Something Went Wrong with My Assessment, I Think

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I got the results of my assessment yesterday. I think something has gone wrong. I don't think I was evaluated properly, because a bunch of stuff never got asked or dealt with at all. I have a bad headache right now, and I can't think to post clearly about it anymore after having already blogged extensively about it, but the recounting of the process and the results are all there in my blog. I'm very distressed about this. Is it supposed to go this way? Please read my last two entries to see what happened. Has anyone else's experience been like this? What do people here think this means?

The Road from Here to There - Part 9
http://www.wrongplanet.net/modules.php? ... &jid=18387

The Road from Here to There - Part 10
http://www.wrongplanet.net/modules.php? ... &jid=18396

I think it's important to read both of these to properly understand. If you want the whole story, however, all my blog entries up to this point have been about this process, from anticipating the first of the four appointments to reflecting on the last on the day that followed it (today).

Just to clarify, I'm not asking the online community here to diagnose me. This is about how the process of the assessment itself went.

Thanks for your input!

I have never been tested for an ASD as far as I can recall.

I have to admit that I didn't read the blog in its entirety, I do have some issues with focus and it was tense at times. I just wanted to say that I feel for you because I am also afraid that, after my testing, they will tell me that I don't have AS and that will be devastating because AS answers almost all my questions and explains all my problems. If it is not AS then I will be lost completely. After seeing a psychiatrist and trying various medications for over five years I do want to be diagnosed with something. I feel like guinea pig: so let's try this drug now....

Two more weeks...

@MindWithoutWalls: Did you not get the diagnosis that you wanted? Do you think that your own subjective assessment carries more validity that that of an objective professional? Or was there some specific failure or omission in the standard assessment protocols that could be better addressed through legal channels?

I don't think the assessment was done properly. The questions about my life that would have indicated one way or the other were not asked, and I couldn't put my concern together in words well enough to list the things I needed to for for the psychologist in the brief time I had. The only appointment in which that could've been addressed was half an hour long and whizzed by, being filled with pretty rudimentary stuff, a lot of it pertaining to whether or not I knew where I was and what I was doing there. Only a few questions about the most basic facts of my life were asked, with no time to elaborate on anything. All the rest was two IQ test appointments and the summation. It was like being smacked with a bat a few times and then being told I didn't fall down like an Aspie. There certainly was no questionnaire like what I've seen posted around here, and there were not really any similar questions asked independently of an official questionnaire. It just didn't seem as though much of anything relevant got asked. When I asked why he thought I didn't have Asperger's, he gave a small number of the most extreme stereotypes, such as that autistics don't connect with people. He just threw them out there, with no opportunity for discussion.

I also think he had some bias, for various reasons.

It's all in my blog. I say it better and more completely there. Here, I'm beginning to think I just sound whiny. The blog gives a more clear picture.

No, you don't sound whiny. The first "specialist" I talked to said I don't have AS after talking to me for 45 minutes and he never asked most questions that actually seem related to AS, which seems like what happened to you.

The Spectrum is wide, so you may be on it. There are no absolutes with Autism/Aspergers. I have many, but not all symptoms. I can also hide things and mimic NTs when needed, so I can appear very NT to those who don' know me.

As for wanting an AS diagnosis in order to fit how you see yourself, well, you could be AS or not. Hopefully you are not and can take steps to improve your life. Still, if you are not satisfied with the diagnosis, get a 2nd opinion, perhaps from someone who specializes in AS. Good luck.

I will finish reading the blog entries later (my eyes are beginning to hurt cause I need glasses, nothing to do with the length), but,preliminarily, I think he's not a very good psychologist. May be a great person and may be able to become a good psychologist but he said a bunch of things that were just plain wrong.

Lack of eye contact is not required for a diagnosis of autism.

People with autism CAN change. What, they don't have the capacity to learn?

As you said, how in the world does he know how bad your fibromyalgia is.

Feeling different due to being gay is not mutually exclusive with feeling different due to having autism.

Etc. I'll read the rest later but he does not appear to know much about autism or diagnostic protocol.

Was this person an ASD specialist?

I had thought that an assessment would involve at least one ASD-related questionnaire for someone to fill out.

