Psychiatrist vs thorough assessment usefulness?
Hey everyone,
I have not been officially diagnosed, but I'm quite certain my brain has pdd-nos wiring (in addition to the adhd diagnosis I already have). I've recently started looking into what resources are available for those on the spectrum, however an official diagnosis is usually a pre-req for taking advantage of those. Unfortunately, the cost of a thorough assessment is way out of my budget. Fortunately, a psychiatrist is able to make such a diagnosis, usually at a much lower cost. Unfortunately, it seems that getting a proper diagnosis from a non-expert can be quite complicated because of ASD's symptoms matching up with other non-neurotypical conditions. Fortunately, it seems that if you can make a convincing case, many psychiatrists are willing to take you seriously and consider the diagnosis (which I'm fairly convinced could be the case for me personally).
My question is, what are the added advantages to getting a thorough assessment? I'm assuming that the more thorough assessment would produce a more thorough (and personalized) cognitive profile of myself. Does this translate into any added benefits in regards to schooling, dealing with social situations, or anything else? Is the difference in cost a worthwhile investment? And are there any added costs once the assessment is made (I'm not sure what exactly, but for example, special counseling with specialists who will work with my idiosyncrasies, and cost fortune? Can I take advantage of the added (if there are any) benefits without having to dish out another large lumpsum of money?)
Honestly, since AS is out of the DSM, professional diagnosis is not something that will help. I found this community because I took a self assessment online, and I kept having specific memories from when I was a child about the questions they had. So, take the need for professional diagnosis with a grain of salt.
_________________
Your Aspie score: 181 of 200
Your neurotypical (non-autistic) score: 30 of 200
You are very likely an Aspie
Myers-Briggs: INTJ
AQ: 44
Getting a job can be difficult when you have a hard time with eye contact, firm handshakes, poor communication skills, and an aura of insincerity that follows you, especially around strangers (or so people have told me). I currently have a job, but need to find something else due to a reoccurring injury. I've found out that there are governmental organizations that can help match people with such problems with an appropriate job. There are educational accommodations available as well. However, all this is dependent on a proper diagnosis. The label "aspergers" has been replaced by other, supposedly more useful sets of cognitive/linguistic/behavioral descriptions. Though I'm a firm believer in taking charge of educating one's self in order to function better, I'm also a believer (though not blindly) in science's ability to use the shared experiences of many people with similar traits for the sake of speeding the learning process up a bit (though not everyone needs both options. In my case, I think I do).
Unless you're textbook, then the likelihood of somebody that does not specialize in ASD and other neurological disorders thinking to diagnose you with it is slim. My diagnosistic history, and this is something that traumatized me, is a long list of semi-fitting diagnosis that I don't have. Started with ADHD when I was a small child, then I had a string of 4-5 professionals in my early teens saying they all disagreed with the ADHD after seeing me for a whopping 40 minutes and then getting diagnosed with mood disorders by them all- different mood disorders at that. I wouldn't recommend seeing somebody who isn't a specialist.
Sorry, I completely scanned over your second paragraph. I don't think it would come with any added benefits beyond a more accurate diagnosis. The more in-depth stuff would be confidential, I assume. When it comes to pros outweighing cost, I think it would just depend on what both of them would diagnose you with and that's not something you can predict. As to your question about added costs, I think that's something you'd have to ask whoever you're looking into.
This is something I have heard of happening all too often. Psychiatrists must meet quotas, they are largely overworked (like all doctors in the States), do not have the time or motivation (because of being overworked) to invest adequate time in everyone they see to have a good sense of judgment, and frequently don't have the specialized knowledge to differentiate the peculiar details that would be required for a proper diagnosis. Sometimes they even have financial incentives from pharmaceutical companies to prescribe unnecessary drugs. To make things worse, psychiatry places a LOT of power in the hands of the doctor, who diagnoses based on subjective understandings of their field (still no blood test, so you've forced to trust the individual shrink's judgment instead of a definitive, objective test).
I'm really sorry you had to deal with all that s**t (which deserves much more attention than it gets). It's thanks to hearing stories like yours that I'm trying to be extra careful, otherwise I would most likely be stuck in the system by now. Thank you very much!
@calstar2, did you eventually see a specialist? Or were the first group of people you mentioned specialists? Also, how long ago would that have been (I hear that ASDs are looked at very differently than they were just 20 years ago, so that might have some relevance here as well)?
The first people I had seen were all psychiatrists. I saw a specialist 5 years ago that specialized in neuropsychological disorders. Even more specifically, she only worked with neuropsychological disorders as they related to education, so struggling learners, college transition help, life/school coaching. The (major) problems I was having in school is what started the long road of diagnosis before the adults in my life finally caught onto the fact that it wasn't my anxiety sparking problems with school, but my difficulties functioning in school environments and troubles learning that sparked my anxiety.
Spectacles I see that you are male. You will be more likely to be recognized as being on the autism spectrum (if you are, and whatever that means) than women. But no guarantees, and only if you look like what people expect is it easy.
