Assessment - My Story (AUG. 2023)

Post Reply New Topic

Just bullet points and place holder for me (here for anyone else to peruse):

As far as I can tell, no one here has ever listed what their testing involved. They simply say, "I took a series of tests," without ever really elaborating. I'm elaborating for myself and anyone else who might find some value in this.

PART 1 (8-11-23):
3 hours

Something called WAIS-IV was the test booklet used by the neuropsychologist lady.

1) PHYSICAL - Block test, 6 blocks, then 9. There was this booklet with a pattern and I had to arrange the blocks to match the pattern. Blocks were six sided - some sides solid white, some solid red, some half/half diagonally. I think they're called Wechsler Blocks based on Internet research: http://finitegeometry.org/sc/gen/bdes/

2) ORALLY - Two words, describe how the two are alike. Some of these words were flat-out opposites, like enemy and friend, but I argued both pertain to how we classify and perceive others. The oddest one was music and tides (like ocean tides).

3) ORALLY - She gave me a set of numbers and told me to repeat them. At first, there were only two or three digits, then it got upwards of seven digits.

4) ORALLY - Same thing, only in reverse. She gave me some numbers and I had to repeat them in reverse order. (Hardest part was not knowing when it would jump from six to seven digits to memorize.)

5) ORALLY - Similar to #4, random set of numbers, but this time I had to repeat them back sequentially. If a number was repeated, I'd also have to repeat it. So, 4-2-9-7-2-6-9 would have to be repeated back sequentially with repeats as 2-2-4-6-7-9-9.

6) ON PAPER in BOOKLET - There were these 2-D pattern tests in the booklet. A sequence of symbols (like a blue square with smaller yellow triangles inside, or a green triangle with red dots inside, etc.) I had to choose from a series of 6 possible options what I thought the next symbol would be.

7) ORALLY and ON PAPER in BOOKLET - Vocabulary. Relatively simple, though some words reminded me of my SAT prep course in high school. There was a list of words in the book, she'd point to a word and ask me to define it. The only word I couldn't define was palliate. Apparently, like palliative care, it means to aid someone who is suffering from an illness, without being able to cure actual illness (according to the Internet). Afterward, I told her that I knew I got that one wrong, could she simply tell me what it meant. She said, "to ease the suffering." She then admitted she herself doesn't use it in her everyday life.

8 ) ORALLY - A series of mathematical word problems. Like: If it takes 8 machines 6 days to complete a job, how many machines would you need to complete the job in half a day?

9) ON PAPER worksheet - Symbol test on paper: each line had a box with two symbols, then a whole row of various symbols. With a pen, she said to put a line through any symbol on the line that matched either of the two in the box for that line. If none of the symbols from the box were on the line, the last option was NO. I actually wasted time because I thought BOTH symbols might be present. She clarified, "It's either one or none." (2 minutes). I didn't complete it, but she said no one ever does.

10) ON PAPER in BOOKLET - Visual puzzles. 2-D on paper (like point #6) There would be an image of an object. Sometimes a solid color, sometimes pied. I'd have to chose three of six smaller pieces that could be put together to create the main image. The six "pieces" (all on paper, 2-D at the bottom of the page) had a corresponding number. I had to give the three numbers of the pieces I thought could be put together to make the image at the top of the page.

11) ORALLY - Schoolboy questions: Much like the classic board game Go to the Head of the Class, it was just random basic trivia: What is water made of? Who wrote Hamlet? On what continent is Brazil? Who was president of the US during the Civil War?, etc. I was confident with pretty much all of them, but there were at least two I blew for sure: How many minutes does it take for sunlight to reach the Earth? and What is the circumference of the Earth at the equator? I joked: This is like the gameshow Are You Smarter than a Third-Grader?

12) ON PAPER worksheet - Similar to point #9, There was a key with set of number, 1-9 I believe. Below each number was a symbol. For example, box 7 may have had a symbol like: ╤. The rest of the worksheet was a series of numbers with an empty box beneath. I had to look at the key and draw the symbol of the corresponding number in the box. Though it seemed relatively simple, there were times I was tempted to go sequentially. Like, I drew the symbol corresponding to number 6, then wanted to go on and draw the symbol for number 7 in the next box, even though the next box actually wanted the symbol for box 3. (2 minutes). I didn't complete it, but she said no one ever does.

- At this point, over an hour in, I took a quick hit of vape. She wasn't upset, but said it was unusual to have people vape in the office. I told her I was anxious and nervous and it was a soothing mechanism. She said she figured as much and asked if I used to smoke cigarettes; I said, "Yes, I replaced cigarettes with vape about 8 years ago." She was surprised that vape has been around that long. But then she asked what I was vaping, and I clarified NICOTINE. That's a relatively new question, as marijuana vape has only been available in New Jersey for a year or so. I told her I don't touch marijuana, as I don't think it works with my brain chemistry. She also noted I was chewing on my pen, something I hadn't noticed/though about.

