I've been asked by a number of people if there is time during the summer for any further adult assessments for autism spectrum disorder or Asperger's Disorder: yes. I have several days set aside for patients who are seeking an assessment for adult Aspergers or adult autism, as I know there are not many clinicians prepared to complete this work.
What does testing for adult Aspeger's or adult autism spectrum disorder consist of? Primarily we look at symptoms and behaviours you had as a young child. This is done with a structured clinical interview, the ADI-R. In addition to that we engage in a structured interview process called the ADOS which requires you to participate in a number of activities and answer some questions about your current life and thoughts. Usually individuals take a structured personality assessment to rule out possible disorders that may look just like adult autism or Aspegers, and when appropriate we use some neuropsychological tests to help flesh out the diagnosis. It is just about necessary to have someone who knows you well, especially your behavioural and social history, to complete some forms about these issues.
We usually start with an initial one hour session and discuss your current signs, symptoms and problems so that we can make a good choice about the appropriateness of proceeding with an assessment.
For more information on testing for Aspeger's Disorder or autism spectrum disorder in adults, teens/adolescents or children, please visit my website and then contact me directly.
My website can be found at www.relatedminds.com
Dr. Jim Roche
Showing posts with label Adult Aspeger's Disorder. Show all posts
Showing posts with label Adult Aspeger's Disorder. Show all posts
Wednesday, June 25, 2014
Thursday, March 27, 2014
Getting an Adult Aspeger's Diagnosis
In my Burnaby office I provide testing and diagnostic services for adults who are concerned about Asperger's Disorder or High Functioning Autism. You can find more specific information about adult autism / Asperger's Disorder testing on the following webpage: http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
A professional diagnosis for Asperger's is necessary and should be based on the following:
Observations of specific behaviours and abilities by a highly trained professional. This might include a psychiatrist, psychologist, speech pathologist or medical doctor familiar with this disorder. The individual should be familiar with Asperger's Disorder over the lifespan.
In addition to a face-to-face semi-structured clinical interview it is highly recommended that a professional normed diagnostic tool be used such as the Autism Diagnostic Observation Schedule (ADOS). Other tools that are sometimes used include the Childhood Autism Rating Scale (CARS) and Autism Diagnostic Interview-R (ADI-R). These may not be normed for the adult's particular age range so they may be used to gather data in a less formal but still highly structured manner.
In addition to this an comprehensive assessment needs to include information from a third part, both as o current symptoms and if possible, about childhood symptoms.
Because of the limited information we often have available for adults as compared to children we also include a short neuropsychological screening to help us understand neurological symptoms and strengths and weaknesses. A additional neurological exam might also be part of this examination.
A general understanding of an adults current social and adaptive abilities is also necessary, so an intelligence test and adaptive abilities test might be necessary.
Finally, Aspeger's Disorder is often misdiagnosed when an underlying personality issue is present, so a comprehensive personality assessment to rule out other possible reasons for these symptoms is necessary.
The cost of such an assessment is approximately $1,200. Forensic assessments, those involving legal or workplace issues, are billed on an individual basis. Some individuals with other possible disorders may require further assessment.
There are some psychiatrists in the lower mainland who are able to complete this type of assessment, however they have waiting lists and you would need a referral from your medical doctor. Please see your medical doctor about that process.
Assessments by a psychologist are not covered in BC by MSP. This is regrettable, as this also applies to children. Children seeking an autism diagnosis/Aspeger's diagnosis should ask their medical doctor for a referral to Children's Hospital or another provincial provider. Extended health care often covers some of these expenses, but you need to contact your insurance provider for information on what they will cover.
The process of obtaining an adult diagnosis of Asperger's is complicated. It is not simply about seeing if you have a list of symptoms, and many of these on-line lists are very misleading in that they strongly suggest you have a disorder based upon a list of symptoms but do not provide any "differential" component to the diagnosis. A diagnosis is not just seeing what problem you have, but ruling out other possible reasons for the symptoms that may mimic Aspegers but not be Aspergers at all! Finally, it needs to be remembered that even if you do have Aspeger's there is a high chance that you have a comorbid disorder such as anxiety, depression or ADHD. Often, until these co-morbid disorders are treated there is little progress made on dealing with the troublesome aspects of Asperger's.
If you suspect you have Aspeger's start with a visit to your medical doctor, and then see either a psychiatrist, psychologist or speech pathologist with experience in this field.
.................................................
This post is not meant to offer medical advice or suggest any medical diagnosis. If you suspect you have a mental health disorder, or suffer from symptoms that you find distressing, speak with your medical doctor or psychologist.
Form information on assessments and treatment I provide in my Burnaby office please visit my web page at http://www.relatedminds.com
A professional diagnosis for Asperger's is necessary and should be based on the following:
Observations of specific behaviours and abilities by a highly trained professional. This might include a psychiatrist, psychologist, speech pathologist or medical doctor familiar with this disorder. The individual should be familiar with Asperger's Disorder over the lifespan.
In addition to a face-to-face semi-structured clinical interview it is highly recommended that a professional normed diagnostic tool be used such as the Autism Diagnostic Observation Schedule (ADOS). Other tools that are sometimes used include the Childhood Autism Rating Scale (CARS) and Autism Diagnostic Interview-R (ADI-R). These may not be normed for the adult's particular age range so they may be used to gather data in a less formal but still highly structured manner.
In addition to this an comprehensive assessment needs to include information from a third part, both as o current symptoms and if possible, about childhood symptoms.
Because of the limited information we often have available for adults as compared to children we also include a short neuropsychological screening to help us understand neurological symptoms and strengths and weaknesses. A additional neurological exam might also be part of this examination.
A general understanding of an adults current social and adaptive abilities is also necessary, so an intelligence test and adaptive abilities test might be necessary.
