Help! What not to do, in a diagnostic interview

Post Reply New Topic

Same as me!

I developed a huge obsession with it, even got myself into a bit of a warped mentality where I thought AS was something really cool, like being a mutant...

Also what happened was that I suddenly had official words for ASD traits, due to talking with other ASD people, and looking at information on the net.

However this fact wasn't necessarily a good thing, because suddenly, instead of saying 'Come here and yell louder, I can't hear you' I'd just say 'I have slight ambient deafness' or something such. But to other people, all they could see was that suddenly I was using all these clinical words to describe myself, and could only assume from what they saw from the outside that I was putting it on.

*Sigh*....Maybe I will just apologize to everyone in my life, morph into an insect, and disappear....(random thoughts there really)

wow, what you described there is just like me.
i just havent got to the getting a diagnosis stage.
let us know how it goes.

Wonderful post Tiffofdoom, I could relate to some of that.

Its hard to say what to do because its likely diagnosticians have different approaches. Mine questioned me and then looked at the 'evidence' from things my family said about me and life stories that I took. When I look back I realize that she cross-questioned me about some things and checked them out so that she could be certain of what was going on. She also questioned me in depth about a couple of things which I presume was to clarify or maybe see how much something affected me or not.

I didn't find the process difficult since my memory of some things is so clear and what my family said about me was very clear too.

I would say just answer as honestly and as fully as you can because you may not be able to remember everything but they can always ask for further information if its not clear and that is likely to trigger extra memories.

The process for me was long over a couple or more hours and although it was a relief to talk about it all, it was very tiring indeed. The good thing was that the lady was already referring to me as if she knew I was an aspie within about twenty minutes so I had gotten used to the possibility by the time she confirmed it at the end. That was the good thing, I was told straight after the process that I was on the spectrum and assured that my report would be sent soon, I didn't have to wait anxiously for weeks until my report arrived

I was seen by a psychologist and a psychiatrist specialized in ASD's last week and they asked about some Tourette like behaviours my father had marked on the questionnaire and the more I had to talk about them the more I did strange things with my face and hands. Maybe I'll just get a Tourette's diagnosis.

I'm not sure what my point is, except I know what you're thinking because I was also worrying I'd come across as a hypocondriac. Hmmm... anyway, the verdict isn't in yet. next week I have three hours of cognitive tests to get through. At least I won't accidentally fake any results there.....

LOL. I came back to bump this post because I thought no one had responded. Apparently, WP just stopped sending me emails, for some reason.

That one was a bit hard. My mother has advanced senile dementia, my father is an abusive asshat, and my extended family is not much better, so we cut off all contact, a couple years ago. These people seem NT, and reasonably sane, but are just plagued by that particular sort of long-handed-down abominable behavior that makes them really terrible human beings. In my father's case, he treated me like s**t my whole life, then treated my husband like s**t, and I'm ashamed to say that it took some time of him treating my KIDS like s**t, before I finally woke up and tossed him out of our lives.

So anyway...no help from family, lol. And there wouldn't be, anyway, b/c I can honestly say no one ever paid much attention to me. They could attest that I'm very smart & very weird, but no specific insights.

I did have an old Gifted evaluation from grade school, which showed a 29-point gap in my Verbal vs. Performance IQ (Verbal higher), so that's pretty impressive. Maybe it's also telling that the same paperwork describes a 9yr old girl who loves dinosaurs, fossils, science, rock-collecting, and "a good thick book" (dear God, I can remember saying that, heh).

I also have my baby book, but my mother was...always odd. Trying to make sense of my baby book hurts the brain, lol - you have to wade through piles of scribbled notes and out-of-order records. I made a list from it, and made a point of telling the evaluator that I'd stuck to listing ONLY oddities described by my mother, and used her quotes whenever possible.



