Help! What not to do, in a diagnostic interview

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Hand raised!
I find any suggestion that no-one with AS cannot manifest these traits, utterly demeaning and denigrating.


Who can say “prejudicial caricature like stereotype”?

I just got diagnosed as 'having all of the pieces of the puzzle' for aspergers. I am 35 and i got complimented on my sense of humour and politeness by the doc. Being an adult you have had time to develop patterns of behaviour that can get you by socially but usually in a limited capacity. I have a wicked sense of humour and can converse normally with people up to a point, then i wander off into anther area. I get invited to parties but wouldnt get invited to something like a fishing trip. People seem drawn to me socially and then after a little while its like they sense something is a bit weird and they find someone else to talk to. With the stimming thing. I got so much grief as a teenager that i learnt alternate stress release behaviours. I now rub my feet together or bounce my feet. I can usually get away with that. I also taught myself not to walk pigeon toed because of bullying. As for reading etc. I am now doing a masters degree and have always read exceptionally well. I dont notice any particular verbosity but the doc picked up on it quickly and commented on my use of language and articulate conversational skills. One of the tests i had to do was a visual one where you have a series of images of peoples eyes and you have to pick their emotion from 4 options. I found this almost impossible. Is it something you have tried yet? generally i cope with social events but when they get too much i just shut down and go and find somewhere quite where i can read a book or something. My wife has to keep apologising to people when i get like that because they take it personally if i wander off.

I have not been given that test, in this evaluation, but I've tried two different versions, online. One I think I scored mildly low on; on the other, I did much worse. If I can remind myself, I tend to look at little details around the eyes, like the eyebrow position, and I think that helps a lot.
Then again, staring at a picture of eyes and analyzing it as data is very different from actually reading emotion, face to face. In real life conversations, I can learn almost nothing from the eyes; I'm too busy trying to handle the talking.

I gave my 7yr old daughter the first part of the "Sally-Anne" ToM test, on a whim (she failed, and I could not get my 4 1/2yr old son to even follow the story long enough to answer) and when I was looking it over, I almost failed it. My first urge was to pick the wrong response, then a few seconds later, I realized "Ooops."

http://en.wikipedia.org/wiki/Sally%E2%80%93Anne_test

I technically failed a test a normal four-year old can pass. This was before I'd accepted that I had AS, so I was shocked, to say the least, heh.

Taken the "Aspie" test, too, and scored 156 (out of 200). I have been fully Intarweb-diagnosed, heh.
http://www.rdos.net/eng/Aspie-quiz.php

Hi TiffOfDoom:

A) I think my sense of humor is pretty good, but most people find it too esoteric to be understood. However, my boyfriend who also has AS has a very funny, and very topical, sense of humor.

B) Good verbal communication, not so good non-verbal communication, though I've spent so much time working on the non-verbal communication that now I'm actually better than some NTs I know!

C) I can pretend to be normal for long enough to fool many NTs (though some still manage to figure out there's something a bit "off" about me no matter how hard I try). So long as the conversation is predictable, I have learned several scripts for "small talk" that I can use, and I have also learned how to be polite and pleasant, often by just nodding and smiling while other people are talking.

I think that most of us adults with AS have learned social routines that allow us to appear fairly "normal" to NTs. Many of us have learned how to supress our AS characteristics like stimming or talking about our special interests when we are in the company of NTs.

I know that Asperger's often looks like a collection of various conditionss like social phobia and OCD, but when all of these "symptoms" are present, a diagnosis of AS is warrented. I would present the psychologist with the DSM-IV definition of AS and give examples of how you express each of the diagnostic criteria. This may help him "assemble" all of your various behaviors into a meaningful whole:

I) Qualitative impairment in social interaction, as manifested by at least two of the following:
(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

~ Caterina

I'm unusually funny, and funny in unusual ways. I've been told I have a very British sense of humor, and that seems pretty accurate. As a child, I had the usual AS trouble with figurative speech, but was fascinated by it. As an adult, I now delight in puns and wordplay, and constantly manipulate language for my own amusement.
My verbal skills are my greatest strength, and that's always boosted my ability to be funny. If anything, my Asperger traits have enhanced my sense of humor. People don't always understand the joke, but they always, always laugh.


