Diagnostically a puzzle; your opinion?

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Wavefreak, I'm very sorry but try as I might, I am overloaded and can't process what you're trying to say. I see that I adhere to facts and then reference feelings, and I don't know why or if that's something unusual for me or what.

Might you try rewording it a different way so that I can try again? Sometimes, with me, you have to try a few different ways of telling me something before I can understand.

This is a good example of why a test-ceiling IQ is useless if you can only easily grasp your own thoughts, and not other people's. Frustrating.


As far as saying "on the spectrum," that had not occured to me, and it sounds like a good idea. I would still prefer a concensus, but since that's not coming at least until the new DSM release, ASD it will have to be.

Sorry. I'm not always so good at explaining my thoughts either.

I think I understand what you mean by needing space to think. When people get too close, my agitation increases and I can't think about what I like to think about. I end up thinking about their proximity and what it is they want me to be thinking about. People getting too close can be very disruptive. But this is a very physical thing. I don't like the physical sensations of closeness and it interrupts the flow of my thoughts.

I may have misunderstood you when you said that you can't see enough space for everybody to be able to think. I'm thinking now that you mean that that there isn't enough physical space for everyone to have the same comfort zone as you do. Or something like that.

Well, my brain quite literally doesn't WORK when people are around. I'm not agitated, per se, but... I just can't think!

What I meant was that if every human needs approximately a 20x20 foot area to think (as I do), then for 7 billion people (an estimate, I know) to think, we would need 23,028 square miles total for each person to have their space. I guess, having Googled the number, that given that the total square mileage of the earth's land is 57,268,900 square miles, we're in good shape.

And that is why the world hasn't exploded, so it all makes sense.

But really that was only half serious, or not even that much. I mean, I wasn't thinking in terms of numbers and stuff, but I just worked it out for fun. The idea kind of holds true, though, that I was wondering how there was enough physical space on the earth for everyone to think properly. But, as you've pointed out, not everyone needs space to think like I do, and this is probably why it's not an issue for most people.

The bigger issue deals with resources. Not everyone can be as wasteful as we are here in America. And, not to mention that while there is plenty of space, a good majority of it isn't even habitable. At least not until we can build floating cities like this.



Hmm... maybe I should see if I can actually do that. The engineering challenges behind it are probably insignificant compared to the economics of it though. Still, it'd be an awesome project to work on.

I got what you meant on account of I need a good amount of space too. When people are around it just destroys my thinking. Even if someone knocks on my door I can't think properly afterward until I reestablish my sense of personal space.

LOL.

My literal thinking strikes again. Somehow, when you said you something about thinking and needing space, I thought you meant your thoughts themselves took up physical space. So I went down that rabbit hole and nobody followed.

Yes, Verdandi is correct. PDD-NOS is just an umbrella diagnosis for all those cases of ASDs that don't fit a textbook description of symptoms. It just means that the individual has "atypical" autism and doesn't fit the full criteria for autistic disorder or AS. But the functioning level of PDD-NOS individuals can range from Asperger's-like to very low-functioning and nonverbal.

And, SuperTrouper, I agree with your one doctor's diagnosis of moderately-functioning autism. I think it's quite clear that you have autistic disorder. I would place you at a moderate functioning level rather than high, due to the more severe communication problems you have, as well as your high level of SIBs and your need for more help with life skills than others on this site.

OddDuck (by the way, I use "duck" for everything... happy duck, tired duck, silly duck... all stems from odd duck. All this to say, I like your usename),

That's what I think, too. Thanks. I consider you to be something of an authority on the subject, so it eases my mind (is that the phrase I want?) to know that you agree with me and the people who have spent the most time with me, over 50 hours (and even they, who say MFA, have not seen me on a truly bad day!). The doctor who says AS only sees me for 15 minutes every 3 months, so a total of 2 hours of my life. The therapist who says HFA has been with me for about 30 hours.

It would seem that the more time an individual spends with me, the more autism they see. This makes sense to me but is still interesting.

It wasn't my opinion. It was what I read in a psychology book. So, those psychologists are incorrect?

