Assessment scheduled for August...What can I expect?

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Nurse_Bill
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22 Jul 2014, 2:02 am

I have a son with a confirmed diagnosis of Autism Spectrum Disorder. His Psychologist specializes in ASD and after meeting her the second time she suggested I likely have it as well. I'm not comfortable using her do to the possible conflict of interest in interacting with her regarding my son but I have seen 2 LCSW's (Licensed Clinical Social Worker) and 1 Psychiatrist. They all felt the diagnosis was likely correct but could not help me. I now have a formal diagnostic appointment set with the Neuroscience division of a local hospital. The appointment is scheduled from 9am to 3PM and I am told I will undergo a series of tests. I was wondering if anyone has undergone anything similar or could share their experiences with obtaining a formal diagnosis. I'm fairly well convinced I have Aspergers.



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22 Jul 2014, 3:25 am

Every test is different, but my experience included the ADOS-2 (autism diagnostic observation schedule), the WAIS-IV (Welscher's Adult Intelligence Scale) the WIAT-III (Welscher Individual Achievement Test), and the following paper self-reports: MCMI-III (Million Clinical Multiaxial Inventory), the SCL-90 (Symptom Checklist 90), the BDI (Beck Depression Inventory), the BASC-2 (Behavioral Assessment System for Children), and the BAI (Beck Anxiety Inventory). My sessions were two hours long (save for the day I took the ADOS: that was less than an hour) and spread out over three days each a week apart.

Of all the tests I took, I think the ADOS and the WAIS were the most valuable sources of information by which to determine my diagnosis. The WAIS showed that I have a 40-point gap between my verbal (higher) and nonverbal (lower) IQ scores, which is very common among high-functioning autistics (though 40 points is very wide, and statistically uncommon: even a 10-point gap is considered anomolous). The ADOS was deceptively un-test-like; it was in effect a social engagement, where lots of questions regarding my thoughts on such things as marriage, friendships, emotions, etc. were asked, interspersed with some curious activities which included describing a story from a wordless picture book (mine was entitled Tuesday, and involved frogs), describing the goings-on in detailed scenes, creating a story using random inanimate objects, and pantomiming and simultaneously describing the steps involved in brushing one's teeth. It all feels very childish, however, the insights doctors gain by using this technique, even on adults, are very impressive.

The BASC-2 was a multi-page questionnaire given to my mother to answer about my early childhood and developmental milestones; it was in lieu of her being present, as I was being tested at my university after school. It is doubtful you will be given this assessment, as it is only administered up until the age of 21.

It took five weeks for my test scores to be interpreted and my report to be written up, though it may not take as long for you, because I was diagnosed by a doctoral student who had to run all of her work by her supervisor, a proper doctor specializing in ASD's.

Good luck with your test; let us know how everything goes!


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Diagnosed with ASD level 1 on the 10th of April, 2014
Rediagnosed with ASD level 2 on the 4th of May, 2019
Thanks to Olympiadis for my fantastic avatar!


brackets
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22 Jul 2014, 5:00 am

I did my assessment last year. It mostly consisted of doing a lot of questionnaires (the "strongly disagree - strongly agree" type, for the most part) and filling out an educational history booklet, which also asked for me to write a short story (about a page long).

Recently I also underwent intelligence testing, which involves a bunch of different tests, like making given shapes out of blocks, determining the differences between two pictures, and remembering/repeating strings of information.

It's not too bad an experience, though you'll probably be a little tired after, especially if you're doing it all on one day (I did it spread over three).



DarkAscent
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22 Jul 2014, 5:57 am

Mine might be different to yours as I'm still a kid. :) I had to do lots of tests which were very tiring by the end of it. I don't know the name of the assessment that I had though but it might give you an idea of what your assessment might be like. I've listed as many as I can remember below:

Interpretation - I was given a short book with just pictures and no words at all telling a story. I had to interpret each picture and say what I interpreted with the people assessing me.

