Newly Diagnosed Questions About Assessment

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I have not written in a while, I received a formal diagnosis of autism today after several years of suspecting I was autistic. I have read that folks have undergone extensive testing that took hours. My assessment was not like that. I already had taken and printed out:

- RAAD-R Autism Questionnaire
- Unofficial listing of autism trait for females highlighted with my traits
- A map or genogram showing the incidences of autism in my family
- A 4 page paper outlining the DSM 5 criteria for autism and the traits I display under each area.

The therapist did not have me complete any assessments even though she took my paperwork I brought with me at the end of the session. She opened the DSM 5 and asked me questions about the areas. I and my husband answered the questions and then she said I was autistic level 1 (need little support). Am I missing something here I believe it is an official diagnosis, but is it legitimate? Aren't I suppose to undergo hours of testing? The therapist was advanced Psychiatric Nurse Practitioner.

Also, after the session I feel confused, excited, and just off. It did not help that the therapist would tell several jokes and I did not understand them. Any insight would be appreciated

It does seem unusual but I have not been assessed yet, but from what I have been told, we have lengthy waiting lists because our assessments are pretty thorough, and they take two seperate days to assess because in theory it could all fit into a single long day but in reality they are too intense for people to keep up the mental focus if they did it all in a day from the impression I have about them.

Isn't it a psycologyst who assesses?

I am guessing here. I do not know your system of where you live. Could it be you have obvious traits so there is no doubt in the assessors mind that you are on the spectrum?

since autism diagnosis as it stands right now is based on behavior, history of behavior, and is subjective to the insights of the diagnosing professional, there is no "standard" way to test for it. It would be different if we had markers in our blood, our physical appearance, genetics, etc... but today there is no concrete, final, discernable way to diagnose autism. Instead the diagnostic manual lists autism traits and it is up to the diagnosing professional to interpret what that means and which traits the subject of diagnostic procedure may possess. There is a "triad of behaviors" that is the standard for diagnosis... Difficulties in communication, difficulties in relationships, repetetive behaviors. If we meet the criteria in those 3 instances and the diagnosing professional observes sensory sensitivities or other struggles, we might get diagnosis. Big IF... if the professional recognizes autistic behavior, if he or she does not get caught up in the idea that we have to have a record of our infancy and early childhood from others than our selves to relate, that we have to avoid eye contact, that we can converse, hold a job, have a family or relationship, etc. None of those things are stated in today's DSM as diagnostic or disqualifying for diagnosis, but a surprising number of professionals still cling to the assumptions about autism from things they learned long ago while in school. At best diagnosis is an informed guess/estimate depending on the experience, updated knowledge of autism as we know it today, and is definitely not always accurate or complete, definitely not precise or simple. Your diagnosis is valid if it meets the requirements of the government for application for support or accommodations, etc. Some countries or states require diagnosis only from doctors with specific qualifications (neurologist, psychologist, psychiatrist) to qualify for aid. Its a mess, and it is not getting better. Until we have standard specific biological tests of some sort , there will always be failures of diagnosis and subsequent troubles surrounding that. We can see science is making progress (EKG has great potential at present) but diagnosis is still primitive and unreliable and is solely based on the individual who is doing the diagnosis. Sending best wishes.

The only thing that causes me suspicion is you said it was a "therapist". My understanding was it should be a psychologist (or, I assume, a psychiatrist).

If it was a psychologist who works with Autistics and does Autism assessments, I find it quite plausible. And I suspect the psychologist was amused.

What follows is my amateur opinion:

Going in with a prepared, organized set of records would be consistent with the diagnosis.

And since DSM-5 is the diagnostic criteria and you had already documented how you lined up with the DSM-5 criteria you had already done much of the work for them. The conversation you had while there would have allowed them to gauge whether you were faking it and assess your severity level.

I don't know for sure but I suspect after you plopped your records on them and they had talked to you and your husband for a bit, what was going through their head might've been something like "Are you an Aspie? DUH!"

P.S. Without regard to the accuracy of the diagnosis: Welcome to WP!

Yes, I think you probably did so much in your preparation which would otherwise be covered in a longer session.
Also, some of the observational "Testing" was devised for children, age around 3, where observation is needed much more because generally conversational and verbal skills probably would not have reached the point for a meaningful interview type assessment.

I recall my assessor told me they were able to do the assessment (using the Cambridge AAA tool) in half the usual time owing to the copious notes I had sent before hand, to the point they were able to joke "Could spot it a mile off"

^{There is a predictable trend here}
My Psychological Evaluation noted that I provided "...copious amounts of documentation and records, to include a detailed index."

That last bit is incorrect, though. It was a detailed Table of Contents, not an Index.