Going in for a diagnosis next month-what do I do to prepare?

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Danielismyname
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15 Jan 2008, 9:52 am

One thing that this dude should know is that it's very common for adults with AS to be picked up [or misdiagnosed] when a secondary anxiety/mood disorder appears after hitting a wall; sometimes, these comorbid conditions are the only sign that something is "wrong" in an individual with AS who has gone for so long without knowledge of their disorder.

Anxiety/depression are extremely common side effects of AS.



sonny1471
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15 Jan 2008, 10:48 am

Wolfpup - sorry to hear about your crappy experience. My psych tried to focus on depression too when I told her that I'd taken antidepressants for several years about 10 years ago. I told her that wasn't my issue but she wanted to focus on that because she felt that it could be the cause of my problems. I felt like jumping up and shaking her! One of my biggest problems is trying to explain to someone what my problems are. I clam up instantly and can't get the words out.

I've never heard of the test you described though so I'd be interested to see what it's all about.

This whole PDD-NOS thing kinda bothers me. It's like "we know you don't have AS, but we don't know what you have." It sounds like a cop out to me. Ugh. I wish the doctors would just admit that they don't have enough experience with AS and tell you who to go to who does.

I look at it this way, if you feel the criteria fits you and you feel that you have AS, that's good enough. An official diagnosis doesn't do much in the US anyway, from what I understand.



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18 Jan 2008, 3:56 am

I'm not sure what is needed for an ASD diagnosis, it's probably different from an ordinary psychiatric evaluation, but I know that for the latter one has to do quite a number of tests to assess one's cognitive functions. I went through the psychiatric evaluation process at least twice - once for affective disorder screening, and later for a friend who was doing her MA in psychology at the time. Initially, she had needed someone she didn't know so as not to be biased, but it happened so that she was unable to find such a person, and ended up having to go through the process with me. Not that I minded. :)

I was given these as part of the evaluation:

Attention test: I was given a sheet with random letters printed on it, and was told to cross out each letter C I came across (I think). The person doing the evaluation was sitting next to me with a chronometer, and every once in a while she gave me a signal and I had to draw a vertical line next to letter I was reading at the moment. Then this was assessed with regard to how long I had taken to complete the task, and how many mistakes I had made.

Association/mnemonic test: I was given several words, or concepts, such as "evening", "fear", "hunger", "joy" etc. I had to think of an image corresponding to each of these, and then the person doing the evaluation asked me to explain why I had chosen each particular image, and what it meant for me. It was a bit embarrassing because I'm ashamed of my lack of technical drawing skills, especially when it comes to drawing concrete objects (rather than surreal symbols or patterns), so I was somewhat self-conscious about most of my drawings sorely lacking in quality.

Memory test: I was given around ten random words which bore no (obvious) relation to one another, such as "night", "stump", "wind", "fright" etc., and was asked to repeat them. Then, after some time had passed, I was asked to repeat them once again. I remember that when I was doing this with my friend, she commented on the ease with which I could recall the words, and when I told her it was mostly because of the vivid imagery, she made notes on that. She also wrote down some additional notes when I happened to mention the letter/color synasthesia, which also helps me a lot to remember such random strings of words. Apart from that, I was given several long strings of numbers and asked to repeat as many numbers as I could recall, first in their initial order, then backwards.

Association test: I was given pairs of words, like "rose - flower" or "tree - honey", and asked each time whether or not there was any relation between the words. When I was doing this with my friend, I mentioned a few times that, while some of the words are evidently unrelated, a connection can still me made between them - that wild bees live in tree hollows, for instance, so that honey may be found there. She took it down too, so I suppose things like these are also important.

Generalization test: I was handed several cards, each of which had four objects drawn on it, and I had to say the general category to which all of the objects belonged. There were several which I couldn't connect at all, even after thinking for a while, so I said this openly. I don't know if it was that important or not - it probably does have some significance.

I could have had to do other things as well, but I don't really remember anymore. And, of course, both times I had to do the interview, where I was asked about how I am feeling at the moment, what troubles me, whether I have enough awareness of being disturbed or disturbing to others during the episodes, what my childhood was like, whether there are any difficult aspects to my relationship with my parents, etc. It basically covers one's whole life, and it's definitely stressful, especially when it is an unfamiliar person asking the questions. But I agree with those who suggested that you should just try to relax and don't do anything specific to "prepare". I know this is much easier said than done, but additional nervousness and self-consciousness really don't help matters - they'll only make you act awkward and unnatural, and it is likely that the counsellor or psychiatrist who is evaluating you will end up with an inaccurate impression.



Danielismyname
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18 Jan 2008, 4:46 am

I've never been given a written test to take in a psychiatric setting other than an OCD questionnaire at a hospital (one of those OCD ones you find online); I kinda scribbled down in any old checkbox that looked right.