YES. I actually told the guy doing my evaluation this - that I rehearse every social conversation, if I can, but it didn't seem to make much of an impression. Maybe tomorrow, I'll point out that I've also rehearsed EVERY SINGLE VISIT I'VE HAD WITH HIM.
I still can't handle small talk, though. It just means nothing to me, and I don't understand its use, so I'll freeze up and blurt out weird things. Mostly, it seems like my mind just can't accept that people enjoy repeating utter bs to each other. I know it's true, but I still can't totally accept it: "How are you?" "I am fine." "How are your parents?" "They are good."
Whereas, my brain wants me to say...

Actual near-miss conversation I recently fought my way out of, with my old principal:

How are you?: I don't know. I'm uncomfortable and I want to go home. I was already IN a conversation, before you came up, so I'd like to get back to that. You're interrupting. Why are you talking to me, anyway? You don't like me. You always hated me, ever since sixth grade. You used to scare the sh** out of me. Remember when you said I had "criminal eyes?" I REMEMBER; I REMEMBER EVERYTHING. You used to corner me against walls and force me to stare into your BIG, BULGING EYES. Then tell me you'd be "watching me," because you could "just tell" I had everyone else fooled because I was "gifted." WTF IS WRONG WITH YOU, THAT YOU WOULD EVEN COME UP AND SPEAK TO ME, NOW, YOU SICK FREAK?

How's your mom and dad?: My mom's a vegetable, my dad's an a**hole, and I don't see either of them because I cut my family out of my life. So, maybe they're dead; I don't know. Why the hell do you care? You hated my father, and thought my mother was an idiot. WHY ARE YOU TALKING TO ME? I DON'T UNDERSTAND.

Heh. And that is why I rehearse EVERYTHING.



I did do exactly that, and he agreed that what I'd written made sense, and sounded right. Then he started talking about my PAI results again, and saying that they covered "everything in the DSM," but did not show AS, in me. I have no idea what he meant, by that, and really wanted to ask him "Wait...are you really saying that you would expect the PAI to spit out a neat little: 'THE PATIENT HAS ASPERGER'S'?"

I don't know if that's what he meant. I hope not, because the idea is terrifying. But that's what his words seemed to be saying. I f*cking hate imprecise language; NTs need to use more words, lol.


And then, when he asked me "What do you hope to gain from this diagnosis?" I just got offended. I know I shouldn't, but that sounded suspiciously as if he were questioning whether I needed the diagnosis, on some emotional level. All I could think, was "I NEED LOGIC. I NEED YOU TO LOOK AT ALL THESE PIECES I HAVE SO NEATLY ASSEMBLED FOR YOU - THIS CASE I HAVE ALREADY MINUTELY ANALYZED AND PROOFED IN THE MONTHS BEFORE I EVER CAME HERE - AND SEE THE SOLE, OBVIOUS PATTERN THAT THESE PIECES FORM. IF YOU COME TO SOME OTHER, ZANIER CONCLUSION, MY HEAD MAY EXPLODE BECAUSE ILLOGICAL ANSWERS HURT MY VERY BRAIN.
Aside from that, I just want all my ducks in a row, nice and professional-like, so that when I bring my daughters - who behave just like me - through the parade of doctors for diagnosis, I can say 'They manifest exactly as I did, and look...I have a diagnosis of AS."

It is damned hard, keeping that sort of thing in one's head. This is why I tend to burst into tears, at the effort of communicating with others, I think. And yet, if I speak honestly with "normal people," they always-always take offense, and/or call me "combative."

I was diagnosed with AS back in February - my psychologist said I fit all 8 of the diagnostic criteria in the first two groups of the DSM-IV (only needed two from the first group & one from the second.)

A) I have great sense of humor - but it's not "mainstream." I understand jokes - but I only laugh if I really find them funny. The things that make me laugh tend to be understated - things that require a bit of thought.

B) Having lived for 50 years undiagnosed, I had to learn to "fit in" - which means I needed to learn the ins & outs of communication, both verbal & non-verbal (although my verbal skills are MUCH better.) AS is a developmental disorder - I have developed these skills - just not at the same rate (or to the same degree) as my NT peers.

