Is there a resistance to DXing someone with adult ASD?

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Is there a resistance amongst psychiatrists with DXing someone with adult ASD in your experience? Or is it more that psychologists are over-DXing people?

I'm in a bit of a conundrum because I'm still not getting a consensus regarding whether I'm on the spectrum between my pdoc and tdoc. Tdoc is saying yes and even went as far as putting it in a letter to the pdoc last year that it was her opinion that I have "undiagnosed Asperger's", while my pdoc is disinterested in giving me the official label (as only pdocs here can officially diagnose) or even looking in detail at it.

Yet he acknowledges I have obsessive compulsions that have occurred from a young age and interpersonal difficulties [the latter he hopes will be partially resolved by medication and partially resolved through therapy]. I can back these up with testimony from my mum regarding my childhood years but he is still disinterested in giving me the label.

Thoughts? I'm still a little confused as to what is going on.

It's harder to diagnose adults with ASD than children because the clinician needs to know what you were like as a child. The symptoms as an adult are often complicated by compensatory behaviour. The fact that your mother is able to be involved in the diagnostic process should certainly help.

I got an unofficial diagnosis of Asperger's from a psychologist. As both my parents have died, I had to try to recall as much as I could remember from when I was a child. This was hard. Even though I was trying to be as honest as possible, it's difficult to really know what you were like as a child without someone else who can remember you being involved. It's also hard to be objective because, having read up on ASDs I knew the sort of things the psychologist would be looking for.

Until the medical profession come up with some sort of diagnostic tool that doesn't require in depth interviews (e.g. brain scan), the whole diagnostic procedure is going to remain somewhat hit and miss.

Incidentally, what's a pdoc and tdoc?

Thanks. Perhaps it's the compensatory skills that are colouring my pdoc's view. I think my mother is willing to be involved in the diagnostics of it all but my pdoc is not interested.

Oops, a pdoc is shorthand for "psychiatrist". A tdoc is a "therapist". In my case I see a clinical psychologist for therapy and a psychiatrist for the medication.

Whether you do have a pervasive developmental disorder is important for the drug / therapy intervention. Some drugs and behavioural therapy are not going to work in the same way, or even at all, if you have an ASD.

So I would certainly push the therapist's opinion on the psychiatrist and ask for a formal assessment, because otherwise you risk inappropriate drug treatment.

I went to a private pshyciatrist first and he suggested I have AS. He wrote to my GP and he reffered me to the NHS mental health team. I have since been to see them and only got seen by a nurse who wrote down my issues. This was two months ago and I have not heard back even though I called them to see what was going on and my GP wrote to them again. I feel as though they don't want to deal with me because I am an adult. I am not even getting any advice from them.

I think it is probably harder for them to deal with adults than children.

My theory is that they are too insecure about themselves to assess an adult because they know an adult is more capable of challenging their assessment. They obvisouly just want to label children because it is easy for them.

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A number of health care companies - HMOs - simply do not offer diagnoses for adults for things such as: dyspraxia, mild gross and fine motor control difficulties, apraxia, Asperger, autism, and central auditory processing disorder.

It's known that psychiatrists and psychologists often do not talk to one another (which leaves the customer caught in the middle). Why? Often business guild turf wars over who gets the money from the customer (my view).

The customer's wallet is what the business guilds want - the health of the customer can be a different matter to some business health guilds and not a priority at all.

For many years, concussions/subtle brain injuries were glossed over by some neurologists and the medical business (both non-profit and for profit) industry in general.

http://www.sportsconcussions.org/

http://www.ninds.nih.gov/disorders/autism/autism.htm
http://www.hbo.com/movies/temple-grandin/index.html

http://www.ninds.nih.gov/disorders/aspe ... perger.htm

http://www.dyspraxiafoundation.org.uk/
http://www.out-of-sync-child.com/
http://www.associatedconditionsofcerebralpalsy.com/
http://www.hemihelp.org.uk/
http://www.balametrics.com/

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Who said "It's a jungle out there."?

So, your question: Is there a resistance to diagnosing someone with adult ASD?

Answer: Absolutely yes - too many HMOs go out of their way to try to pretend adult ASD doesn't exist and they simply will not deal with the topic at all and intentionally exclude it from their health care coverage.

Does that match the PR advertising that America has the best health care system on planet earth and the best doctors who help everyone?

No. It reveals the PR is simply a fib (lie).

Wisdom says to judge a person by their actions, not what they say.

Yes, there is a big resistance to diagnosing adults with ASD.

Whether this will change much at all under the new Obama Health Care Reform legislation is a big question. There may be no changes. There may be little changes. Time will tell.

I think that is fairly accurate, and especially for people who seem relatively functional at all. "The system" is only about what it can gain from anything given, and our "productive" or "value added" potential continually diminishes as we age.

The main reason that the focus is put on children, is because children are cute and innocent. Adults look just like every other adult, and the cute factor isn't there. Correct me, if I'm wrong.

Well, I certainly had a hard time getting in to see a shrink. Around here you can't see one without a referral from a regular doctor, and around here, the doctors dont really talk to you about your mental state, or about your life / quality of life.

When I actually went to a doc asking for a referral, I was given what I call 'the blank no' - they look at you for what seems like 5 minutes and don't respond, waiting perhaps for more to be said? and just looking stupid. Prompting me to ask "Do you know what Asperger's / Autism is?" (a nod in response, then that same blank stare - so I define the conditions to him)

One of them started arguing semantics when I presented a local shrink's name who I had been informed was free to see me. Just because I was unsure if the name I had brought was that of a psychologist or a psychiatrist. (I always mix them up / eye-doctor names have the opposite endings!) He demanded I say one or the other. I guessed wrong and he was saying no because of that. GAH!

Long story short, it took three doctors and I still felt I hadn't gotten anywhere. I had to refuse to leave the room on the last doctor and got pretty worked up before he said he'd look into it. The next week I got two calls - One for the shrink I wanted and another for a shrink to help me "deal with my anxiety issues".

Yeah. There's a penchant to stand in the way of any sort of self diagnoses. And with the system the way it is, there's no way anyone would have their social / mental issues adressed unless they <A> self diagnose or <B> do something nutty.

I guess it's not just me who finds the system frustrating

I think I will continue to push for a firm consensus between my team. It's going to be untenable eventually when I have separate members from my team saying different things about my DX. I understand the schizoaffective side of my label and there's consensus on that, but I think there's a lot more happening with me that isn't being addressed by that label, and which the ASD label would cover sufficiently.

then if you can get lucky enough to GET diagnosed as an adult (and my diagnosis came as a COMPLETE surprise; we initially thought I had a head injury at 3 months of age that did this), try getting treatment. That's even harder. And around here, freaking IMPOSSIBLE.