Asperger's--Underdiagnosed or Overdiagnosed?

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bee33
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10 Jan 2011, 12:24 pm

Zen wrote:
Verdandi wrote:
I didn't consider myself disabled until this year, I just figured I wasn't trying hard enough.

That's exactly what it is for me. I've been blaming myself for everything my whole life. It's hard to let go of that.

I still feel that way as well. I feel like I should be able to do a lot more than I do -- and I have to think that I can and perhaps will, otherwise I would be overtaken by despair.



Janissy
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10 Jan 2011, 5:32 pm

Mindslave wrote:
I don't know if it's Asperger's per se that is overdiagnosed, but behavioral issues themselves are overdiagnosed. I think this is a symptom of a culture where it's always someone else's fault. Blame all your problems on something...might as well blame your kids problems on some behavioral condition that might not even exist in your kid, (or if at all) instead of your lack of parenting skills. God forbid you go out somewhere and your kid embarrasses himself...which would embarrass you as a parent, since your kid is an extension of you. Children have to succeed for the sake of the parents. So now Asperger's gets thrown into the mix, and I would say overdiagnosed, only because there is a rush to diagnose kids with something, not so much because of any lack of accuracy. Everyone has SOME AS traits. After all, if your kid messed up in school, now it's the kids fault, it's the fault of Aspergers, it's the fault of school officials who aren't doing enough, anything but the parent's fault.


I have a better idea. Instead of arguing over who or what deserves blame, how about abandoning the blame paradigm entirely? If a kid needs help with some things, then he needs help. Why assign blame before any help will be forthcoming? If there is overdiagnoses going on, then maybe abandoning the blame paradigm would fix that. If neither a condition nor people nor one's own self needed to be blamed before a kid was helped, maybe the overdiagnosing would stop.

There are so many faces of the blame paradigm: telling the kid they are lazy and need to try harder. Telling the parents they are terrible parents. Telling the school they are terrible teachers. Finding the closest fit in DSM and shoehorning the kid into that. But why must all this precede help? Sometimes a diagnosis really is warranted. Sometimes a kid really is being abused at home. Sometimes the school sucks. But what if those just became possibilities to explore without mandating that one of those things must be presumed guilty before there can be any help?



Cornflake
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10 Jan 2011, 7:53 pm

The only reason I did so well in my last full-time job, about 8 years ago, is because I was given a rough outline of what was required and then left alone to work out, create, and then implement the steps required to achieve it (this was in computing - a long-standing and intensely special interest), so it was very easy for me to do it.
But the simple reason why I'm not doing the same thing today is because it started involving more & more interaction with people and something I absolutely cannot do: manage a group of people.

So one aspect of an impairment enabled me to succeed, and another aspect of the same basic condition caused me to stop succeeding.

It's a very fuzzy line indeed between disabled/not disabled. 8O


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Craig28
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10 Jan 2011, 7:56 pm

I have Aspergers Syndrome, BUT, I am more normal then most Neurotypicals!



Ariela
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11 Jan 2011, 8:55 am

I don't know whether Aspergers is overdiagnosed or underdiagnosed but the reality is that the types of people being diagnosed are so diverse.



sfmarie
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13 Feb 2011, 5:14 pm

Based on my daughter’s mid-diagnosis, I suspect Aspergers is both under and over-diagnosed.

I took my 7-year-old daughter to a seemingly reputable child psychologist because we were thinking of moving her out of her school. She’s bored and feels she’s not well liked at school now. She’s been the victim of some bullying, takes rejection very personally, and in my opinion over-reacts to the sometimes-insensitive behavior of other 7-year olds. We simply wanted to know if changing schools made sense.

