Diagnosis and personal circumstances

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So, I think I have autism (Asperger's-style) and would benefit from a diagnosis, and I was able to find an autism research center that does assessments. I had to make the appointment about seven weeks in advance. Only two weeks left!

BUT... I know a lot of people have trouble with psychologists not understanding them. I've got a lot of traits that seem typical of autism but are contrary to the ideas people often have about autism, so even though they are autism specialists, I'm a little worried. Anyone have any ideas or advice for what I can do/say to avoid having them underestimate my problems?

They are going to use ADI-R to interview my mom about me, the Vineland Adaptive Behavior Scale to interview my roommate about me, and me personally with ADOS. The whole thing will take about 3.5 hours. These are the traits I'm worried about:

I'm an adult female. Even though they assess adults, I get the feeling they normally deal with people who have different impairments than I do. The appointment-making process was a bit of a hassle (multiple steps, phone calls), possibly made more for NT moms. I looked up the name of the doctor who will be doing the assessment, and he was listed as a "child psychologist."

I can live independantly... barely! I have a lot of problems here. My roommate is not my caregiver in any way, but his presence still makes a big difference. I lived by myself a whole year once, but I dug myself in quite a hole...

I have many interests (too many for my own good, maybe!), many of which could be considered artzy.

My interests and hobbies lead me to getting a lot of human relations knowledge. For example, I systematically studied facial expressions in order to draw better. So I have a lot of social skills "book smarts" even if I don't know what to do in the moment.

I live in a place where BAP traits (introversion, less eye contact, relatively less talkativeness, fondness for consistancy, etc) are common and accepted, so I rarely have a problem with people criticizing or rejecting me for those traits. I fit in, without a metaphorical mask. Although it seems I make a poor first impression, people usually end up liking me. The people who don't like me don't tell me to my face, because that's not how it's done around here. (The downside of that is it's a lot harder to tell whether they dislike me versus feeling neutral.) Not sure how much the doctors are aware of this, or if they're from around here.

I have a fairly good job. It is the perfect match for my odd set of skills, and I don't worry about getting laid off any time soon. My coworkers like me, and the folks in charge love me (except the HR department, but I figure the CEO trumps them). However, I lucked into this job with odd circumstances. I normally have a lot of trouble getting or keeping jobs, so if I lose this one before I'm ready, I'll probably be doomed to living in my mom's driveway. This is surprising to lots of people who consider me "smart" or whatever, but the universe doesn't hand you money just for being smart.

My mom will probably tell them I learned to talk early, only ever had one tantrum my entire life, did incredibly well in school, and was overall the most well-behaved child ever. She won't tell them about the time I punched my sixth grade teacher, or how I used to accidentally terrorize my classmates, or how my other parent often punished me for "throwing a fit," or about that time I got kicked out of a school dance for biting somebody, or even about how I lost my cool and attacked an inanimate object last time we went out to eat together. She doesn't know about or remember those things. My roommate will probably be more helpful. Maybe.

Most of my bad impairments come from trouble with transitions (executive dysfunction?) and sensory issues. Those things are totally destroying my life in numerous ways, but they are just two little symptoms at the bottom that people have trouble wrapping their brains around. Even my neuro-atypical(?) mom and roommate don't understand those.

I'm making a list of problems/symptoms to take with me since I have trouble verbal communication. Do you suppose I should include non-problem things that match up with something on the DSM criteria, like wanting to eat the same thing for lunch everyday (repetitive behavior)?

Maybe I should print out my article about social skills and take it with me.

That would make me concerned..
It's not necessarily a bad thing, some people are trained in both Adult and Child, but it would give me some hesitation.
I'd want to find out more about that individuals experience and qualifications.
Does he normally handle adult patients, or is he covering for another Doctor who is away/indisposed?

I'm not saying it's necessarily a bad thing, I'm saying it could be, and that in your position I would probably try to obtain more information before deciding if it was a bad thing or not.

Hope your assessment goes well, in either case.

Good luck with your appointment! One of my main interests is acting, which every inexperienced doctor I've met says is an interest an autistic person would never have, and it's taught me a lot about social skills and how to "pass" as a slightly eccentric NT, but the specialist who diagnosed me with moderate to severe Aspergers could see through all of that.

Concerning your question, I would put everything you feel is related to your AS in you document, whether it's a "problem" or not. Repetitive behaviour is not often problematic, I've found, but it's still a strong indicator of AS.

I am curious, could you describe your trouble with transitions a bit more. I think this may impact me and I am interested in learning more about your experiences.


I did this as well. As I wanted to make certain that I didn’t forget anything. In fact, several months before I was diagnosed, I read Tony Attwood’s Book (“The Complete Guide to Asperger's Syndrome”). Each chapter triggered memories of “issues” I had had in my life. Rather than try to remember everything, I started to document and categorize these memories. This document included: therapy history, list of anxieties, list of ocd traits, list of social interaction difficulties (including several quite troubling bullying incidents), list of sensory difficulties, list of motor difficulties, list of work difficulties, list of special interests, list of stims, list of rituals/routines, etc.

