Autism assessment - ADOS Module 4

I remember that book as well.  Cheltenham, in January.  Actually I quite enjoyed the book.

I was told I couldn't be autistic as I used my finger to point at the frogs (I was working round the page, and it helps to have a finger there). "You were pointing at them to show the other person".  Err - no I wasn't. 

I was also told that being in a long-term relationship, and holding down a job, also made it unlikely for me to be an Aspie.  They also didn't have my parents there (dead) but did have my wife and I'd sent a 26+ page doc of problems during childhood & youth.

The whole assessment seemed to be based at proving a deep level of disability, which as a 56 year old, high-functioning person, doesn't strictly apply.  I do have many problems that inhibit 'normal' behaviour, and are hard to work around.  I also have developed coping mechanisms (masking), but am less stressed if - for instance - I'm talking about a specialist subject, which includes talking about me.

Unsurprisingly, they didn't give me a diagnosis.

I went private a few months later, was tested using Baron-Cohen's AAA assessment (of which the AQ/EQ questionnaires are just the basis for the diagnostic interview), and was told I was Autistic wth problems at a clinical level, some severe.  Which fits in with my life experience.  Curiously, my wife was present at the diag interview, and said she would have answered most of the questions the same as I (apart from not being me, of course). 

After this, I went back to the local NHS Trust who said that ADOS 4 wasn't 100% reliable, and offering me a second opinion.  I declined as I didn't want to go through it a third time.

I had the flying frogs on my ADOS-2 (sounds like a terrible affliction), although a different picture book when I volunteered to go through it to help train some assessors.The book used is called Tuesday by David Wiesner. I remember it well:

I actually expected to 'pass' the test easily, since I thought the way I was behaving couldn't be distinguished from any other adult in terms of eye contact, tone of voice and so on, was my usual affable self, and had little problem with the tasks (apart from deciding which of several stories to tell). I was quite wrong, and got a relatively high score: here's my thread on ADOS results. I think I probably did point, but it's the other gestures and ways of relating to people and conversational abilities that the assessor may have thought were absent.

So it's either quite hard to judge your own performance, or it's a rather random judgement of the assessor, or both. I mentioned what was going through the characters' heads in the book, for example. What was the teeth-cleaning demonstration supposed to prove? Does anyone do it 'wrongly'? Here's another person describing the test, and dubious about the result. https://www.reddit.com/r/aspergers/comments/2k23dp/i_not_convinced_with_my_diagnosis_for_aspergers/ Professionals there also may the point that the tool is not taken in isolation.

Confusingly, Module 4 of ADOS, which as I understand it corresponds Module 5 of ADOS-2, are both designed for adults, even if some of the tasks are in common with the modules for children. Like many psychological assessment tools. it's copyrighted. If you've not had the assessment yet and want the result to be as reliable as possible, you may not really want to know what they're looking for.  But if you do, it's summarised in a slide here:
http://wp.vcu.edu/virginialend/wp-content/uploads/sites/2676/2014/04/Meera-Supplemental-ADOS-Doc.pdf

Jobs: I remember having to fill in a form for schools careers advice, and put 'hermit' as a chosen career. A shame they didn't take it seriously. I think I might have excelled at it.

I had the flying frogs on my ADOS-2 (sounds like a terrible affliction), although a different picture book when I volunteered to go through it to help train some assessors.The book used is called Tuesday by David Wiesner. I remember it well:

I actually expected to 'pass' the test easily, since I thought the way I was behaving couldn't be distinguished from any other adult in terms of eye contact, tone of voice and so on, was my usual affable self, and had little problem with the tasks (apart from deciding which of several stories to tell). I was quite wrong, and got a relatively high score: here's my thread on ADOS results. I think I probably did point, but it's the other gestures and ways of relating to people and conversational abilities that the assessor may have thought were absent.

So it's either quite hard to judge your own performance, or it's a rather random judgement of the assessor, or both. I mentioned what was going through the characters' heads in the book, for example. What was the teeth-cleaning demonstration supposed to prove? Does anyone do it 'wrongly'? Here's another person describing the test, and dubious about the result. https://www.reddit.com/r/aspergers/comments/2k23dp/i_not_convinced_with_my_diagnosis_for_aspergers/ Professionals there also may the point that the tool is not taken in isolation.

Confusingly, Module 4 of ADOS, which as I understand it corresponds Module 5 of ADOS-2, are both designed for adults, even if some of the tasks are in common with the modules for children. Like many psychological assessment tools. it's copyrighted. If you've not had the assessment yet and want the result to be as reliable as possible, you may not really want to know what they're looking for.  But if you do, it's summarised in a slide here:
http://wp.vcu.edu/virginialend/wp-content/uploads/sites/2676/2014/04/Meera-Supplemental-ADOS-Doc.pdf

Jobs: I remember having to fill in a form for schools careers advice, and put 'hermit' as a chosen career. A shame they didn't take it seriously. I think I might have excelled at it.

I don't get the slide  when I click on this link. Is it still working? 

I wish I knew.  Perhaps it varies between areas.  I did have my school reports ready but the appointments went in a different direction.

I am formally diagnosed, but didn't have to do anything like that.  I had to go through an initial assessment then two very long interviews, one including my parents.  They also reviewed all my old school reports and medical records.  Is there any reason why the diagnosis process is so different?

Thank you so much for all of this detail.  It does help to clarify what they were looking for and also makes me wonder whether what I went through was actually level 5.  

I have always been drawn to the lifestyle of a hermit.  Indeed, I often refer to our houses the hermitage.  Those careers forms never revealed anything useful to me, well, other than the massive gulf between me and the world and how hard I would have to work to fit in.  

After years as an accountant I eventually moved towards counselling as an option.  Basically my lifelong interest in psychology combined with some life events that saw me running a helpline from my home gradually pushed me in that direction.  I had thought, when I set up the helpline for others with the same physical illness as me, that I would be giving out information and signposting.  In fact people actually wanted a shoulder to cry on and I realised that I wasn't coping very well with this.  I therefore did a level 1 course in interpersonal skills and was really shocked and surprised.  Why had nobody thought to teach me all of this before?  

The result was that I became outwardly better and better at using the right body language and conveying empathy.  Plus, since the course was so interesting, I kept going on to the next level.  The thought was that a part of my hermitage could become my counselling space.  

What this now means, though, is that the ADOS assessment was being used on someone with 8 years of counselling training, including being regularly observed and evaluated in that role on the quality and genuineness of my every interaction.  So I'm more than a little curious as well as dubious about how they might be able to separate out the various strands.