Help with interpreting the social communication criteria?

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Okay, so from analysis I suspect that I meet the criteria for sections B, potentially C, and definitely D but only if A did turn out to be the case (as taken from here > http://www.myaspergerschild.com/2012/01 ... utism.html). I also have what appear to be quite severe meltdowns, that until now I have never found any convincing potential explanation for, although that isn’t mentioned within the criteria (sorry if I am repeating myself – I have already made several other posts but this one is more specific to asking about social communication/interaction, so I am just giving some brief background if people who haven’t read the other posts happen to read this.)

Anyway, so here lies the problem: Based on my surface presentation, I think close friends who don’t live with me and indeed doctors would find it very hard to believe that I have any social communication/interaction problems, as nowadays, with a private one on one conversation if I am given the space to think and talk in my own time, I can appear to be pretty talkative. I am confused, because up until now even I have always thought I am just shy and I thought that had nothing to do with my other problems. It never occurred to me that my problems with socialising could be connected to my pretty debilitating yet still unexplained mental health problems, beyond being down to the by-product of low self-esteem (as mentioned before I have been diagnosed with an eating disorder for a long time, but doctors always said there was something else wrong too that they couldn’t put a name to, primarily relating to my head-banging rage/panic attacks.)

I wondered if anyone could give me some examples and more detailed explanations for what the following criteria for section A actually mean when applied to real life?

Also, I wondered if anyone could read some of my past diary extracts below and tell me in your view whether they: demonstrate mere shyness and therefore would be likely to not qualify for an assessment for ASD in a professional’s eyes, OR whether they are indicative in any way of actual deficits in social communication beyond just a personality trait of shyness?

Past diary extracts (I am 23 currently):

(apologies for the emo-like moaning, rather embarrassing but oh well )

Age 15

[i]‘...I’m basically nothing. I’m too shy. ** says, then change. But I’ve tried. I can’t do it. I remember at some point in high-school I tried to be talkative. I told myself eventually it would become second nature, the shyness would go away. But it didn’t. I forced myself to be talkative. For months. But it was too hard. It didn’t get easier & it’s still as rock solid as ever. If I’m talking to someone I don’t know very well I run through my mind what I’m going to say for 5 minutes, checking it’s ok. Then when I speak I feel stupid, coz I know it doesn’t sound natural. Then I do strange things like muttering, swearing under my breath afterwards. I can’t help it. Even if the conversation went well. I’m like ‘f**k s**t’ to calm me down. Then I suddenly realise what I’m doing and hope noone’s noticed’

‘ School is crap. I hate it. But it’s all my fault because I’m a loner. I’m sad. People say hi to me. People sometimes try and make conversation with me, but they get bored and walk away. I just can never find anything to say. Then when I do speak it comes out all wrong & I don’t form sentences properly & I’m scared I’ve offended someone. I feel like I wasn’t made to communicate with humans. I feel all wrong. I try so hard to be friendly, but it’s so hard to keep on talking I just drain away & feel like a failure’

Age 16

‘…I’m still quite quiet, but that’s ok. But I’m gradually learning. It’s as though I’m a baby learning to talk again. It’s like I’ve been set free. I can be me & there’s no need to pretend... Though I’ve realised that I need to start explaining myself more. When I start to speak, I suddenly want to get all the attention off me as quick as possible, so I panic and take the shortest route to the end of my story, which often leads people to interpret it wrong.’

‘…I’ve realised I have a problem; I’m scared even to talk to my close friends; speaking doesn’t come naturally. It’s a conscious effort. And when I do speak, I get scared, I’m paranoid people are thinking I’m a fake, that they can see that I’m forcing myself to speak. And then, when I’m thinking all this at the same time as speaking, I don’t make sense. My words come out wrong or back to front. I feel immature, pathetic and dumb; because I get to college, and I’m trying to learn something you did when you were 3; to talk, to form sentences properly.’

Age 21

'I went to ***’s birthday. The fear builds up like the fear of an essay. I went down at 8 because on facebook it said 8 (I’ve now locked myself out of there because it makes me a very sad person), and I ‘knew’ I’d be too early. Even half 8 was too early. But I was terrified of them leaving without me after I’d built up all the courage to go, so I had to go down to check. **** said to come back in half an hour then people should be ready. I could have easily gone back and given up, all the uncertainty about times kills me. Why can’t anyone ever be on time for a social event?

… They are nice people, I just somehow don’t fit in, and I don’t think I would even if I was well. It was okay when we went out to * and danced and didn’t have to talk, I had a good time then… I don’t know how much of me not fitting in is because I don’t think I fit in. If I did think I fitted in, then maybe I wouldn’t give off the ‘awkward’ vibe. Then again, some people are so busy thinking they fit in, and I think they fit in, then I realise that everyone just talks about how annoying they are, when they’re gone I wished that someone would start a conversation with me as I didn’t have a clue what to talk about…

…I think I’m scared of being more confident because weird becomes bad when it’s in your face and in the way. As I am, not forcing myself upon anyone, just listening quietly... I guess I’m harmless except for the fact that I’m taking up a chair. I do feel guilty about the chair, like, what if the two people either side of me could talk better if I wasn’t taking up space between them?’

‘I can’t sit still in any lecture. I don’t know whether I’m paranoid about how much I move, or whether people can really see it. If they can see it the way I think they can, then it must be really annoying. I feel bad because what they are saying is really interesting, but I just want to jump up and down.’

‘I still struggle to deal with people being nice to me. I feel warmth mixed with what feels almost like extreme embarrassment but isn’t quite. It’s as though the kindness scolds me and I want to hide away from it.’

