Allowing myself to raise the question: Am I on the spectrum?

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akn90
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25 Sep 2017, 4:15 am

I've looked at the DSM-5, but I feel like diagnostic criteria is often overly broad to allow for clinicians to use their professional judgement without being bogged down by overly-specific checklists.

But, one of the criteria in the DSM is: "Symptoms must be present in the early developmental period"

Honestly, I have no idea what that means, since early development period isn't defined. My initial interpretation would be before school starts, so meeting the milestones, like crawling, walking, talking, and bring potty trained on time, which I was. However, once I began school, there were some issues. On my report card in early elementary school, I got all As except I consistently got a C for conduct and could never figure out why. When conduct stopped being a letter grade, it moved to discursive comments about me having friendship problems, and these types of comments continued through middle school. In middle school and high school I couldn't anyways tell when I was being bullied, either.

So I don't know.



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25 Sep 2017, 6:55 am

akn90 wrote:
I've looked at the DSM-5, but I feel like diagnostic criteria is often overly broad to allow for clinicians to use their professional judgement without being bogged down by overly-specific checklists.

But, one of the criteria in the DSM is: "Symptoms must be present in the early developmental period"

Honestly, I have no idea what that means, since early development period isn't defined. My initial interpretation would be before school starts, so meeting the milestones, like crawling, walking, talking, and bring potty trained on time, which I was. However, once I began school, there were some issues. On my report card in early elementary school, I got all As except I consistently got a C for conduct and could never figure out why. When conduct stopped being a letter grade, it moved to discursive comments about me having friendship problems, and these types of comments continued through middle school. In middle school and high school I couldn't anyways tell when I was being bullied, either.

So I don't know.


Again this looks consistent.
Those reports from school show one of the core areas -the social stuff being present through early life .

School is he first point where the social side is really put to the test. The various traits will often only show when the demands in those areas excede one's "Intuitive" abilities to meet them. NT folk seem to be able to do this social stuff without having to think it through and wing it fine, the rest of us however don't seem able to do that stuffwithout having to think about it.



AspieUtah
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25 Sep 2017, 6:59 am

akn90 wrote:
I've looked at the DSM-5, but I feel like diagnostic criteria is often overly broad to allow for clinicians to use their professional judgement without being bogged down by overly-specific checklists.

But, one of the criteria in the DSM is: "Symptoms must be present in the early developmental period"

Honestly, I have no idea what that means, since early development period isn't defined. My initial interpretation would be before school starts, so meeting the milestones, like crawling, walking, talking, and bring potty trained on time, which I was. However, once I began school, there were some issues. On my report card in early elementary school, I got all As except I consistently got a C for conduct and could never figure out why. When conduct stopped being a letter grade, it moved to discursive comments about me having friendship problems, and these types of comments continued through middle school. In middle school and high school I couldn't anyways tell when I was being bullied, either.

So I don't know.

"Early development" means childhood, say from age two to 12 years. When I was aged two to five years, I used different names (neologisms) for my family members and for things like cars and water. From age five years, I have dominated conversations (data dumping). These are some examples of early developmental symptoms. Your C grades for conduct could be a signal that you experienced some social-responsiveness impairments (shyness, frequent hostility toward others, failure to share, meltdowns and such).


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akn90
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25 Sep 2017, 9:36 am

This is the thing that's confusing.

For instance, I mentioned that I like idiomatic expressions, but when I go back and remember my childhood, I remember my parents telling me I sounded like my grandparents when I used idiomatic expressions (my grandparents were not native English speakers and so they mixed up expressions all the time). But people also tease and exaggerate things, so I have no idea how much stock to put into what people say.

But at the same time, I feel like there are plenty of people who have behavioral issues when they're younger who aren't autistic, and English idioms are so rooted in historical realities that no longer apply that I'd think anyone would mix expressions up when they're younger.

I function well most of the time. Are there benefits to digging deeper into this?



akn90
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25 Sep 2017, 9:42 am

A more recent example, though, was an internship I had. I personally hate daily showering and deodorant, not because I don't care about personal hygiene, but because I hate the way deodorant feels and I don't like how daily showering dries out my skin. Apparently, people were throwing hints left and right that my odor was an issue, but someone had to take me aside and tell me to take a shower, wear deodorant, and to do it every day. But after that, things were fine, and they wanted to fire me the next summer.



AspieUtah
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25 Sep 2017, 9:51 am

akn90 wrote:
This is the thing that's confusing.

For instance, I mentioned that I like idiomatic expressions, but when I go back and remember my childhood, I remember my parents telling me I sounded like my grandparents when I used idiomatic expressions (my grandparents were not native English speakers and so they mixed up expressions all the time). But people also tease and exaggerate things, so I have no idea how much stock to put into what people say.

But at the same time, I feel like there are plenty of people who have behavioral issues when they're younger who aren't autistic, and English idioms are so rooted in historical realities that no longer apply that I'd think anyone would mix expressions up when they're younger.

I function well most of the time. Are there benefits to digging deeper into this?

What you describe is called Theory of Mind (ToM) where what someone says to you makes little sense without further definition. This makes understanding social and cultural expressions difficult. ToM is a significant impairment for many autists.