The psychologist recommended a very expensive full assessment, so she endured 6 hours of cognitive, academic and social skills testing. I was not interviewed, but did complete a very short, multiple-choice test about my daughter’s behavior. We were told she is highly gifted (very high IQ), but then were shocked by a matter-of-fact diagnosis of Aspergers. Some other seemingly off-the-cuff comments were made, like 1) they would normally recommend grade advancement because of her giftedness, but because of the Aspergers they did not; 2) they did not recommend the school toward which we leaned because it emphasizes social activities and team sports, as well as academics, and because of the Aspergers, that would be setting her up for failure; 3) we should inform her current school of her Aspergers and seek funding from the school board so they could better assist with her special needs; and 4) she needed treatment, and their office fortunately have cutting-edge social skill groups and other treatments for her problems. These recommendations seemed wrong for our up-for-anything, routine-hating, sports-team-loving but somewhat socially awkward and introverted daughter.

After researching Aspergers and concluding that, other than social awkwardness and perhaps over-reaction, she had none of the characteristics of Aspergers, I told the psychologist I believed this was a mis-diagnosis. He agreed to meet with me to discuss the matter. In this meeting (for which I ended up paying for his time) I was told:
- My daughter actually did NOT meet the DSM criteria for Autism, but because of their office’s concern that Aspergers is generally under-diagnosed, they diagnosed. This, he thought, would give us better access to early treatment.
- The only criteria she met was for social skills impairment, and that.s because she scored worse than they’d expect on some of the ‘mind blindness’ and imaginative play assessments. She actually scored ‘about average’ on those tests (still not sure what that means), but because of her giftedness they would otherwise expect her to perform more neuro-typically. In other words, if her intelligence was lower, she would not necessarily have met the criteria for social skill impairments, but they expect gifted kids to have better social skills. I can’t find any information on this, but cannot believe it's true, since I know social challenges are common among gifted kids.

Following this discussion it was decided she would be given a diagnosis for PDD-NOS and they still recommended treatment and counseling. There was no longer a need to inform the school, since there is no funding available for PDD-NOS.

Now I’m not exactly sure what all this means, but it just doesn’t sit right. I would have been fine, without the Aspergers label, to include her in any social skills programs and even counseling, because I don’t think it could hurt, and might really help her. But to rush to label, and worse, to make assumptions about what kinds of things would and would not be good for her based on that label, is a big concern to me. I also feel this ‘jump to diagnosis’ does a disservice to others who really do have Aspergers. Surely diagnosing those who don’t actually have Aspergers is not a solution to under-diagnosis!

The whole thing sounds a bit dodgy to me.



Yensid
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13 Feb 2011, 6:16 pm

I would say that it is both under diagnosed and over diagnosed. The current system tries to put people into nice little categories and people who do not fit into one of the categories get shoved into one anyway, regardless of how well it works.

My AS is relatively mild, and would not be considered a problem on its own. However, it led to social isolation and social abuse and those led to severe depression, suicide-type depression. I do receive psychological treatment because my depression is severe enough to warrant it. If not, I would simply have fallen through the cracks.

Janissy wrote:
I have a better idea. Instead of arguing over who or what deserves blame, how about abandoning the blame paradigm entirely? If a kid needs help with some things, then he needs help. Why assign blame before any help will be forthcoming? If there is overdiagnoses going on, then maybe abandoning the blame paradigm would fix that. If neither a condition nor people nor one's own self needed to be blamed before a kid was helped, maybe the overdiagnosing would stop.


Yes. We need to identify children who need special help, and get them that help. We do not need to assign blame.

bee33 wrote:
Zen wrote:
Verdandi wrote:
I didn't consider myself disabled until this year, I just figured I wasn't trying hard enough.


That's exactly what it is for me. I've been blaming myself for everything my whole life. It's hard to let go of that.


I still feel that way as well. I feel like I should be able to do a lot more than I do -- and I have to think that I can and perhaps will, otherwise I would be overtaken by despair.


I need to understand my limits. If I try to push myself too far and too fast, I risk falling into the trap of depression. At the same time, I need to push myself out of my safe zone. It is a delicate balance.


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