C) I may come across as "quirky" - but most people would say that I'm very polite & can socialize quite well. I smile at the right times & can laugh with the rest of the group.

Best of luck to you, tiffofdoom.

As so much knowledge has been collectively acquired and disseminated in the last 15 years or so about ASDs, it can be surprising, especially to younger people, how people that "run the table" on the diagnostic criteria - being described as "strong autistic characteristics" - can go undiagnosed well into their 40s and beyond. To the extent we can and are called upon by life's circumstances to do so, we adapt; i.e., hide as much of what got us bullied, shunned or otherwise rejected and emulate what appears to work for others. Some of us get pretty good at it, or so we think, but at a psychological cost we cannot quite understand until its effects accumulate over time.

However, at the end of the day, some of us are just not as normal as we believe we have become. For many of us, the occasional bit we hear from time to time about being quirky or difficult to get to know is just the beginning of how the world really sees us. People just don't say such things unless they have a compelling reason to do so. However, they think these things all the time. Many of us can fake normal for an hour. A few can for a day. Hardly any of us can day after day with the same people - it's darn near impossible.

I shared all of the same concerns about being diagnosed just six months ago - would they only see my adaptation routine? A few hours of being myself put all of that to rest. If in advance of your assessment you are obsessively preoccupied with "will I appear too normal", etc. you are probably a no-doubter and will be easily seen as such by any half-way decent assessor.

Well put!

I'm sure that just about everyone I interact with on a day-to-day basis can see that I'm not very adept socially - even though people often ask my advice on how to behave in formal social situations (that's because there are rules for those situations & I'm good at rules.)

My psychologist says I present myself very well & have no trouble communicating. But I'm sure that he also realizes (because I've told him) that finding the "right" word is extremely important to me - so much so, that in the past it has made it very hard for me to communicate. It's only 50 years of vocabulary development that allows me to pick the "almost right" word & communicate with "no trouble."

The effort that I expend just getting by & trying to appear reasonably "normal" is so great that there is virtually nothing left over for actually making & keeping friends. That is the carrot suspended from a stick - always just out of my reach. I suppose the more effort I expend trying to appear normal, the more apparent it is to normal people that I'm not (quite.)

First off: many thanks to all who have responded, thus far. Hearing others describe similar thoughts and experiences not only reaffirms my own, but will hopefully provide valuable insight for Evaluator Dude.


I had another appointment on Monday, and apologized, straight off, for my sort-of/almost meltdown, the visit before. Evaluator Dude reassured me that he had not seen any extreme behavior on my part, which is probably true - much of the turmoil was going on IN my head, and not coming out in any way other than more rapid speech, and more obvious avoidance of eye contact.

So, I did my best to describe the mental processes behind that agitation he'd seen, and why it happened. I'd had time to get perspective on it, and so I pointed out that, most likely, many of the things I'd thought he was saying were simple misunderstandings. He had been speaking in a form that most normal people would probably understand, but some of his phrasing and statements were either vague or confusing, for me, which had made me very unsure of whether or not he'd changed his views on or plans for my evaluation.

I had prepped like CRAZY for this appointment. Rehearsed and rehearsed and rehearsed, and...I don't know. Sort of "shored up" my mind, to try and stay as focused and calm as possible. That largely worked, and I was able to communicate much better, albeit with the usual shoddy eye contact and rambling.

I talked A LOT, heh. Even by my usual standards. Spilled out everything I could think of, in an effort to show him what it was like in my head. Trying to pull back the curtain, so to speak, so that he could see how much WORK is involved in just normal conversation, for me.

Like I said, much of my fear was unneccessary, it seems. He did have some inaccurate ideas about me, and my abilities, but he was not jumping to diagnose right away, and was not as wonky with his perceptions as I'd worried.

The results of the PAI, by my standards, were inconclusive. I think he feels the same. There were lots of "high points," in areas like OCD, paranoia, etc, but the closest it came to diagnosis was "non-specified relational disorder." If I recall correctly, that's a pretty ridiculous use of the term - relational disorder refers to pathology in a relationship between TWO people. If it's just YOU, unable to relate to the rest of the world, then you're usually just called a sociopath, heh. I could be wrong, but that's my understanding of relational disorder.