If you need (or might need) governmental, educational and professional assistance in your life now or in the future, having a diagnosis for autism can be helpful. A diagnosis can qualify an autist for financial assistance, tutoring and protection in the workplace, among many other benefits. But, if the benefits won't really help you, maybe you can be self-identified as autistic (you learn enough to confirm your identity without the help of diagnosticians) and live your life with that knowledge. There are many people who are satisfied with just their self identification of autism.

Yes, hygiene can be a problem when sensory sensitivities pop up. But, there are ways to mitigate the problems without having to endure the sensitivities.


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Diagnosed in 2015 with ASD Level 1 by the University of Utah Health Care Autism Spectrum Disorder Clinic using the ADOS-2 Module 4 assessment instrument [11/30] -- Screened in 2014 with ASD by using the University of Cambridge Autism Research Centre AQ (Adult) [43/50]; EQ-60 for adults [11/80]; FQ [43/135]; SQ (Adult) [130/150] self-reported screening inventories -- Assessed since 1978 with an estimated IQ [≈145] by several clinicians -- Contact on WrongPlanet.net by private message (PM)


akn90
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25 Sep 2017, 10:17 am

I guess I have two concerns with any kind of diagnosis.

For a formal diagnosis, the worry is that I will have to invest a significant amount of time (i.e., researching local neuropsychologists, calling to make an appointment and dealing with certain psychologists only seeing children and adolescents, going through a long, intense and drawn out testing process, waiting for results) when it's entirely possible that this is all in my head and I'm just seeing what I want to see.

For self-diagnosis, I took the three tests recommended and my scores were more associated with ASD than NT, but at the same time, I'm not the most objective evaluator of myself, and subconscious biases can skew my responses.

I was reading another thread about someone who says she misstated something during her testing and no longer thinks she is on the autistic end of the spectrum, and several people said that sometimes, when people know what's wrong and they see something that they think might explain it, they'll unintentionally interpret things in a different light and see things that aren't there. I'm worried that's me.



akn90
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25 Sep 2017, 10:27 am

AspieUtah wrote:
A diagnosis can qualify an autist for financial assistance, tutoring and protection in the workplace, among many other benefits.
I wonder about how this plays out in reality.

I was out drinking with a professor-collaborator a few months ago, and I've always thought of him being mildly autistic, since he's so asocial and unable to have a conversation that's not work related when he's sober, but he animates right up when he's drunk. Well, this past time we went out drinking, I remember him making a comment about some other professor being terrible to work with, someone I shouldn't work for, etc because that professor is autistic. I was thinking in my mind that he's one to talk, but I didn't say anything, obviously.

The thing about academia is that you have all sorts of policies and half-hearted commitments to diversity and accommodations, but the truth is that when a professor is bringing in more grant money than anyone else in his department, he gets to do whatever he wants. So I think even if I were to get a formal diagnosis, I'd have to keep it to myself or risk losing collaborators.



akn90
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25 Sep 2017, 10:36 am

On the other hand, my therapist (who I never told about my suspicions since I didn't want to go into that rabbit hole and I have more immediate issues that I need to deal with right now, namely grief) but she has told me repeatedly that she feels the spirit of Oliver Sacks in me when it comes to my social issues and how I prioritize work, and really wants me to read one of his biographies that she lent me, which I haven't gotten around to doing because the thought of opening a book and reading it start to finish is too daunting for me. Interestingly, he did a lot of work with autistic people, but he was not autistic himself. The fact that he was not autistic leads me to believe that maybe my social issues are something else.

Sorry for three posts in a row, just a lot on my mind.



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25 Sep 2017, 10:52 am

What you wrote is all true. Your concern about a misdiagnosis is fair, but most diagnostic tests are quite standardized today relying on more than more test to determine autistic deficits. The thing to remember with autism testing is to choose the answers which describe what you "do" as opposed to what you believe should be done.

The benefits I described which are provided to autists with diagnoses are largely included in law. While your average educational administrator might try to trim from what the law requires, they would gain nothing by doing so. Interoffice reviews would quickly spot some game-playing if it occurred.

Your therapist might be onto something. Most therapists don't go looking for diagnoses. They respond to what they see and hear (and sometimes test). Have you shared your self-reported screening test results with your therapist? They might be convincing enough for you to be referred to a diagnostician.


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Diagnosed in 2015 with ASD Level 1 by the University of Utah Health Care Autism Spectrum Disorder Clinic using the ADOS-2 Module 4 assessment instrument [11/30] -- Screened in 2014 with ASD by using the University of Cambridge Autism Research Centre AQ (Adult) [43/50]; EQ-60 for adults [11/80]; FQ [43/135]; SQ (Adult) [130/150] self-reported screening inventories -- Assessed since 1978 with an estimated IQ [≈145] by several clinicians -- Contact on WrongPlanet.net by private message (PM)


akn90
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25 Sep 2017, 11:02 am

AspieUtah wrote:
Your therapist might be onto something. Most therapists don't go looking for diagnoses. They respond to what they see and hear (and sometimes test).
What do you mean by this?



