2e ASD

[Lighthouse]

I have some questions about the diagnostic process of high functioning ASD in a younger teen. I have a preliminary diagnosis, and will have a full eval in less than a month.

1. Is a regular child psychologist able to make this diagnosis? And will someone who specializes in birth through 14, my age, be able to recognize it in someone my age who is also what I would consider a borderline case?

2. Is it possible for ASD to have had no affect on my grades? And that none of my teachers noticed it?

3. What is the diagnostic process and how long should it last for? I read on hear that it should be over multiple days. Is this still the case with an older child?

4. What would be the treatment if I received a diagnosis? I also have a social anxiety disorder diagnosis from the same professional who made a preliminary diagnosis of ASD. I just started medication for that.

5. Should I consider it a good or bad thing that my symptoms come off much more obviously when in a psychiatric setting? In my daily life it is not nearly as obvious. With the professionals I spoke to previously, I couldn't look them in the eye, talk comfortably, and I even started tearing up, almost crying! There's also the added thing of that this child psychologist I have an appointment with is a man. I, as a girl, am not very comfortable with male doctors. The other two professionals I spoke to were female, so I can't imagine how uncomfortable, fidgety, and unable to keep eye contact I will be.

6. I also hear on here that you should find someone who specializes in 2e autism or autism in girls. Is this absolutely necessary?

Thanks in advance for any responses or information you can give me. While I do want to pursue a diagnosis and treatment, I'm also somewhat nervous and unsure of what to expect.

Eta:7. I've heard on here that they need reports from people other than my parents for a diagnosis. Is this true? They haven't asked for that. I don't think I could get that if they needed it.

Edited October 12, 2016 by Lighthouse

[Lighthouse]

Bump?

[PeterPan]

Not ignoring you.  I have pneumonia.  I'll probably just write you privately.  If you find a behaviorist (BCBA) who works with teens and adults, they'll be able to answer a lot of your questions.  The jist is that there's a lot they can do for you *if* they're experienced in the things you need.  Behaviorists just vary.  The key is to take your time, find someone who explains well, someone you feel you can talk with.  

 

There are really good teen and adult materials now for social thinking, etc. etc.  I think you'll find it much more helpful than you anticipate, and it doesn't have to be "treatment."  You are not a problem to be cured.  You have some amazing strengths and some things that aren't so strong right now.  They can give you some help with the things that aren't so strong, which will help your social relationships, decision making, anxiety, etc.  

 

So yes, you want the diagnosis and access to services. 2e for the psych?  Maybe.  Hoagies Gifted has a list.  Just see what you can find.

[Pawz4me]

I'm not as well versed as many on here, but since we've just been through the process with 17 yo DS I'll take a stab at answering some of your questions. FWIW he was diagnosed with ASD-1, NVLD and giftedness in several areas.

 

 

I have some questions about the diagnostic process of high functioning ASD in a younger teen. I have a preliminary diagnosis, and will have a full eval in less than a month.
1. Is a regular child psychologist able to make this diagnosis? And will someone who specializes in birth through 14, my age, be able to recognize it in someone my age who is also what I would consider a borderline case?

 

I assume you mean "borderline" as in mildly ASD? If so, then yes, I think an experienced psychologist should be able to diagnose.

 

 

2. Is it possible for ASD to have had no affect on my grades? And that none of my teachers noticed it?

 

If you're gifted then I think it's very possible for ASD to have had no noticeable effect on your grades and for teachers not to have noticed Or maybe they noticed something but convinced themselves you're "just" a quirky kid. Giftedness often masks disabilities and teachers are busy people. Even if they see something "off" I think if the student is performing well academically and behaviorally they're not apt to bring it up.

 

3. What is the diagnostic process and how long should it last for? I read on hear that it should be over multiple days. Is this still the case with an older child?

 

DH and I went in for an initial appointment with the psychologist. Over the course of 75 minutes she asked us all sorts of questions--everything from the details of my pregnancy, DS's birth weight and development as a baby/toddler to how he functions now as an almost adult. She scheduled him for testing on two days, one appointment for two hours and the other appointment for three hours. Neither session took quite the full allotted time. She also gave us assessments to complete at home and return at the first testing session. DH and I were given the same set (for each of us to complete individually) and DS was given different ones to complete. DH and I went back about two weeks after testing to receive the results. She stated that it would probably be best for DS to not attend that appointment so that we could talk about it w/o him there. He will be going tomorrow for his own appointment so that she can explain the results to him. She left it totally up to us whether we wanted to bring him back in to talk to her about the results or whether we wanted to do it ourselves. Given that he's almost an adult we felt it would be best for him to have an opportunity to ask her any questions he might have.

 

 

 

4. What would be the treatment if I received a diagnosis? I also have a social anxiety disorder diagnosis from the same professional who made a preliminary diagnosis of ASD. I just started medication for that.

 

I think it would depend on what the psychologist recommends. DS has generalized anxiety disorder and is on medication for that. The psychologist suggested that some therapy/counseling might be helpful and we're pursuing that. She also made a list of recommendations for accommodations that might help him academically. Although he does very well academically already she believes that some of the accommodations will make it possible for him to perform even better and be less stressed. Remember that whatever is recommended is just that--a recommendation. You can take them or leave them, decide which ones would be worth pursuing and which ones not, etc.

 

 

 

5. Should I consider it a good or bad thing that my symptoms come off much more obviously when in a psychiatric setting? In my daily life it is not nearly as obvious. With the professionals I spoke to previously, I couldn't look them in the eye, talk comfortably, and I even started tearing up, almost crying! There's also the added thing of that this child psychologist I have an appointment with is a man. I, as a girl, am not very comfortable with male doctors. The other two professionals I spoke to were female, so I can't imagine how uncomfortable, fidgety, and unable to keep eye contact I will be.