Did he ask you questions about your childhood?

It does sound like he didn't listen to you or give you a very helpful explanation afterward. You have no other options after this?

I don't think a thirty minute appointment + an IQ test is anywhere near sufficient to gather enough information as to whether one is autistic. Also, the questionnaire your girlfriend took sounds inadequate in comparison to tools like the ADI-R, which involves significantly more context and explanation.

He's the psychologist at our local branch of Easter Seals, and they supposedly deal with adults and children who have developmental disabilities. I was clear when I called them what it was about (wanting to be assessed to find out if I had a mild form of autism, since I didn't know to ask specifically about Asperger's syndrome back then), and they said that's what they did. It took about a month to a month and a half after that before they got the medical records they needed from my doctor and my first appointment day finally arrived.

He didn't really ask directly about my childhood, as I recall. At the summation at the end, he said he dealt with people with autism all the time, and that I was nothing like any of them. But I'm not sure what he was referring to, since he seemed to know so little about me, from what I could tell.

I went there because I needed to find a place that would assess an adult and also take Medicaid. Other places would do one but not the other. Easter Seals did both, so they seemed my only option. I don't know if Medicaid would cover getting a second opinion, even if I could find another place that would do it.

I read the third part from your blog. I won't be able to read it all today. I got a lot of questionnaires, in total I counted 998 questions. They were for assessing autism and other disorders or to exclude them. I read you wrote that the choices of answering were not broad enough. I thought the same, so with the questions I felt like that, I didn't answer them but wrote my view about it at the side of the paper. Or I wrote that I don't know how this question is meant.

I didn't read the second entry and I don't know if you're autistic or not but

Even just the part up to this doesn't make sense.

There's can't be an "unknown reason". If the reason is unknown, any conclusion based on observations and results of testing of which all require an interpretation based on the reason that "caused" the results to be what they are is... do I need to say it? There's no way to base something on nothing.



That means that part of the "unknown reason" turned into your sexual orientation and cross-dressing as far as he is concerned?

On a sidenote, many birthmarks can be "changed" and even removed. Sexual orientation can't as far as I'm informed and gladly, he didn't suggest you try changing that.

Cross-dressing I don't know much about - it can't make you more uncomfortable than you're comfortable with it if you think you're comfortable with keeping that part of expressing yourself.



If he thinks you're depressed or anxious (how can there be an "or" if he is sure enough to tell you about it?) then why not diagnose you with it? Either you are clinically depressed and/or anxious or you're not and he can't diagnose you - and shouldn't have suggested any of this to you to begin with.



If he can't tell, why indicate he can tell?



Just out of curiosity but is there a way to bathe yourself better than what a thoroughly cleaning bath requires? What's above average for bathing? Does that hint at that the way most people bathe isn't as good as it could be? Worrisome. I hate germs.


My suggestion: see a new one.

A mental health professional isn't needed to make a guess about this because that's what everybody else can do for free with equal lack of clear-cut validation.

It seems sort of odd to me that he made up his mind so early in the interview. It's important to gather enough information to draw a solid conclusion; and however perceptive a person is, first impressions aren't really enough unless it's blindingly obvious.

I don't see why he thought you could solve some of your problems by not cross-dressing. I assume that if you're cross-dressing anywhere other than your own home, you know people may look at you oddly because their ideas about gender have been challenged and they're not sure how to place you; and if you are okay with that, then it really isn't a problem, is it?

It is quite possible that you are eccentric rather than autistic. Psychologists are taught from their first psych class that you don't diagnose eccentrics with anything, because however odd they are, they are functioning just fine and aren't in distress. However, they may forget that eccentrics may have mental illnesses and disorders just like anyone else, and that the eccentricity is basically unrelated to their illness or disorder--which needs treatment. There's the danger of focusing on the person's eccentricity and thinking that if you fix that, then you'll somehow fix the disorder too. That's not a valid conclusion to draw, though. A dangerous one, in fact. Puts you at risk of fostering self-rejection in your client.

Some evidence that he's relatively ill-informed about autism...