Emotional expressions in eyes - I was given a sheet with a pair of eyes that exhibited an emotion, and four key words that described a single emotion. I had to study the eyes and try to work out which emotion the person was feeling and circle the words that described the possible emotions, or say, "I don't know." There were about 25 of these questions in total. I did have the choice to continue with more of these questions but didn't.

Facial recognition test - I was given a group of faces that I had to memorise. These faces were then mixed up into another group and I had to say "yes" or "no" or "I'm not sure" to each face ("yes" to the faces that had been in the original group; "no" to the faces that hadn't been in the original group).

Questions - I was asked about how I coped in certain situations (such as social situations), my daily routines and interaction with classmates and coping in school. They also asked me about how I coped with my emotions.

Imagination skills - One of the people who was assessing me took out a group of objects and selected five of them. She then told a quick story involving five of them. I then had to pick five of these objects from the remaining ones and tell a quick story involving five of them on the spot (I couldn't do this).

Boxes - An object that had blue square cuboids on it was placed in front of me. One of the people who was assessing me would create a sequence by tapping on a certain number of these cuboids in an order which I had to repeat back correctly. In the second part, she would tap out a sequence but I had to tap back this sequence to her backwards.

Pictures - I was given a groups of cards. Each card had a picture on them without words and each group made up a scenario. I had to put each card in a group in the correct order to form the scenario. This was timed.

IQ test - In this one I had to work out the next shape that fitted into the sequence and this tested understanding of patterns.

That was pretty much what my assessment was like. My dad was also spoken to by a psychiatrist and they discussed my behaviour in certain situations. After my assessment was evaluated, I received an informal diagnosis of Asperger's. I hope I helped. :)



Waterfalls
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22 Jul 2014, 6:12 am

Nurse_Bill wrote:
I have a son with a confirmed diagnosis of Autism Spectrum Disorder. His Psychologist specializes in ASD and after meeting her the second time she suggested I likely have it as well. I'm not comfortable using her do to the possible conflict of interest in interacting with her regarding my son

I don't understand and am wondering, would you (or anyone) be comfortable explaining how this would be a conflict of interest? I know some people would see it that way and am not saying it isn't, just, it would not be for me unless maybe the psychologist seemed too closely affiliated with the school. I know others see it differently, and have no idea why.....



MrGrumpy
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22 Jul 2014, 11:48 am

StarTrekker wrote:
Every test is different, but my experience included the ADOS-2 (autism diagnostic observation schedule), the WAIS-IV (Welscher's Adult Intelligence Scale) the WIAT-III (Welscher Individual Achievement Test), and the following paper self-reports: MCMI-III (Million Clinical Multiaxial Inventory), the SCL-90 (Symptom Checklist 90), the BDI (Beck Depression Inventory), the BASC-2 (Behavioral Assessment System for Children), and the BAI (Beck Anxiety Inventory). My sessions were two hours long (save for the day I took the ADOS: that was less than an hour) and spread out over three days each a week apart.

Of all the tests I took, I think the ADOS and the WAIS were the most valuable sources of information by which to determine my diagnosis. The WAIS showed that I have a 40-point gap between my verbal (higher) and nonverbal (lower) IQ scores, which is very common among high-functioning autistics (though 40 points is very wide, and statistically uncommon: even a 10-point gap is considered anomolous). The ADOS was deceptively un-test-like; it was in effect a social engagement, where lots of questions regarding my thoughts on such things as marriage, friendships, emotions, etc. were asked, interspersed with some curious activities which included describing a story from a wordless picture book (mine was entitled Tuesday, and involved frogs), describing the goings-on in detailed scenes, creating a story using random inanimate objects, and pantomiming and simultaneously describing the steps involved in brushing one's teeth. It all feels very childish, however, the insights doctors gain by using this technique, even on adults, are very impressive.

The BASC-2 was a multi-page questionnaire given to my mother to answer about my early childhood and developmental milestones; it was in lieu of her being present, as I was being tested at my university after school. It is doubtful you will be given this assessment, as it is only administered up until the age of 21.

