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AceofPens
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25 Sep 2018, 10:55 am

Thank you to everyone for your explanations. I do understand that autism can be "invisible" in some people, and that their impairments can be mild enough so as not to make their functioning level sub-standard, in spite of the increased effort they have put in to sustain it. Or they might be affected by autism in profound ways that do not affect their ability to function in daily life because of certain strengths and naturally accommodating environments. These are examples of autism that I am familiar with, but it's not their autism that I'm questioning. My question is about the diagnosis of ASD (or its equivalent) - clinical autism.

The reason why I've been mulling over this topic is because I'm going through an autism assessment right now. The testing, as far as I've gone, has been entirely based on absolute ability. I have not been asked how hard it is for me to achieve something; I've been asked whether I can. This seemed to confirm my earlier impression that autism diagnoses were an indication of clinical impairment. I am confused as to how a person who manages to succeed in most areas of neurological function can receive a diagnosis if the diagnostic criteria demands this level of disorder.


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ASPartOfMe
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25 Sep 2018, 11:20 am

AceofPens wrote:
Thank you to everyone for your explanations. I do understand that autism can be "invisible" in some people, and that their impairments can be mild enough so as not to make their functioning level sub-standard, in spite of the increased effort they have put in to sustain it. Or they might be affected by autism in profound ways that do not affect their ability to function in daily life because of certain strengths and naturally accommodating environments. These are examples of autism that I am familiar with, but it's not their autism that I'm questioning. My question is about the diagnosis of ASD (or its equivalent) - clinical autism.

The reason why I've been mulling over this topic is because I'm going through an autism assessment right now. The testing, as far as I've gone, has been entirely based on absolute ability. I have not been asked how hard it is for me to achieve something; I've been asked whether I can. This seemed to confirm my earlier impression that autism diagnoses were an indication of clinical impairment. I am confused as to how a person who manages to succeed in most areas of neurological function can receive a diagnosis if the diagnostic criteria demands this level of disorder.


You should explain to the assessor how hard it is for you to achieve things that most people achieve with ease. If when the assessment is over you are not satisfied with the results you have every right to seek a second opinion.


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NotThatKindOfIT
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25 Sep 2018, 11:41 am

ASPartOfMe wrote:
You should explain to the assessor how hard it is for you to achieve things that most people achieve with ease. If when the assessment is over you are not satisfied with the results you have every right to seek a second opinion.


I second this, 100%. I generally don't have any trouble walking down the sidewalk. But if I sprained my ankle, I probably would. I may be in a lot of pain, and even if I hide the pain and nobody on the outside can tell, it doesn't mean my ankle isn't sprained.



rowan_nichol
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26 Sep 2018, 4:14 am

Thank you for starting this thread.

These considerations were very relevant in my own investigations as to whether and later where I was on the Autism spectrum. After the first suspicions and the strong hints in the results when I used some accepted screening tools they were some of the reasons I waited two years before making the decision to seek an assessment and the type of assessment I eventually underwent.

I did not feel disabled when I considered those suspicions during those two years. I was, after all, in work and as a result of that I was housed. I had even acquired someone who counts as a Very close friend indeed in my adult life. I had even had one or two flings, and ended up in a (not especially standard) long distance arrangement which seemed to meet a god selection of the needs and desires of all the parties.

However, I did have to note I did not follow what seemed to be a standard way off life. I did most of my stuff on my own. My best holidays were always alone and self contained in the bicycle saddle with my tent and youth hostel membership card, or with others towards a purpose such as a working party. Couldn't really enjoy going to an urban pub, loud club, no way, initiate in a social unstructured situation, big difficulty,... and all the clues kept coming to light as I did my reflection and research. Going into lots of detail, too much detail, well I can already see that tendency coming out as I type an entry into this very thread.

ASPartOfMe's brief reference to the Social Model of disability is certainly useful for my own considerations. The parts of the autistic profile which give a disposition to a very deep interest in a subject, memorising of information, focus and so forth fitted with the environment I was in during my education, and gave me the qualifications which landed me in an area of work where they helped me survive the effects of mistakes in the social, communication or executive function fields. From that being employed and thus having independence allowed me to avoid the situations which would have pressed the weak spots in that profile.

There is a lot of gratitude and remembering "There but for good fortune" in my thinking.

I did like seeing someone else who would like an expansion of the criteria to include a "Severity 0" At this point in time the System made up of me and my traits, where I work and the requirements of the job and the way my abilities fit those does not result in me being impaired in any obvious way, but the Knowledge that my profile is none the less Autistic enables me to refine that good fit further. It backs my resolve to avoid situations which press on weaknesses in the profile where there is no necessity to be involved with the situations. Where there is a good reason to go into such a situation I can make better preparations, and no longer be unduly concerned when I come away exhausted. If DSM6 and ICD12 had severity levels 0 to 3 with levels 1 to 3 being those which were the ones opening the way to statutory or insurance based financial benefits and all levels being accepted as grounds for "Reasonable Workplace Adjustments" then I would be a very happy person indeed.



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26 Sep 2018, 8:50 am

Relationships are very important to many people. The dating business is around $2 billion a year. Yet disability evaluations typically consider just your abilities to perform the activities of daily life and your ability to hold a job. Relationships are outside the scope of disability evaluations.



jimmy m
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26 Sep 2018, 9:56 am

AceofPens wrote:
My question is about the diagnosis of ASD (or its equivalent) - clinical autism. The reason why I've been mulling over this topic is because I'm going through an autism assessment right now. The testing, as far as I've gone, has been entirely based on absolute ability. I have not been asked how hard it is for me to achieve something; I've been asked whether I can. This seemed to confirm my earlier impression that autism diagnoses were an indication of clinical impairment. I am confused as to how a person who manages to succeed in most areas of neurological function can receive a diagnosis if the diagnostic criteria demands this level of disorder.


