, and an OCD box. If there were other such diagnoses out there, I wanted to find them.
The evaluation itself consisted first of a brief self-report questionnaire about motor difficulties and there impact or lack thereof on various parts of my life, and then a series of physical tasks. Most of these focused on gross motor issues of the kind you’d think would be implicated in things such as bicycling, driving, and walking.
These included relatively straightforward tasks like throwing a ball at a target or tossing beanbags into a bowl. They also included the more bizarre, such as standing in front of a large board on the wall adorned with a complicated starburst-like pattern of red buttons—the idea being to stand relatively close to the box and press the buttons as they lit.
It felt a little like being evaluated for admission into the Dharma Initiative, especially when the task later was made more complicated by adding the sensory input of music being played and the concurrent physical task of remaining balanced on a wobbling platform and the concurrent mental task of needing to alternate hands regardless of where on the board was the next button.
We also played a game of Connect 4, but with music playing plus having to stamp our feet on the floor, in unison, to the beat of the music. (I lost.)
In light of how I’ve described my sensation of walking, I also took a short walk out of the office, as well as up and down a short flight of stairs. This, in fact, is where things started to get interesting from a diagnostic point of view.
It should be noted here that Occupation Therapy cannot itself give me a diagnosis. Instead, their role is conducting an evaluation, writing up a summary with observations, and sending that to my doctor. That said, what I was told after the brief test walk was revelatory.
When I move, I was told, I do so methodically, something interpreted as me doing a bunch of extra processing in my head that other people do not have to do when they move. That feeling I have when I walk, comparing myself to how other people look when they walk? It’s legit. It’s real. My walking is a notably different mental and mechanical thing than is typical.
I was told that I should feel good about the fact that I’d somehow managed to self-generate ways to compensate, and while I agreed to do so it’s not without some angst: every time someone can point to a way in which I’ve “managed”, I fear there’s someone out there with authority to make decisions about my life—for example, in the disability filing process—who will take it was evidence. If I can do X, they will say, then obviously I can do Y and I can do Z. Even if it’s untrue.
This idea of doing things methodically struck me so hard that I later in the appointment had to stop what we were doing because I was still stuck on it, and as my mind raced to place any number of other ways in which I physically interact with the world within this context.
It also, the next day, made me realize something else. Something I quickly realized is key to…well, most everything.
As an autistic, my brain already has to do a bunch of extra work because the physical and social world around me isn’t built for me. Now I know that my brain—my already taxed autistic brain—also has to do a bunch of extra work to compensate for motor and coordination issues.
This realization unlocks, I think, my routine battles against fatigue. I’m doing so much extra work, day in and day out, just to get through. It’s no wonder I feel it’s safe to assert that I am, you know, debilitated.
On my way out, as I turned from a hallway into the lobby, my brain lit up. I hadn’t noticed I’d done it until after I’d done it, but I realized that when having to make a turn around a chair, I’d put out my arm and placed my hand atop the backrest. Unconscious it might have been, but it also, indeed, was methodical. A kind of embodied intelligence that had learned how to keep my distance from things I might otherwise bump into while moving through the world.
What’s next: I await word from my doctor. In the end, my occupational therapist made it pretty clear that had I been evaluated as a child, I’d have been given a formal Developmental Coordination Disorder diagnosis; had they been able to diagnose me themselves now, I think they would have done.
Much like my midlife autism diagnosis wasn’t somehow negated by any compensations (or camouflage) I’d managed to find on my own through the intervening decades, I don’t expect this to play out any differently. For a bit of time now, I’ve self-identified as having DCD; I’m torn about whether the intercultural confusions around terminology mean I can or cannot refer to myself as dyspraxic.
Whatever the case, I’ll shortly have one more official box to put things in. All because of pop culture. All because of Ryan Sinclair.
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