- She then gave me a packet of questionnaires to fill out at home. Behavioral and emotional functioning, sensory profile. Executive functioning inventory, psychiatric screener, social skills inventory. OCD inventory. A lot of these things regard how true something is (not at all, somewhat, mostly, totally) within a timeframe (like the past 2 weeks or past 6 months).

- I clarified "chicken/egg." If I'm anxious, am I just anxious? Or is my anxiety due to being neurodivergent in the first place? One doesn't preclude the other. Poor communication with NTs due to neurodivergence can then lead to hostile conflicts with people, which then creates anxiety and PTSD atop pre-existing Autism.

She told me, "You over-think things," and I responded, "Isn't that typical with Asperger's/Autism?"

She seemed genuinely interested in my list of generalized bullet points that I made regarding things that pertain to me regarding symptoms of Asperger's: viewtopic.php?f=3&t=415200

I asked if she wanted anything from my mother regarding my childhood (as I've heard others who have had these tests were required to do the same). She was very honest with me, AND I AGREE WITH HER - she said she's "supposed to" get information from parents, but in her experience, parents are often oblivious to neurodiversity in their children, or simply don't remember as time goes on, so she finds it unreliable. Her exact words: "Rarely are they [parents] ever helpful."

When I mentioned Theory of Mind problems, she noted she had a test for that, but it only goes up to age 16...

She also said I "talk fast." She then went on to say she doesn't like to do multiple diagnoses. I protested, "I want to know what I have. If I have ADHD and Autism or OCD but not NVLD, etc., I'd like to know exactly what's going on. One diagnosis doesn't necessarily preclude another. I want to know what I have."

- After all this, I had to fill out a "personality inventory." I did this on my own, but the test couldn't leave the office. PERSONALITY ASSESSMENT INVENTORY by PAR. It was 344 questions in a booklet and I filled in bubbles on a form in degreed true-false fashion: FALSE / SLIGHTLY TRUE / MAINLY TRUE / VERY TRUE. It took me over an hour to get through it, and most of the questions were general things. Similar to Internet tests, just very, very long. I was really tired of it by the end. Questions were along the lines of: Since the day I was born, I was destined to be unhappy. Sometimes, I'm very violent. I've forgotten what it feels like to be happy. Every 10-to-15 questions seemed to pertain to suicide. There were also a lot of drug questions, like, My best friends are the people I do drugs with.

NOTE: The neuropsychologist did explain that age factors into the equation. How quickly I completed a task may or may not be related to be age (40 years old).

I have to go back in a week for PART II. Originally, this was supposed to be a 2-part assessment, but she seemed to realize it may require a third session, regarding how long these various tests take. I wonder if she hasn't assessed an adult in a long time, if ever.

Those sound familiar to what I did. I remember one where I had to name kinds of furniture in sixty seconds. I totally blanked other than table and chairs or sofas because I didn't know what counted as furniture. Is a bed furniture or just a bed? Is a lamp furniture or a lamp? If I wanted a lamp I wouldn't go to a furniture store, or would I? Is a TV furniture? I don't think so.

There was one where I had to draw a connect-the-dots of some sort. I think it might have been a page with numbers and letters and I had to connect just the numbers or letters in order and ignore the others. Something like that. Maybe it was connecting every second letter / number?

There was Reading The Mind in the Eyes with those pictures of eyes and multiple choice emotions of how they felt.

Lots of spatial tests with rotating shapes on paper or with blocks.

Oh, an oral test where I had to name a fruit and then a _______ (sorry I can't remember but something weirdly random, not vegetable) back and forth and it was timed for a minute. I think it might have been boys' names. There was also something where I had to say words that all started with the same letter of the alphabet. I think it was F. Again I was timed.


My whole testing was close to 12 hours on one marathon day. I don't know if you've done it all yet but I remember at the end she was asking me what my goals were in life and I said I didn't have any. That didn't mean I was pessimistic or depressed, it meant that I don't think in terms of goals. I said it might be nice to have grandchildren but that's not a goal I can actively pursue because it's not up to me, and besides I'd be fine if my kids don't have kids. I'm likely too far into burnout for grandkids anyway.


Here's my list:

Nope, they didn't do ADOS with me, I only had an interview kind of thing (ADI-R?) and then a questionnaire (something like RAADS-R?) (just 2 sessions of about an hour and a half each).

I had the impression they were more designed for Aspergers diagnosis than classic autism. The questionnaire had me coming out "severe" (presumably for Aspergers) but I'm pretty sure I'd be "mild" for autism in general, I should be Level 1.