I got that result because, naturally, I do not relate at all, to other people. Very, very "set apart," which also made me score high on the schizophrenia scale (just minus all the psychosis I'd need for that label to fit). Apparently, I don't properly fit in any psychological box, so further analysis is required.
I like to think that means I pwned the test.

I also managed to go into a lot of neurological symptoms that had yet to come up, in Evaluator Dude's questioning. Sensory issues, gravitational/directional/spatial issues, etc. As well as how I'd originally come to the self-diagnosis of Asperger's - and one very important point, for me, was to explain just how OPPOSED I'd been to the Asperger's diagnosis. I was convinced I did not have AS, so it had taken much self-examination, contemplation, and challenging my own ideas about myself, to finally accept AS as the only logical answer.


And so on, and so forth. The plan now, is for Evaluator Dude to confer with his supervisor, I believe, and figure out where we should go next, as far as zeroing-in on the Asperger's. The only problems I see, is that Dude still seems to have a somewhat narrow view of what AS looks like - at least, in an adult female. He mentioned having some small experience around people with AS, but since this is a university program, I wonder if his experience has been with much younger college students. He's still wowed by my "social skills," due to the fact that I can participate in back-and-forth conversation, and will sometimes smile and/or look pleasant.
The truth is, I've been able to do that, for years; it was always a stronger area in my social skills. I may walk around with a grim look on my face, but if you're talking to me, I'm going to make an effort to smile. Now, I may smile at the wrong times, and there's often a sort of "frozen" quality to that smile, but I'm bright enough to have learned that people want to be smiled at.
As for the back-and-forth, I learned that quite early. The problem is, I still WANT to run the other person over with lecturing; I don't really enjoy back-and-forth conversation. I get cut off, a lot, because people will jump in and interrupt, likely sensing that they HAVE to, in order to speak, heh. I'm notorious for running on, interrupting, changing subjects, driving back to my own desired subjects, and just generally dominating conversation to a degree other people don't like.
But if you ask me a question, I will answer it. And if you grab the reins of the conversation away from me, I will grudgingly relent. And then smile and nod, while thinking and talking to myself in my head.

Anyway, I questioned him on his ideas about my "nonverbal language abilities," and he said "Well, sometimes I smile, and then you can smile back." LOL. I cannot recall if he has EVER smiled. I'm sure he has, but I never paid any attention to it. I still can't even recognize his face, when he comes into the waiting room - I have to carefully check out his spikey hair, general size, and his distinctive blonde eyelashes, before being sure that yes, this is my Evaluator Dude. I glance at his face a lot, in the interview room, but I don't really process much of what I'm seeing. And I can honestly say that I have never returned a social smile, in a "normal" manner. I just smile on a regular basis, whenever I get some small language cue that a smile is appropriate, or when I am saying something I want him to take as lighthearted. It's not exactly "natural," but it's a very simple technique, where my "social programs" are concerned.
He also sort of started to say that I laughed in response to his laughs, I think. Something like "And sometimes I kind of chuckle, and you..." then he never finished. Maybe he suddenly realized that he wasn't sure he'd ever seen me laugh aloud, heh. That's one of my gaps: I can't laugh passably, very well. I smile big and make weird noises, at best, and I would never, EVER be able to summon even a fake laugh, just because someone else "chuckled." I can't figure out WHY anyone would even do that. Or, for that matter, even remember ever seeing Evaluator Dude laugh.
I don't think he's really wrong, about what nonverbal stuff he's seen. Just reading it in a more hopeful fashion than is warranted, I suppose. Who's got the Theory of Mind issues, NOW, lmao?

This discussion took place near the end of the session, so hopefully I can remember to go into that more, next time. There are lots and lots of "scary thoughts" I NEVER share with anyone, because they reveal just how artificial most of my interaction is, and I know that creeps out the Normals. My husband's seen a lot of it, so I may drag him in to tell stories of all the "checking" I do, with him: "Why do people need hugs?" "Why did (blah) say that?" "Why do people like to hear that stuff? "How did I look Scary, there?" "What's the purpose of (insert social custom, here)?"