But stay away from generalizations. There are people with a lot of experience who are great. But not if they encounter someone who looks too different than what they expect and have experience with. Psychologist, psychiatrist, social worker sometimes as well....if they are knowledgeable they can make a diagnosis. Psychologist and psychiatrist have more authority for benefits. As to which, I would contact a local organization, do some research online what is needed to back up the appropriateness of what you think you need, be it social skills group, counseling, money etc.
For treatment purposes a full psychological assessment isn't necessary. If you are young and having trouble working a public agency MIGHT cover the cost though the quality even if they do may not be what you want, and may not be specific for ASD as they're more likely to assess things like IQ and memory and understanding that might affect performance. If you needed a high intensity of services specific to a developmental disability then the full assessment is more likely to be helpful. They can be wrong but if you get an expert psychologist or neuropsychologist, and they don't take a dislike to you they will put the information together most thoroughly.
This can't be canned and be done well for many people. I don't mean to sound cynical. As a female who became, like Calstar, very anxious, and I also became very sad and easily overwhelmed but in a feminine way, I was given all sorts of labels and often got these weird looks as people tried to figure me out. You just have to be careful not to lose yourself looking for answers. And think about what you need, what is required to access it locally where you live.
@Watefalls, thanks for the advice. Finding who has experience in the autism spectrum area has proved quite difficult for the area I'm in. From what I've read, it seems especially important to find someone who has experience with ASD in adults, as all the masking mechanisms can make it rather difficult to get a good diagnosis. I've seen 4 different psychologists and 1 psychiatrist since moving to the area (in the span of 4 years), without ASD ever coming up (a big part of this is that I couldn't figure out how to express myself. I knew something was different, but I had no idea what). I wasn't too aware of it myself until recently (a couple months now), but after reading through a good bit of literature on the subject, I have little doubt that I fit the PDD-NOS description to a tee (well, as much as you can, since part of the reason we have PDD-NOS is to put together everything that overlaps significantly with Autism Spectrum, while at the same time having some distinct differences).
I've contacted a local organization and have an apt set up for Sep 2nd, so I guess I will find out more then. I'm just worried that if I go to the wrong person, I'll be given all sorts of labels, prescribed meds that are easy to become dependent on, provided counseling services that are not helpful for me (because of the wrong labeling). From reading your posts, it seems that a neuropsychologist or educational psychologists might be my best bet, given that there are no specialists around the area.
Thanks again for the responses!
little_blue_jay
Velociraptor
Joined: 31 Jul 2014
Age: 48
Gender: Female
Posts: 421
Location: Ontario, Canada
Can you say more?
It's kinda long so I don't feel like typing it all out again so I'll try to post a link to my recent thread detailing why my first-ever psychologist appointment was a waste of time -
http://www.wrongplanet.net/postt265812.html
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Diagnosed "Asperger's to a moderate degree" April 7, 2015.
Aspie score 145 of 200
NT score 56 of 200
AQ score: 47
RAADS-R score: 196
ASPartOfMe
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Joined: 25 Aug 2013
Age: 67
Gender: Male
Posts: 36,518
Location: Long Island, New York
Advantages in the outside world
MIGHT help with workforce accommodations or if need be a discrimination suit.
If needed someday Vocational Rehabilitation MIGHT help.
MIGHT help with relatives who are in denial
MIGHT help you get disability benifits
For yourself
As you see outside help is a matter of luck and chance so the main reasons to get a diagnosis from a specialist in adult ASD are just about you. Some people need that professional validation otherwise they will be crippled by doubt, always wondering if they a JUST the lazy awkward, nerd excuse making loser so many people say we are. For some THOROUGH self-diagnosis will do just fine.
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Professionally Identified and joined WP August 26, 2013
DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity
“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman
We had a terrible and expensive assessment done by an "expert". She had her intern perform one test, spent 5 minutes with our son, asked us questions which were not thorough (she focused more on my childhood history) and after 2.5 hours (an hour of which was for lunch) she un-diagnosed him, took him off the spectrum. I have since found out she has a track record of un-diagnosing kids. We are demanding our money back. It was awful. Be careful to get a THOROUGH assessment!
ASPartOfMe
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Joined: 25 Aug 2013
Age: 67
Gender: Male
Posts: 36,518
Location: Long Island, New York
Unfortunately dominique22 this is not uncommon and I am sorry your child was a victim of this. There are bunch of psychologists that think Autism is way over diagnosed or they are employed by school districts to save money. There mission in life is to undiagnose and not diagnose people.
This is an older article but explains this line of thinking well
Asperger’s, Overdiagnosed, Ill Defined, May Not Be a Syndrome Much Longer
Aspergers Syndrome is the Cause célèbre of this perceived massive overdiagnoses of Autism Spectrum Disorders, that is one reason Aspergers was dropped as an official diagnosis.
3 years have passed since the article was written and they were successful in removing Asperger's from DSM 5 but that does not mean this line of thinking which is to go back to the or get back to as close as possible back to the 1950's-1980's strict diagnostic criteria of Autism has changed.
So do your research and get references before seeing anybody.
_________________
Professionally Identified and joined WP August 26, 2013
DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity
“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman
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