The fibromyalgia thing interests me. If you've flipped through the DSM, you know that it's kind of an axis system, and one of the axes is "general medical conditions". That's not just there to add more clutter to the diagnosis; it's there because your physical condition is relevant to your mental condition. So you have fibromyalgia--I'm guessing that when you're physically tired, you also have fewer mental resources to tap; and that it raises your stress level? If so, that affects your mental state as well. There are even psychologists who specifically train to teach people how to solve the problems associated with chronic illness. That this guy didn't think too much about the body-mind dynamic is kind of worrisome.

I have to say that I'm really appreciating every one of these comments. Thank you, everybody!

The fibromyalgia does, indeed affect me greatly, both physically and mentally. It does muddle the issue of potential Asperger's, I believe. But that never got discussed, because he assumed it was no big deal.

As for the "cross-dressing" thing, I'm butch. I buy clothes in the men's department. I'm not uncomfortable about it, nor do I worry about people's reaction to it. But he gave the most weight to this as his argument for why I don't feel that I'm like most people and have trouble fitting in.

As for being gay, when I was too little to know what that was, I didn't realize I was different for being attracted to other girls. I thought all girls felt that way, but that we would all grow up and marry men anyway, because that's just the way things were. I had no clue what feelings had anything to do with selecting someone to marry, and I didn't realize that having feelings like mine, but towards boys, had anything to do with it. My misconception wasn't cleared up by asking anyone about it, because I assumed that the reason nobody ever mentioned such feelings was that they were simply not something anyone discussed, not because they didn't have such feelings. So, I never asked my parents, or anyone else, about the matter, even though my parents tried to make sure we were properly informed about sex and reproduction from an early age. (They even explained sex before adding that it could bring about reproduction, so that my sisters and I would understand it had its own merit.) I didn't know I was gay and that it made me any different from others until several years later. So, that wasn't the cause of my sense of being different and not belonging. But the psychologist will never know that, because he made an assumption instead.

What also never got brought up was the careful balance I maintain in order to socialize now. I have friends and activities, but when he asked a few limited questions about that part of my life in the first visit, he seemed to think I was very busy and social, without any trouble. I had a feeling he was assuming this because of the very quick comment he tossed off to that effect, but I couldn't get into it with him, because he sped on with the rest of the questions.

I spent years - most of my life - reviewing every social interaction after the fact, going over and over how things went, why anything that seemed to go wrong went wrong, analyzing all the details and trying to learn. I was awkward, and I struggled. It especially seemed to take a mighty effort to manage being in any kind of group, and I often left feeling embarrassed and/or frustrated with myself. I made a lot of mistakes. Even now, I still sometimes have trouble, and I feel drained at the end of a day of being with others at, say, an SCA event. Even meetings and practices can be a strain, and I can only handle so many after a while. One event a month is almost too much, and I occasionally need a break. One or two other, smaller things a week feels like a lot, though I have at least one thing I have to attend, because I'm committed to keeping the activity going. An annual week of camping at a major event takes everything I've got, physically and mentally. Having a house guest for more than a day or so is so disruptive that, after a while, I feel too stressed to cope. I eventually start to feel suicidal. I can't function that way for very long, with someone present all the time, touching stuff, disarranging things, and making it impossible for me to follow my usual patterns throughout the day. My girlfriend and I have had to work very hard to manage this so that hosting a friend from a foreign country that she really wants to have stay with us doesn't ruin our relationship because of my stress. I like to occasionally spend the night at a friend's house to give my girlfriend an evening to herself, but I get uncomfortable if I stay too long the next day, even though my friend isn't eager to push me out the door. I love my niece and nephews, and I'd love to be able to play with them more, but I can only handle a little. Babysitting, even for just an hour, is a real challenge. I really dislike it so much that I rarely get asked, much to my relief. And they're really nice kids! Also, I have trouble initiating getting together with others and almost never do it. Talking on the phone, even with my girlfriend, is uncomfortable, even painful, even at the same time that I like to hear from her. It's weird to like social activity and find it painful and difficult at the same time, even when it's going well, so that I'm often reluctant to make or let it happen. But that's what I'm used to.

None of this got discussed. I didn't know how, in the context of this evaluation, to think of enough of the relevant concerns and get him to let me talk about them. What a mess!

Then get a second opinion - problem solved.