I agree with you that the subject is very confusing and I offer no solutions. I consider myself an Aspie because I share many of the traits of one with Asperger's Syndrome. But I do not consider myself autistic and I do not consider myself as disabled. I always take the attitude that I can accomplish anything that I set my mind to. And I have been doing this successfully for over 70 years.

I have a disability. It is called color blindness. There is nothing I have found yet that allows me to overcome this disability. It is an absolute. I have another disability. I am extremely nearsighted. I was essentially blind during my early years in school. I overcame this disability when after several years I was able to convince my dad that I needed glasses. So I successfully managed to overcome that disability. I believe that many of the negative traits that Aspies have can be overcome. But I also currently believe that the current approaches being used may actually be causing more harm than good.


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28 Sep 2018, 1:10 pm

AceofPens wrote:
I haven't been here in a while, but this is something that's confused me for some time and I was hoping that some members here could shed some light on the subject. Many of the people my age who are diagnosed later in life (in their twenties, for example) do not consider themselves impaired by their disorder, and indeed they are remarkably high functioning. It's quite the norm (in my experience) to meet autistic people online who have maintained good friendships and relationships throughout their lives and are thriving in college and their careers without any accommodations or support. I've felt somewhat judgmental towards this demographic because they don't appear to me to fit or require the diagnosis, but I expect it's more likely that I've simply misunderstood their situation. Currently, my understanding of autism is that a diagnosis requires one to be impaired in several specific areas of neurological function. If that understanding is flawed, as I suspect, could someone explain to me the basis of an autism diagnosis? Or, otherwise, show me where I've misinterpreted these examples.



This is something I don't understand either. How do you get diagnosed if there is no impairment? Isn't that how a diagnoses is made in the first place if there is one? That is like diagnosing someone with dyslexia just because they see words wrong but then see them correctly after looking at them again and it doesn't impact their reading or comprehension and their life. You also wouldn't diagnose someone with an anxiety disorder if their anxiety is a normal reaction to an abnormal situation nor would you diagnose someone with social anxiety if they had to always prepare speeches before giving one and making notes and thinking of what to say and feeling a little nervous which is all normal nor would you diagnose me with a panic attack disorder just because I had one that one time in the year 2015.


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28 Sep 2018, 1:16 pm

ASPartOfMe wrote:

A person might have been legitimately impaired when diagnosed but they are not now. This might be because as people mentioned above they learned how to cope/mask their autism or they could have been misdiagnosed. There is a school of thought believed by a lot of people that there has been massive overdiagnosis of Autism for a variety of reasons. I find that widespread belief more harmful than helpful because it casts a cloud of suspicion on everybody who claims they are autistic and indeed if autism is an actual real condition.




Well the doctor could say they once met the criteria for autism and no longer do so they can't give them that diagnoses. After all a diagnoses is only made if there are impairments.

A gray area would be maybe the person itself isn't impaired and it's the school and other people around them that make it an impairment for them. The only way the person can learn and function is if they have the autism diagnoses so they can be "normal." The school would be forced to teach them in their learning style way and give them the help they need and would be forced to give them the IEP so the child won't be abandoned in the system and treated as having a behavior problem and be put in a behavior class. Plus it also helps them as an adult too with employment and getting social security. You cannot change people nor force them to do things in a way you operate so you won't be impaired. So hence the diagnoses.


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28 Sep 2018, 1:31 pm

I checked out a book called Awkward: The Science of why we're socially awkward and why That's Awesome.


In the book, the person described it and it sounded a lot like autism because they have the same symptoms so I believe socially awkward people do have autism symptoms too. It also impacts their life, their childhood, their self esteem, anxiety, depression, and people can also tell they are different. But their impairments are not severe enough for them to be actual impairments despite the challenges it gives them and they also have to work harder in social situations.


I am sure these people can still get diagnosed if they go to the right doctor and it's up to the person if they want to be autistic or not if you know what I mean. :wink:

The author of that book also scored in the late 20's on the AQ test which is a borderline score for ASD and he did not believe he is autistic so therefore he makes the choice to not get assessed for it despite the struggles his social awkwardness gave him and the special interests he had and strong ones. So he found a way to work around his struggles and compensate. I know he would not diagnose everyone as autistic despite their struggles. He would just say you are just socially awkward and that is okay. You are still normal. So you would have to go see another doctor who will give you the diagnoses.


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28 Sep 2018, 1:50 pm

https://www.carautismroadmap.org/medica ... -with-asd/
Parents are often surprised to learn that a medical diagnosis of Autism Spectrum Disorder (ASD) does not automatically entitle a student to special education services under the Individuals with Disabilities Education Act (IDEA). Eligibility for special education services is based, rather, on an educational determination of a disability, which includes meeting not just the criteria for a specific disability (such as autism), but also finding that a student is in need of special services.



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29 Sep 2018, 10:14 am

MrsPeel wrote:
I'd be in that borderline autistic zone.

I can see where the OP is coming from - sometimes I feel like I shouldn't be claiming to be autistic because, for example, I'm able to maintain a full-time job. On the surface I probably don't seem to be significantly impaired.

But it feels like I'm impaired. Every day I'm having to compensate or work around my autism, and it's hard work. It's certainly affected and continues to affect my life.

It doesn't seem fair to say that one cannot be autistic on the basis of levels of impairment, since our brains are still wired up differently to NTs. Instead, I put myself in the Autism Level 0 category - I'm autistic but usually able to get by without assistance. In other words, I claim autism more as explanation of the way I think/behave, and less as a means to get assistance.

Yeah, that sounds like me. It clearly is a spectrum, and some of us are way up one end. Doesn't mean that we aren't autistic and don't have struggles though.


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