Need advice on pursuing adult autism diagnosis.

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I'm finally trying to pursue an official autism diagnosis and I'm having trouble figuring out how to proceed. I started with my primary care doctor, who is very supportive. Her "plan A" was to refer me to a local psychiatrist. (I know she mentioned a "plan B" but I don't recall if she told me what it was.) I went to this psychiatrist last week and it didn't exactly go great (long story) but I did leave with a list of 'local' places that do neuropsych evaluations. After weeding out the ones that only do ADD/ADHD and/or don't do adults, there was only one or two options left.

I just got some information from the one place and there seem to be two options, which I'm not sure how to pick between. The one option is a one-hour initial session with a neuropsychiatrist who supposedly does a lot of work with (high functioning) autistics. I could get an appointment to see him as soon as next month. The other option is that they refer me to a neuropsychologist who will perform a series of cognitive tests, which will take 4-6 hours.

I'm not really sure which to pick. My mom is pressuring me to try the neuropsychiatrist first. I'm not sure if that's the best option. I just can't see how someone can diagnose something as complex as autism in just one hour (assuming that's even what he would do). I'm also concerned because when I hear *psychiatrist I think 'drugs', which are something I'm not a fan of and prefer to avoid if possible.

I would appreciate any insight or suggestions that anyone here may have.

I'm unsure of your location, and it certainly doesn't sound like the UK so could be very different wherever you are to what we experience here.

However, what I can say is that the cognitive tests sound more what you need than 'I work with high functioning autistics and will see you for an appointment'. And, if it is any help to know about the experiences of others, I was diagnosed by a psychologist.

I'm sure not an expert, but my guess is that the neuropsychiatrist will do the ADOS, which can give you an answer on ASD. The neuropsychologist is likely planning on doing a full IQ test and maybe the ADOS, too. The benefit of the cognitive/IQ testing is that it should give you a really good idea of your areas of strengths and weaknesses and I think it may help in detecting anything else (like ADD/ADHD, anxiety, etc.). In other words--it would be the more thorough examination. Also, if you're in college or have any interest in taking classes and think any type of accommodation would be necessary or helpful you'll need the neuropsychological tests.

If you're in the U.S. you also may want to check your insurance coverage. I think most probably cover services by a psychiatrist, but many don't cover psychological testing.

A psychologist is a professional who evaluates and studies behavior and mental processes. A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Either professional may administer tests and diagnose.

Much of what others wrote is accurate. It comes down ultimately to the professional you choose. The deciding factor for me would be "which professional best understands autism in adults. Too many clinicians say that they can diagnose adults while having diagnosed mostly children. Look for the professional with adult experience.

Do the one hour with the expert on adults on the spectrum!! !

Having someone understand what the differences are with an adult is HUGE. The ADOS was created to screen children. It is not as accurate with adults. You need someone who has seen adult autistics and knows what to look for with you.

Also, neuropsyciatrists don't tend to prescribe drugs to people they just met. Its not the same as being a regular psychiatrist. And if he suspects you are on the spectrum, he will likely request follow up testing. You are right, you shouldn't go by one hour long interview. There will probably be more to it.

I’ve always been confused by this. I been seeing a LMHC (With Masters) who specializes in Asperger’s. Is she a Psychologist or is there a difference between Therapist and Psychologist? She says I have Asperger’s and seem to go about treatment as I do. But I never been formerly diagnosed with test or anything. Does she or can she diagnose? Is that something I discuss with my Psychiatrist she referred me?

The psychiatrist can give you a basic screening to see if traits of ASD, and can help with some therapy after diagnosis if you are interested.

The psychologist can give you a formal evaluation with diagnosis if appropriate.

Thanks for all the advice. I am located in the US (MD) and it does sound like my insurance may cover the neuropsychiatrist. I'm glad to hear that they may not be as big on pushing pills as a regular psychiatrist. Though I'm still not sure this is exactly what I'm looking for, it sounds like it may be worth going to the neuropsychiatrist first and seeing how that goes.

There is actually a newer test, ADOS-2, that has a module for adults.

If there is a research group in your state working with autistic adults at all, sometimes they will do the ADOS-2 etc. and register you for possible future research, and it might be free.

It is amazing how much difficulty many clinicians have with the concept of undiagnosed adults. However the DSM-V really does not give good diagnostic guidelines for adults, esp. for females, I discovered recently. Adults have often learned on their own how to "pass" more or less, for survival; things that are more obvious in us as kids can be suppressed with a lot of work (which we do on our own due to repeated terrible experiences, no aversive ABA practitioners needed...) so the tests have to be different.