Diagnosed with AS by experts without meeting criteria

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I received a diagnosis of Asperger's Syndrome from a clinic that specializes in doing this kind of testing. They are the experts in town. I went through the written report from the clinic, and things aren't making sense. Here is some background...

I have suffered verbal abuse from my wife for 12 years, and our divorce is proceeding based on the AS diagnosis. My diagnosis is based in part on my self-assessment, and my wife's assessment of my social skills. I feel that my answers are skewed by my mental state (abuse and relationship ending). I also have kids and I worry about how their lives will be affected by the events unfolding. My wife has her own issues she is in therapy for, but in her eyes, I am the reason why our marriage is not working. So that is some background on my situation. Here is what doesn't make sense about my diagnosis. Per the DSM-IV...

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:
- failure to develop peer relationships appropriate to developmental level - This is me. I don't have close friends. I did have close friends, but my wife cut me off from them years ago. For now I am content hanging out with kids, and social interaction of casual friends like other parents, work associates, neighbors, people I share activities with in sports and gardening. Before kids, I would say my wife was my best friend. Over the last 12 years, my wife has gone from best friend to someone I hide from.
- lack of social or emotional reciprocity - This is me. I have potential here, and I'm working on this. I'm pretty good at 1-on-1 conversations, which is how I romanced my wife.. The more I practice reciprocity, the better I get. I like social interactions, and I seek out situations that push me beyond my comfort zone.
The other critieria do not apply in group I... I have good eye-contact, gestures, facial expressions. I share my enjoyment and achievements with others, and find pleasure in hanging out with others when my wife let's me.

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
None of these apply. No preoccupations. My routines are functional, and as a parent I need to multitask and be flexible. No hand flapping, etc. No preoccupation with parts.

How can the experts give me a diagnosis of Asperger's Syndrome when criteria in group II don't apply? And If I don't have AS, what do I have, if anything other than being shy, a victim of abuse from my wife, and in need of practicing my communication skills? I'm frustrated and confused by the conclusion of the experts. I'm just trying to find the truth so I can get the help I need.

It does seem like the abuse and its impact needs to be addressed first. My own therapist has speculated that there are family situations that can cause Aspie-like responses; it was one of the things we sorted through during my own Dx. Though I am in a loving, supportive relationship now, my childhood situation was fairly verbally & emotionally abusive.

Is there any other autism/AS in your blood family?

Also, the stereotyped patterns of behavior can be very subtle, especially in adults. In my own case, I rub my upper lip with my index finger or the palm of my hand with my thumb... not very noticeable, but very predictable and stereotyped.

Of course your abilities with social interaction would improve with practice... Aspies can learn. AS is not a fixed state, it's merely a different way of being. We grow and learn, too. It's often harder to Dx adults because they've worked so hard to adapt to their surroundings.

I hope your situation becomes more caring and supportive, with or without your wife. As a kid, I prayed my folks would divorce... Two separate happy parents is a whole lot better than two married parents destroying each other.

DonkeyBuster,
It is helpful to hear your experience. No other autism/AS in my family. I see it in others I know, but not my family. To be honest, I don't see it in myself except for the lack of close friends my age - 50, and the social reciprocity that I am working on. As you say, it could be that my missing symptoms are very subtle or I have compensated for them so I seem normal. But if you looked hard enough you could find traces of AS in just about anyone. I read through the DSM-IV and found PDD NOS. It seems like a better fit than AS, but I'm not sure if that helps me find the help I need any better than a AS Dx.
-CatGuy2

On the other hand, you could just be a browbeaten NT... I've known a couple of those. Poor eye contact & social skills due largely to no self esteem and the expectation of being attacked if they 'stood up', met another's eyes, spoke first and firmly, etc.

How were your childhood family's social skills... were theirs as maladaptive as yours? Both my parents had few close friends, and neither was much for the social scene... well, they both liked to party, but infrequently and not at home. Kind of interesting, now that I think on it.

I think my dad's the Aspie, my mom's probably narcissistic, and I've got a brother that's severely autistic, lives in a group home, stimming his little heart out. He's the happiest guy I know... completely cut off from the world. There's got to be a message there.