I worry, because I know the guy evaluating me has zero experience with Asperger's, and he said they use the DSM-IV standards, which are difficult for even experienced clinicians to go by. So, I worry that one of those little signals is going to look like something else, to him - childhood trauma, OCD, rampant insanity - whatever. He's already been probing my childhood quite deeply, and there's no telling what he must make of it. I know at one point, when he kept asking about trauma," I finally admitted "I don't really know what you mean; you're going to have to define 'trauma.' People always tell me how horrible my life was, but really...I didn't notice a lot of it, at the time. Being clueless about how to fix my hair, in jr. high, felt more "traumatic" to me, than being screamed at and abused by my parents. I don't always feel things the way other people do."

I only ever nod my head when I want the person to stop talking, or am totally not following them, heh. Usually both. I suppose I should really stop doing that.



I guess it's official; this university psych clinic does evaluations for school & employment, so their verdicts must be well-accepted.
This place uses a sliding scale, and technically, you don't have to pay anything - I don't think they'll hunt you down over it. But the standard fee starts at about $200, for a couple interviews and basic testing. If you need more tests, it could go to $300. And extra sessions are about $25 a pop. SUPER-cheap.



Lmfao. And that was my version of "being concise." I've always thought of it as the Verbal Assault, and there's this wonderful look "normal" people get, when hit with it, in person. I'm not certain why, but I stopped being humilated by my insane verbosity, as soon as I understood it was an AS thing. Never really minded any of my weirdness, at all; what I minded, was not having an explanation for it that people could understand. Now, I feel like I should just print up cards with the AS info on it, and never bother worrying over it, again.

tiffofdoom, thanks for the posts. I feel like you must be my long-lost sister or something.

I'm looking for a neuropsychologist to do my assessments.... finally narrowed it down that that's the specialty I need to find. found one I liked, but not in my insurance network so would have to fork out $1500 that my ex-husband would rather have the lawyers scalp off me. so, I have to save it for them and find an "in-network" provider. I found 2 in my area (yes, only 2 in a huge metro area), and hopefully will find out tomorrow if they assess adults. I've found that's also a big problem for us grown-ups. you can't swing a dead cat by the tail without hitting a shrink who will assess children, but not many are interested in assessing adults.

tiffofdoom, so much of your behavior and thought processes remind me of me. I am almost 50 and I would love an AS assessment. I just might do it someday. I respect your courage for forging through with it.

Just wanted to say thanks, to everyone who's replied, thus far.

My next appointment is this Monday, so my idea is to print this whole thread out, and hand that to the evaluator - just "Here. You should probably read this," lol.

And since they seem to use only the DSM-IV criteria, rather than any of the superior AS scales available, I used the DSM-IV criteria as a sort of written interview format, to list some of the traits I've noticed. I considered writing the sort of biographical lists I've seen some of you guys mention on WP, but with my hyper-verbosity, the thought of how huge that would be, made even ME weary, heh.

The DSM-structured list was only 2 1/2 pages, so that seemed like a good compromise. Plus, it's continually unsettling to me that I haven't been asked any of the questions a professional would normally ask, in an AS evaluation, so this seemed like a good way of getting some of that necessary information into his hands.

I think autism is really kind of cool. Disability, yes, but definitely cool. It's one of the most fascinating neurodiverse conditions I've ever met, right up there with schizophrenia and dissociative identity disorder.

The phenomenon of autistic people getting fascinated with autism itself definitely needs to be made known to the psychiatric profession. It can change symptoms. I started rocking when I realized how good it felt and how much it helped me think; my mom said I insisted on being carried in a baby sling as an infant, and it was a good guess that I had been rather fond of movement as a little one, so why not try it again? It doesn't interfere with function. But that phenomenon can actually make you pick up superficial autistic traits; not ones that impair your functioning (at least I've never heard of it); but maybe ones that make you look more autistic than you actually are. I also look more autistic now because I know my limits--I limit my exposure to some of the things that would otherwise create meltdowns, burnout, and depression. It increases the things I can do; but it does make me look a little odder. It may in fact make me look odd enough that my actual competence is underestimated.