This document was more for me than anyone else. As I would think of new things every day. And, I wanted to remember it all. The only way I could remember everything was through a very detailed, well-organized (and categorized) document. Eventually, I had a ~50 page typed document.

I shared this document with the clinical psychologist who diagnosed me. She had asked to see it after I mentioned that I had written it. She was quite impressed with its detail and organization.

Thanks for the advice, guys. I will definitely expand my symptoms document.

Sure, no prob. It's what I was talking about in this topic, although I didn't frame it as transitions at the time:
viewtopic.php?t=284220
(I'm still not sure transitions are the best way to think about it, but that's the closest thing that's even hinted at in the autism criteria.)

Basically, I feel sad/stressed about getting started on pretty much anything. Knowing that my feelings of stress are unwarrented don't keep me from feeling them, and stupid stress feels about the same as reasonable stress. This makes it hard to do things unless the emotions about not doing them are worse.

It's like being really lazy, except laziness normally comes with the expectation of some kind of benefit. I feel like I should be able to overcome this by force of will, but even if I'm able to do the stuff I need to do, I'm still going to be pretty miserable about it.

Generally it sort of works like this:

• *Mildly inconvenient task + imminent dire consequences for not doing it = I can make myself do it, but it's harder than it should be. (Example: Putting gas in my car, feeding my pets, giving my pets medicine.)
  
• *Mildly inconvenient task + consquences for not doing it aren't going to matter unless I avoid the task for a long time = I probably won't do it until it moves into the previous category. (Example: Taking out the trash.)
  
• *Currently doing something boring + have the option of something fun + fun thing is easy to get going = I want to do the fun thing. The fun outweighs the transition.
  
• *Currently doing something boring but easy + have the option of something fun + barrier of inconvenience in front of the fun thing = I'll probably keep doing the boring thing. (Example: Surf boring websites or play a crappy mobile game because it's too much hassle to go use the XBox. I have to go to the other room, turn everything on, find the game from the shelf, put away whatever game is currently in the system, and I can never remember which input channel goes to which system, and my roommate's TV is complicated....)
  
• *Currently doing something unpleasant and difficult = Have a hard time resisting the urge to just stop and daydream inactively.
  
• *Some tasks are more daunting than others, but diving the large things into smaller tasks means I have a large number of tasks, which is about as bad.

Especially when combined with other problems like planning and memory, it can be trouble. Like, I'll procrastinate on something because of this problem, then at the last minute, when I could more feasibly make myself do it, I'll just plain forget about it. Some implications:

• *I have so many problems about food, I don't know where to start. Maybe I'll make a seperate post about it tomorrow.
  
• *I hate going to bed. I hate getting out of bed. I'm usually slightly sleep-deprived. I tend to feel dehydrated and sick by the time I get out of bed on the weekends.
  
• *I hate taking a shower. I hate getting out of the shower. It wastes a lot of time. When I was a kid I got in fights with my parents about it.
  
• *I have made almost no progress on my hopes and dreams. I'm pretty sure I could have a modest home business making comics, short stories, small-scope video games, maybe the occassional novel... if I could actually make myself make any of those things.
  
• *I think I ruined my last car by not getting the oil changed enough. I think I ruined the warranty on my new car, the same way.
  
• *I don't clean. I don't care about being as tidy as lots of other people want to be, but I want to be a lot tidier than I am. Junk piles up. I have to step over things. It's hard to find things. Some tasks are more difficult because I have to stack things on top of other things. Even my mom judges me. This sucks.
  
• *If my friends want me to go somewhere with them, they'd better make an appointment. That's not how things normally worked when I was a teenager, but they got used to it.
  
• *Last year, I filled out my tax returns on time! On my dinner break at work at 7:00PM on April 15. I was too broke to spend a few bucks efiling and turns out I was owed a refund, so I decided I'd mail them. I mailed them in October. They were in envelopes on my living room table for the six months between those points.
  
• *I tried to get a copy of my credit report. It was too hard.
  
• *I pretty much always have to skip some days of my Adderall because I don't refill my perscription in time. I cause myself a lot of inconvenience with my other meds too, but the Adderall is more trouble because of the special rules about controlled substances.
  
• *I tend to like my job when I have a few big tasks or several super-easy fast tasks. Sometimes I get so caught up on the big tasks that I accidentally stay late or even don't want to go home. But if I have a bunch of stuff that'll each take around 15-60 minutes, I feel miserable.
  
• *I think I was like this when I was a kid but I can't really be sure. I recall I had a problem with procrastinating on going to the bathroom.

Depression comes with a similar sort of laziness, and I've had depression, but I feel like this is different.