Differences in diagnostic procedures

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I have gone through two diagnostic procedures done by different people in two different places.
he first procedure I went through was kind of sloppy and weird. An important aspect of the diagnosing someone with aspergers is the fact that experts need to know quite a lot about your childhood. The way that this is done is by having a lenghty conversation with your parents (in my case my mother) in which the experts asks an enormous amount of questions. The first place I had to go to didn't do that at all, which is strange because it is an important aspect of the diagnosistic procedure. After thissloppy and incomplete diagnostic process I was told that I had some asperger traits but not enough to diagnose me with aspergers syndrome. I was immensely relieved about that because I didn't want to get labeled so to speak.

However, after a couple of years I had to see a therapist because of something completely differnt, a depression. She advised me to get tested for aspergers again because she had the feeling that I did have aspergers and that the outcome of the first diagnostic procedure was wrong. I was send to a different set of aspects this time, which meant that I had to go a different place alltogether. I was very reluctant to do this because but had no other choice other than to go along with it. The second diagnostic procedure was much more thorough than the first one. One of the things they did was pay a visit to my mum to gain an enormous amount of information, dating back to the time I was born. Anyway, after a lengthy and draining procedure they came to the conclusion that I did have pretty severe aspergers. I specifically asked them if they had any doubts and they told me they did had no doubts whatsoever. It took me a while before I came to the conclusion that the second set of experts was right and that I had to come to terms with the fact I have aspergers.

The morale of this story is that there are significant differences in diagnostic procedures and the knowledge and cababilities of different experts. I think that a clear set of standards has to be set regarding the diagnostic process and that the whole procedure should be limited to institutions that are specifially specialised on autism alone. There are too many people who think they have the knowledge to diagnose kids and adults with autism but the reality is that many of these so called experts are doing a bad job. After gaining a lot more knowledge about asperges in general and the way that it should be diagnosed I came to the conclusion that the first place I had to go to get diagnosed sucked in many, I repeat, many different ways.

I am currently playing "phone tag" with another psychologist that my first psychiatrist recommended for seeking a diagnosis. I can't find any solid info online but it seems that autism or aspergers is not even her specialty. So idk...I am basically taking shots in the dark with these doctors and am afraid of receiving stressful and unproductive testing like what you experienced that will leave me back at square 1 but down a bunch of money.

I was just thinking about making a post about this yesterday.

Compared to the diagnostic process other people have described, my evaluation was very incomplete and seemed better suited to children than to an adult. There was a person on here who posted about being diagnosed after filling out some questionnaires and giving an interview with a spouse...not even taking any real tests.

People are clearly giving out sketchy evaluations. The evaluation process needs to be more standardized: a list of certain tests that must be conducted in every evaluation, along with a list of optional tests for people who are difficult to diagnose or want specific information for educational purposes or something like that.

Tests alone are not nearly enough for obtaining a good diagnosis. Talks with your parents and observation by experts as well as lists with detailed and specific questions are much more important.

When I went trough that first ridicuolous diagnostic procedure I mentioned earlier the whole diagnostic process consisted out of weird tests and that was about it. I wasn't interested in those tests at the time. I was in the middle of moving house, I was depressed and I even managed to smoke some pot beforehand and during breaks ( I just stepped outside for a couple of minutes). I messed up almost every test that was given to me. The girl who was responsible for the whole thing was so inexperienced that she didn't have a clue about what was going on with me and I sure as hell wasn't going to tell her. The fact that I was mortified of being diagnosed with autism at the time didn't help either because that didn't improve my honesty when it came to answering certain questions. I am almost incapable of lying in daily life but I made some serious attempts during my first diagnostic procedure.

The tests I had to do where downright silly by the way. I can't for the life of me understand how so called professionals can diagnose someone with autism based on these superficial tests alone. It's a downright shame! When the outcome of that first procedure was negative for aspergers I had mixed feelings. I was relieved but in the back of my mind I knew that it was a load of crap and that I probably had to get tested again some time in the future.

The second diagnostic procedure was definitely better and much more professional. The fact that I wasn't depressed and anxious anymore and didn't smoke pot before, after and (even) during the whole testing procedure contributed to a better diagnosis as well as the fact that I was completely honest and much more clear headed than during that first diagnostic process. Last but not least, I had faith in the professionality of the people who diagnosed the second time, for all the right reasons.

In hindsight I am at ease with being diagnosed with aspergers during the second process. It was difficult to accept the diagnosis but it gave me a lot of piece as well.

