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(I hope this is the right place to post this- I feel like some of my symptoms are kind of specific to women with Asperger's moreso than men.)

I recently visited a psychologist (a specialist in adult ASD) because I suspect that I might have mild Asperger's. I came to her with a 12 page list of the symptoms I'd found in various resources (Aspergirls, Aspienwoman) because I'm not very good at answering questions when I'm on the spot- unfortunately she barely glanced at it before just asking me to rattle off my symptoms instead which, of course, I did a poor job of.

In the end she said that she suspected that I wouldn't meet criteria because I didn't think that I had had any noticeable developmental delays in early childhood- no delayed speech or anything like that. (I do think I was somewhat stunted socially when I was very young (I mean, I still am!) but I always had "bossy" friends who would pretty much take me under their wing and tell me exactly what to do and when and how to do it.) She said that because it's a developmental disorder, if there is no clear record of developmental delays, it wouldn't count, and that I'm just "introverted and anxious." She did give me the option of bringing both my parents in for a multi-hour interview... but I don't have very good insurance and my parents are pretty much totally unwilling to believe that their kids have any sort of psychological issues so I don't really think it's worth the expensive nightmare that would ensue.

I was hoping maybe you guys would be able to give me some insight and tell me what you think? Is she right that there absolutely has to be an obvious (like, my parents would notice) developmental delay? (And if so, why would Aspergers in women be so under-diagnosed? Hmm.) And if not ASD, any ideas what could be going on? I don't feel like introversion + anxiety quite explains it.



Here are some of the symptoms I came to her with, not that she actually looked at them all...

-149 on the Ritvo Diagnostic Scale, which is almost exactly the average score for "females with suspected ASD" (neurotypical average is 81, ASD average is 165)

- a sort of social cluelessness- I have to consciously evaluate social norms and frequently "misjudge the room"- I'm getting better with age but had a very hard time in school with things like, say, not realizing that nobody else tucks in their shirts or wears leggings (and getting made fun of as a result without realizing why.) I learned to pay close attention to details like that so that I could fit in, whereas it feels like other people just "know." Same with conversation flow- I have a hard time figuring out where it's going, and keeping it going... and I have NO idea when people are flirting with me (unless they are being very explicit about it), or if I am creeping them out/boring them/etc.

- had good friends as a child but almost no close friends as an adult (and ones that remain are mostly from childhood- they all think I'm "weird"- I remember being told that a lot as a kid- but they find it charming.) Very few girl friends and pretty much never had close "girly" friends.

- sensory issues, especially with smell and fabric

- low tolerance for frustration- something that other people can "brush off" can send me into a complete raging, weeping, dish-smashing meltdown (example: having to sort out an incorrect bill and getting crappy customer service.)

- "youthful" behavior and tastes

- control issues- namely that I don't like not being in it

- smart/gifted/academically accomplished

- strong focused interests- some are long term, others can be short term but very intense and often niche and odd (for about a week I had my mind set on writing a book about poisonous pigments used in antiquity and researched intensely for many hours... another time I wasted a solid day reading about orcas attacking their trainers... you get the idea. My husband will frequently ask "Why on earth are you reading about THAT?" and I'm always shocked that he doesn't find whatever it is fascinating.) Able to hyperfocus on the obsession-of-the-moment.

- anxiety and emotional sensitivity, can't take criticism well

- affinity for animals and nature (over people)- I am able to feel more empathy towards animals than humans, I feel like (but not for lack of wanting to- I just don't understand them.)

- fidgeting, leg bounding, hair twirling; when happy, jumping, bouncing, clapping, singing, etc

- physically very sensitive to drugs, alcohol, caffeine, etc - also have IBS and TMJ which are apparently often comorbid (also some OCD-like tendencies but probably not enough to warrant diagnosis)

- shy, and not seen as particularly warm- I was always hurt as a kid/teen that my friends never came to me with any sort of personal issues even though I did care a lot.

- extremely introverted- I crave close, quiet, intimate relationships and one-on-one time, and need a lot of time to recover after socializing. Easily overwhelmed in social environments.

- lousy listening comprehension vs. excellent reading comprehension. Likewise much, MUCH better at expressing thoughts in writing than verbally.

- difficult time with establishing boundaries, saying "no", etc especially when younger. Until recently also had an EXTREMELY hard time dealing with the idea that someone might not like me but I am starting to get used to that as I definitely rub some people the wrong way.

Yikes this is already a novel so I will stop there- there is more (like I said, 12 pages! Ha) and feel free to ask anything. If you have read all this, thank you so much.

I think the idea is that it would be obvious someone was different if people are paying attention. Which parents aren't always. Trouble is that if one is truly socially clueless one might have no idea how others saw one.

