Is Asperger's overdiagnosed or underdiagnosed?

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If one strictly applied the critera, except for "impairment", you'd be amazed how many possible cases you'd get.

Let's imagine this case for a minute.....young aspie in the US, who's obsessions are (a popular sport) and fitness. If their IQ and verbal abilities are within one standard deviation of their age group, I doubt most places would pick it up. There might be a ADHD, OCD, or learning disability DX, but that's as far as it goes.

I know of cases where people have more obvious traits than I do, and they were DXed with OCD or ADHD. The DX process is socially and culturally driven, and there's no way around that, since it's based on observed traits and interviews, not on mechanically registered information.

+1

Some of us have really embarrassing / unacceptable interests; so don't discuss them. I don't go on about my interests all the time. Does that mean I don't have AS?



Quite a few females (including myself) were diagnosed with depression / a mental health issue before we received our Autism diagnosis. I do know someone who received her diagnosis when she was in her late 30s. She'd been known to psychiatry services since she was 12.

I wanted to add my support to the above statements and also underline what whirlingmind just wrote that Alex just agreed with : I think that there are a lot of women out there that could benefit from a diagnosis, or just knowing about AS. There is currently hardly any training given to social workers and frontline workers to help them spot someone who might benefit from being assessed in the UK. Maybe I just have only work experience to back this up and no stats, or hard evidence, but my theory is that women are being routinely diagnosed as having personality disorders ( especially borderline) as opposed to considering whether they fit with any autistic categories.

Certainly I think there is such a lot of reticence still in relating aspergers or autism to women and girls.
I believe that disorders such as anorexia ( that has links to proprioception problems and NVLD issues )that seems to affect more women than men -at least in the public's opinion, should provide medical staff with the opportunity to look and screen for any autistic problems.

An expert should say that. Not me.

Yet, you're claiming that some people can't have ASD because they don't go on about their interests all the time?

I'm sorry, I don't want to derail this thread, but I feel compelled to respond to this... There is only one female blogger on this site, whose articles are introduced as "the female perspective," and she hasn't written much beyond how lucky she has been and how relatively easy she has had things. I'm genuinely happy for her, and her viewpoint is valid, but it is definitely not the norm and not representative of the experiences most women on the spectrum have. I wrote to you months ago offering to write for the site, partly to give a different female viewpoint, but my message was never answered. I'd be overjoyed if you really did offer more information for/from/about women with autism and our experiences. It doesn't have to be from me and I don't even care if I'm credited if you do publish anything of mine, but please, anything you can do to help out would make a big difference. You have no idea of the frustrations female aspies often have to deal with that men do not.

Again, I don't want to derail the thread - Alex, feel free to contact me privately if you are interested in my offer.

So you're basically saying that people can be too high functioning to be on the spectrum? I know people who were diagnosed very early and went through early intervention programs. They were able to remove all of the negative signs of AS and their obsessions became their careers. Jacob Barnett is the most famous example that I could think of. I also personally know college-aged autists who were part of a longitudinal study that involved early intervention. If you were to just take a superficial cursory glance, you wouldn't even think that they had autism. People always assume that I'm high-functioning, but that's only because I hide a lot of stuff. For example I can't even drive a car. My point is that just because someone is more high-functioning than you does not mean that they don't have autism.

@drewski56 - how can you say +1 for under-diagnosis of ASPERGERS in women and yet support its abolition from existence in DSM5?

Quite simply, Asperger Syndrome is the currently accepted naming for a set of characteristics which are under-diagnosed in the female population. Asperger's diagnoses will not simply evaporate, the vast majority of individuals would be absorbed into ASD under the DSM-5. Without proper attention female individuals who are under-diagnosed in regards to AS under the DSM-4 will continue to be under-diagnosed in regards to ASD under the DSM-5.

No. I said they didn't look like having AS to me. I didn't say they didn't have it. And however, there are other important symptoms that characterize AS, not only "obsessions".

So you're saying it's just me being more low-functioning than them?

Just from a cursory glance at the home page, there are at least three female contributors. Their posts are not all about sunshine and daisies; they write about overcoming obstacles and coping with frustration. I don't see what the problem is. Alex probably gets hundreds of messages from people asking to be a blogger on his site. He can't just cater to every single one.

The people in my autism group, some are obviously autistic and some not, and some very high-functioning with careers and marriage and kids, and the very high-functioning ones appear least obviously autistic, but most are officially diagnosed.

Seeing as I don't know you, it's a question that you're going to have to answer for yourself.

Overdiagnosed. It's very common to have a diagnosis of Aspergers for "insurance purposes" (my practioner's words regarding my diagnosis) when a narrower--or composite-- diagnosis might be more appropriate. A classic example is practitioners who diagnose NVLD as Aspergers/ASD in individuals without stims, intense interests, or other characteristic behaviors. Minor visual-processing issues, such as brain damage, combined with a schizoid personality might be sufficient in some cases also. Others would be certain auto-immune issues like PANDAS or simple social awkwardness caused by environmental factors, such as homeschooling, sexual abuse, or video games.

It's a big problem that Aspergers is overly broad because it is diagnosed by external characteristics rather than structural factors or causes, and practitioners don't have a policy of defaulting to the most restrictive diagnosis when applicable.

Last edited by Tyri0n on 04 Jan 2013, 2:45 pm, edited 1 time in total.