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Hi
I've been lurking on this site for a while and finally joined. This is my first post.

I have a question:
My 16 year old daughter was recently evaluated. The psychologist explained that she has many aspergers/autism spectrum traits including theory of mind issues, sensory issues, rocking when distressed, and more. However, his final conclusion was that she does not fit DSM criteria because she also has an anxiety disorder and a type of OCD (probably stemming from anxiety) that is not the typical obsessiveness that comes with aspergers. (Her rituals are specific and thought out).

I am confused, as I see that many on this forum have also been diagnosed with OCD. Why would one diagnosis negate the other?

A little background, all my children have sensory and other issues remarkably resembling aspergers, although each presents a bit differently from the next. I definitely have aspie traits (psychologist agreed) and have an uncle who I'm sure is undiagnosed.

Appreciate any input!

Obsessiveness, specific thought out routines, OCD behaviors, and ESPECIALLY anxiety are all very normal AS traits. I don't know whats wrong with the person who evaluated her but he obviously didn't know what he was talking about.

This is the official diagnostic criteria for AS. You don't need to have everything listed on here as it explains. No where on here do those traits automatically rule out her AS
http://www.autreat.com/dsm4-aspergers.html

thanks!
that's what I thought
he also said that because she's able to make friends he does not think that it's apsergers. He would define her as someone who has aspie traits but not enough for diagnosis. The way my daughter puts it is that "friends" pursue her because they think the sometimes strange behavior-when she's not intending to be strange- is amusing. She's in a class full of kids with ADHD. She's not really good about maintaining most friendships.

I'm really puzzled, guy is supposed to be the best in my area. I want to trust what he said, but my maternal gut says otherwise.

Im able to make friends. Its not a absolute thing that someone with aspergers cannot make friends. Thats absolutely ridiculous. Yes there is more of a difficulty in that area with people but its not impossible.

Now I can see him not giving her a diagnosis because she isnt greatly affected in a negative way by some of her symptoms. She could instead have borderline aspergers and be on the tippy end of the spectrum.
(which in my opinion is ridiculous because borderline is still aspergers, aspergers is genetic and a spectrum so just because it dosent have some severe symptoms dosent mean its not there)

I greatly dislike the way the current criteria is set up and the massive differing opinions on how its interpreted by various psychologists. Im sorry to say you will run into this problem often and your best bet is to take her to a different psychologist

Having a diagnosis of OCD does not prohibit one from having a diagnosis of AS, and having a diagnosis of AS does not prohibit one from having a diagnosis of OCD.

One simply must be able to distinguish rituals and obsessions from OCD, and rituals and obsessions from AS. The two are very different. Obsessions due to OCD are more properly called intrusive thoughts and are composed of violent or sexual imagery, or irrational worries that the person knows are irrational and cannot rid themselves of without doing rituals, also known as compulsions. These might take the form of hand washing, counting, or doing something a particular way.

AS related obsessions are also known as "special interests". This is when the person is intensely interested in a subject and takes great joy in engaging with it or thinking about it. Interests tend to be narrow in scope. For example a person with AS may have a special interest in horses and might like to think about horses and might be able to tell you some factual information on horses, but wouldn't necessarily know much about horses beyond that.

AS related rituals usually take the form of certain daily schedules but are not done to rid ones self of unwanted imagery or irrational fears, and are done out of familiarity instead.

However, a person does not need to posses either of these traits to meet the criteria for AS.



So a child might meet D, but not A, B, or C, or any combination there of and still have AS, as long as at lease one of those points is met.

Also be advices that a person with AS may have a "special interest" and never share it with those around them.

It should be understood by the diagnosing clinician that the DSM-IV criteria was written based on case studies of children and may not be applicable to those with AS as teens or adults. For this reason, there are various assessments used to diagnose AS in teens and adults, however, the person should have still met the DSM-IV diagnostic criteria as a child.

well, she surely has B and C
I surely have A
not sure about D
this is her first evaluation. I should have had her evaluated when she was little, and naively attributed her violent meltdowns to having a bad temper (she used to repeatedly hit her head on the floor). My wrong assumption was that if she speaks (and she did) then it couldn't be something autism-related.
It's been a long few months now. I've realized a lot about myself as well, I'm pretty sure I'm somewhere on the spectrum. And yes, it does affect my quality of life.

Back to my daughter, the psych recommended CBT therapy. Any thoughts? would it be useful? My insurance doesn't cover and really not in a place to throw away money on inappropriate therapy.

what an incompetant evaluator, OCD and anxiety can exist with aspergers......those things do not rule it out.

thanks
---sigh--
frustrated

he added that it's rare for a woman to be diagnosed. He has personally never diagnosed a female.
he felt that her autistic behavior is a result of her anxiety issues (including severe social anxiety).
I pointed out that when she had her meltdowns as a toddler she did not suffer from OCD nor social anxiety

He also felt that her non-interest in "romantic" relationships--she's 16---has to do with her anxiety: that because she's bright she's worried about the responsibilities of growing up; he said this issue is in no way connected to a spectrum disorder.

Going to bounce this all off her psychiatrist (she's medicated now for social phobia).

thank you for your replies!

RED FLAG! Never diagnosed a female?!

Oh my god this man is a absolute hack. Never having diagnosed a female is a definite red flag. The fact that these kind of people are out there diagnosing aspergers disturbs me greatly

what was really surprising is that the actual test results pointed to a spectrum disorder, and then like a good suspense-thriller novel, the story ended differently. The conclusion did admit to a "slight communication disorder", but the emphasis was to do cognitive therapy to treat the anxiety and OCD.
In terms of dealing with daily life in my house, I've come to realize that we're a family with asperger-like qualities, and relating accordingly has been helpful in keeping the peace around here. Too bad I didn't realize this years ago. My kids are older now, 2 have finished high school. No one is thriving...yet
Problem is that when clashes arise at school, without a diagnosis my kids don't get the appropriate help.
And I've learned a lot about myself, which has been eye-opening and intense, but again, overall useful.

I'm with the others are the conclusion he came to being odd. AS is a spectrum, and few have every trust to the letter.

As for CBT, I haven't heard any negatives from those who have tried it on themselves. The key is to make sure everyone agrees on the priorities and goals, especially when money is tight and the amount you can afford to use it is limited.

It's rare for a woman to be diagnosed because....



And...





I would get a second opinion based on the fact that he has demonstrated that he cannot distinguish the difference between obsessions and compulsions due to OCD and those due to AS. He cannot apply the DSM-IV diagnostic criteria appropriately and did not use any assessments designed for adolescence. And he is admittedly inexperienced with girls and spectrum disorders.