How do they test for autistic spectrum disorders?

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Guineapigged
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17 Sep 2011, 1:28 pm

Hello, I am new. :o
My OT asked me the other day if I have ever been tested for autism, because she thinks I display some of the behaviours. I told her no, and she wants to write to my GP about it. Since that day I have read online about autism spectrum and she is right, it describes me very well.
However, I am 20 years old, so I am sceptical that I could have got through childhood without somebody noticing. Surely a teacher would have said something?
Anyway, my question is, how would they test an adult for ASD? Would my GP refer me to somewhere else? And what is actually involved in the testing, is it like a questionnaire?

Thank you.



Willard
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17 Sep 2011, 2:04 pm

Guineapigged wrote:
I am 20 years old, so I am sceptical that I could have got through childhood without somebody noticing. Surely a teacher would have said something?



:D First, somebody did notice, or you wouldn't be asking about it now.

Second, if you do have AS, trust me on this - people have been noticing all your life, they just didn't know it had a name. Have people, including your friends, said things to you like: 'You're weird' or 'What the f*ck is wrong with you!?' If so, they were noticing that you do not think like regular folks.

Third, I made it all the way to 45 before someone emailed me a link to a web article on Asperger Syndrome and said: 'Read This, It Sounds Like You.' Wasn't diagnosed until 49. So, yeah, you could easily get through childhood and several other 'hoods before anyone recommended you should be tested for Autism.

Asperger Syndrome wasn't added to the Diagnostic Manual until 1994 (though it was named in the 40s), so until then most Mental Health Professionals weren't really looking for it - most were (and many still are) largely unfamiliar with the symptoms. Even now, a lot of professionals who have learned to recognize it in children, have no idea how to recognize it in adults, and of course, as you get older you unconsciously develop 'coping mechanisms' to mask your differences, in order to function in the real world with minimal conflict, so it manifests somewhat differently in adults than in kids.

Guineapigged wrote:
Anyway, my question is, how would they test an adult for ASD? Would my GP refer me to somewhere else? And what is actually involved in the testing, is it like a questionnaire?.


When I was tested, there was a battery of psyche tests, to determine whether or not any other mental health issue might be present that could affect the diagnosis - which is to say, first they wanted to eliminate the possibility of any form of psychosis. That was a 3-4 hour multiple choice test.

Then there was a personal interview with the Psychologist on my life history, personal relationships, history of friendships, interactions in school, etc.

Then there was a succession of tests like Rorschach Ink Blots, Word Association, puzzle assembling, and several I can't even recall, to determine your current emotional state and to time your neurological reactions under pressure and so forth.

I understand that in some cases, they may interview immediate family members and even do an MRI, but I did not experience those. Ultimately, its painless. I found the process fascinating, but by the time I went in for the testing, I'd read enough about AS that I knew what the results would be - I had no doubt that it described my psyche down to the most minute detail.

But all that said, I don't how the process is handled where you live. :shrug: Its probably not too different.



Guineapigged
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17 Sep 2011, 2:42 pm

Thank you for the detailed answer, it was very helpful.
My parents have been asked about my early childhood before but they are very defensive and do not tell the truth. Or, rather, they told professionals I was completely normal in every way and their opinion overrode mine, if that makes sense. Like this:
Therapist: "How were you at school?"
Me: "I didn't have many friends. I was anxious all the time and faked sick to stay home."
Parent: "Really? I thought you were fine."
So "fine" ended up on the therapist's notes. Which is why I don't involve my parents in my psychiatric care anymore. Can ASD be diagnosed without parental involvement?


By the way, when I read about ASD/personal hygiene standards I couldn't help but smile because I once had a therapist who drew a pie chart to explain "why it's not you're fault you were smelly at school". I don't know if I had poor hygiene because of an underlying ASD or if it was just because my parents were neglectful. They didn't prompt me to wash and I would wear the exact same clothes to school for months. I feel angry when I look back at the situation. Why didn't they remind me to wash?
The line between mental illness and poor upbringing is blurred, which is why I am reluctant to link certain "symptoms" I have to ASD in case it's just a learned behaviour.