The first dude who brought AS up with me did so after a year of CBT therapy for the aforementioned OCD, probably when he realized OCD wasn't the only thing affecting me--he wrote Asperger's in my folder, then autistic disorder when we spoke of my developmental history. No tests.

When I first went to a specialized ASD clinic, it was kinda weird; I had a note from the aforementioned psychic saying I meet the criteria for autistic disorder, but he always saw me as someone with AS; I went to a..., uh, what's the word, [TEN MINUTES LATER], I don't know what the word is, but it was a basic interview with a diagnostician, to see if I'd benefit from the therapy they offer, or something, and at the end of the session, the session where I just spoke of...stuff I cannot remember, something about how high school really, really sucked, I asked her if I had autism or Asperger's, she said the latter. No tests.

Observation of how the individual acts intermixed with developmental history has been my experience (no written tests).



torment
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18 Jan 2008, 6:17 am

I have just been through testing. three one hour sessions plus a one hour review. one of the tests is the WISC (wechsler intelligence scale for children) there is an adult version.
consists of ten areas of assessment. It's not painfull. the time taken to complete the tasks appears to be a factor so reply as soon as the answer comes to you.
the thing I resented during testing was that conclusions could be
drawn about my mental health on such small samples of infomation.but it all adds up to a big picture I suspose.
One test involved hitting the space bar on a keyboard when a letter appears on the screen.(conners continuous performance test)...don't hit the space bar if you see an X. It appears forty times during the test I hit it thirtysix times..duh
my two brothers just cracked up when I told them. so you have a laugh to



Wolfpup
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18 Jan 2008, 12:08 pm

Thanks for all those test descriptions and everything! Nothing I did sounds like any of those, except he did ask me to tell him how two different words were similar (I don't think he understood what I meant when I asked him if he meant to say similarities between the words themselves-like number of letters, etc., and the concepts the words represent).

The only computerized test I took was that Wisconsin Card Sorting test, and because I did well on that, he claims I can't have Asperger's. He also basically ignored the actual test results, as they didn't say I'm depressed, he just decided that (only based on silly observations and my mom's test because of the suicide thing). One test I filled out came up with that I have poor executive function or something, but that contradicts the card sorting test I guess. Another test said I was really bad for my age at a variety of different...I don't know what they were exactly, sort of interaction/everyday skills types of things? (One thing was like I was 7 years, another 13, that sort of thing).

(I've got the actual test names at home and what he said, if anyone wants to know more about these tests.)

And I didn't think the interview was thorough at all. It was maybe 15-20 minutes long (I think it was supposed to be an hour), and he never asked me anything relevant to anything. Neither he nor I ever mentioned Asperger's, and he didn't really ask me anything about any difficulties I had or anything. I'm really bad at coming up with what I'm supposed to say when put on the spot. The best I did was I did at least mention I had been diagnosed with OCD 10 years ago (I wonder if he would have come up with that otherwise?)

So this whole result packet I got is just ridiculous. It doesn't mention my real difficulties I have at all or how I could try to address them. Some minor difficulties I have like OCD it barely touches on (I wouldn't mind have my OCD treated, but it's much less of a hindrance than it used to be, and doesn't really bother me much-it's not may main problem). And then he just makes up that I'm depressed because I drink water, supposedly don't enjoy doing things, and would prefer to kill myself than live on the streets somewhere if it came to that.

He was really condescending at some points too (which my mom picked up on). When I'm trying to ask where this idea of depression is coming from he's claiming that I'm showing "oppositional defiance" for daring to ask how I can be depressed when I'm not depressed and how I can not enjoy things when I actually enjoy them. Seem like valid questions to me. I mean I'm not married to the Aspger's diagnosis, but if you're going to come up with an alternate, you need to explain why it makes more sense. Claiming I'm depressed based on symptoms I don't have doesn't cut it.

He mentioned about eye contact too for depression, that I guess I started looking at him more later on but not at first. Well I'm sorry, but I generally don't like looking at people or being looked at, particularly people I don't know or when I'm having to deal with stressful situations, or depending on my mood, etc.



torment
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19 Jan 2008, 4:03 am

I have a report here that covers twenty two pages.whenever I
read it I pickup a little more information.the main reason for evaluation was ADD and Hyperactivity Disorder.I knew this already had it all my life I just wanted proof.
seventyfive percent of aspies have ADD. thats not to say all
people with ADD are aspies.not all aspies are ADD
the report never mentions aspergers at all.It devotes one paragrath to "Multiplex Developmental Disorder"(mdd).aspergers by any other name is still aspergers.
don't worry about the testing it may only confirm what you
already feel or it may tell a different story. :wink:



nominalist
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19 Jan 2008, 1:12 pm

torment wrote:
I have a report here that covers twenty two pages.whenever I
read it I pickup a little more information.the main reason for evaluation was ADD and Hyperactivity Disorder.I knew this already had it all my life I just wanted proof.
seventyfive percent of aspies have ADD. thats not to say all
people with ADD are aspies.not all aspies are ADD


There are some people who speculate on whether Asperger's autism and ADHD actually point to the same underlying neurological condition. A good book on this subject is, The ADHD Autism Connection, by Diane Kennedy. Another, though more of a textbook, is, Reweaving the Autistic Tapestry: Autism, Asperger Syndrome, and ADHD, by Lisa Blakemore-Brown.