In good news, the first of our three Very Weird little kids has been officially diagnosed, so that should help. Our 4 1/2yr old son was finally diagnosed by his pediatrician, today, as having ASD. His doc suspects it's specifically Asperger's, but wants to send him in to see a team of developmental pediatricians, further down the road, to fine-tune his diagnosis - the ASD label is just to push his school district into starting services.
It's ironic, because I originally came in for diagnosis with the hopes MY Asperger's label might help in diagnosing our high-functioning daughters. And now, I think my son's diagnosis may actually assist in confirming mine.

tiff, the behavior you describe at your diagnosis is SO classic ASD I'm surprised they didn't come right out and diagnose you then and there. Losing access to decent communication when stressed is such a familiar thing to me--not being able to get out what you wanted to, and defaulting to some other topic that you kind of ramble on about... and it's not because it's emotionally difficult to talk about but because it's hard to gather all the words together... Plus, the way you got overwhelmed, yeah, that'd say AS to me too, especially the "pressured speech" thing, which can be easily mistaken for GAD if it isn't for the fact that AS doesn't cause "generalized anxiety" as a rule. I mean, he'd have to do the differential diagnosis on it, but it would be pretty obvious: Rule out social anxiety, rule out OCD, rule out speech/language problems. All three, pretty easy. And we often do learn social skills by rote; learning how to identify a smile and copy it when you see it is something that practically anybody with autism can learn to do. Is he assuming your case will present the same as that of a child who's had not even a quarter of your life experience?

Callista:
This is a grad student, earning his PhD, supervised by (I think) the head of psychology. So, his knowledge is very, very fresh and up-to-date, but his experience is somewhat limited. He's quite professional, but it does seem likely that he has never met a "well-trained" person with AS. I'll be 31 next month, I'm female, my IQ is high, and if there is such a thing as a verbal savant, then I probably am one. So, if I were not fighting the old "fake-normal" social routines, then he'd have nothing, at all, to work with. People who meet me tend to think I'm "mysterious," "aloof," or "eccentric," in that way that people often assume the gifted are. People who've known me my whole life think I'm very strange, but would never, ever think I was autistic. None of my old school friends ever even knew I had any learning difficulties; they just assumed I was lazy.
So, if I had met this guy at a party, and even sat down and talked with him, I would bet money that he'd never have suspected a thing. Verbal strength goes a long, looong way.


The impression I get is that he has probably seen boys in their late teens with either lower-functioning AS, or just AS boys who have not yet figured out how to fake it well. Real stereotypical AS, the way I have not appeared in public since about age 12-13. He briefly described someone who would not be able to smile, or take turns in conversation, and that sounds like the most severe levels of AS, usually seen in young boys.

He DID acknowledge that AS can manifest very subtly, in some people, but I got the feeling that he thinks if you get a handle on social skills, then your AS must be very, very mild. That rankled me, because as far as I can tell, my own symptoms range from moderate to severe, but in the end, it doesn't really matter - let him think I'm some kind of Super Ass Burger, lol.


Ironically: the one person I've actually met, in real life, with a confirmed Asperger's diagnosis, was SO MUCH MORE SOCIAL than me, that we were like night and day. I met him when he was only about 18. Most people thought he was very annoying, and I may have been the only one of our little group who truly liked him, but he came off as UBER-friendly. Huge smile, very outgoing, eager to make friends, good eye contact, and excellent manners. He was even a fabulous dresser, heh. And, I mean, the extent to which his AS affected him was legendary, lmao; everyone had a story about this guy and some awful, humiliating blunder he'd made. My husband and I think of him now and groan, because our son is exactly the same, minus the good manners and good eye contact. Just a high-speed, super-friendly FIREBALL...and yet heartbreakingly unable to "blend."

I think of that guy, now, and would LOVE to see what Evaluator Dude would make of him, heh.

And, I have struck out. Evaluator Dude now says he does not believe I have Asperger's, and sees no point in continuing to evaluate for AS...despite having never actually performed an appropriate evaluation for it, in the first place - as the only one who's ever been asking the standard questions a professional would use, has been me.

Actually, he didn't say that I do not have Asperger's. Not directly. He really didn't say anything, directly, but rather, beat around the bush quite a lot.

But the bottom line was the same: if I insist, we shall push forward and do "more Asperger's-related things." But he does not expect to find anything, and because he does not expect to find it, naturally, he will not.

