The MIGDAS-2: Supporting a strengths-based, neuro-affirming approach to autism diagnosis

The Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2), is a qualitative, sensory-based assessment tool designed to support clinicians in diagnosing autism across the lifespan. Developed by Dr Marilyn Monteiro, the MIGDAS-2 represents a significant shift from the more traditional diagnostic model, embracing a strengths-based, neurodiversity-affirming approach.

The MIGDAS-2 uses interactive interviews, naturalistic observation, and narrative-based responses to explore the unique ways individuals experience the world. It focuses on three core areas that can be impacted by autism: 

• language and communication
• social relationships and emotional responses
• sensory use and interests

One of the more compelling benefits of the MIGDAS-2 is its ability to uncover more subtle autism presentations. This includes individuals who mask traits, possess high verbal abilities, or do not fit traditional diagnostic criteria. By engaging individuals in conversations about their sensory preferences and interests, the MIGDAS-2 creates a safe, affirming space that encourages authentic self-expression.

The system is highly adaptable, with protocols tailored for toddlers, children, adolescents, and adults. It accommodates varying levels of verbal fluency, making it suitable for individuals with limited language as well as those who are highly articulate. The assessment process includes structured interviews with parents and teachers, allowing for a comprehensive understanding of the individual’s behaviour across different environments.

Importantly, the MIGDAS-2 is not a standalone diagnostic tool. It is often used, for instance, alongside quantitative measures such as behaviour rating scales to provide a balanced view of both qualitative and quantitative data. This integration enhances clinical judgement and reduces the risk of misdiagnosis, particularly in cases where traditional tools may overlook subtle or internalised traits.

In practice, the MIGDAS-2 fosters collaboration among evaluators, families, and individuals. It supports the development of tailored recommendations and interventions that align with the person’s unique needs and strengths. By framing autism as a distinct brain style rather than a disorder, the MIGDAS-2 promotes acceptance, understanding, and pride in neurodiversity.