UK - NHS Diagnosis

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Hi everyone, I went for a diagnosis last week after referral by my GP. He didn't think I had Aspie tendencies but my partner and a friend with an Aspie son do and I've always had a feeling of being different. It started well, saying it might need several appointments to make a diagnosis but after about 20 minutes he said I just wanted a label so I could do what I liked and people would leave me alone! and said that perhaps I should make a list of things that I feel make me Aspie and we may meet again in a few months and he'd send some stuff in the post.

So here I am at 48, knowing I'm different, with a partner who has read everything about Aspergers and is convinced I have it and me who purposefully didn't read anything so that I didn't sway the diagnosis or myself.

So the question is can anyone suggest where to go from here - I don't know what I have but I do know I struggle in social situations, I find job interviews and business networking an absolute nightmare (not good when you're out of work). I give more affection to our dogs than I do my partner which she obviously struggles with and at the moment I have zero motivation because this feels like a cloud hanging over me and I would really like to get a definitive answer.

A lot to ask but I would appreciate any advice from UK based people who can suggest alternatives to the NHS for diagnosis

I would read up on AS and see what you think about it. If they're doing a diagnostic assessment of a particular type, maybe avoid reading about those procedures.

You could download the AAA from the Autism Research Centre in Cambridge. It's designed for researchers, but it does have tabs for the AQ and EQ (common self-administered tests for screening). Then, it lists the plain English items scored under the the jargon of the DSM IV for Aspergers.

DSM 5 is the most recent edition but I don't think the AAA has been updated for it, however the AAA is also designed (and actually slightly more narrow as they've added extra criteria) than the DSM IV and ICD.

Also get your partner to write a list of traits they think you have.

Here's the thing, I've been in mental health settings for a while. Recently, I did the SCID II (for Personality Disorders) and although it turned out that I didn't have one, there weren't items relating to my Post Traumatic Stress symptoms nor my sensory issues. Similarly, in many of the conversations I've had about various mental health things there's symptoms I do have that I forget are relevant.

The assessment is geared up for Autism, which is an advantage but you can't volunteer relevant information (which may seem minor or irrelevant to you) if you don't know much about it.

Another example: Suppose you go to your doctor and you tell your doctor all about your flu-like symptoms. Your doctor is qualified to look for flu. You think this is a good thing. Your doctor tells you to leave - they don't have anything to give you. You leave feeling something is off and your partner is convinced that other things are wrong with you too. Something is different about this 'flu'. However, you didn't realise that bull eye bruise had anything to do with it, so you don't bring it up. You actually caught Lyme Disease from a tick but your doctor didn't have all the information to diagnose you with it.

That seems very inappropriate and rude of him. A diagnostician's job is to diagnose, not to pontificate about the client's motives for being there. All he needed to talk about was why his study of you had ruled out autism. If there was an argument about his having ruled you out, maybe he argued ad hominem like that to get rid of you. I'm afraid it's normal that the initial brief screening test is all you get (as the standard procedure) if it doesn't score above the diagnostic threshold. It's cheaper that way. It can come as a shock to realise that a referral doesn't necessarily lead to a thorough evaluation.


That was nice of him. Whether or not there's any point in taking up the offer is another matter. After his comment about your supposed disingenuous motive for seeking a diagnosis, it's hard to believe he's truly open to having his opinions corrected, but I don't know exactly what was said or why.


I got mine by asking the NAS for a list of diagnosticians in my area. There were about 8. I then checked out each diagnostician's website, and eliminated those who showed little or no history of a particular interest in ASD (i.e. as evidenced by their research publications), because I think such diagnosticians are likely to underdiagnose autism, because they don't understand or like it. I also rejected one whose blurb was not much more than "I always make it plain from the start that there are no benefits to be had from a positive diagnosis of Aspergers Syndrome." That may be the truth (although theoretically at the time, an Aspie could have scored the cooking component of the Disability Living Allowance, with the right help, and more revealingly, another diagnostician was actually helping an Aspie client with a benefits claim at the time), but I got the impression he may be over-mindful of clients who are chiefly concerned with benefits, which suggested his attitude to his clients might be rather dogmatic and unsympathetic, though I may have misjudged him, it could have just been a sincere warning because of seeing past clients having their unrealistic hopes of government support dashed.

I then had a shortlist, so I emailed each of them and tried to evaluate their quality from their replies. I rejected one because he wanted to do a barrage of additional psych tests, which I think would have been an unnecessary expense. I also looked to see who seemed to be listening to me and who didn't. Eventually it was a tie between the best two, and my final choice was rather arbitrary, I think one of them had categorically said that the DX would be confidential, which maybe tipped the balance.

But my reason for getting diagnosed was primarily work-related, I needed to be exempted from some very Aspie-unfriendly work I was being expected to do, else I feared getting sacked or burned out, because the management was being rather forceful over the issue. That could be called wanting a label so people would leave me alone, I guess But I'm convinced that Aspie traits were making it particularly hard for me to cope at work, so I don't feel my motives were wrong.

Your reason for getting a DX seems to be about knowing whether you've got it or not. Frankly I don't think the DX really proves much, because I suspect the result is often wrong. I don't think most diagnosticians are very good at it. They are often quite flawed people, and subject to outside pressures that may bias their reports, and diagnosing ASD is quite hard - it's been confounded by the supposed existence of Pragmatic Language Impairment, which is very similar to AS.
http://en.wikipedia.org/wiki/Pragmatic_ ... impairment

So if you only want self-knowledge, you might do better to study the condition in depth and find out for yourself. Even then, it's not really question of autism or not autism, as it's a spectrum disorder, all you can really conclude is roughly how autistic you are (we all have a smattering of it, I'm told). I find it much better to just concentrate on the traits, because there's more certainty about those, and they can be tackled more directly. I'm wary of diagnostic pigeon-holes, they can be useful but I don't believe many real people fit them very well.

You can make a list of your autistic traits, another list of your impairments caused by autistic traits, another list of accommodations that you might benefit from given the impairments, and give to psych if you see him again. Don't make the lists too long, just put the most important things. He will have more information about you if he has these lists too, in addition to you being there and interacting with him. Possibly you appear like a normal person during interaction, and that is why he didn't want to go further through diagnostic process.