Most people crave relationships so strongly that they can not be prevented from socializing. That is not to say that the clinic is correct, of course. I am kind of shocked that your test results are being used in an adversarial contest.

How do you score on the ASQ and similar tests linked at the top of this forum? I don't mean post the results, just gather the data for your analysis of the report. And look back at your play and relationships as a child.

It seems to me that your priority is in the divorce proceedings, not the AS diagnosis. But if you have AS and argue that you do not have AS then it will not do you any favours, so you should maybe be more receptive to the results and gather firm evidence for or against. I don't see why it would negatively impact you approaching the proceedings by saying "Yes, I have AS, and what is your point?"

From a medical perspective, the lack of a mandatory criterion contraindicates diagnosis. Period. So, I think the question is properly directed at the person who diagnosed your AS. Ask for more information about the behaviours that you presented and how they fit within the diagnostic criteria.

It may be that you are demonstrating physical behaviours under observation of which you are unaware, or to which you are attaching less significance that the psychologist.

One of the issues shared by many people whose AS is diagnosed when they are adults is the development of coping skills and learned behaviours that mask their AS presentations. During periods of stress or fatigue, often these behaviours become more difficult to access.

So, the stress of the change in your family life might not be a cause in se of your presentations, but rather a factor in the failure of your coping mechanisms, exposing the underlying deficits. A thorough, objective look at your childhood and adolescent behaviours may help you determine whether this is, in fact, the case.

In your position (and I have been in it!) I would be loathe to discredit the diagnosis until I had had the opportunity to review the observations that led to it. Rather, I would treat it as an opportunity to explore further.

It sounds like AS is the best diagnosis at this time and if you are comfortable with it, you should just go with it. If later, as you recover from the abuse, you find it doesn't fit you anymore you can seek a more accurate diagnosis. People are misdiagnosed all the time! There is no conclusive test, they can only find the label that makes the most sense and is therefore the most useful.

My youngest son was once dx'd as PDD-NOS, and did at that time fit the criteria for dx very well. He outgrew it! You can't outgrow ASDs so obviously we had the dx wrong, and now we are trying to work out who he really is and what he really needs. He's a great kid.

I would like to add that I agree with the other poster who says you may be doing some things you aren't aware of.

Once I was told by a young man that he was "just dx'd with AS and didn't think it was possible, and what did I think?" He was reading one of the classic AS books and having a terrible time believing that he fit the criteria. He wasn't the kind of Aspie that just seems a little different once you get to know them. I'd say his mannerisms were about as different as Temple Grandins. I'd not have picked him out for sure as an Aspie, I might have guessed Moderate Functioning Autism...if that's a thing, but I don't know his history. If the Dr says it's AS, in his case, it probably is. He's a great kid, plenty smart, very kind hearted, but it's also extremely obvious he's not NT, he just doesn't see it.

You may not be quite like that, but you could be doing more Aspie things than you are aware of.

So I did get a second opinion, and the opinion is
1. I don't meet the criteria listed in the DSM-IV.
2. The diagnosis is likely Asperger's.

I am comfortable with the problem areas that have been identified with my social skills. I have been struggling with this all my life. Everyone has something they can improve on. What I don't understand is the label that I am being given. My therapist who specializes in AS patients, and gave me the second opinion, is not seeing my hobby as being a preoccupation for me, I don't have hand flapping, etc. So why call it Asperger's if it doesn't pass the test listed in the DSM?

What if I was sufferering from severe headaches? I get my head scanned and nothing usual shows up, but the doctor concludes I have a tumor because the pain I have is one of a list of symptoms associated with tumors. That is how I feel I'm being treated.

If anything you should have been given the label PDD-NOS. This is the category for people on the autism spectrum that do not meet the criteria for Asperger's or Autistic Disorder.

However, this will be of little use to you now that the criteria is changing to eliminate AS and PDD-NOS and the new criteria will include repetitive behavior and routines.

If you have two diagnoses, and one is from your therapist, then it will be hard to argue against.

I think the important issue is whether it has any impact on the divorce proceedings, and what you can do about that.