But when the same place diagnosed my 16-year-old son they made him do all kinds of IQ-type tests, and it took several sessions.

So possibly they took a short-cut with me (as I think the tester had realised I was on the spectrum from first meeting). That probably wouldn't be allowed nowadays, as there's now a standard method for autism diagnosis in Australia, I believe.

Took these tests gradually at home

Adult Asperger Assessment (AAA)
Behavior Rating Inventory of Executive Function (BRIEF-A)
Social Responsiveness Scale, Second Edition (SRS-2)

The actual in person interview was only an hour. Unlike most today prior to the interview I did not do extensive research or come to the interview with a list because I feared biasing the assessment. She asked about why I did and did not do certain things in my life and how I felt about them. I had trouble answering the questions which I now understand is a major indicator of Autism. At the end of the interview the clinician with 30 years experience including adults said “I have no trouble diagnosing you with Aspergers”. She briefly explained what we now call masking. In 12 days it will be the 10th anniversary of me getting diagnosed. Even though from what I read today’s assessments are much more thorough I had and have no doubt the diagnosis is correct.

Some TESTS to take at home and return:

1) PDSQ test booklet by WPS
2) SRS-2 AutoScore form by WPS
3) Obsessive-Compulsive Inventory by Clark-Beck
4) BRIEF-A, and anacronym for (Behavior Rating Inventory of Executive Function) by PAR
5) Sensory Profile Self-Questionaire by Pearson/PsychCorp

1) PDSQ test booklet by WPS: questions like, "During the past 2 weeks, did you feel sad or depressed?" and "Did you keep your guard up because of witnessing a traumatic event?" and "During the past 6 months, did you feel that you were drinking too much," or "did you worry too much about saying or doing something to embarrass yourself?"

There were 111 questions, and it was very similar to the PAR (Personality Assessment Inventory) 344-question test that I took in the office.

2) SRS-2 AutoScore form by WPS: A fill-in-the-circle test (like the California Achievement Test in school). The bubbles were numbered 1 through 4. Fill in the the bubble that corresponds to the question in degrees

(1 = NOT TRUE 2= SOMETIMES TRUE 3 = OFTEN TRUE 4 = ALMOST ALWAYS TRUE)

65 questions along the lines of "I avoid eye contact or am told I have usual eye contact, I avoid starting social interactions with others, I have repetitive behaviors that others consider odd." For each question, choose a number from 1-4 with how much I feel it applies to me and fill in the bubble for corresponding number.

3) Obsessive-Compulsive Inventory by Clark-Beck: Similar style to test #2 with degrees of 0-3, though instead of filling in bubbles that applied to the statement, each question had a statement (numbered 0 through 3) that repeated 4 times but with a different lead:

The 0 statements began with "I never or rarely," the 1 statements began with "I occasionally," the 2 statements began with "I frequently," and the 3 statements began with "I very frequently..." and the same statement per question.

Questions pertained to things like, "Follow rigid routines," or feeling compelled to count, or avoiding certain places or people, or the level of feeling distressed over not being able to carry out mental compulsions. There were 25 questions.

4) BRIEF-A, and anacronym for (Behavior Rating Inventory of Executive Function), Adult Version, Self-Report by PAR: 75 questions, circle the letter next to each question that pertains to how true the statement is.

(N = Never S = Sometimes O = Often)

Examples:
I have trouble getting ready for the day
I say things without thinking
I have trouble doing more than one thing at a time
I get overwhelmed by large tasks

5) Sensory Profile Self-Questionaire by Pearson/PsychCorp:

It asked me to write a statement regarding any aspects of daily life that are not satisfying to me. I wrote: Interpersonal problems, Underemployment, Failure to reach 'adult milestones,' Depression/Anxiety as a result of bad experiences with people.

The rest of the test was kind of interesting. I want to explain this for my own edification:

There were a total of 60 questions/statements, and each statement had a box for me to mark based on the degree of how much I felt it applied: Almost Never - Seldom - Occasionally - Frequently - Almost Always.

But the questions were grouped into different boxed categories of "chunks", of about 8-10 questions. These categories were labeled A-F and included: Taste/Smell Processing, Movement Processing, Visual Processing, Touch Processing, Activity Level, Auditory Processing. So, for instance, the first 8 questions were in chunk 1 (Taste/Smell Processing). The 9th question began the next chunk regarding Movement Processing.

But things get more unique. Each numbered question also had a symbol next to the number. There were 4 different symbols kind of like this: -- | @ ~

So, for instance...
Chunk D - Touch Processing. Question 34 @ : I don't like particular food textures
Chunk C - Visual Processing. Question 10 ~ : I like to wear colorful clothing

For each, I'd select from the five degrees from almost never to almost always.

