Clinician handoff
Autism
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
My brain fog seems tied to sensory overload, social exhaustion, and what I think might be autistic burnout. I've been experiencing skill regression and cognitive shutdown after high-demand periods, which doesn't match typical depression. I'd like to discuss autism assessment.
What would weaken it
- -No sensory-overload, masking-fatigue, shutdown, or lifelong neurodevelopmental pattern behind the fog.
- -The cognitive changes are entirely new, clearly medical, and unrelated to social load or overstimulation.
- -ADHD, sleep loss, or another condition fully explains the pattern without an autism component.
Key points to communicate
- •I want to know whether this is autistic burnout, sensory overload, ADHD overlap, or something medical layered on top.
- •Are you familiar with autistic burnout as distinct from clinical depression? I'd like to discuss the difference.
- •Can you refer me to someone trained in adult autism assessment specifically?
- •I've brought developmental history notes and screening results to share.
- •If autism stays in the differential, I want practical next steps around accommodation and recovery.
Bring this to the visit
- •A description of sensory sensitivities: noise, light, textures, crowds.
- •Examples of masking and its cognitive cost: social events, work meetings, daily interactions.
- •Sleep quality data since autistic sleep difficulties are common and drive fog.
- •A list of demands and obligations that may be exceeding capacity.
Useful screening structure
- -AQ-10 (Autism Quotient) or RAADS-R as structured autism screening tools.
- -Sensory Profile questionnaire for sensory processing assessment.
- -Burnout Assessment Tool adapted for autistic burnout if skill regression is present.
Tests and measurements to discuss
AQ-10 or RAADS-R screening (if not yet diagnosed)
ADHD screening (co-occurs in 50-70% of autistic adults)
AASPIRE Autistic Burnout Measure (ABM) for burnout severity
Rule out compounding conditions: thyroid (TSH/free T4), iron (ferritin/TIBC), vitamin D, B12, sleep disorders
What this helps clarify: Severe deficiency doubles dementia risk
Range context
40–60 ng/mL
How to use the result
Save the result with date and symptoms from the same week.
Referral for formal autism assessment (ADOS-2) if screening suggests
Basic labs (TSH, ferritin, vitamin D, B12)
Restricted eating patterns common in autism can cause deficiencies that compound cognitive fog.
What this helps clarify: Severe deficiency doubles dementia risk
Range context
40–60 ng/mL
How to use the result
Save the result with date and symptoms from the same week.
Questions to ask directly
- •Is this autistic burnout (demand-exceeds-capacity) or a medical condition causing the fog?
- •Should we screen for co-occurring ADHD since 30-80% of autistic people also meet ADHD criteria?
- •Would demand reduction and environmental modification help more than medication?
- •Are there medical causes worth testing: thyroid, iron, sleep disorders, celiac?
Functional impact snapshot
- -Rate fog severity against social/sensory demand level for the day.
- -Track whether demand reduction (canceling obligations, reducing sensory load) improves cognition.
- -Note whether the fog improves during low-demand recovery periods.
Escalate instead of self-managing if
- •Skill regression beyond cognitive fog - loss of speech, self-care, or motor abilities.
- •Severe depression, suicidal ideation, or self-harm.
- •Complete social withdrawal and inability to meet basic needs.
Peer-reviewed references
- 1. Arnold et al., Autism, 2023 - Towards the measurement of autistic burnout. PMID 36637292 [DOI]
- 2. Raymaker et al., Autism in Adulthood, 2020 - Defining Autistic Burnout. PMID 32851204 [DOI]
- 3. Pearson & Rose, Autism in Adulthood, 2021 - Conceptual Analysis of Autistic Masking. PMID 36601266 [DOI]