The instrument decides whether you get found.

What the MIGDAS-2 is

The MIGDAS-2 — the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition — is a sensory-based, structured clinical interview. Rather than scoring your performance on standardized tasks, it guides an in-depth conversation through the domains where autistic differences actually live: your sensory experience of the world, the shape and depth of your interests, and the way you use language and communicate. The result is a rich qualitative profile of how you experience and process the world, gathered in your own words, compared against the diagnostic picture.

In practice, adults consistently describe the MIGDAS-2 session as the opposite of being tested. It is closer to being thoroughly, precisely understood — often for the first time. That is not a marketing flourish; it is a property of the method. An interview about your actual inner experience has no puzzle to perform well on, which means there is nothing for a lifetime of learned competence to hide behind.

Why instrument choice matters so much for adults

The instruments most clinicians trained on were developed around presentations most visible in young children, and the most widely used of them are observation-based: a clinician administers standardized activities and rates what they can see. That approach has real strengths — and one well-documented weakness. Adults who have spent decades masking are, by definition, skilled at managing what an observer sees. Research on camouflaging has repeatedly linked it to under-identification in exactly this population: capable, verbal, late-identified adults, and women especially.

An interview-based approach inverts the problem. Your polish is not an obstacle to the data; your account of what the polish costs is the data. The MIGDAS-2 was selected for this practice specifically because it is well-suited to adults with strong masking and adaptive skills — the people observation-based measures historically under-identify.

Never used alone: the cross-battery approach

No single instrument — including the MIGDAS-2 — should ever carry a diagnostic conclusion by itself. Here it anchors a cross-battery evaluation: a comprehensive developmental and clinical interview; standardized rating scales gathering both your perspective and, when available, an observer's; and performance-based measures that reach beneath self-report. Every conclusion is triangulated across sources rather than reduced to one score.

The battery always includes a full differential diagnosis. ADHD, anxiety, OCD, and trauma can each resemble autism, co-occur with it, or explain parts of the picture better — and a serious evaluation must be equally prepared to reach any of those answers. The goal is the truth, not a predetermined conclusion.

What this means for you, practically

If you are comparing providers, three questions will tell you most of what you need to know. What instruments do you use, and why those? — you now know what a considered answer sounds like. Who conducts the evaluation? — here, every hour is conducted personally by a doctoral-level psychologist who is a Certified Autism Clinical Specialist, never handed to a technician. What happens if it isn't autism? — the answer should be a full differential explanation, not a shrug. If a provider's answers to those three are solid, you are in good hands, wherever you go.