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Wolfpup
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19 Jan 2008, 8:58 pm

The high overlap between Asperger's and ADHD is one thing I've thought would point towards me not having AS. As far as I know, I don't have ADHD at all, and for a lot of the criteria are the exact opposite (like instead of being easily distractable and flitting from thing to thing or whatever I focus in highly on whatever I'm doing and have a hard time switching over to something else).

Someone in a recent thread said that people with ADHD need things explained to them, need to know how things work to remember them versus just random memorization. If that's true, I do fit that, and I am horribly disorganized without the use of my PDA, but other than that I don't think I'd fit at all.



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19 Jan 2008, 9:15 pm

Thanks for the book recommendations, nominalist, and I'll definitely try to check those out. I've been diagnosed with both AS and AD/HD at various points in my life, and I find the connection/similarities between them confusing. I don't really think I fit the core requirements of AD/HD (nor did I fit them before I started taking meds for it, really), but a few days ago I was browsing through the book "Understanding Girls With AD/HD" and it felt like reading my life's story. I was especially confused because many of the aspects mentioned in the book are not part of the official AD/HD criteria, like social problems and sensory sensitivities, etc. Unfortunately I couldn't really afford to actually buy the book, but it did make me wonder whether AS and AD/HD are simply very similar conditions, or whether a lot of spectrum people have been misdiagnosed as AD/HD, thus making AD/HD seem closer to the spectrum. When I get back to college tomorrow I'll try to order these books through the library system so I have a better idea about these issues. I wonder a lot about both my diagnoses, so it's a difficult, somewhat ambiguous issue. I know I have something going on with me, but no one label fits perfectly. AS is a better fit than AD/HD going by the DSMIV, though.

On the subject of AS diagnosis, I didn't take any of those kinds of tests for my diagnosis (from a psychologist who specializes in AS). I filled out some forms, my parents filled out some forms (about when I was younger), one of my high school teachers filled out some forms, and I met with the psychologist a few times, as did my parents. The most important form was the "Gilliam Asperger's Disorder Scale", I think, which my parents filled out. I know all professionals do diagnosis differently (and frankly I sometimes wish my own diagnosis were more "solid" and less subjective), but not all professionals require a certain performance on the Wisconsin Card Sorting test for an AS diagnosis. I've never taken anything of the sort.



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19 Jan 2008, 9:16 pm

Definitely take your mom along. Psychologists are notorious for requiring to talk to a family member before giving adult AS diagnosis. They at first didn't want to re-diagnose me with AS because my family is 2000 miles away and I had no close friends available that they could interview.

I think what made the neuropsych think I have AS was my staring down at the floor or else out the window for the entire 6 hours of my testing. Plus she asked me about if I had obsessions and then I wouldn't shut up about them plus the fact it was weird obsessions normal people would never have.



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19 Jan 2008, 9:32 pm

Sorry dude I responded not having read all of the posts and didn't realize that you just got your test results back.

For what its worth I did really well on the Wisconsin Card Sorting test and I have AS diagnosis. She even remarked how surprised she was that I did so well on that test when in other tests I showed the cognitive ability of a 60 year old because of the brain injuries I've had. So it goes to show the tests are highly subjective and probably worthless for diagnosing AS.



nominalist
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19 Jan 2008, 10:30 pm

srriv345 wrote:
Thanks for the book recommendations, nominalist, and I'll definitely try to check those out.


Here is Lisa Blakemore-Brown's website:

http://www.lisablakemorebrown.co.uk/


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Wolfpup
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28 Jan 2008, 9:20 am

For the time being I decided to "demote" myself to "not sure if I have it or not" on here. Who knows, maybe OCD can cause Asperger's symptoms. (I seem to relate more to the experiences of people with Asperger's than OCD though, but who knows.)



gwenevyn
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28 Jan 2008, 11:35 am

Wolfpup wrote:
For the time being I decided to "demote" myself to "not sure if I have it or not" on here. Who knows, maybe OCD can cause Asperger's symptoms. (I seem to relate more to the experiences of people with Asperger's than OCD though, but who knows.)


I just hate that this professional made you doubt your perceptions like that. :(


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