What I'm trying to say is that questions were separated into chunks (A-F). But regardless of what chunk I was filling in, the different questions in all 6 chunks had one of these four corresponding symbols next to the number. It seemed random question per question which symbol there would be next to the number.

Afterward, there was a scoring page. It had four columns, one for each symbol. It then had all the numbers for any and all questions that had had that particular symbol (so, question 34@ was scored under the @ column, question 10~ was scored under the ~ column.) Next to each question number, I had to score my response from 1-5. If I had selected almost never for the answer, I put a 1. If I selected almost always, I put a 5, etc.

Then, I had to add up the four columns -- ~ | @. Each column, and the symbols they represented, corresponded to a different category: -- Low Registration, ~ Sensation Seeking, @ Sensory Sensitivity, | Sensation Avoiding. Questions pertaining to these four different columns could be found in all of the various chunks when I was taking the test. So, it's like a question could be dually categorized based upon what chunk it was in (letters A-F) when taking the test, and then what symbol it had next to it (tabulation columns 1-4) when scoring the test.

Neuropsych won't give me the results until the whole testing process is complete.

PART 2 (8-18-23):
2 hours

I gave her a list of all the qualities and traits of mine that made me suspect Autism. She read it and said it seems like the classic symptoms of Asperger's.

I'm 40, the neurospychologist is 50. I asked her if she had ever heard of Asperger's or Autism when she was growing up. Like me, she said she'd never heard of Asperger's. She learned of it in grad school, I learned of it on the Internet in my 20s. She'd heard of Autism as a kid, but, like most back then, thought Autism = Rain Man = Classic Autism. I explained I was the last generation to miss any sort of childhood testing. If I was born 10 years later, I very may well have been diagnosed as a child, but in my youth, Asperger's was unknown to the masses.

I said school is focused mainly on academics. If you do well on paper, you're seen as "normal," but they don't/didn't test the social aspects of things.

Then some more testing - -

1a) ON PAPER in BOOKLET - Trail Making - A bunch of circles with various numbers/letters in each circle. Find all the circles with number 3 and put a line through them. Single page in booklet. It was timed.

1a) ON PAPER in BOOKLET - Trail Making - A bunch of circles with various numbers/letters in each circle. Find all the circles with number 3 and put a line through them. This time it was on TWO pages of the booklet. It was timed.

2) ON PAPER in BOOKLET - Trail Making - A bunch of bubbles with numbers in them, scattered randomly across two pages. Starting with (1), find and draw a line to the bubble with the next number in the sequence. It got a little tricks when the next number was all the way on the other side of the other page in the two-page spread. At one point, I said, "That's embarrassing, I went from 12 to 15." I was so nervous about not completing it in time and was rushing toward the end.

3) ON PAPER in BOOKLET - Letter Sequencing - Same thing, only with letters in bubbles spread out randomly over two pages.

(At this point, I took from a jug of unsweetened iced tea I'd brought with me. I told her that like vaping and pen chewing, I down at least one jug of unsweetened cold tea per day, which seemed to intrigue her.)

4) ON PAPER in BOOKLET - Letter AND Number Sequencing - Numbers and letters in bubbles across two pages spread out randomly. Had to connect number followed by letter, so letters and numbers alternated: 1-A-2-B-3-C-4-D, etc. She said it was an exercise in multitasking. It sounds easy in theory, but it gets hard. Off the top of my head, I'm not sure which letter of the alphabet J is. Plus, it was so easy to screw up and go from a number to another number (totally forgetting and forgoing the corresponding letter, or vice versa). Instead of going from K to 12, I was all set to go to L.

5) ON PAPER in BOOKLET - simply trace over a dashed line with pen. I was a bit sloppy.

She said it was hard to judge progress based on RAW scores, she'd have to score it all up later, and there were different expectations based on age and even sometimes gender.

6) ORALLY - Letter/Word test - She'd give me a letter, and I had a minute to name as many words as I could think of starting with that letter (no names of people or places, no derivatives like Look, Looks, Looking). Harder than it sounds, and at some point I couldn't be sure if I'd said a word or not. Did it for the letters F, A, S. It did get easier each time, less off-the-cuff struggling to think.

7) ORALLY - Animal test - List as many animals as I could think of. At one point I got hung up on PRIMATES and said "Orangutan, gorilla, chimpanzee, bonobo, tarsier." At the end, she asked me what a tarsier is and asked me to spell it. She'd never heard the name, but supposedly had seen a video about one earlier. Weird coincidence.

8 ) ORALLY - Male names - List as many male names as I could think of. A lot harder than I expected with the pressure of being time. At one point, I said, "Matthew, Mark, Luke, John..."