He did not say why he thought I did not have AS, so I said it for him, at which point he confirmed it: I do not have AS because I have social skills. Not remarkable social skills, or even healthy social skills. Just the ability to be pleasant and occasionally give a small smile, while in the room with him, for an hour at a time.

He says that people with Asperger's are not only incapable of this, but would not even learn enough social adaptation to fake it, because a person with Asperger's would not notice or care about getting along, socially, no matter what their age, gender or IQ. People with Asperger's, apparently, must be much more like Rainman than I thought.
Oh, and though it wasn't mentioned, today, please remember: people with Asperger's also lack a sense of humor, much less the ability to be Snarky.
/end non-Aspergian sarcasm.


That's it, for him. He can never get over the Social Hump. I suspect he must have very poor Theory of Mind, heh.

I told him (kindly) that, in that case, I did not believe I could give him any more than I already had. I'd handed him a documented 29-point gap in my IQ scores, favoring Verbal IQ. Developmental records showing strong autistic traits at an early age, precocious verbosity and reading ability, and hallmark deficiencies. I'd described experiences of social dysfunction so severe that I do not have a single "normal" friend, aside from my husband, a profound disconnect from natural empathy, and deeply obsessive behavior - all of which were verified by my PAI results, which showed me so strongly walled-off from normal social relationships that, were I not so very sane, that dysfunction would match up best with schizophrenia. On the PAI, I scored exactly as adults with Asperger's have scored, on similar inventories.

And then, of course, in person, the same sort of behavior I described, showed up, again and again. Tendency to dominate any conversation (but he did point out that the fact that I grudgingly accepted his need to occasionally speak was non-Aspergian, because "people with Asperger's do not let others speak"). Tendency to ramble on and on in a very formal manner, showing difficulty reaching a point. Tendency to miss the points made by him, or show trouble understanding his language, when it was not perfectly precise. I twitched and stimmed almost continuously, just bearing down on the worst of it (though I still broke out in rocking, from time to time), from the sheer pressure of trying to maintain a normal, productive conversational flow. And I'm fully aware that my eye contact is atrocious; I eventually stopped even trying to fight it, and switched back and forth between "shifty" eye contact, and just staring to one side of him (or at the floor), while I was speaking.

Oh, and I was even able to deliver a genetic link, in the form of my son, who has recently been diagnosed with Autism Spectrum Disorder, suspected as Asperger's Syndrome.


I do not know how I could have possibly given him an easier case to diagnose, short of being ridiculous. I have no idea what he wants - or rather, I am flat-out horrified that what he seems to have wanted, was for a 31 year old female with an IQ in the 150s to have come in looking like a moderately autistic little boy.

That sounds angry. I'm not angry, other than my usual knee-jerk rage at illogic. But I'm just....aghast at the stupidity of it all. As well as at this evaluator's bizarre behavior.
Last visit, about three weeks ago, he reassured me that we were nowhere near done, would now be beginning (finally, and for the first time) evaluation specific to Asperger's, and that he would give me a call, to schedule the next session.

Would you believe he never called?

I had to call him, today, both to find out what was happening, and to update him on my son's confirmed diagnosis. At which point he filled me in on all the above. It was positively surreal, as if his brain had been taken over by Pod People.
I may miss things, in conversation, but I have the mind of a tape recorder, where dialogue is concerned. I have reviewed every single conversation we've had, every word he's spoken, and my first impression was correct: he just did a complete about-face, AGAIN, with zero warning.

When people do things like this, it just makes me want to run away. Sort of like "Oh, I had assumed you were a Person, but it now appears you are a talking lawn gnome. Excuse me while I run, screaming." I should know better, by now, but the near-constant illogic of Other People still catches me off-guard.

I don't see any future, here. He suggested therapy, to help with my issues, but since he's already ruled out all manner of personality disorders and the like, my impulse was to ask "How, when you can only identify the symptoms, having ruled out all causes?" I would also be fascinated to see how therapy can address life-long neurological abnormalities, but in the end, it does not seem worth paying for the amusement of finding out.


