Psychologist or Psychiatrist?

Post Reply New Topic

According to my insurance plan description I do not require a reference to see a specialist. Question is, which specialist? To get diagnosed (or have an appointment that would lead to testing) who should I go see? What your strategy for choosing the doctor from among many?

My diagnostician was a university psychiatrist who specialized in autism. All psychiatrists are M.D.s (so they can prescribe medications), and most psychologists are Ph.D.s. Psychologists also are trained to conduct testing. Otherwise, both professions are pretty similar. So, I would recommend finding the best specialist in autism regardless of their chosen profession. It is most important to find someone who you can trust even if (or especially if) the specialist ends up telling you something you don't want to hear. In other words, you don't want to doubt the specialist's assessment.

My diagnosis was done by a psychologist. He was fully trained and equipped and fully capable. After the diagnosis, he has continued to see me regularly and now I am a regular patient of his. He is a great help to me and I really like having him in my life.

But like Aspie Utah stated, the most important thing is to find the most competent person regardless of his or her title. I personally much prefer not dealing with a psychiatrist because I am very opposed to taking big pharma drugs. I don't judge people who do, but that is just not for me so I don't even want to be near someone whose profession would even think of offering them to me. But I respect that each person has to make his own decision about his convictions on those things and if others feel that a psychiatrist is right for them, then I support them in that decision.

How do you evaluate a specialist's proficiency in autism without seeing them?

That is a really good question. Sometimes people have to see them once to get an idea. There are lots of stories here of people who had the first meeting with a diagnostician and after the first interview realized that they needed to very quickly find someone else because the diagnostician knew nothing about what Autism really is. If you can't have a first interview to find out, I would ask the person's office what tests do they use to diagnose Autism, and what is their diagnostic procedure. You can learn a lot from just that question. You want to find out how thorough it is. You can also ask around if you have an active Autistic community and resources for Autistic people in your local area. People love to talk about the good and the bad when it comes to doctors and diagnosticians. If someone had a bad experience, it is not too hard to hear about it if you ask around. And if you are comfortable sharing your location here, there are so many of us on this site that have gone through the process, you might find someone in your area who can recommend someone to you. If you are in my area I will give you the information for the place that diagnosed me.

My approximate location is on the left.

What are some good questions to ask when evaluating a specialist's (or their practice's) proficiency in autism? For me accuracy of assessment is important. I don't want to go to a "diagnosis mill" where I get a positive diagnosis just because I brought it up.

Well, that is difficult. I chose to search the Internet for local autism diagnosticians ("Salt Lake" "autism" "diagnosis"), then create a list based on the results. After that, I searched each available web site that the clinics had published themselves, and ranked the clinics based on what their web sites described. Finally, armed with a workable list of possibilities, I began telephoning each clinic asking whoever answered the phone about the prices (cash and insurance) for an autism assessment. I asked specifically if the diagnostician had experience with autistic adults, and if the diagnostician used the ADOS-2 series of assessment tests (module 4 is specifically for verbal adults). Since my search results numbered only about 10 clinics, I was able to learn about each quickly. After excluding clinics based on no experience with autistic adults (about two-thirds of my overall results), and excluding clinics which didn't use the ADOS-2 tests (about half of the remaining clinics), I was able to consider just two or three eligible clinics. While I initially wanted to attend a clinic which offered everything I wanted (including a price of just $250), I ended up choosing to attend the university clinic (with the price of $1,000) because, after a botched diagnosis the previous year, I needed to attend a clinic that I could trust.

ADOS-2? What makes this one good, and what other tests exist? This is for adults, correct?

ADOS-2 is one of the best assessment instruments in the United States and Europe in diagnosing autism throughout the lifespan ( https://en.wikipedia.org/wiki/Autism_Di ... n_Schedule ). The ADOS-2 module 4 test is, indeed for verbal adults. I amn't suggesting that other assessment tests are better or worse, only that ADOS-2 is very effective. I have read about the DISCO test (it also includes adults within its diagnostic scope). There are many tests for autism available, but relatively few for autistic adults.