9) ORALLY - alternate between a fruit and a type of furniture. This got a bit tricky. Do kitchen tables and end tables both count as simply tables? Toward the end, I started using furniture words like credenza and chifforobe.

10) COLOR TEST in booklet
10 a) Rows of boxes of three different colors: red-blue-green. Simply go along row by and list the color of the box
10 b) The printed WORDS themselves in black ink. Simply go row-by-row and read the printed words red-blue-green
10 c) The words red-blue-green printed in any combination of the three colors. Ignore the printed word, and say color of the ink itself.

At his point, I sort of cheated. I used my index finger to cover up most of the printed word only exposing the first letter. So if it said GREEN, I'd cover up most of the word exposing only the G and say "blue." It was easier to say the color of the ink when only looking at one letter (like with the boxes in part A) instead of reading the whole word which didn't match the ink it was printed in. Neuropsych didn't seem to object.

10d) Same test, except some of the printed words had a box around them. If unboxed, say color of ink. If boxed, disregard ink color and read the word. I did the same thing as above, covering all but the first letter with my finger except when I came to a box, where I'd just read the actual word regardless of ink color.

11) ORALLY using Booklet - There were a bunch of illustrations of a page. I had to ask a bunch of YES-NO questions to try and deduce which item she was thinking of. All sorts of random images: animals, transportation vehicles, kitchen appliances, fruits.

We did this 4 times. Third time was funny, I asked, "Is it a living thing?" She said YES. I asked if it was a mammal. She struggled for a moment. So I asked "Is it a bird?" (birds aren't mammals). When she said yes, I asked if it was an OWL (the other bird was an eagle).

**She then asked me if I ever tried joining clubs or groups. I told her I didn't, as it was too awkward that it defeated the purpose. I did ask her, "If you weren't my doctor and we were in a social club together, be honest, what would you make of me?"

She then told me her 80-year-old father is Autistic, but doesn't know it. She diagnosed him sub rosa. She said he was more obtuse and lacks awareness. When people get annoyed with him, he simply dismisses the other party as strange. I told her I used to do that, too. However, I don't have that luxury anymore after things I've experienced.

I'm 5'9. This woman was shorter than me. But based upon what she was saying, I asked, "Is your father a big-and-tall guy?" She nodded in amazement. I told her that because of his size, people are probably less willing to mess with him then they would someone of "fair game" height like me, so he has the luxury of being obtuse and aloof without major altercations because he's big. She was amazed, said she'd never thought of that before.

She said "Oh my gosh, if he were shorter, someone might have attacked him and he'd be forced to confront his Autism. I never thought of that!" **

Back to testing:

12) PHYSICAL - Tower (looked it up online, it's called Tower of Hanoi) Started out with three, then up to four and five of these wooden circle rings of various sizes and three pegs. I had to move them around to match an image in the book. So, if all the circles had to be stacked up from biggest to smallest on the middle peg, I had to rearrange them to accomplish that. The test would start off with the the circle rings placed arbitrarily on the three different pegs.

Couldn't move more than one circle at a time. Couldn't put a larger piece atop a smaller piece. So, there was much moving and trial and error to move the pieces around and finally accomplish the goal. It was challenging. I felt like giving up a few times, spoke aloud to myself, eventually got all of them.

The background music was classic rock, and I started singing slightly. I said, "I sing as a calming mechanism," and she affirmed she figured as much. It's comparable to stimming or humming. She said her Autistic father does the same thing. Despite being a terrible singer, he actually sings in a church choir. As a big guy, his booming bass-level voice is easily heard.

I finished up and said that some NTs may be tolerant of me because they have Aspies in their families. Case in point, because she grew up with a man like me, she may be more receptive to be than NTs who have no exposure to our kind. This is a big factor in interpersonal relationships - familiarity.

13) ORALLY - proverbs - verbal abstraction - she gave me a bunch of idioms and told me to define what they actually mean. Stuff like, "Rome wasn't built in a day" and "Too many cooks spoil the broth." I think I did decently.

14) COMPUTER - Attention Module on a laptop: I had to hit the space bar after a series of low-high tones. Sometimes, there'd only be a high tone. I wasn't supposed to hit the space bar until I heard low-high (boop-BEEP). This went on for 15 minutes...

15) COMPUTER - Attention module on a laptop: a bunch of letters popped up and disappeared. Sometimes slowly, sometimes rapidly. I was supposed to hit the spacebar as soon as I saw a letter, except for the letter X. I don't think I missed any of the non-X letters, but multiple times I screwed up and hit the spacebar for X, even though I'd mentally tell myself not to do it. It was anticipation anxiety and wanting to hit the bar whenever ANYTHING popped up on the screen. Again, this went on for 15 minutes...