Willard
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17 Sep 2011, 4:48 pm

As I say, no one asked to talk to my family, so that isn't done in every case. From what I understand, its just to get a picture of how you responded to social situations and group dynamics as a child. Funny thing is, if you had asked my parents before I was diagnosed, they'd have said things like 'fine', too - even though they know very well my social skills have always been horrible, they had just never allowed themselves to think of me as anything but normal.

Once I had been diagnosed, my Mother began reading about AS, now she tells me stories of Aspie behaviors I exhibited when I was very small, that I don't even remember. She told me not long ago that she became a Cub Scout Den Mother to try to get me involved in interacting more with kids my age, but while everyone else would get involved in the group activity, I would go off in the corner and play by myself. So not only did they know my behavior wasn't 'fine', they were actively involved in trying to create forms of 'Behavioral Therapy' for me. They knew I wasn't normal all along, they just didn't want to admit it, which was easy in those days because in the 60s, nobody had heard of AS.

I never had any hygiene issues that I recall. If I did, my parents must have done a good job of overcoming it, because I've always been the opposite - ultra clean and a bit of a neat freak. I will sometimes wear the same article of clothing for several days, if I'm just hanging around the house and haven't gotten it dirty, but I wouldn't wear the same thing out of the house more than once without washing it. Gotta get the smell of other people out of it. Of course I do have a lambskin Bomber jacket I still wear every winter, though I should have thrown it out 6 or 7 years ago. :oops:



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17 Sep 2011, 5:18 pm

Guineapigged wrote:
However, I am 20 years old, so I am sceptical that I could have got through childhood without somebody noticing. Surely a teacher would have said something?


I didnt get diagnosed till I was 18 because I had a co-morbid condition that covered the Aspergers. Once that co-morbid condition was removed, the school counselor thought I had Aspergers. A lot of us slipped through the cracks quite easily. The only thing that my teachers said was that I was overly shy and mute.

Quote:
My parents have been asked about my early childhood before but they are very defensive and do not tell the truth. Or, rather, they told professionals I was completely normal in every way and their opinion overrode mine, if that makes sense. Like this:
Therapist: "How were you at school?"
Me: "I didn't have many friends. I was anxious all the time and faked sick to stay home."
Parent: "Really? I thought you were fine."
So "fine" ended up on the therapist's notes. Which is why I don't involve my parents in my psychiatric care anymore. Can ASD be diagnosed without parental involvement?


My parents were pretty defensive too and I still got diagnosed. My mom thought I was just shy and that I was perfectly fine. Thats cause the way my parents work, is if you cooperate and do what they say = your fine. If you dont socialize with your peers, its kinda a good thing cause you dont get the bad influences that so many people get as teens. Often times parents dont like to admit theres something wrong with their kid if the kid aint disruptive. They like to think their kids are perfectly fine. My mom took 2 yrs after my diagnosis to understand aspergers. Until recently, she disliked that the aspergers label was placed on me.



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17 Sep 2011, 7:46 pm

Guineapigged wrote:
However, I am 20 years old, so I am sceptical that I could have got through childhood without somebody noticing. Surely a teacher would have said something?


I'm 22 and was only diagnosed earlier this year. While someone had noticed something when I was younger, it was a psychologist who'd noticed (and told me about AS when I was 13). My parents and teachers never thought autistic might apply to me, autism is stereotypically this thing where people are completely non-verbal, completely non-functional, and cannot be in public, and there is little understanding of what people on the autistic spectrum are actually like. I was seen as shy, gifted, and different than my classmates, but never as autistic.

Quote:
Anyway, my question is, how would they test an adult for ASD? Would my GP refer me to somewhere else? And what is actually involved in the testing, is it like a questionnaire?