Well, if they qualified it, then they might not have been - it's certainly possible to be mild and diagnosed as PDD-NOS. But if they described it as the "mildest form of autism" because people diagnosed with it don't fit AS or autistic disorder, then that is inaccurate based on actual clinical practice. The people I can name offhand who have been diagnosed with PDD-NOS are not what I would describe as mild.

Also, technically, PDD-NOS should supercede AS and someone who fits the criteria for both should be diagnosed PDD-NOS (although in practice this does not always happen).

How can you fit the critera for both when the criteria for PDD-NOS is that you don't fit the criteria for autism and aspergers?

Hmm, you're right, they both say they exclude the other.

But that means that people who might otherwise fit the criteria for AS but have symptoms (like language delays) that would rule out AS might be diagnosed with PDD-NOS, and people who technically should fit the criteria for autism might be diagnosed with it because the diagnostician can only get an incomplete idea of what childhood was like. In another case I know of someone who was diagnosed as PDD-NOS because if she had been diagnosed as autistic her insurance would have apparently not covered her or dropped her. I know of yet another person who was diagnosed as PDD-NOS despite meeting the criteria for autistic disorder because she had undergone some therapy to help her with certain problems and the psychologist who diagnosed her as such claimed it was because she had overcome some of her symptoms.

The problem is that many don't strictly follow the same set of protocols for each diagnosis and people who best fit one category are diagnosed in another. This probably has a lot to do with the decision to collapse all of the diagnoses into ASD for the DSM-V.

You don't need a speech delay for the classic autism diagnosis; the echolalia is enough. I'm in the same boat there--spoke on time, read early, but couldn't hold a conversation and took longer to learn to take care of myself; so that put me in the classic autism box as a child, and then after I learned speech, dumped me into catch-all PDD-NOS. My initial diagnosis was Asperger's primarily because it was made after my speech difficulties were no longer particularly noticeable when I wasn't stressed out, and after I had learned basic self-care. Classic autism can look like Asperger's in adulthood, because it is much more likely that you'll gain communicative speech than not. But then, from what I gather here at WP, almost all people diagnosed Asperger's are also diagnosable with classic autism.

So I'll have to agree with the people who say "Just say autism," or "just say autism spectrum." Because with the diagnostic categories being so messed up, that's the most narrow category you can quote that still has any meaning.

So the question remains, why don't doctors follow the rules?! The DSM was created for them to have rules to follow, yet they ignore them.

pretty sure there is a place on the autism spectrum for people with progressive autism/aspies (you start out without symptoms and gain them early on) 'im not sure but if i remember correctly symptoms start to appear progressivly up to puberty. might wanna look at the "other" on autism spectrum. You seem to suffer from over stimualiation. That being said, its mearly a label that helps us find others like us, and for a few others helps them get SSI. Don't put to much faith in it, because before we had aspie genuis's, they simply catagorized us as a form of mental retardation. Obviously they where wrong, and to a greater extent idiots, as even low function autistic people have proven not only smarter but are more kick ass. Honestly look at autism research if you want to know how far doctors have gotten. I think there at the stage where they are agreeing that we may infact have social problems and that 1 of us suffers from overstimulation.

Then you have ICD-10, or here in the UK AAA, possibly others worldwide, all loosely similar, but subtle differences are enough to result in different labels - not to mention that our symptoms vary form day to day, our ability to describe our symptoms may be impaired, and the criteria are somewhat subjective, so application varies from practitioner to practitioner....

eg. In my diagnosis, some of my 'dx positives' are not what I would have described as problematic, whilst some of my problems were not counted as within 'criteria'. One that bothered me most was that, because for most of my life I have had a friend, and I have around 100 facebook contacts - I, apparently, do not display a 'failure to make peer relationships appropriate to developmental level'. Whereas, as far as I'm concerned, every NT person I know is surrounded by a group of friends, and my ability is not at all commensurate with my peers.


I think you have your answer when you think that the practitioner who has spent the most time with you has given you the most accurate diagnosis - and I feel (actually quite strongly) that the right diagnosis will tend to be the one you identify with - so long as you are being honest with yourself.

To me, your description of language development would not give you an AS diagnosis, but rather would fit the criteria for delayed functional speech and therefore classic autism.


Perhaps diagnosis should take longer in order to be more accurate?....but to be honest the process took a month for me, and that was bad enough, I'd hate for it to take longer.