Although essment procedure was quite fast and not done by specialists, however I don't think it was sloppy. It included tests, questionnaires, interviews with the psychologist and getting data from my family. I could complete the questionnaires between sessions and mail them to the psychologist. About the input from family, since my parents don't live in the UK and don't speak English very well, the psychologist wrote down some questions (there were 17 of them), I translated them, my parents gave (quite detailed and in-depth) answers, and I translated them back. I only spent maybe 4-5h in total with the psychologist but it was time spent discussing in depth some answers to the questions, or my symptoms, not filling forms.

The psychologist had no bias or preconception about what aspergers should or should not look like, and I found all of what she said intelligent and to the point. Also she was very honest and told me several times that she was not a specialist, and she was quite confident she could diagnose me but if she had any serious doubt she would send me to an expert.

As a result, although I probably not have been as exhaustive an assessment as some of you, I have the feeling that my assessor was competent, honest, lucid on her own abilities, and I really can't think of her as having done a sloppy job.

The lack of standards has always bothered me.

My own diagnosis was mostly based upon a bunch of neuropsychological tests conducted divided into 3 x 2 hour sessions (see below).

I recently was speaking with another Psychologist (because I was thinking of starting some term therapy to see if there were things I could do to better deal with life). I mentioned to the Psychologist that I was interested in getting a “second opinion” (on the Aspergers diagnosis). She basically said there were two methods used – one objective (based upon neuropsychological testing) and the other subjective (based upon in depth discussion of events in my life, starting with early childhood).

I am always surprised when people say they get a diagnosis within a 1 or 2 hour session. Then again, I’ve heard Tony Attwood say that he can speak with someone for < 15 minutes and determine if they are on the spectrum.

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My neurological testing included the following:

--- Wechsler Adult Intelligence Scale (WAIS-IV)
--- Integrated Visual and Auditory Continuous Performance Test (IVA+Plus)
--- Brown ADD Scales
--- Wisconsin Card Sorting Test (WCST-R)
--- Behavior Rating Inventory of Executive Function (BRiEF-A)
--- Wechsler Memory Scale (WMS-IV)
--- Vineland-II Adaptive Behavior Scales
--- Advanced Clinical Solutions (ACS)
--- Adult Asperger Assessment (AAA)
--- Social Responsiveness Scale (SRS-2)
--- Millon Clinical Multiaxial Inventory (MCMI-III)
--- Multidimensional Anxiety Questionnaire (MAQ)
--- Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
--- Rorschach Psychodiagnostic Test

Some of the above tests were done with the Psychologist (WAIS-IV, WCST-R, WMCS-IV, Rorschach). Some of the above tests were simply questionnaires that I completed at home. My wife also completed several questionnaires at home (SRS-2, BRiEF-A, Brown ADD Scale).

It also included a short interview which was mostly focused around an intake questionnaire that included basic questions about Gross Motor capabilities (when did I first crawl, walk alone, run), Fine Motor capabilities (when I could feed myself with a spoon, write letters, tie shoes), Language capabilities (when did I first use single words, sentences), Social/Adaptive capabilities (when was I potty trained during day/night). It also asked me to describe my temperament, sleeping patterns, eating patterns when I was an infant and any problems with early child development. It also asked me to document various milestones with each grade in school (e.g. performance, best subjects, salient comments from teachers/parents, key events). Finally, it asked about mental health issues in the family (on my mom and dad’s side). We discussed my responses to the questionnaire during one of those aforementioned sessions.

Note: My diagnosis included additional tests (not typically used for an Asperger-only diagnosis), because I asked to be assessed for other stuff (including Social Anxiety, Generalized Anxiety, Avoidant Personality, Obsessive Compulsive Personality Disorder, Schizoid, etc.).

The first testing procedure took place in my home town and that was a sloppy, unprofessional and superficial assessment. I had to go to another town the second time to be tested by a whole new set of people. I was much more contented with their professionality than with the therapists in the town I live in. The point I am trying to make is that not every therapist and institute is capable of diagnosing people with asperger and other forms of autism.

Eventhough I feared being diagnosed with aspergers, which happened when I was assessed for a second time, it all worked out for me. I accept my diagnosis now and in the end it's all for the best. Sometimes it may be worthwhile to get a second opinion.

There are a lot of non asperger specialists that think it does not exist, it does not exist in adults or females or that it is highly over diagnosed. These people it seems are looking for reasons not to diagnose people. When they say you have some traits 1. They may truly believe that 2. As a indirect way of saying you are as lazy, or are making excuses for bad behavior. This is bullying really.

Unfortunately it seems most posters here have had to go through one to several psychs who are ignorant or bullies before getting the correct diagnosis. Instead of doing there jobs in helping people they are causing a lot of people mental damage.