Willard gave a good description of this. For me, it was about a 4.5 hour evaluation, involving questioneers to fill out to do with both AS and generic mental health, questions for me, observing me, an IQ test, Theory of Mind stories to describe, and other things like that. They want to both see whether you match the symptoms for an ASD at the moment, in your childhood and whether these symptoms are better describable by anything else.



Tadzio
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17 Sep 2011, 11:49 pm

How do they test for autistic spectrum disorders?

They do not test for autistic spectrum disorders very good. None of the tests are very valid nor objective. "Accuracy versus precision" using physical examples is easier to understand (such as hitting a target's bullseye).

One Asperger's Syndrome "trait" is use of reductio ad absurdum logic, with Bertrand Russell's notice of what is "repugnant to those who are not familiar with logic or mathematics." So, I will respond with the wrong sense of the question.

Throughout my childhood, I experienced around a dozen different cultures, and these cultures can be used to illustrate the intense inherent flaws in psychological testing. "Test Correction" for the flaws in the tests is a major joke. Blatant examples of such are as "speaking Polish" at an U.S.A. international airport" is valid and objective evidence of paranoid schizophrenia, requiring involuntary confinement and treatment.

A quick test for a test is on how easy is it for a person to "fake bad" or "fake good" on the test. Test defenders will usually respond that there are "no right or no wrong responses", but if the test is because of things like a bitter divorce and child custody disputes, such test defenders are then dangerous Pollyannas. If the person taking the test can deliver manipulated responses that give the test results the test-taker desires, the test is not valid nor objective. The same is so if the test administrators can manipulate the results. A recent uproar involving "the key to the normal answers" for the Rosarch Test (inkblot tests) in the "Public Domain" still continues (they all look like Beauty Queen Sarah's joke photocopies while sitting on the photocopier in college, and might still get a person an Attorney General appointment under Senator McCain). The MMPI is big and strange enough to somewhat side-track "fakers" (with still much controversy), but cross-over effects of physical impairments damages validity and objectivity (defenders will argue the exact opposite, in that it "reveals" a possible physical source for the psychological impairment).

To gum-up validity and objectivity for a test for autism, this might be a near silver-platter example:
http://www.ncbi.nlm.nih.gov/pubmed/19888642 versus "cultures shaking head yes means no" and poor or different language skills. http://www.straightdope.com/columns/rea ... hem-for-no

Then, good eye-contact is a sign of disrespect to authority.

Tadzio

Speaking Polish may even result in years of Mental Health Hospitalization in Alberta:
http://plawiuk.blogspot.com/2007/11/he-was-polish.html



LadySera
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18 Sep 2011, 4:45 am

Now I'm scared. I really hope that this thing I have to go to next month isn't 4-5 hours. I'm already scared enough since it's someone I've never met and in a strange building. Being made to perform for hours, arggh, really worried now.



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18 Sep 2011, 5:57 pm

LadySera wrote:
Now I'm scared. I really hope that this thing I have to go to next month isn't 4-5 hours. I'm already scared enough since it's someone I've never met and in a strange building. Being made to perform for hours, arggh, really worried now.


It's not being made to perform for hours, its just wanting you to be yourself for hours. For mine he was explicitly swapping off between active tests and questioneers to make it easier on me, and asked me at multiple times if I needed to take a break and such (I did also get a lunch break).

But it at no point felt like I had to perform for hours. I just needed to be there for a few hours, doing what he wanted me to do, while he was doing what he could to make that as easy as possible on me.

Some evaluations are done over multiple sessions in order to make it easier on the person going if they have issues with being there for multiple hours.

But they do need to be able to not only determine that you have symptoms, but also that the symptoms aren't coming from other sources. I know so many people who have developed ASD traits because of social anxiety caused by bullying, that doesn't make them have an ASD, because they were developed because of something else.



LadySera
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19 Sep 2011, 4:34 am

I guess I was just feeling dramatic because that's how I will feel because of my social anxiety.