Adult Autism Assessment and Diagnosis

Today I was asked if using the GARS-2 (Gilliam Autism Rating Scale-Second Edition) was enough for an adult diagnosis of autism or Asperger's Disorder. I have a new copy of the GARS, and have used it many times in the past, especially when working in California. With children we would do a dual interview, two professionals asking questions, and we would score separately to make sure there was evaluator agreement. The GARS is used for individuals from age 3-22, and most of us would use a version of it for older individuals. But in British Columbia the GARS simply isn't good enough.

Usually a diagnosis of either autism spectrum disorder, or Asperger's Disorder, sometimes called Asperger's Syndrome , in adults can be complex. It requires not just using a checklist/interview like the GARS, but also ruling out the many other possible disorder that could be causing the symptoms of concern. I usually do this with a structured personality assessment and structured mental health history/health history.

In BC, with children and adolescents (teens) who are suspected of having autism spectrum disorder or Asperger's (yes, I know they are now considered to be on one single spectrum, however many individuals still find it useful to distinguish between these two disorders) we use the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Inventory). These are considered the gold standard here in BC, and are a required part of any autism assessment that will be accepted by either a school district or the Ministry for funding. So, I try to follow these guidelines as much as possible.

Often people need a diagnosis for "legal reasons." For instance, they may require a diagnosis to obtain services, or to make a tax credit claim, or sometimes they are having social problems at work and a diagnosis is part of keeping their job and getting appropriate accommodations. As you might suspect, when this is the case we need a very comprehensive assessment. One that rules out other possible causes for their symptoms, and one that shows both their strengths and weaknesses so we can make specific accommodation recommendations. That's why a simple check off list of symptoms doesn't make for a good diagnosis!

A diagnosis of Asperger's Disorder or autism in an adult takes several hours of face to face time, the collection of historical information (much of the diagnosis is based upon behaviours and concerns at an early age) and some period of time to observe the individual doing tasks that we consider important markers for the disorder.

For more information you are welcome to contact me in my office at 778.998-7975. There is a short waiting period for adult and child assessments, but usually you can be seen within a week to ten days. For more information visit my website at www.relatedminds.com

I have offices in both Burnaby and Vancouver, British Columbia.