 

I don't really know the answer to this, other than to say that while DS is very high functioning and generally gets along okay, it is harder for him to talk with strangers or to function well in any new/different situation than it is for him to function well in his normal routine. But honestly--that's true of most people! My gut feeling is that you'd be most likely to get the most accurate diagnosis from someone you feel comfortable with, but that a good psychologist should be able to minimize any distress you may feel. FWIW, DS found most of the testing to be interesting and enjoyable.

 

 

6. I also hear on here that you should find someone who specializes in 2e autism or autism in girls. Is this absolutely necessary?

 

I can't address the need (or not) to seek out someone who specializes in girls. The psychologist who did DS's testing was a regular psychologist with a special interest in autism spectrum disorders. We were very happy with her. She administered the WAIS-IV IQ test which clearly showed DS to be gifted in some areas. He shines in academics, so doing that part (the part necessary for the gifted diagnosis) was easy and enjoyable for him.

 

 

 

Eta:7. I've heard on here that they need reports from people other than my parents for a diagnosis. Is this true? They haven't asked for that. I don't think I could get that if they needed it.

 

I don't think it's necessarily true. The psychiatrist who is treating DS for anxiety sent her notes to the psychologist, but as far as I know she didn't fill out any formal report. Nor did we get anything from anyone else.

 

Edited October 13, 2016 by Pawz4me

[Lecka]

Here a teacher would not say anything to a student without the parents' permission.

 

They might try to feel out a parent and then not say anything if the parent seems offended. (In even bringing it up with a parent.)

 

It is not the norm for teachers to mention things like this.

 

I get asked (as a parent) whether or not it is okay with me to have the word "autism" used with my son. He is still young but I have heard here that some parents are still not using the word through middle school and then it isn't allowed for someone at school to use it. Parents may allow information and discussion without using the word, or they may say they don't want it discussed at school.

 

I don't know if that changes in high school or not, I have heard this through middle school age.

Edited October 13, 2016 by Lecka

[Lighthouse]

Here a teacher would not say anything to a student without the parents' permission.

 

They might try to feel out a parent and then not say anything if the parent seems offended. (In even bringing it up with a parent.)

 

It is not the norm for teachers to mention things like this.

 

I get asked (as a parent) whether or not it is okay with me to have the word "autism" used with my son. He is still young but I have heard here that some parents are still not using the word through middle school and then it isn't allowed for someone at school to use it. Parents may allow information and discussion without using the word, or they may say they don't want it discussed at school.

 

I don't know if that changes in high school or not, I have heard this through middle school age.

That makes sense, but none of my teachers mentioned anything to my parents either. Even if my parents hadn't told me at the time (which I think they would), they would tell me now since I know what we are pursuing evaluations for anyway. I'm in middle school now, so I wouldn't know if anything changed in high school anyway. I think it is good that people are polite enough to ask if you are comfortable with the word being used around your son. I don't have an official diagnosis, and no one except family members knows we are even pursuing evals, so no one would be asking my parents about that.

[Lecka]

Also, the "report from other people" may or may not be needed.

 

But this often means an observation form where someone is circling numbers 1-5 for 20 questions. Teachers at school fill them out for students routinely.

 

It is like -- if you ever hear of a teacher filling out a form for ADHD? It would not be very different from that.

 

Just to say -- that is common and maybe something you have heard of. Teachers also may fill out forms like this (generally) when a student is adjusting medications.

 

It is common and a lot less involved than I think it sounds!

 

So I don't think it will be a big deal.

[Lecka]

Here I can tell you some things that are options at middle school.

 

One is using a class period as a resource room kind of thing.

 

One is having a group of 4 kids who have the same schedule and stay together in the day. Unlikely for you if you are already in middle school and going to classes.

 

There is a "home base" thing where kids can be allowed to take a break to a certain place.

 

There are some Social Thinking programs. One is a "movie club" where kids can discuss social things in movies.

 

There happens to be some drama therapy available here, it would not be during school. My son has a great time, my daughter does, too, she goes with my son.

 

The school district here uses autism internet modules. You can register for free and then go to the "autism in the classroom" section and that is the kind of thing they have here. There is a section on "home base" for example (this is something they seem really into).

 

http://www.autisminternetmodules.org/user_mod.php

 

Also here for some kids they use The Incredible 5-Point Scale for anxiety, you could see the section on that.

 

It would depend on what they think would be a good fit for you, it is not like they just make everyone do the same thing.

 

These are just things I hear about here. My son is in 2nd grade so I just hear from other parents about middle school, or thing I have heard come up at a parent support group I attend.

 

Also some of it is more about kids in pre-school in case you see things that seem babyish, they would not do babyish things in middle school.

Edited October 13, 2016 by Lecka

[Lighthouse]

Also, the "report from other people" may or may not be needed.

 

But this often means an observation form where someone is circling numbers 1-5 for 20 questions. Teachers at school fill them out for students routinely.

 

It is like -- if you ever hear of a teacher filling out a form for ADHD? It would not be very different from that.

 

Just to say -- that is common and maybe something you have heard of. Teachers also may fill out forms like this (generally) when a student is adjusting medications.

 

It is common and a lot less involved than I think it sounds!

 

So I don't think it will be a big deal.

I assume since they have not asked for a report they, hopefully, don't need one because my teachers would not be able to tell them anything. I've been in a virtual school this year and last year, so they don't know a ton about my behavior. 

[Lecka]

Oh, I didn't realize that.