After these two tests, a half hour of silence, we discussed social imagination, how one might try to anticipate what the other is thinking but get it wrong, and the set off the other person with their behavior.

16) BOOKLET - Social Cognition - One page had a printed list of various emotions, the other pages had pictures of people making expressions (24 pictures of faces in total). I had to describe how I thought each person felt using one of the words on the list. Some of it was guess work. Sometimes, I wanted to use a word not on the list, but had to stay within the parameters. I think I tuned out one or two of the options from the list.

17) AUDIO and BOOKLET - Listen to a person saying something, then match the statement and tone to whom I thought would have said it. I think there were 8 pictures to choose from for each recording. Sex of the speaker didn't necessarily have to match the person in the picture. For instance, if the recording was of a man saying, "I'm scared out of my mind," and I saw a woman with her mouth agape, I'd have to decide if that was the best picture to match the statement. Some of it was guess work.

During this test, the upcoming patient knocked on the office door, even though I still had 20 minutes. When I myself arrived early, her office door was closed, and I stayed in the waiting room, not wanting to disturb them. This inconsiderate jerk kind of threw me off. (Turns out, his appointment was for the same day of the month but in SEPT!). But knowing someone was waiting messed up my rhythm.

18) AUDIO and BOOKLET - similar to #17, except there were 4 pictures with TWO people in each of them. The recording was of only one person speaking. I had to decide which person I thought was speaking to the other and choose from the 4 photos. After choosing a photo, I had to describe the speaker's tone of voice and whether or not I thought it changed the meaning of what was said. (What if I got the picture right, but the meaning wrong, or vice versa?) If I thought the tone of voice changed the meaning of what was said, I had to explain how and what I thought the speaker really meant.

Sometimes, even if I thought I knew the meaning of the recordings, none of the photos seemed to accurately convey what was being said, so some of it was guess work.

After the test, she asked whether or not I had problems recognizing faces. I told her the short answer is NO. The longer answer is that I was surprised, years ago when I pumped gas - we had regular customers who I'd recognize instantly. Even if I didn't know their names, I knew their faces. But from time-to-time, someone would come in and say something like, "Oh, hey, you're here again! You work a lot of hours! You were here yesterday when I came in. And I remember you were here last week." It was odd, because as far as I could tell, this was the first time I'd ever seen them, but they seemed to imply they were regulars and they were familiar with me. This happened enough times that I did start to question things.

She asked if I thought it impaired me, and I said, "I'm not actually sure. Maybe it does and I don't realize it." She found this interesting, but not enough to order a face test.

This concluded PART 2 testing, and I told her I'd like to know what I have/don't have. She had said she doesn't like giving people multiple diagnoses, but I implored her, since she's the first person to have ever tested me for anything, to accurately diagnose me with whatever it seems I may have.

I need to return for a PART 3, final round of testing - Structured Autism Diagnostic Interview.

After that, she says it takes about 3 weeks for her to score all the tests from the three sessions and the take-home tests, then return again for a FEEDBACK session.

PART 3 (8-31-23)
1 hour

Structured Autism Diagnostic interview

She looked over the test I took at home. Said she'd score them properly later, but noted sensory processing issues and PTSD...I told her I don't think Autism and PTSD are mutually exclusive. Living with undiagnosed Autism could lead to social problems which could then cause PTSD...

Questions (mainly childhood-related) about:

-- Eye contact (as a child and now)
-- Using smiles and greetings
-- Range of facial expressions (can people tell what you're thinking/feeling or not)
-- Did I play imaginative games with other kids?
-- Was I interested in playing with other kids as a child?
-- When another child invited me to play, how did it go? What if there were more than two children you were playing with?
-- Did you have best friend growing up?
-- Spontaneously sharing toys and objects with people as a child
-- Sharing jokes and ideas with other people - (I actually did, but often they didn't seem enthusiastic, so I became withdrawn)
-- Using someone as an extension as self (using father's arm to pick up an object)
-- Would you try to soothe your parents if they were sick or angry, would you avoid them, would you not know what to do?
-- Problems coordinating gestures, using non-verbal language to get needs met
-- Did I ever point, but not look, in the direction or object I was pointing at / ambiguous gestures?
-- Ever have the wrong look on your face, ever been accused of laughing or smiling at inappropriate time, having an affect that others see as inappropriate? - MAJOR YES!
-- If someone engages in small talk, how do you beave?
-- Did you have to be taught what nodding head for YES/NO meant?
-- Interpreting hand gestures
-- Do you use gestures yourself?
-- Ever imitate a grown-up when you were a kid?
-- Playing pretend games with dolls/action figures/props
-- Any problems with games like Simon Says, Patty Cake, Peek-a-Boo, Ring-around-the-rosie, Tag?
-- Is it hard to have a conversation with you, is it like pulling teeth? - MAJOR YES!
-- Any echolalia?
-- Any running commentary on what you were doing step-by-step
-- Accused of asking inappropriate questions or making odd statements - MAJOR YES!
-- Any problems with first, second, third person pronouns?
-- Own made-up language or odd ways of phrasing things?
-- Any unusual interests or obsessions with objects, even when they're not physically present?
... ... ... ... ... ... -- If you were not allowed to engage in that interest, would it intrude on your life?
-- Special hobbies or interests that are unusual? Interest in non-functional things? (This question was a bit odd, she meant fascination with things don't serve an immediate purpose, like obsessions with counting street lights.)
-- Verbal rituals, feeling like you have to say something over and over until it seems right?
-- Rituals where things would have to be done in a certain way, put in a certain order before moving on?
-- Any odd hand or finger mannerisms?
-- If you were prevented from doing a stim, how would you feel?
-- Engaging in full-body movements, like spinning around or bouncing up and down
-- When playing with a toy, did you play with the whole toy or just aspects of the toy (like spinning tire wheels of a toy car instead of playing with the car as a whole)
-- Any fascinations with sensory perceptions (like sniffing or smelling or tasting objects of fascination)
-- Do you like to collect things that have a particular look or feel?