So, ther verdict is: I do not have Asperger's Syndrome. I also do not have any known mental illness. I have been profoundly disconnected from the entirity of the human species, my whole life...for no discernible reason. My autistic traits are, just "character," perhaps. The fact that I match up perfectly with the DSM-IV criteria for Asperger's Syndrome (which the evaluator did actually agree on), is just a coincidence. And, I suppose, my having a son on the spectrum is just another of those wacky coincidences.

One day, I want to buy a huge mallet, to carry around, in the event of this sort of situation. On the side, I will write "Occam's Razor."



And that, is that. Let this be a lesson, and let this thread be referred to, whenever some doof comes asking questions about how to make the right "impression," to their shrink. TRUST YOUR INSTINCTS.

I put a couple months research into this, before ever seeking professional opinions of my kids, or myself. Given my obsessive attention to detail, and a 12-13 year "special interest" in psychology and sociology, I'm pretty darn confident in my self-diagnosis. So, I'll be getting a second opinion, in a couple months, once our schedule clears out, a bit. Only this time, prior experience with adult Asperger's will be a prerequisite.
On the plus side, walking in with the information I was able to provide Evaluator Dude, plus PAI results, plus a diagnosed child, should guarantee that the next evaluation takes a bit less than the three months wasted, on this one. For that matter, I still have no idea what Evaluator Dude will even find to write, in my final report, as so far as I know, he never did find a diagnosis.

BIG MALLET. OCCAM'S RAZOR. RIGHT TO THE HEAD. SWEAR TO GOD.

Sounds like he doesnt know what hes talking about to me. Definitely seek a more qualified opinion.

We went to a counselor who specializes in working with adults who have Asperger's. He did not do any blatant diagnostic tests such that we had the realization that this is a test now. By talking to us several times and observing my husband, combined with his experience, he was able to dx him without a shadow of a doubt. I agree that someone skilled in working with adults who have AS should be a fundamental pre-req. With so many people having such trouble getting diagnosed and falling through the cracks with long-practicing docs, there's no way I would recommend spending the money on a student in a clinic where no one had adult AS experience (though I understand why you did, I'm not surprised at the outcome). We went to many counselors before and none had any answers. They didn't even know how to effectively talk to my husband. The AS knowledgeable doc made such a difference.

As someone else mentioned earlier, my husband has pretty much every trait down the diagnostic criteria with the exclusion of hand flapping. There's another thread that mentions picking at one's skin, pimples or scabs as one possible learned redirection and in this one knuckle popping is mentioned, both of which my husband does without noticing or appearing to have control over. It makes me wonder if those are his "stims" which is a new word for my expressive vocabulary.

All the rest of the AS related stuff, I could handle fine and we would have never gone looking for professional guidance. The alexithymia and its effects is what was hard for us to figure out how to navigate. However, someone here or on a blog I read said that not all people with an ASD have alexithymia, which, if you're correct could explain why you have more emotional feedback than the student expected. Someone else on another thread said that all the books he read gave caricatures of AS. I think the example used was that a wife told a husband a guy wasn't to step foot on their property again so the husband somehow transported the guy on the property in such a way that his feet didn't touch the ground and then didn't understand the problem. Uh, I don't think so. If that's the best place he's getting his info from, who knows what the worst is.

What not to do:

I. Utter a threat of inflicting harm by any of these means:
I.a Spoken or Orally
I.b Physically
I.b.i By body alone
I.b.ii Brandishing a weapon

II. Come infected with a pneumatically transmitted disease
II.a Unless you are being diagnosed by a physician.

III. Come with intent to lie
III.a By an out right lie
III.b By a white lie
III.b.i A white lie is admissable if it is used to protect valuable information that should not be disclosed in the scope of a diagnosis.

I can probably think of more. . . .

FiveEggsIn:

I don't know if I have alexithymia, as I don't know enough how to differentiate between it and other possible conditions. It should have been very clear, though, from the many conversations my evaluator had with me, that I am far from normal, where emotions and empathy are concerned.

I don't notice or think about other people, unless my attention is directed towards them. I can honestly say that my husband is my soul mate. He is also my best, and oldest, friend. And yet, I have to remind myself that he HAS feelings; otherwise, I'll just blunder around, continually hurting him without noticing.
Other people's feelings rarely occur to me, in the moment, so to speak. Later, I may ponder their confusing actions, and often draw exacting conclusions about what they must think and feel, to behave the way they do. But that's always a "post-game," hyper-logical process. During actual social interaction, I behave and respond as if I'm talking to my own mind, expecting the same perspective in everyone I meet. Unless I know they are very stupid, heh.

