Is ASD doctor-led or patient-led?

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ASD forums are full of people who are agonising over whether or not to ask their doctor for a diagnosis which will confirm their own well-researched suspicions.

But I have never heard of an 'innocent' adult patient going to a doctor to describe their difficulties, and coming away with a doctor-led suggestion that there may be a possibility of Autism.

Any comments?

It can be either way. Although for an adult, I'd suspect a patient led diagnosis would happen more often. For me, I was actually more of a doctor-led diagnosis as an adult. I was actually a senior in highschool, technically 18 tho. And I was turned into this psych for a diagnosis by the school counseler but nevertheless my diagnosis was more doctor led. Me and my parents had no clue what aspergers was or that I could even be diagnosed with something so late. Now theres a lot more awareness of aspergers so perhaps, if I was a kid now, I coulda received a much younger diagnosis.

It seems as if the diagnosis is mostly "patient"-induced.

My impression is that, within the adult diagnostic process, the "patient" answers questionnaire questions; and questionnaire questions are sent to people who are close to the "patient." I don't think there's much opportunity for the doctor to observe the "patient," unless the "patient" brings film clips of himself in everyday life.

I don't think of people with Asperger's as "patient"s in most cases," by the way. It's usually more of a "client-therapist" relationship, it seems to me.

I think that the medical profession would totally agree with your point of view. I think that doctors are very doubtful about the whole idea of autism, and they certainly know that there is nothing they can do to help.

But, on the other hand, a therapist is not a qualified diagnostician, and can only offer a sympathetic ear.

Until there is some kind of scientific breakthrough which will come up with some kind of clinical evidence or proof about autism, then we have to continue to accept that we will continue to be lumped in together under the overall label of 'oddballs' (both by the professionals, as well as by the 'man in the street').

I went in to my doctor and said "I think I may have Asperger's and here's why".

My doctor referred me to a registered psychologist in the same clinic who, after testing and discussions, made a formal diagnosis of Asperger's and forwarded the diagnosis (with my permission) back to my doctor - it now forms part of my medical record.

Not sure how the process works elsewhere.

I'm pretty sure autism is a real thing.

This will sound cynical, but how was the process paid for? In the UK, National Health Services are free at the point of delivery, but heavily over-subscribed. In a fee-paying or insurance-based health service, the parameters will be a lot different from a state-funded service.

Here in Canada, the doctor side was covered by public health insurance while the psychologist side of things was 100% covered by my company supplementary health insurance plan.

I have heard of at least 15 such cases, and I know one personally (my husband).

Mine was also doctor-led. I was diagnosed at 13 by a psychiatrist. The school referred me to a psychiatrist who specialized in anxiety. That psychiatrist, after my first session with her, told my mum she thought there was more going on than just anxiety and asked her if she thought "it could be something developmental". She referred my mum to the psychiatrist specializing in PDDs, who diagnosed me with Asperger's . Both psychiatrists ,the one who referred me to the PDD guy and that guy himself , were paid for by the government , by OHIP. I'm Canadian.

I think diagnosis as a child is probably more doctor-led than adult diagnosis.

I agree with that, and go further by saying that child diagnosis is school-led. When I tried to get some sense out of the UK NHS more than 10 years ago, I was told by the NHS psychiatrists that Asperger's/ADHD is a childhood condition, and is dealt with by the education/school authorities. They said it was outside the remit of the NHS, and they wouldn't even discuss it with me. That was despite the fact that there was at the time at least one NHS hospital (The Maudsley in South London), which had an Autism/Asperger's clinic.

At that time, there was lots of stuff coming out of North America about adult autism, and I think that the N. American medical profession is still leading the way. At the time, there was a handful of private 'consultants' in the UK who would happily test adults for ASD, but when I mentioned that fact to my GP the shutters came down in an instant with a resounding clang - the GP more or less stated that if I went for a private diagnosis, he would have me removed from his patient list.

I still know of no UK examples of a doctor being the first to suggest the possibility of ASD to an adult patient. I have to say that I have come around to believing that the UK NHS view is not unreasonable, given that we are still a long way short of a clinical understanding of autism, and we are even further away from the time when there will any kind of treatment for the condition. The NHS has better ways to spend its limited resources. But, having said that, it would be nice to think that undiagnosed adult ASD is, somewhere in the world, still the subject of ongoing research.

It was both for me. For many years before my diagnosis I was convinced that I had it but no one would listen to me. However, the doctor who finally diagnosed me, came up with it without my ever mentioning my belief that I had Aspergers.

Well I didn't go to a doctor and get told I have AS, so it certainly did not go that way with me. Basically my sister told me she thought maybe I had aspergers syndrome which I really didn't know anything about at the time so I looked it up and it seemed pretty damn fitting. So yeah did some reading up on it and determined it was very possible.....Then a talked to the therapist i was going to about it and he looked into some info and also agreed it was very likely but I don't think therapists can officially diagnose. So for a couple years I was pretty sure of being on the spectrum but without having an official diagnoses, then last year I finally got a diagnoses from a neuropsychologist who did various tests to determine it.

But yeah I knew there was something different about me since a young age....just didn't know what it was.

I was one of the lucky ones. I was diagnosed when I was 8.

At least I think that makes me one of the lucky ones. But... It just seems like the ones who are diagnosed late in life end up being more successful.

That's what I've observed anyway. Both here on WP and in meatspace.

All the assessments I had as a child for what used to be called 'giftedness' was some-other-authority-figure led.

The assessment I had as an adult a year ago was suggested by the therapist and not myself.

I DID mention a desire to try and see if there was/is a root cause for my lifelong socializing troubles (amongst other things) and he agreed and I ended up going through not just a, "Does this person have depression?" assessment (which one of my other doctors wanted before treating a totally non-related medical condition) but a WHOLE neuropsych evaluation.

I paid out of pocket (my insurance wouldn't have paid re: deductible not yet fulfilled) and I paid on the low end of a sliding scale.