She's going to score all this up, and I go back for a feedback session at the end of SEPTEMBER.

EDIT: She mentioned that prior to the bundling of AUTISM under one large umbrella, she always had a hard time telling the difference between Asperger's and High Functioning Autism. I threw in PDD-NOS for good measure. She seems to be leaning toward Autism, probably Asperger's pre-merger, but can't confirm anything yet.

It's been 10 years since I've been on this site, and 15 years since I've suspected Autism. It'll be good to get some kind of feedback from an outside party.

This is almost exactly what I had to answer in my Developmental History questionnaire before the assessment, when I wrote 188 pages. I had to answer each question for all the different age groups in my life.

PART 4: Feedback Session (9-29-23)
1hr 30 min

Final session with Neuropsychologist after three previous sessions of testing.

I suggested bad experiences from being Autistic can then lead to further disorders. She agrees.

Something about how my executive functioning skills in the office seem fine, but are breaking down in the real world. I did okay in testing, but as per my questionnaires, these problems manifest in day-to-day life.

End result:
Autism Spectrum Disorder
ADHD
PTSD
GAD
Avoidant Personality Disorder

...but not OCD as I don't display any rituals. The only one that was excluded. She said any OCD-like traits could be covered by Autism, therefore it can't be accurately diagnosed. I asked if she'd ever heard of Pure-O (Pure Obessive-Compulsive Disorder) which is OCD without rituals. Not necessarily acting according to thoughts, but still having obsessive thoughts stuck in one's head. She hadn't heard of it, found the idea interesting, but as it's not in the DSM, she couldn't diagnose such a thing.

ALSO: Alcohol Use Disorder (mild). I told her I probably do drink more than I should on my off nights from work in an attempt at self-medicating.

She was very much a stickler for the rules of the DSM, making it clear she wouldn't diagnose one disorder if precluded by some other disorder. This was the first time she diagnosed ASD and AvPD, saying she herself was hesitant. But, following the rules and her own code of conduct, the two are not mutually exclusive, so she followed the results of my testing and diagnosed both, noting AvPD often comes on in adulthood, regardless of ASD or not.

I was well above thresholds for Autism. Like, if you need a minimum of 11 points to be borderline for possible Autism, I was in the 20+ point range, well over the range for any possible doubt. She also said I was "loaded" with sensory processing disorders.

Highly elevated for paranoia (I told her that after what I've been through socially, I'm not surprised) and highly elevated for social detachment, both common in schizophrenia. But I lacked any of the "positive" symptoms or delusions associated with schizophrenia. I asked if she thought I was at high risk of becoming schizophrenic, and she said that the social detachment that I display is common with both schizophrenics and Autists, so the Autism "covers" it.

Split between verbal and non-verbal skills. Almost 2 standard deviations, though she said it's not so much that my non-verbal skills are poor, but my verbal skills are so much more superior it sets a higher bar for the non-verbals. "A lag between verbal ability and non-verbal ability."

My working memory was HIGH, but my processing speed was average, with a wide spread between the two. I wonder how much of that is due to age, as these tests were easier when I was a kid in school. Surprisingly, I was "superior" at the verbal numbers test. For the prior test, she would say a bunch of numbers, I'd have to rearrange them sequentially in my mind and repeat them all back (like 6-2-4-9-8-3 would have to be repeated back as 2-3-4-6-8-9). I felt I was struggling with that, but did better than expected. Though the results for "trail making" paper-and-pen test of finding sequential numbers in circles and connecting them with a line was low average, still considered "functional," but compared to the verbal, the paper-and-pen results were subpar, showing a split. This is more common with NVLD, but she still went with ASD due to repetitive behaviors, and said I was "lacking some things for NVLD" as well, though didn't elaborate.

