Adult AS Symptoms Don't Reconcile with Diagnostic Criteria

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Hi everyone

I've been lurking for a while but this is my first post here. I'm 55 and male. Like a lot of first posts, it's an epic.

I came across the AS symptoms by accident whilst searching for information on anxiety, which I'm on medication for. It was a kind of epiphany moment and caused me to read much more. The on-line tests I did tend towards an AS diagnosis:

AQ, 38 (80% of those diagnosed with autism or a related disorder scored 32 or higher)
EQ, 20 (0-32 = low (most people with Asperger Syndrome or high-functioning autism score about 20))
Reading the Mind in the Eyes, 22 (A score under 22 indicates you find this difficult)

And some other tests which show similar AS type scores.

I also believe I have faceblindness. If I meet someone today, I won't recognize them tomorrow. I cannot follow any kind of TV film or drama because I often can't tell the characters apart (at least, not by their faces). When my daughter walked up the drive with her friend last week, I didn't realise who it was for a second or two. I think it was her saying "Hi" that caused me to realise before her face registered. Yes, I'm talking about my own daughter.

I've had a severe food fussiness for my entire life, I don't eat anything strongly flavoured, have a very restricted diet, and my wife cooks 2 different meals most evenings. Some foods I cannot bear the smell of. I've read that extreme sensory perception to odour, taste and texture can be an AS trait.

The most significant AS trait that I most certainly have is socialising. I have no friends. I'm fairly content with my own company most of the time. If I go to a social (usually family) occasion, I'm the one who sits at the back hoping that no-one will come near me. I contribute almost nothing to the occasion, unless someone asks me a direct question or it's a subject about which I have a strong interest. I never do "small talk". My wife is the opposite character, talkative, outgoing, good socialiser and she talks for me.

At school, my ball game skills were extremely poor, no-one wanted me in their team. I can recall some things in childhood which point to poor large motor skills generally. At the same time I was very good at drawing and crafts skills, and remain so. My long term memory is excellent and I can recall lots of totally pointless numbers from decades ago, like my old credit card (lost and cancelled 30+ years ago). What did you say your name was? I can't remember.

I have lots of other symptoms which fit perfectly with the traits described in Tony Attwood's very comprehensive book.

It starts to fall apart when I look at the diagnostic criteria for AS, though. My parents are no longer living so they can't be asked about early development, but my own memory is of being a bit lazy in general life skills, dressing, washing, that kind of thing. But no-one has ever said, as far as I know, that I have any kind of 'clumsy/gauche body language', or a 'peculiar, stiff gaze'. I do use gestures when speaking, though perhaps, a little less than some.

I remember Mum saying, "he doesn't say much", but I'm not aware that my speech is odd - ok, maybe it is a touch monotonous, and I am certainly guilty of being trusting of what people say and a bit naïve but I'm learning to try and hear beyond what people are actually saying. I still struggle with humour, am totally disinterested in comedy or fiction, and I've embarrassed myself quite a lot by taking sarcasm literally.

Have I had a lifetime feeling different ? Well, no more than any other self confessed geek. Yes, I had some narrow and unusual (for a youngster) interests in adolescence but I've never though of them as compulsive, they were just the interest of the moment . I'd have been disappointed to have them removed but I don’t think I'd have had a meltdown. I had classmates at school and I wasn't bullied even though I was never part of the 'in crowd'. In married life, my wife organises all the socialising and I've come around to being fairly content to be thought of as eccentric, quite happy to sit and read or surf whilst the rest of the party carries on quietly as though I wasn't there. She is of very strong character and says "he's quite happy there, just leave him alone". If she feels it's time I put something in to the conversation, she throws me a line about this year's pet interest and that kick starts me. See, I can even do metaphors.

So I'm struggling with this a bit. Part of me would like to be able to say "You know why I'm always a problem at mealtime? You couldn't understand why I didn’t notice your new spectacles? You wonder why I get so tired after an evening out? Why I'll quite happily let the telephone go unanswered? Well, here's the answer". But I don't need outside support and my quiet life is generally ok, thank you.