It took five weeks for my test scores to be interpreted and my report to be written up, though it may not take as long for you, because I was diagnosed by a doctoral student who had to run all of her work by her supervisor, a proper doctor specializing in ASD's.

Good luck with your test; let us know how everything goes!


brackets wrote:
I did my assessment last year. It mostly consisted of doing a lot of questionnaires (the "strongly disagree - strongly agree" type, for the most part) and filling out an educational history booklet, which also asked for me to write a short story (about a page long).

Recently I also underwent intelligence testing, which involves a bunch of different tests, like making given shapes out of blocks, determining the differences between two pictures, and remembering/repeating strings of information.

It's not too bad an experience, though you'll probably be a little tired after, especially if you're doing it all on one day (I did it spread over three).


If anyone still doubts the random nature of diagnosing adult autism, please check out the above two posts which appeared as two consecutive replies to the OP's question.


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22 Jul 2014, 1:01 pm

MrGrumpy wrote:
StarTrekker wrote:
Every test is different, but my experience included the ADOS-2 (autism diagnostic observation schedule), the WAIS-IV (Welscher's Adult Intelligence Scale) the WIAT-III (Welscher Individual Achievement Test), and the following paper self-reports: MCMI-III (Million Clinical Multiaxial Inventory), the SCL-90 (Symptom Checklist 90), the BDI (Beck Depression Inventory), the BASC-2 (Behavioral Assessment System for Children), and the BAI (Beck Anxiety Inventory). My sessions were two hours long (save for the day I took the ADOS: that was less than an hour) and spread out over three days each a week apart.

Of all the tests I took, I think the ADOS and the WAIS were the most valuable sources of information by which to determine my diagnosis. The WAIS showed that I have a 40-point gap between my verbal (higher) and nonverbal (lower) IQ scores, which is very common among high-functioning autistics (though 40 points is very wide, and statistically uncommon: even a 10-point gap is considered anomolous). The ADOS was deceptively un-test-like; it was in effect a social engagement, where lots of questions regarding my thoughts on such things as marriage, friendships, emotions, etc. were asked, interspersed with some curious activities which included describing a story from a wordless picture book (mine was entitled Tuesday, and involved frogs), describing the goings-on in detailed scenes, creating a story using random inanimate objects, and pantomiming and simultaneously describing the steps involved in brushing one's teeth. It all feels very childish, however, the insights doctors gain by using this technique, even on adults, are very impressive.

The BASC-2 was a multi-page questionnaire given to my mother to answer about my early childhood and developmental milestones; it was in lieu of her being present, as I was being tested at my university after school. It is doubtful you will be given this assessment, as it is only administered up until the age of 21.

It took five weeks for my test scores to be interpreted and my report to be written up, though it may not take as long for you, because I was diagnosed by a doctoral student who had to run all of her work by her supervisor, a proper doctor specializing in ASD's.

Good luck with your test; let us know how everything goes!


brackets wrote:
I did my assessment last year. It mostly consisted of doing a lot of questionnaires (the "strongly disagree - strongly agree" type, for the most part) and filling out an educational history booklet, which also asked for me to write a short story (about a page long).

Recently I also underwent intelligence testing, which involves a bunch of different tests, like making given shapes out of blocks, determining the differences between two pictures, and remembering/repeating strings of information.

It's not too bad an experience, though you'll probably be a little tired after, especially if you're doing it all on one day (I did it spread over three).


If anyone still doubts the random nature of diagnosing adult autism, please check out the above two posts which appeared as two consecutive replies to the OP's question.

To be fair, I did take some of the same inventories/questionnaires as StarTrekker, I just didn't see the point in rehashing their post so much (and I couldn't remember the names of the ones that were different, except that there was a "Friendship Inventory").



