To Diagnose or Not to Diagnose
Follow your own unique golden thread
Donna opens this episode by admitting it might be too big for one sitting. The question came from a parenting group where she was tagged this week: do you diagnose, or not diagnose, and what are your reasons why. Kirsty takes the first pass with a broad, thoughtful look at what a diagnosis like autism or ADHD actually captures and what it leaves out, and Donna follows with her own needs based, biology first way of working, anchored in a story about a school principal who changed how she saw her own quirky child.
What this episode is about
This is a conversation about one of the most loaded questions in modern parenting and self understanding: should you seek a diagnosis such as autism or ADHD, or hold off. Rather than landing on a fixed answer, Kirsty and Donna each explore what a diagnosis can offer, what it can never tell you, and how easily it can become either a helpful map or a limiting identity. Donna brings it home with a story about a school principal's advice on her own child, and both agree the real work is staying curious about the individual in front of you rather than the label alone.
Key themes
A diagnosis is a collection of traits
Kirsty explains that conditions like autism or ADHD are identified through a tick box collection of traits, gathered through questionnaires, observation, and conversations with parents and schools.
What a label cannot tell you
A diagnosis does not reveal genetic variability, gut health, primitive reflexes, breathing patterns, inflammation, or a person's emotional world, relationships, and history of stress or trauma.
Identity as a double edged sword
Finding a diagnostic community can bring huge relief and self compassion, but a tight grip on the identity itself can tip into tribalism and closed mindedness.
Working from a needs perspective
Donna describes her own approach as untangling a ball of wool, observing without labelling, and asking why and why now a behaviour is showing up, rather than starting from a diagnosis.
Normalising biology
Both agree that many children and adults carry a false belief that something is wrong with them, when what is really happening is a nervous system or developmental timeline that society has judged rather than understood.
Strengths over weakness framing
Donna and her husband bring different attachment styles and strengths to parenting, and she argues for seeing a child's quirks as potential rather than defect.
Reasons for and against a diagnosis
Where a diagnosis can help
- Opens access to funding and support at school or in the workplace
- Offers a tidy explanation after years of feeling like you keep missing the mark
- Can bring real relief, self understanding, and self compassion
- Gives useful shorthand, since humans naturally categorise to make sense of the world
Where to stay alert
- The same diagnosis can sit over very different underlying causes for different people
- A label says nothing about gut health, nervous system state, trauma, or relational history
- Holding an identity too tightly can slide into tribalism and closed mindedness
- Strong attachment to a label can make someone resistant to support that would genuinely help
Conversation timeline
Setting up a big question
Donna introduces the episode's question, prompted by being tagged in a parenting group: do you diagnose, or not diagnose, and why.
What does a diagnosis actually mean
Kirsty starts broad, asking what a diagnosis of autism or ADHD really represents, and how it is arrived at through questionnaires, testing, and observation of traits.
If you know one person with autism
Kirsty references the well known idea that knowing one autistic person only tells you about that one person, since the diagnostic umbrella now covers a very wide range of experience.
What a label leaves out
She lists everything a diagnosis does not capture: genetic variability, neurotransmitter production, gut and microbiome health, primitive reflexes, breathing, inflammation, and a person's emotional and relational world.
The pragmatic case for diagnosis
Kirsty names funding, school support, and workplace accommodations as real, practical reasons a diagnosis can matter, alongside questions about how that funding gets allocated.
A gateway to self understanding
For someone who has spent a lifetime feeling like they keep missing the mark, a diagnosis can be an enormous relief and a route to self compassion.
Identity as a double edged sword
Kirsty describes how being welcomed into a neurodivergent community can also slide into tribalism, where the label becomes so central to identity that other perspectives get shut out.
Staying open to what might help
She gives the example of someone bristling at the suggestion that gut health could ease their autism symptoms, and reframes much of the disagreement in this space as semantics about what counts as autism in the first place.
Looking at the individual holistically
Kirsty circles back to essence: whatever the diagnosis, the real question is what is going on for this person emotionally, relationally, and biologically, and how they can move toward greater thriving.
Designing life around sensitivity
Kirsty shares a small personal example, letting her husband do the grocery shopping, as one way of shaping daily life around her own nervous system rather than fighting it.
Pragmatic, not anti diagnosis
Kirsty clarifies she has two children with diagnoses herself, and that her real question is simply whether a label serves the person and whether they can still see beyond it to their own uniqueness.
Donna's needs based lens
Donna describes her work as untangling a ball of wool, watching for the next sticking point without labelling the people in front of her as anything other than themselves.
I hear a lot of not good enough
Donna shares how often she hears adults carrying childhood wounds of not being good enough, fearing abandonment, or feeling unloved, wounds she believes are often rooted in an unmet need rather than a defect.
Normalising biology
Donna talks about children on a slower biological unfolding being made to feel wrong by their environment, and mothers with overwhelmed nervous systems being judged rather than supported.
Planning for the extremes
From her early childhood centre days, Donna describes designing her environment around the two most extreme children, sympathetic and dorsal vagal, on the basis that what works for them works for everyone in between.
The why and why now question
Rather than starting with a label, Donna uses the self reg question of why and why now a behaviour is showing up, focused on what the child actually needs.
The principal's advice
Donna tells the story of a school principal calling her aside when her child was six, describing her as having quirky children, and giving the advice never to change them because that child will change the world.
Watching the eyes shut down
The principal told Donna to advocate for her child the moment she saw their eyes start to shut down, since that was a sign a teacher was trying to dim the child's light rather than support it.
Choosing your battles as a family
Donna and her husband, who hold different attachment styles and strengths, learned to divide when to step in and advocate at school and when to let a mediocre year pass.
Mums whose nervous systems are activating
Donna talks about mothers who are flummoxed by not coping once they have children, and how unmet needs, whether from trauma, attachment wounds, ADHD, or autism, tend to surface under that pressure.
Time blindness and using tools
Donna laughs about her own time blindness and how she now uses a visible clock to keep herself on track, rather than talking for three hours when twenty five minutes would do.
Closing thoughts
Kirsty closes by returning to the core idea: come back to the individual in front of you, ask what they actually need, and try to explore that without judgment, projection, or comparison to how they should be. Both agree the conversation needs a follow up episode.
In their own words
If you know one person with autism, then you know one person with autism.
I don't label. I go in, and I see Sally. I see John. That's who I see.
Do not ever, ever change them. That child will change the world.
The principal's story
A conversation at the school gate
When Donna's child was six, a school principal pulled her aside. Donna immediately braced for bad news, expecting to hear something was wrong. Instead the principal told her that out of five hundred and twelve children at the school, she had ten quirky children, and two who were highly quirky, including Donna's own child. Her advice was simple and direct: never change them, because that child will change the world. She warned that some teachers would try to shut down that light because the child would challenge them, and she urged Donna to step in and advocate the moment she saw her child's eyes start to dim. She explained she recognised herself in that child, having once been shut down in the same way and never able to grow to her full potential as a result. That single conversation shaped how Donna advocated for her child through the rest of their schooling, and how she chose which battles were worth fighting.
Concepts and references touched on
Reflection questions for listeners
- If you or your child have a diagnosis, has it opened doors, become an identity, or a bit of both?
- Can you recall a time an unhelpful trait was really an unmet need underneath, once you looked closer?
- Where do you notice judgment from others about biology, whether your own or your child's?
- Who has been the principal in your life, the person who saw potential where others saw a problem?
- What would it look like to design your own days around your nervous system, the way Donna does with her clock?