As for my own feelings...I think I'm too close to tell. I *feel* like I'm very in touch with my emotions. At the same time, I suspect there may be bigger issues there than I'm fully aware of.
I often can't discern what I'm feeling. Sort of like "MADBADSADHYPER," or "HAPPYGOODWOOTANXIOUS."
I'm obnoxiously verbose, so I can prattle on at length, about my feelings, but on that subject, like all others, people have told me they get lost in all the words and can't understand my point. VERY often, I feel conflicted or contradictory, and it makes me nervous to try and "pick just one feeling." I always feel the need to be very precise with my words, so I fret over finding the *right* way to describe what seem like very complex, muddled feelings.

And, of course, my emotional "weighting" and expression vary, from strange to very flat. Things that greatly hurt or upset other people, don't bother me as much. For example: I was molested, as a very young child. Never bothered me at all, so much so that I eventually forgot it, for many years. Not repressed, FORGOT, lol.
Then, things which most people brush off, drive me up a wall. Example: I'm neurotic about words, demand that people say EXACTLY what they mean, and naturally memorize and over-analyze the words of others. I could, right now, pick a fight with my husband over the wording he used in a conversation several years ago. Just about ANY conversation, heh.
Where expression is concerned, my natural affect is quite flat. My "social" affect, is uneven, ranging from flat to fairly normal. It takes concentration to "look normal," so I kind of swing between the two extremes, as my attention shifts back and forth from my own thoughts, to the expectations of others.


All of the above was visible, to my evaluator, unless he just wasn't paying close enough attention. They record sessions, though, so I had assumed he would go back and scrutinze the dvds, to see what he may have missed.
Everyone who knows me, even casually (and most people don't "know" me, more than superficially) is aware of these kind of trademarks: a certain distracted denseness; a dry, absurd sense of humor; a somewhat aloof/cold/insensitive manner; a very odd perspective of/offstep with society; weird facial expressions, or none at all; pronounced social awkwardness, etc.

I don't know what he wasn't seeing, or how - even assuming I was the king of all Aspergian social skills - that could outweigh the large amount of evidence for an AS diagnosis. But, then again, I usually DON'T understand the seemingly absurd decisions and conclusions other people come to.


Getting a psychiatrist or neuropsych with loads of specialized experience in adult Asperger's is, at this point, a wild fantasy for me. I doubt it will happen, though, here in North Louisiana, as there don't seem to be that many options.

At the very least, though, I'm sure I can find a shrink with better capacity to diagnose, even if he/she doesn't have much experience with Asperger's. If I can just establish that they know and accept that AS displays very differently in adults, especially adult females, then that should be enough perspective to allow a competant professional to diagnose. After all, our son's pediatrician rarely sees autism, and most of his knowledge of Asperger's comes from simple research. Yet I would wager he has a much stronger understanding of AS, than my evaluator.

Also, just a plain old licensed shrink should be much more familiar with the wider scope of traits associated with AS. One example I could NOT get over, was the way Evaluator Dude did not seem to be interested in the gap between my Verbal & Performance IQs. He administers the Wechsler intelligence tests, yet seemed unaware of the implications of such a gap. A gap the size of mine indicates the presence of a severe learning disorder, specifically non-verbal learning disorder (and I actually had TWICE the discrepency that would indicate NVLD). When you combine apparent NVLD with the host of other traits I exhibit, I would expect that to ring some bells.
He never showed any real interest in that, however, which seemed bizarre, considering that this clinic does evaluate and test children. And that the meaning of a Verbal-Performance discrepency is actually written in the instructions for evaluation of IQ scores. I could somewhat understand him taking the experiences or observations I describe with a grain of salt. But ignoring documented testing from my educational history so full of alarm bells, was beyond my understanding.


The example you mentioned, about "not stepping foot on the property" is awesome. We have to watch what we say, in front of our kids, because they ARE still that literal. I have not been quite THAT literal, since childhood.