Tag Archives: Assessment

Psychological Evaluation

Last week, I would’ve had my ten year Aspieversary/autiversary or the anniversary of my autism diagnosis. I did realize this and even started writing a blog post about it, but it didn’t feel right to celebrate an anniversary of something that no longer is. After all, I’m no longer diagnosed as autistic. I was also quite shocked when it dawned upon me that I’d been institutionalized for almost the entirety of these ten years. I then started thinking about the ten years before that and how much longer they seemed to have taken. Time flies when you’re getting old(er).

I then started writing a post on the psychological evaluation that I had the day before my would-be-Aspieversary. That was hard too – both the evaluation and writing about it. For the first time that I had a psycholoigical assessment, the personality testing was in fact the easiest – or least difficult – part. I just can’t get past the fact that I did rather poorly on some of the neuropsychological tests and didn’t seem to score as great on the intelligence test.

The neuropsych testing consisted of a couple of memory tests. Most went okay, but with one, I kept losing focus. Then there was a test for semantics, the way words and their meanings are formed and articulated. I had to name as may words starting with a given letter or in a given category (animals, occupations) in one minute as possible. In the animals category, I started blurting out donkey, squirrel and Brazilian wandering spider, which are three words I use repetitively, and then I got stuck. I don’t know what the average score is of course, but some of my staff tried this one and did much better than I did. Of course, they weren’t in an actual test setting.

Then I got what I think is the verbal part of the Wechsler Adult Intelligence Scale. Older versions of this intelligence test consist of a verbal and a non-verbal (performance) part, but the performance part isn’t possible for me because I’m blind. The current version does not provide a verbal or performance IQ score, but it still consists of verbal and non-verbal tasks. I did okay and still seemed to have the same strengths (similarities, arithmetic) and weaknesses (compreheension) as when I last had an intelligence test twelve years ago. I don’t think I scored as mind-blowingly high as my parents would want me to though. When I told my mother so, she said I just don’t want to know that I’m gifted. I don’t know whether she meant that I didn’t try my best or that I underestimated my actual performance.

I also got some tests that seem to be specific to autism. One of them was a kind of weird test that seemed to measure theory of mind. I heard these little stories and then had to say whether a character had said something inappropriate. Then there were follow-up questions abou thow each character would feel, whether they could know that what they said was inappropriate, etc. I got rather frustrated with this test.

Some of the questionnaires also seemed to be relevant to my possible autism. One was some kind of systemizing/empathizing test. I once took a similar (or the same) test online and scored below-average on both scales. I mean, I am interested in systemizing, but I can’t actually do it right in daily life. For example, I can’t balance a checkbook, but I do take an interest in random strings of information, such as share prices (yes, I did at one point perseverate on that). There was also this test that asked about the ability to read one’s own feelings. This was a rather weird one to me, but that may be because I barely understand how anyone would be able to tell the difference between for example feelign excited and feeling enthusiastic.

Lastly, I got a coping sytles questionnaire and several personality tests. I scored high on avoidance twelve years ago when I got the same coping styles questionnaire and I think that has only gotten worse. After all, all I’ve learned in the mental hospital is to distract or take a tranquilizer. This is the worst coping style according to my college psychology professor. I did okay on the personality tests. I mean, it’s likely I have at least some personality disorder traits, but that’d show in my behavior too anyway.

A week has gone by since the psychological evaluation. My husband had to fill out another questionnaire about me again over the week-end. It was some kind of executive functioning questionnaire and I felt rather awkward at how many boxes my husband ticked. I also got a call from the student doing the evaluation on Monday with one more questionnaire. It seemed to be the other half of the systemizing/empathizing thing. I got to do that over the phone. The student also asked for my E-mail address, so that the psychologist could contact me regarding some questions and concerns I had written down and taken to the assessment.

I have mixed feelings about the possible outcomes of the assessment. I mean, I don’t even know whether I want to be autistic after all. Of course, you’d think, most people wouldn’t choose to be autistic over neurotypical. That’s not what’s at stake here though, since I won’t change neurotype if the psychologist diagnoses me one way or the other. I still think I need the validation that my impairments are real. Realizing these impairments makes me feel a little inferior to the people I love, and in that sense, it’d be great if I made them all up. Of course, that may be internalized ableism.