‘I was so scared noone would like me and everyone would shut me out. I didn’t introduce myself when I walked in... Maybe I should have, I dunno. But maybe that’s not me. Me is waiting for permission... But then I was scared maybe I’d missed the signs of permission. I hope that someone talks to me, but sometimes just because someone doesn’t approach you, doesn’t mean they don’t want to talk to you. A guy who looked a bit younger (from listening to the conversation he turned out to be a fresher), kept smiling at me, and he did give me eye contact when he was talking to another girl. That was nice. Even if I don’t speak, it is nice when people include you just by acknowledging that you are stood there, and not acting like you’re invisible. I smiled back. I think a few other people smiled at me too. They seem like a nice bunch, I hope. I didn’t instantly get negative vibes anyway’

Retrospect details of more recent years that I have just written now:

- I can’t seem to answer moderately complex - complex questions verbally – this makes me feel really stupid in an academic context especially, but even when talking to a friend it happens, then I feel like they’ve received completely the wrong impression of me but I am too embarrassed to explain. The only person I do explain it to is my boyfriend, so when he asks a question like that now I say: ‘I can’t verbalise an answer to that right now but it isn’t because I don’t know the answer; if you seriously want an answer to that I can write it down’

- I have problems living with other people. E.g. I currently live with my boyfriend and his family. My boyfriend I am now comfortable with to just be myself no-matter how weird my speech comes out. But I get huge anxiety when I need to communicate things to his family, as in general I get so scared of talking to them and my mind goes blank when they try to small talk. So then when I need to tell them something, I spend ages trying to build up the courage, then often mess up because I never managed to tell them. E.g. When I ordered a food delivery as going to the supermarket overwhelms me with fear, I tried to listen out for it so that I could collect it myself and not have to communicate with the rest of the house. But then it came early and I had set a time to start listening, and it came before that time, so then the delivery got sent away because I hadn’t communicated to let the rest of the house know that I was expecting a delivery. Cue meltdown and being so angry at myself for messing up when I ‘knew’ I should have let people know.

- I would also have constant anxiety when I lived in uni halls of residence as although I wanted friends, I couldn’t deal with bumping into people and the small talk when I hadn’t planned to talk to someone. So if I needed the toilet or to go to the kitchen and I could hear voices in the corridor, I waited and waited until I could hear them walk away, so that I could come out.

- Eye contact problems: I constantly worry about appearing rude; the fact that eye contact exhausts me so much and distracts me when I’m trying to listen to what someone is saying, because I’m concentrating so much on when I should be looking them in the eye and when I can look away, as it doesn’t feel natural to me to look them in the eye much, it feels intimidating, but I don’t want to look weird so I’ve always tried to do what I know I ‘should’ do to appear normal. Only the people living with me have noticed this - I guess it is harder to keep 'normal' eye contact up all the time without letting it slip, when living with people, whereas keeping it up for just an hour or so when I meet someone, I can do more convincingly.

Hi! A while back I made a bullet-point list of my symptoms according to the DSM-V criteria... I'll post that below, just in case you find it helpful! (And yes I have been diagnosed by an autism specialist.)

I read your diary entries, but I don't feel qualified to judge whether your experiences are typical for autism or not... A lot of it I could relate to, though you definitely have a higher level of social awareness and desire for interaction than I do (which again, doesn't really mean anything!)

Anyway here are my own symptoms... Good luck and I hope you can get an answer to your uncertainties – I know it's helped me a lot to understand what I'm dealing with!

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following:

1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

• In nursery school I basically just sat in the corner by myself and refused to play with the other kids
• In elementary school I always made sure I had a book to read, so I wouldn't have to interact with anyone
• In high school I skipped lunch every day, because I felt so uncomfortable socializing with the other kids
• I prefer the typical autistic 'info dump' style of conversation, and have trouble taking turns
• I can't talk on the phone because I never understand when it's my turn to talk, or what I should say
• I have abnormal interests and emotions, so I keep quiet and don't share them with others
• I've always tried to avoid social interactions, my entire life

2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

• I can't look anyone in the eye when I'm talking
• I can sometimes look at people if they're talking, but it still feels weird
• I can't read body language at all, in terms of what someone's posture means
• I understand smiling and frowning, but not more subtle expressions
• Unless someone tells me they're feeling sad, I probably won't pick up on it
• I often can't tell if someone is being sarcastic or joking
• I have trouble with facial recognition, even with immediate family members
• I've always been told my facial expressions are strange
• I often speak too quietly or too loudly, and have trouble knowing what's the right volume
• Strangers usually ask me to repeat myself, because I speak too fast and without inflection

3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

• I've never had many friends, and my relationships generally end in hopeless misunderstandings
• I try to figure out the 'rules' of social interactions, and it confuses me when the rules are inconsistent
• I never wanted to share my imaginative play because it was my own private little world, not for anyone else
• I've never been interested in my peers, or 'popular' interests and activities

Ashariel - Thankyou for your bullet point list, yes that is really helpful Also thanks for reading my diary extracts haha. I don't seem to have any problems reading facial expression, body language, emotions or understanding sarcasm/ jokes etc, so my problems when it comes to social communication I conclude are probably pretty subtle/ relatively mild for ASD. Therefore I guess that is the area I would most need to discuss with a professional to see whether my difficulties in other areas are autistic or whether they just look similar to autism but are caused by something else. *Sigh* I keep changing my mind as to whether I think Asperger's is a credible explanation for me or not. I am really glad your diagnosis helped you understand what you are dealing with.