So … does the panel think I have AS at all? If so, is it even possible for me to get diagnosed? I know from reading the fora that there are plenty of mature adults who suspect they have AS, but it's the visible/physical criteria that doesn't reconcile with what seems to be the reality. I mean, if you had an unusual gait combined with odd speech and prosody, wouldn't you or your doctor have picked up on it by now? Do those who self-diagnose AS ignore the symptom criteria and focus on the symptoms they do have? And what about compensation techniques? I have to work at it, but I can usually grunt the right amount of yes, no's and feign at least some interest in a conversation even if I'm actually designing my next project in my head.

Any input appreciated ...

yes, and no.as far as text book symptoms autism is a developmental difference so any person with any type of autism progresses toward being normal as they get older.for instance some people dx with classic autism as a child may act asprgers at 35.it is normal for a person who has apergers or hfa to slowly fade towards normal later in life.however most doctors understand this.as my shrink once said,i dont think you will ever walk down the street and feel like other people.but over time things will get easier

yes, and no.as far as text book symptoms autism is a developmental difference so any person with any type of autism progresses toward being normal as they get older.for instance some people dx with classic autism as a child may act asprgers at 35.it is normal for a person who has apergers or hfa to slowly fade towards normal later in life.however most doctors understand this.as my shrink once said,i dont think you will ever walk down the street and feel like other people.but over time things will get easier

All the symptoms you describe are consistent with what I understand to be HFA. I am also self-diagnosed late in life (53). I don't fit every symptom and I have learned many compensatory skills over my (undiagnosed) life. I can "pass for normal' for short times. But how I feel inside and how I have experienced friendships (mostly not) and other social experience along with some of the other criteria convince me that I fall somewhere on the spectrum. I'd say trust your feelings on this.

Also, it is good to remember that AS was not even in the DSM 20 years ago. Those of us who had it before that were just categorized as "weird", "out-of-the-box", "geeks", or having some kind of psychiatric or personality disorder. Neurotypical (non-autistic) people have come up with the diagnostic criteria as they exist now and it's all evolving and changing rapidly as more and more of us come forward and say, "but wait a minute. It's not exactly like that for me." So don't worry if you don't fit the NT currently defined criteria perfectly.

I'd say it's definitely possible.



Yes, it's definitely possible for you to get diagnosed. If you seek an assessment for AS, I recommend looking for a clinician that specializes in diagnosing and treating ASDs (and ideally has experience working with adults).



Try not to worry too much about that. The criteria are subject to interpretation--even for children. Autism spectrum disorders look different from person to person (not everyone will have the same symptoms...the same symptom, shared by two people, might look totally different in one person than the other).



Nope, not necessarily. Lots of people, even doctors, don't really know much (if anything) about ASDs. They don't look for autism/AS because they aren't familiar with ASDs--they look for what they are familiar with, such as shyness, anxiety, ADHD, depression, etc. (Many people are familiar only with stereotypes about autism/AS--so if you don't match the stereotype, the idea that you have AS won't even cross people's minds.)



Knowledgeable clinicians would take compensation techniques into account. If you go for an assessment, you'll be asked about your childhood history and can explain how you've learned to compensate for difficulties/differences as you've grown up.

"Development" doesn't mean "childhood", in the field.
It means the progression of people throughout our lives-
meaning people who are developmentally-delayed as compared to their average-population counterparts will likely always be in at least one area-
that's the idea of critical periods-
certain life stages must be resolved and/or conquered before moving onto the next.

I would add that the typical conception of ASD in many people's (including doctor's) minds seems to be "is like mental retardation." So, if you come across as odd but intelligent (whether you are intelligent or not), the oddities may be brushed off as "eccentricity."

i know it means progression throughout ones whole,thats what i was saying in my post.read my post again

You should also think if there is any advantage in a diagnosis.

i cant say for sure,i was dx in my late teens.if you have your old childhood medical records i think you would get diagnosed.thats just my guess.i think a smart doctor can figue out that age can mitigate traditional symptoms

i cant say for sure,i was dx in my late teens.if you have your old childhood medical records i think you would get diagnosed.thats just my guess.i think a smart doctor can figue out that age can mitigate traditional symptoms

That's a good point and one which I'm pondering over.

As to the detail of the symptoms in the diagnostic criteria, I'm currently reading 'Asperger Syndrome and Long Term Relationships' by Ashley Stanford which goes a long way to explaining what the actual wording of the criteria means in 'real-life' situations.