Diagnosis: Finding Out About Autism #AtoZChallenge

Welcome to the A to Z Challenge, day four. Today, I have a bit of a personal post for you. I am going to share what it was like for me to get diagnosed with autism. My experience will hopefully empower adults who suspect they are autistic to make the right choice for themselves.

First, I was “self-diagnosed” for several years at around age sixteen. I didn’t like the term “self-diagnosis” at the time, because I didn’t feel a layperson (or even a professional) could diagnose themself with autism or any such condition. I’d rather say that I suspected I was on the spectrum.

My father’s comments both caused me to start suspecting I’m autistic and to stop suspecting it again – at least openly. One day in June of 2002, he came to my room at night yelling whether I was autistic or something (in the tone of voice that parents use to discipline their children). I wasn’t sure what being up late at night playing music, which bothered my father, had to do with autism, but somehow soemthing clicked with me. Maybe I was autistic after all.

A little under two years later, my father read me a newspaper article on fashionable disorders like PDD-NOS, and said he knew I had one of those conditions too: I had an asparagus addiction (bad wordplay on the pronounciation of “Asperger’s”). I decided that day that I wasn’t autistic after all.

Many adults nowadays suspect they are autistic long before they get formally diagnosed. There are many reasons why a person might seek a formal diagnosis, such as:

  • Getting professional confirmation of their suspection.

  • Having less trouble getting accommodations at work or in school (they can prove that they have a disability and are protected by the ADA or similar laws).

  • Getting disability-related services, such as independent living support.

  • Being able to pursue treatment.

There are also many reasons why people might decide not to seek a formal diagnosis and stay self-diagnosed. For example:

  • They may have negative experiences with psychiatrists, psychologists or other healthcare professionals, whom they will need to see in order to get diagnosed.

  • Some people don’t view autism as a disorder, so don’t believe they need to be diagnosed with it by a mental health professional. They just know are autistic.

  • A diagnosis may lead to an increased risk of discrimination, for example for health insurance or in employment situations.

IN late 2006, I myself was pretty much falling apart and hardly able to function in the independence training home I lived at. It wasn’t my decision to get me formally diagnosed, it was the staff’s. In fact, I couldn’t communicate to my GP that I wanted a referral to mental health services. It wasn’t even until the staff said they were wanting me to be assessed for autism that I started believing I might be autistic after all again.

The process of getting diagnosed may vary depending on the person’s age, cognitive ability, etc. In my case, for my first assessment, I had some meetings with a psychiatrist and then my parents were asked to come over to answer questions about my early development. If parents aren’t available, a sibling or other relative who has known the person being assessed for a long time, will be asked to complete this assessment.

Because the paperwork got lost, I had to be reassessed half a year after my initial diagnosis. This assessment consisted of the AQ-test (which stands for either autism quotient or autism questionnaire). This is a fifty-item questionnaire which asks about autism symptoms. I do not feel this questionnaire is worth much, as it can be completed by anyone online and someone who’s suspected they have autism for a while, can easily answer the questions in their favor. I also had to complete a DSM assessment. The DSM is the psychiatrist’s manual with criteria for each disorder. In a DSM assessment for autism, they walk you through the criteria and ask you to explain whether you meet them and if so, why. Lastly, my parents had to complete a developmental assessment again.

For a reason unbeknownst to me, I had to be assessed yet again in 2010, three years after the second assessment. I was this time given the AQ-test again plus the Dewey Story Test and something similar to a DSM assessment. The Dewey Story Test is a test of social awareness. It consists of a number of scenarios about human interaction. The person being assessed has to rate the person’s behavior at certain points in the scenario, with ratings ranging from “normal” to “shocking”. This test, too, at least used to be available online, though I can’t find an English version right now. I scored quite poorly on this test and again scored high on the AQ-test.

Other elements of an autism assessment might include IQ testing, neuropsychological testing or specific observation or interview instruments for diagnosing autism. An example of this is the Autism Diagnostic Observation Schedule (ADOS).

Unfortunately, the paperwork from my second diagnostic assessment, which was the most comprehensive, got lost last year too. Because I am going to get a consultation at the country’s top notch center for autism, I fear I’ll need to be assessed once again. This is because they require a clinical psychologist’s or psychiatrist’s diagnosis and the third assessment was by an educational psychologist. Besides, my parents weren’t asked for a developmental ssessment this time, because firstly they wouldn’t want to come over again and secondly I didn’t want them to. Unfortunately, because I badly do need services and treatment, I have no choice but to get reassessed if that’s what they want.