On the other side of things, being fascinated with autism can get you confused with a hypochondriac who is fascinated with the diseases he presumes he has, and fears having; or, worse, with someone who deliberately assumes the role of a patient in factitious disorder. (I have not yet heard of someone faking autism in this way, or being so afraid they have it that they are obsessed with it; but it could happen.)

Psychiatrists need to know about those possibilities. They need to know that being fascinated with autism is actually very likely to happen in an autistic person, and should not be an indicator that he is fascinated with it out of fear or out of desire to become a patient and be taken care of by somebody else, unless there are other very good reasons to draw those conclusions. It's hard enough when you are the first person to figure it out; you doubt yourself enough as it is, without endangering your chances of an objective diagnosis simply because your own tendency to get fascinated with things is making it appear differently.

weelcome and just be yourself don't go too OTT with your finding and just be cool and calm personally to my diagnosis I am taking a digital recording of an interview with my mum abut my traits and as a poster advised just take family feedback as a lot of AS is diagnosed linked to yor childhood

See, me personally? I can't fathom ANY person finding out their child or themselves even MIGHT be autistic/aspergian/etc, and NOT wanting to learn every single thing they can about it.

My husband, who is strange in somewhat Aspergian ways, but seems neurotypical, overall, is not very interested in any of this. If I broach the subject, he is often intrigued to hear what I can teach him, and may enjoy discussing it, but that's enough for him. There seems to be no desire to explore the condition, or understand his children or wife in minute detail.
To be honest, his lack of curiousity mildy offends me, and greatly disappoints me. Try as I might to "be fair," in accepting his mind does not work like mine, I cannot help but think somewhat less of his intellect, because of that lack of curiousity.

It's always been like that, for me. Whenever I've seen people who seem or proclaim interest in a subject, and do not dive in to the profound degree I would, I have to fight off the assumption that they must be a little stupid. It's one of the worst of my ToM biases: that inability to accept the idea that smart people are not always passionately, overwhelmingly curious.

I don't know what it's like to be satisfied so easily, and I don't want to know. The better I understand NT thinking, the less I want to.


But yeah. Point being...if I were evaluating someone who claimed/suspected themselves of having AS, I would be much more wary of the person who professed to have the condition, but showed little sign of having researched it. The person nervously staring at his/her hands, while embarrasedly admitting "I've read rather a lot about it. I sort of get voracious, about things that catch my interest." - THAT person, would look more AS. Most especially, if they could then back that admission up with obvious familiarity with the subject, at a professional level.
Because no matter what the stereotypes about hypochondriacs, the average person cannot absorb large amounts of knowledge that well, much less "fake" a neurological/psychological condition.

I just wish I felt more confident that the average shrink/counselor/PhD student is aware of that fact. :/

I agree, it is very interesting especially since we all vary so much. I think its so fascinating because we don't know everything about it yet and the lines between each kind don't appear to be fully set either.

Tiffofdoom, I would caution against going to see someone for a DX who is not well versed in ASD's.
I really mean that sincerely.

Good luck.

tiffofdoom, how did it go?

Hi TiffOfDoom:

I just got diagnosed with AS in a somewhat circuitous manner, and my experience may be of use to you.

Like you, I was afraid to "display" too many of my AS characteristics in front of my psychologist -- hand flapping, talking endlessly about my obsession with Phantom of the Opera -- because of experiences I had had earlier in my life. When I was a teenager, a member of my family tried to convince my parents that I should be medicated for my "strange behaviors," and from that point on, I tried my very best to conceal what I now recognize to be AS traits. Every time I felt the need to hand flap, I cracked my knuckles instead. Every time I wanted to talk about my obsessions when I was with other people, I would either mentally retreat into myself or physically retreat to a place where I didn't have to interact with people.

It felt horrible doing this. Sometimes I felt like I would explode with my need to talk to somebody about my obsessions, but because of my family's reaction to my behaviors, I actually believed that talking about my obsessions made me sound insane enough to be institutionalized. When I was being evaluated by my psychologist, I tried to key my obsessiveness down, because I thought that she would label me schizophrenic or insist that I be put on medications. When she asked me about a suicidal episode I'd had when I was fifteen, I didn't tell her it was triggered by my depression over the traveling cast of Phantom leaving Ohio and moving onto the next state. I figured she'd think I was a nutcase.