But that's a really good question why are women underdiagnosed. There are a lot of researchy answers, but for myself the answer I think is the idea of ASD did not exist as now, and I wanted to avoid being noticed as different because I was afraid of being hurt. So I really tried hard not to stick out by making sure I followed every rule. And girls often try to be good. That may be part of it since what gets adults attention is behavior that's different and hard to control, much more than just different.

Exactly, I am pretty sure I didn't stick out, because I tried very hard to blend into the woodwork.

The psychologist made it sound like EVER aspie girl would've had some sort of very early developmental deficit though, like serious sensory issues or delayed speech, and I had never heard that :-/ I know I had some freak outs because my pajamas weren't "quite right" or my tag was itchy, but I'm not sure it was out of the realm of normal- little kids are always kinda strange!

Interestingly my sister definitely had some language deficits and major sensory issues with her clothing, but she is very normal and social (maybe even extroverted) now.

I am just so frustrated because I thought I had finally found an explanation that *fit* and brought all the pieces together, and I feel like she disqualified me on a technicality without giving me another explanation that made sense

Trouble is people don't know and don't admit what they don't know.

When you're not sure it's out of the realm of normal she doesn't want to label you with ASD. That's reasonable as if you were a relatively normal child, not just flying under the radar, that isn't consistent with having ASD.

But what relatively normal is isn't quite clear. And it appears that relatively normal women who don't have ASD and get label of broader autism phenotype or normal but quirky ARE more likely to have children with ASD. Which would only make sense if normal but quirky and not ASD actually IS related to ASD.

Try not to get to caught up in the label. I've done that and it goes nowhere

Honestly I'd be happy with a label of BAP - at least it's something! The labels aren't truly important, I know...but somehow it would be very comforting to say to myself that, yes, X Y and Z are hard for me, but there is actually a reason and it's not just a personal failure I felt like her "diagnosing" me as an introvert with anxiety was almost... condescending. Yes, I KNOW I'm those things - I wouldn't have come in if I didn't think there was something more at play

I find it odd that the psychologist said you can't be Asperger's because you didn't have developmental delays in early childhood -- because from what I've gathered, one of the criteria FOR an Asperger's diagnosis (or what used to be named Asperger's up until recently, at least) was that you DON'T have certain other early developmental delays, such as delayed speech. While, on the other hand, for classic autism, those early developmental delays including delayed speech are indeed necessary for diagnosis. For Asperger's they are not, in fact, if I recall correctly, NOT having delayed speech, but having certain other issues, are actually required for it to be Asperger's.

Based on this, I have a feeling that this particular psychologist doesn't actually know enough about the Asperger's end of the spectrum, because it sounds more like she was looking for the things that more indicate classic autism on the more severe side of the spectrum.

I think you should try to get a consultation with someone else, if possible someone already with a known track record for diagnosing Asperger's/HFA and also in women. Women do present differently to males.

It's not that I'm advocating the idea of "trying different specialists until you get the diagnosis you think YOU want" -- that's not a good thing either, and I'm not advocating that. What I simply mean is, it doesn't sound as if the person you saw even knows what she's talking about in this particular matter, as she seems to be mistaken about one of the criteria for diagnosis, thus a second opinion if at all possible seems appropriate here.

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I agree with the psychologist that if your parents didn't notice many abnormal things about your development in early childhood by age three or five at the latest, then you probably don't have ASD.

Based on your descriptive list of yourself, I think that you are following the Aspergirls description too closely, but that description is not scientifically valid in any way, as it is just a list of vague traits that someone assembled based on interviews with a small number of autistic women.

So btbnnyr, you are saying that you absolutely DO have to have noticeable developmental delays, but BirdInFlight is saying the very opposite, haha. It seems like from asking around that there's a lot of disagreement about this

To be honest I don't know for sure what my parents did or didn't notice because asking them about it is likely to cause more drama and trouble than it's worth. They've never mentioned anything like that to me, though. If it had been severe I think they would have, but milder quirks, maybe not.

I'll have to keep my eye out for other specialists- she seemed to be the only one in my area who worked with adult aspergers at all And my insurance is crap so I can't do too much pursuing. But it sure would be nice to know.

Re: Aspergirls- that was one of the sources I used, along with a few others that were aimed specifically at women and girls. Most "credible" medical listings are based mostly on men, though, right? They all seem to be focused on children, too :-/ I have passed every screening test and inventory I can find available online though, which are based on more "traditional" signs/symptoms. (I know online screening tests are just about worth the paper they're printed on, but they're the only thing available to me at the moment. Bleh.)

You sound like me.

I think if I had clued-up middle class parents, they would've picked up on it. My parents were not well-educated when they were younger and I come from a social class where anything to do with mental differences/disabilities is very taboo. Plus, it was the 80s.