"Cognitively, there's nothing wrong." Short-term memory problems may be due to functional attention issue, alcohol, anxiety. I also did well at picking up tone of voice (prosody), affect, sarcasm was actually good in the controlled "lab" testing environment.

Felt I was over-reporting or overexaggerating some problems, I have a "negative filter on," may not be as bad as it seems. Might benefit from an IOP (Intensive Outpatient Program).

I suggest I'd love to get on Social Security Disability in the event that a job goes south and I have to worry about staring over again and not having any money. She says she'd hate to see me become a shut-in waiting for a check.

I told her my Amanda story.

She says that people "with a history of trauma are going to react" to my odd behaviors. "They might not know why, but they're going to know they don't like being around you." People not realize I'm a literal thinker or thinking of things in black and white and not realize I'm not picking up on their nuances.

She makes a distinction that Autism was there since childhood, but Avoidant Personality came on in adulthood; she found this co-morbidity surprising as she's never diagnosed ASD with AvPD. "I became both wary and weary regarding socializing."

We went over specific parts of the report regarding my biography on her computer before she printed it: Where I was born and raised, details of my childhood idiosyncrasies, education level, migraine with aura/ocular migraine, etc.

I mentioned that while I did well in many of her cognitive tests, real word results are sub-par. That was the problem in school: my academic performance was fine. On-paper there was nothing to suggest anything was wrong with me. But socialization and sensory processing were a different issue, which academic tests didn't/couldn't test for. "That's why people like me fall through the cracks."

Socially, don't know what to do when victimized...she agrees, says it's very one-on-one informal, need to report to authorities to have documentation.

I told her it's like fairytale magic seeing NTs naturally making friends and socially engaging without any apparent effort. In my case, my few "friends" ultimately turn on me. She asked if I ever try to explain myself and ask them for feedback. I told her that I have numerous times, and they always incorrectly interpret it as me deliberately pouring more salt on the wound when I'm sincerely being apologetic and trying to make things right. They assume I should know what I'm doing wrong, therefore I'm deliberately being a jerk; I never get the benefit of the doubt.

She asked and I told her I've never been in a psych ward. She suggested the IOP. I inquired if their were any medications she'd recommend, but she said she can't prescribe and it's case-by-case which issue to treat, suggested seeing a psychiatrist.

I asked about interpersonal problems I've had all my life, and hostility from people. She said, "You may just trigger the loosies." She then printed out the report.

I told her that her IOP suggestion sounds like an out-patient program after someone is released from a psych ward. She said while it often follows in-patient hospitalizations, it can also be for those "in the community" in times of duress.

She suggested a "therapist who goes out with you in the community and models behavior," though I don't think that's practical or realistic. Honestly, her main job was to diagnose. All the post-diagnosis suggestions just sound like fluff / guesswork / or a need to write a concluding paragraph on an essay.

I ask if she can compare to any former clients. She recalls one. When I ask if he was on any meds, she says, "No, he wasn't dysthymic"...seemingly implying she thinks I have dysthymia.

Apparently, the paper fill-in-the-blank tests were submitted to a computer that then prints out a summary. Based upon my results, the computer gives her these paragraphs. However, it's up to her to interpret the generic computer findings. She said I couldn't have a copy of the computer print-out summaries because they could be potentially damaging if read by "the wrong person" and don't know how to interpret it and take it as fact (not knowing it comes from a computer vs. a person). Computer says I'm a good candidate for treatment.

I asked her about her first impression of me, what she thought. She said she figured either Autism or NVLD (Non-Verbal Learning Disorder). She thought NVLD because of the higher verbal skills, but NVLD was ruled out due to my restrictive, repetitive behaviors and sensory issues, putting me in the ASD camp.

I told her I think NVLD should be a subset of Autism and will probably end up under the Autism umbrella someday. But I don't have to worry about NVLD as I'm now officially diagnosed Autistic.

"Grr!" I can't look as these are the things that these days stress me. In the past beforee I hit burnouts/breakdowns I saw them as a challenge, but these days things that get my mind to work in this way cause me to be in a state of partial shutdown. They didn't so much in the past before.

I am not sure I can remember numbers backwards any more or place them in order in my head...Because as given them by speaking them I can't think in dots, but I can if I see them on paper. My mind can do dots and patterns of dots!

Welcome back to WP

It sounds like you were put through a lot just to get a diagnosis.

I’m tired just reading it. Sheesh!