Finally, Aspeger's Disorder is often misdiagnosed when an underlying personality issue is present, so a comprehensive personality assessment to rule out other possible reasons for these symptoms is necessary.
The cost of such an assessment is approximately $1,200. Forensic assessments, those involving legal or workplace issues, are billed on an individual basis. Some individuals with other possible disorders may require further assessment.
There are some psychiatrists in the lower mainland who are able to complete this type of assessment, however they have waiting lists and you would need a referral from your medical doctor. Please see your medical doctor about that process.
Assessments by a psychologist are not covered in BC by MSP. This is regrettable, as this also applies to children. Children seeking an autism diagnosis/Aspeger's diagnosis should ask their medical doctor for a referral to Children's Hospital or another provincial provider. Extended health care often covers some of these expenses, but you need to contact your insurance provider for information on what they will cover.
The process of obtaining an adult diagnosis of Asperger's is complicated. It is not simply about seeing if you have a list of symptoms, and many of these on-line lists are very misleading in that they strongly suggest you have a disorder based upon a list of symptoms but do not provide any "differential" component to the diagnosis. A diagnosis is not just seeing what problem you have, but ruling out other possible reasons for the symptoms that may mimic Aspegers but not be Aspergers at all! Finally, it needs to be remembered that even if you do have Aspeger's there is a high chance that you have a comorbid disorder such as anxiety, depression or ADHD. Often, until these co-morbid disorders are treated there is little progress made on dealing with the troublesome aspects of Asperger's.
If you suspect you have Aspeger's start with a visit to your medical doctor, and then see either a psychiatrist, psychologist or speech pathologist with experience in this field.
.................................................
This post is not meant to offer medical advice or suggest any medical diagnosis. If you suspect you have a mental health disorder, or suffer from symptoms that you find distressing, speak with your medical doctor or psychologist.
Form information on assessments and treatment I provide in my Burnaby office please visit my web page at http://www.relatedminds.com
Thursday, January 2, 2014
Adult Aspeger's Syndrome | Adult Aspeger's Disorder
For almost 20 years I have been specializing in work with individuals with Asperger's Syndrome or Aspegers Disorder here in British Columbia and in California. Much of my work has been with parts of the population not seen by other mental health providers, children and adolescents with extreme behavioural problems, and young adults and adults who are experiencing difficulties at home, work or socially because of Aspeger's symptoms.
Asperger syndrome is one of the autism spectrum disorders, or was until the new DSM-5 put all of these disorders together on one single spectrum. It was classified as a developmental disorder that affects how the brain processes information. In this case, social information. Getting the point of interactions, understanding what's in other people's heads. It's funny, because normally we talk about "being in someone else's head" as a bad thing, but the truth is it is hard to communicate without having a real understand of what the others in your conversation are thinking. We sometimes call this "social thinking" or "perspective taking" or even "pragmatic language." Someone with Asperger's may have this problem to a slight degree, or to a great degree. It really is different from person to person, however the main concepts of treatment - teaching these skills - remains the same. All in all people with Asperger syndrome have a wide range of strengths, weaknesses, skills and difficulties.
Common problems adults come to see me for include difficulty in forming friendships, communication difficulties (such as a tendency to take things literally), an inability to understand social rules and body language and often the associated anxiety one would expect to have if you aren't sure what others around you are thinking!
Common problems adults come to see me for include difficulty in forming friendships, communication difficulties (such as a tendency to take things literally), an inability to understand social rules and body language and often the associated anxiety one would expect to have if you aren't sure what others around you are thinking!
Although Asperger syndrome cannot be cured, appropriate intervention and experience can help individuals to develop these communications skills. I avoid saying "social skills" because far too often children and teens with Aspergers are sent to "social skills" groups which are inappropriate, as they are aimed at simply teaching social skills (you can learn those from a book) instead of focusing on the communications or language deficit that is really going on. Learning compensatory strategies and help build up coping skills. And talking with someone who understands the problem and it's relationship to anxiety, depression and obsessive thoughts can be very helpful.
Counselling or psychological therapy (including modified Cognitive Behaviour Therapy) can help people with Asperger syndrome understand and manage their behavioural responses and learn to live a calmer, less anxious and better understanding life.
An adult’s diagnosis of Asperger syndrome often follows their child’s diagnosis of autism spectrum disorder. This can be a very difficult time for both partners, as now the "neurotypical" spouse may feel very alone, and worried about what the future holds. We deal with these issues in couples counselling, and psychoeducation - learning the science based techniques to deal with the symptoms and the situations you find yourself in.
Most of my patients with Aspeger's syndrome /Asperger's Disorder are fairly successful in life, especially at work. Some are HIGHLY successful, but the influence off the symptoms becomes stronger after the birth of a child, or a change in living arrangements. Some person with Asperger syndrome may find their job opportunities limited by their disability. It may help to choose a vocation that takes into account their symptoms, and capitalises on their strengths rather than highlights their weaknesses. At any rate, Asperger's Disorder is not something that goes away after childhood, it is a neurological disorder, language/communications based, which can be treated, but not cured.
Two excellent books I often recommend to my teens and adults with Asperger's are: "The Journal of Best Practices: A Memoir of Marriage, Aspeger's Syndrome and One Man's Quest to be A Better Husband," by David Finch, and for teens and young adults, "Socially Curious and Curiously Social,: by Michelle Garcia Winner.
If you are interested in contacting me about my practice in the field of Aspeger's Disorder or Autism Spectrum Disorder I have offices in both Burnaby, BC and Vancouver, BC. More information can be found at my website: http://www.relatedminds.com or http://www.relatedminds.com/autism/
http://psychologists.bc.ca/users/jimroche
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