I got my report back a few weeks ago with a diagnosis of Nonverbal Learning Disability because I showed "no evidence of repetitive, restricted interests." The report went onto say that I had "an interest in musicals, but not to an extent that was impairing." The report also said that I "did not exhibit any stereotyped or repetitive motor movements, such as hand flapping or twisting." For this reason, Asperger's was ruled out.

After a day pondering whether I should tell my psychologist about my obsessive tendencies, I decided to write her an e-mail and explain why I had not discussed them during our sessions. I wrote her a five page e-mail explaining that I was afraid she would think I was crazy if I went into the extent of my obsessions, and so I had tried to downplay them as much as possible. I also explained that I do in fact hand flap in private, but that I have trained myself to do other, more "socially acceptable" repetitive movements, like knuckle cracking, in public (I actually cracked my knuckles constantly during our sessions -- I'm frankly surprised that she missed it, or didn't consider it a "repetitive motor movement").

At our follow up session last week, my psychologist reassured me that my obsessive behavior was not crazy, and that I certainly didn't need to be institutionalized. She also said that along with my other behaviors, it warranted her changing the official diagnosis from NVLD to AS.

The things that I have learned from this experience are:

1) Be yourself. No matter how "strange" you may think you appear, your psychologist/psychiatrist is (or should be) a professional, and, unlike family members, is trained not to attack you for your differences.

2) Be completely candid. The more information you give your psychologist/psychiatrist, the better chance they will have of getting your diagnosis right. If you only give them partial information, they may diagnose you with a condition that is different than what you actually have.

3) Discuss your diagnosis with your psychologist/psychiatrist. Tell them if you think they have gotten your diagnosis wrong. Give them further information about yourself if you think it is pertinent to a correct diagnosis. Be persistent. Scientific tools are only just beginning to be sophisticated enough to diagnose autism spectrum conditions by analyzing the actual structures of the brain (such as using Transcranial Magnetic Stimulation), and as such, autism is still a behavioral diagnosis. Because of this, diagnosing autism is a more subjective process than interpreting a blood test or an fMRI. If you have more information that you think will help your psychologist/psychiatrist in the diagnostic process, give it to them.

I look forward to reading about the results of your testing.

~ Caterina

I'm pretty limited, right now. I'd love to find a neuropsych with AS experience, but we can't afford it...and our area isn't exactly bursting with qualified professionals, anyway.
Wish my son's pediatrician could diagnose me, too. He's seriously fabulous.

But yeah, I know what you mean. I'm already seeing problems. First they were going to use the TCI, to get a feel for me, and that made sense, as the TCI has been used with AS patients. Then somehow that turned into using the PAI, instead, so I was a bit disappointed. But he said that was a jumping-off point, and he would do more focused AS evaluation, afterwards. Then, at my last visit, he started making comments that really disturbed me - like, that the PAI "doesn't show Asperger's." How the hell WOULD it? It was never designed to. We got started, digging through my results, and it sounds like I scored as one would expect: obsessive-compulsive, socially withdrawn, manic, non-depressive, VERY "irritable," lol. All of that was par for the course, and nothing struck me as odd. It seemed like he must have read it COMPLETELY differently, though, because that was when he began to talk as if I did not have AS.

I'm baffled. Those results perfectly describe a typical AS personality profile.

He mentioned more scary things, like: "You seem to read non-verbal language well." What the HELL? I finally figured out, later, that he must have been referring to my telling him that, although I can't see nonverbal cues, I am extraordinarily adept at picking up on small variations in people's voices. "You have a good sense of humor" While he acknowledged that not EVERY person with Asperger's is without a sense of humor, he did seem weirdly convinced that "many" did not have one.