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22 Jul 2014, 5:42 pm

Hello All,

I'm an NT teaching preschoolers, most of whom are on the spectrum or likely to be on it. I really appreciate everyone sharing their experiences here and find it quite interesting. I don't actually administer any assessments myself (I'm an assistant teacher) but agree that the wide variety of procedures used can be curious. I'm thankful that in our school system, no single diagnosis or assessment is considered to be final or unquestionable; and each individual student's needs and strengths are considered the most important factors. Students are welcome to attend their IEP meetings and give their own input, too.

DarkAscent--based on your spelling of words like "memorise" and "behavior", I'm assuming that you may live outside the U.S. and wonder where you took your tests. Would you mind telling me where you live and/or where you participated in your assessments? (If you prefer to keep that private, that's okay with me.)



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22 Jul 2014, 9:08 pm

MrGrumpy wrote:
If anyone still doubts the random nature of diagnosing adult autism, please check out the above two posts which appeared as two consecutive replies to the OP's question.


I wouldn't necessarily call it random, just two different roads to the same place: psychological testing is not like curing a physical illness, where only one drug works consistently; there are different methods of examining thought processes and neural functioning that are all as effective as each other. That is not to say that all means of testing for autism are perfect, but just because some are different from others, doesn't make them wrong.

Case in point: there is a very wide variety of different "theoretical orientations" or methods of doing therapy, including but not limited to: psychoanalysis, behaviourism, humanistic approach, gestalt theory, cognitive behavioural therapy, mixed approach, etc. All these therapies are different from one another and focus on different aspects of the mind as a root to a patient's difficulties, and yet there have been repeated studies that show that the type of theory used is irrelevant because they all work just as well as each other. The same holds true for diagnosing neurological disabilities; there are many different approaches, but for the most part, they are all as effective as each other, and, until we develop physical tests to determine the presence of autism, they are better than being left undiagnosed, unaided, and confused as to why one's life is falling apart due to difficulties outside one's control.


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Diagnosed with ASD level 1 on the 10th of April, 2014
Rediagnosed with ASD level 2 on the 4th of May, 2019
Thanks to Olympiadis for my fantastic avatar!


Nurse_Bill
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23 Jul 2014, 10:39 pm

Hello All, I wanted to chime in again to say thank you to those of you who have responded thus far. I also wanted to reply to some of the additional questions/comments that have come up.

In no particular order:

1) Why I feel using my son's Psychologist could pose a conflict of interest....

I am a nurse as well as a parent and frequently question what medication the Psychologist wants to use and why, dosing, want follow-up for possible side effects like weekly weight checks, semi-annual liver function tests, etc. In addition, the Psychologist while in private practice, is affiliated with a Special Needs school that my son attends. While I have been open in saying that I believe I have Aspergers, and my son, Justin's ASD is likely Asperger's as well, I want to retain a parental relationship with his Psychologist, unclouded by her seeing me as a patient. In short, I don't want her to have to balance her interaction with me as both a patient and as the Guardian of a patient. For Justin's sake I need her to view me solely as his parent and respond to my questions/concerns and inquiries regarding his treatment accordingly.

2) The randomness of assessment tools.

As a nurse I can tell you this is not uncommon in most facets of medicine. While there are some things for which a single test is considered the norm for obtaining a diagnosis (a Monospot to determine mononucleosis for example), most Physicians use a process of elimination or multiple diagnostics are used to determine a likely diagnosis. Consider something as simple as a broken arm for example, you could diagnose this through observation, palpation (touch), an x-ray, a MRI, possibly an ultrasound, etc.

Usually with any medical problem you start with the simplest and cheapest assessment and work up from there until you are fairly certain of a diagnosis. In the absence of a widely recognized standardized assessment tool, it is to be expected that a number of assessments will be utilized so as to both rule out other possible diagnosis as well as affirm the veracity of those tests/assessments which are administered. It is precisely what these tests are and each individuals response to going through them that I am curious about. Knowing what to expect at least in a rudimentary format will help to reduce any anxiety I have about the process.

Thanks again all, and please keep the responses coming. I can't wait to share my experience with you all and Praise God to Please get a formal diagnosis and some help getting and keeping a job.