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25 Sep 2017, 11:18 am

akn90 wrote:
AspieUtah wrote:
Your therapist might be onto something. Most therapists don't go looking for diagnoses. They respond to what they see and hear (and sometimes test).
What do you mean by this?

Most therapists use spoken conversation to achieve their goals. While spoken conversation is a large part of the autism diagnostic toolbox, it would fail the portions of most autism diagnostic testing where observation of behaviors and characteristics (provoked or otherwise) is required. Moreover, counselors and therapists aren't generally certified or licensed to practice diagnostic testing, though they are great in personalized advice, and usually have more knowledge than they are credited with having. But, they often are limited to their advice and referring clients to psychologists or psychiatrists.


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Diagnosed in 2015 with ASD Level 1 by the University of Utah Health Care Autism Spectrum Disorder Clinic using the ADOS-2 Module 4 assessment instrument [11/30] -- Screened in 2014 with ASD by using the University of Cambridge Autism Research Centre AQ (Adult) [43/50]; EQ-60 for adults [11/80]; FQ [43/135]; SQ (Adult) [130/150] self-reported screening inventories -- Assessed since 1978 with an estimated IQ [≈145] by several clinicians -- Contact on WrongPlanet.net by private message (PM)


soloha
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25 Sep 2017, 12:05 pm

akn90 wrote:
A more recent example, though, was an internship I had. I personally hate daily showering and deodorant, not because I don't care about personal hygiene, but because I hate the way deodorant feels and I don't like how daily showering dries out my skin. Apparently, people were throwing hints left and right that my odor was an issue, but someone had to take me aside and tell me to take a shower, wear deodorant, and to do it every day. But after that, things were fine, and they wanted to fire me the next summer.

Try a salt block for deodorant. That's what I use. Kills the smell and isn't itchy or slimy. I also will sometimes only lather my pits and privates not soap my body. I don't wash my hair everyday though I do scrub my head in hot water. That helps me with dryness



akn90
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25 Sep 2017, 1:54 pm

Ok, so a few more things:

I'm struggling to figure out how to bring it up with my therapist. And once I bring it up, where do we go from there? A big, big, big part of me thinks she'll dismiss it right away.

I think there are two things at play right now:

1. I grew up in a dysfunctional family where my brother was the focus, so family therapy or meeting with other mental health professionals has always been part of my life. I remember on multiple occasions being told in different ways that my feelings were invalid ("I don't think you're feeling X, I think what you're trying to say is that you're feeling Y!") so I don't really trust mental health professionals when it comes to talking about feelings rather than behaviors and actions. My therapist has realized that we hit a wall when we talk about emotions or try to pinpoint emotions (she has workbooks with specific emotions, how to identify them, and how to cope with them) and instead we focus more on behaviors.

2. I hate testing. I hate testing. I hate testing. I've had two occasions where I've sought mental health services from my university, and I had to take a computer triage test, and then I got interrogated by some "doctoral intern" who made me feel bad about the answers I chose until I told her I answered wrong or I accidentally checked the wrong box, or read the question wrong, and then she'd move onto the next question. It's so incredibly dehumanizing.

My idea is that I could e-mail my therapist before the session, and show her the results. I look the tests for the first time very shortly after a longtime childhood friend died, and so I'm thinking I'll take the tests again to make sure my answers weren't tainted by my grief and my feelings at that point in time. But does this also mean that if I become more familiar with the questions they ask that could be problematic?

Sorry for all the posts. I know the simple answer is to just tell the damn therapist that I'm wondering if I have an ASD, but things are never that easy.



Last edited by akn90 on 25 Sep 2017, 2:32 pm, edited 1 time in total.

akn90
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25 Sep 2017, 2:13 pm

And one other thing (lol)... hand flapping.

So I made my first public presentation about a year ago, and I remember when I was practicing in front of class, the prof let me know afterwards that my hands were distracting, and he did a little impression of it which looked very much like stereotypical autistic hand flapping. I didn't realize I was moving my hands, and he told me to hold onto the podium when I'm speaking, which I've tried to do from then on. More recently at a mock interview event, the first mock interviewer said something similar, and for the rest of the interviews, I kept my hands on the table and was very aware of my hand movements.

Similarly, in a previous job, when I'd get excited when I spoke, I'd apparently do the same thing, because whenever my hand gestures got out of control, coworkers would start moving their hands exaggeratedly as a joke. I chalked it up to my cultural heritage where we "talk with our hands" and that the people I worked with just didn't have much experience with people from a different ethnicity.

But this again brings up the question: If it's really autistic hand flapping and not cultural hand gestures, if they're that distracting, and if it's really that stereotypical, then how has it gone unnoticed by people who actually know things about autism? This is the part that I'm not understanding, it's the part that makes me think I'm not autistic at all, the part that makes me think I'll embarrass myself to even bring it up with my shrink.



akn90
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25 Sep 2017, 7:17 pm

Ok, so I took the tests again, taking the questions completely literally. For example, when the question asks if people often comment on something, do they actually comment on it or do I think they're commenting on it amongst themselves? I would only put agree if people actually do make the comments to me often, and not just once or twice.

Scores didn't change.