I don't remember what else he said. But I promptly began freaking right the hell out. This is a oft-repeated nightmare, for me: thinking I have adequately described my thoughts/feelings to someone else, then being slapped in the face with the reality that I've instead given them a completely wrong impression. It's heartbreaking, that feeling of "Oh...no, you didn't understand, at all," and my first reaction is always to go mute and slink away.

In this case, though, I just started skirting around the edges of a meltdown. I was so frightened...not by what he was saying, but by the fact that he seemed to have done such a 180. I felt like I'd slipped into bizarro world, and had no idea how to vocalize that, aside from an infantile "B-BUT YOU SAID DIFFERENT THINGS BEFORE WHY IS EVERYTHING CRAZY NOW WHAT ARE YOU TALKING ABOUT?" I started getting antsy, stimming harder, the whole shebang, and I eventually had to just scoot forward, lean over, and stare at my knees while talking. So F*cking Embarrassing. Worse, I have a horrid, life-long habit of CRYING when I get overwhelmed and can't communicate my thoughts. Not actual sobbing, but tears, so it probably looked like I was having some sort of hysterical fit. *is mortified*

Funny, though...since he'd just told me my "rage" was far above normal levels, heh. God knows what he must have been thinking.

So, I totally blew that visit. Ended up so...tangled up in my own head that I just went into a sped-up ramble, and couldn't communicate. He asked "what this diagnosis could do for me," and I never really got to answer, because my idiot ass took off on a ramble about my daughters, and the difficulty of diagnosing girls...and then our time was up, before I could even start circling my point.

Gah.

Soon as I stopped trying to "express myself," the tears immediately dried up, and I stood, smiled, bid him goodbye, and walked out of there looking like a total psycho.

I hope this can be a learning experience, for him. I would like to help, in that way. But I realize that, no matter how many thousands of words I throw at him, he still may not understand.
I really get the feeling, now, that he's going to try to diagnose me with everything BUT Asperger's. You know...social anxiety, OCD, mood disorder, generalized anxiety...every little facet that makes up the AS profile. If so, I am fascinated to see how he will explain the 29-point gap between my Verbal & Performance IQs, the sensory issues, the gravitational insecurity, the spatial problems, the poor directional ability, the prosopagnosia, the special interests, etcetcetc.




My father used to scream at me and call me a "goddamn ret*d" when I rocked, or did various other stims. I can do hand-related things, now, but can't bear to be seen rocking. I'm fine admitting it, but since childhood, that's been a very, very private stim.
As for the special interests, I talk to myself about them, in my head or out loud, ALL THE TIME, heh. I really like talking to myself more than talking with most other people, anyway.



I'm STILL awestruck, when I hear someone else say something like this. I spent my whole life, thinking I was the only one. My husband often likes to "learn" from my lectures, but I'm still very shy about it, even with him. The slightest hint of disinterest, from him, and I'll shut right off.

I'm not afraid he'll attack me, just that he'll get the wrong idea. I have no idea what training he's had, with AS, and since it's a neurological condition, not an actual mental illness, I worry that various things will just be easier to classify as psychological in origin.

GOD. MY husband volunteered a story about a particularly nasty period of social anxiety, several years ago, during which I was frightened to walk to my mailbox, because it felt like the neighbors were always watching me. All I could think was "NOOOOO! DON'T TELL HIM THAT; IT SOUNDS LIKE SCHIZOPHRENIA!"
I just have waaay too many crazy stories like that, that require far too much explanation.


--------------------------------------------------------------------------------------------------------
And now I really AM printing this whole thread, tonight, and taking it to tomorrow's appt (I tried before, but ran into various printer difficulties). So, he'll get to see everything, anyway.

SO, RAISE YOUR HAND IF YOU HAVE ASPERGER'S AND YET MIRACULOUSLY STILL MANAGE TO HAVE:

A.) A brilliant sense of humor.

B.) Greater abilities in both verbal and non-verbal communication than you had when you were, say...eight.

C.) The ability to smile, laugh aloud, and act reasonably polite and pleasant for up to one hour at a time.