I think even now, they would downplay some of the difficulties I had. They'd need to be totally honest for me to get a diagnosis, and that would be hard for them to do. I understand why; they would feel like it's their fault and they would want to say that I'm 'normal'.

That's part of it too- I think that they would want to think that they would've noticed, and since they didn't, need to believe that nothing is wrong.

Maybe part of the confusion was how she put it. People who have ASD have some noticeable difference at a young age, IF someone is looking. Not necessarily a delay in spoken language but some kind of delay in socializing and communicating. And still see themselves and/ or are seen in the present as different.

It's unfortunate she was condescending. That's never helpful, and left you with too many questions.

This is not an exact science IMO. Meaning there is an aspect of evaluations that's up to the subjective opinion of the evaluator, even if they are doing a very structured evaluation. There is some logic to it, just a lot of grey. There is also pressure recently to diagnose less ASD that seems to be having an effect.

Do you think you have ASD, that is you are impacted now and were very significantly impacted as a young child even before starting school, or do you feel the effects of the issues you talked about hasn't had that major an effect on your life? Because how you proceed I would think depends if you're just confused what she meant and frustrated by her behavior, or if you need the validation of an explanation for what you notice about yourself or are in need of services. In which case maybe think about another evaluation when you can even if it's awhile.

What it really comes down to is the fact that I have crap insurance and wouldn't really be able to do ongoing therapy or anything anyway :-/ Fortunately I have managed to structure my life in such a way that I am pretty functional- I work at home where I can control my environment, and I never attend a social event if I won't be able to leave as soon as I need to (and usually they are pretty close to home as well.) Getting a diagnosis isn't really crucial, it would just be nice to be able to understand myself that much better, and to feel like I could seek out support from others who are similar and understand (as well as have a better way to explain to people who are confused or frustrated by my behavior, haha.)

As far as I can tell you don't need a diagnosis to come to this website for support. Plenty of people say not sure or have a family member or even some say neurotypical in their profile.

I said many abnormal things about your development, not necessarily developmental delays like language delay or cognitive delay.
But definitely abnormal social development, and developmental delay in social cognition/behavior.

Things like did you respond when people called your name, did you point at things or understand when other people pointed at things for you to look at and take action, did you request things from people when you needed something like you were thirsty and you wanted a drink, were you able to have back and forth conversation with your parents when you were four or five, did you notice other children and play with them, did you do pretend or social play, were you able to talk about topics like what you learned in school, and did you spontaneously share your interests like talk about them with others, but did you always talk about one thing on and on and on such that others were bored and annoyed and children started avoiding you, these are some of the questions that would have abnormal answers if a child were autistic.

There are many more questions like this, so a significant number of them have to have abnormal answers for a child to be autistic.

greyhook, you are in such a similar boat to me! There are no ASD specialists where I live, so even if I wanted to try and get a diagnosis, I couldn't.

The criteria for ASD is not anywhere near as specific, scientific, and precise as we'd like at this juncture. The only real hard data I found was a study that tested 26 diagnosed Aspies against much larger populations of autism (non-Asperger) and people who weren't anywhere on the spectrum, and found that both autistic and Asperger persons had fewer connections in the left arcuate fasciculus in the brain, whereas Asperger had more connections overall in the left hemisphere relative to both the autistic and non-autistic groups. Of course, a brain scan is out of the question for most of us.

As to whether you are just introverted, intellectual, and anxious, I've heard that, too - but introversion and extroversion are also notoriously vague realms that are difficult to quantify with hard science. Most data suggests that introversion is primarily in the back of the brain while extroversion is primarily in the front of the brain where most dopamine receptors are (dopamine causes us to "act," in the most direct sense), but even this is somewhat controversial, for planning and careful thought also occurs in the frontal lobes, and I've seen some studies argue that such thinking can fall under the umbrella of "reflective" or more introverted thinking. Finally, serotonin plays a huge role in sociability as well. If you have low serotonin levels, which urine tests suggest I do, you'll be less social, or "extroverted" and confident, than you otherwise would. I'm speaking as someone whom almost everyone agrees is either an ENTP or INTP, but the debate over which one fits better is so torn on so many levels that it would probably take pages to dissect all the points of evidence for and against either type fitting better.

You sound a lot like me. My parents didn't notice just how "off" I was (because they were in denial) until it became blindly obvious when I was an adult and I still refused to follow gender norms and date guys etc. The truth is you don't at all need to have developmental delays in early childhood in terms of speech and etc in order to get a diagnosis of Aspergers. Now that they have changed the diagnostic criteria it may be more difficult to get one under ASD. I wouldn't even consider going to get a diagnosis unless the person in question has specialized in Aspergers, otherwise you are wasting your time and money.