Countdown to diagnosis

Hi everyone, 

I've been undergoing autism assessment by a team of Clinical Psychologists for the last few weeks.  I hear the outcome later today.

I am a woman in my late 50s and the component parts of my ASD assessment are as follows:

  • Initial assessment with psychologist (1.5 hrs)
  • Full developmental history meeting with psychologist (1.5 hrs)
  • AQ / EQ questionnaires (completed at home and handed back to psychologist) 
  • Developmental history (written autobiographical information supplied by me)
  • Developmental history questionnaires (completed by parents/siblings & emailed to psychologist)  
  • Narrative account of issues and challenges (emailed by husband)
  • ADOS-2  with two different psychologists (1 hr) followed by analysis of results (1 hr)
  • Multi-disciplinary Formulation Meeting (professionals only) 
  • Feedback meeting - psychologist + me (1 hr) 
  • Post assessment follow-up sessions - optional (3 x 1 hr)

I first emailed the service provider requesting information on 10 August. 

The Formulation Meeting will be held sometime next week (mid November). This is where everyone in the team gets together to consider all the evidence and reach conclusions about likely causes of difficulties, and potentially helpful recommendations. 

I will get feedback from a psychologist at a meeting next Friday 16 November. 

Although I am paying for this assessment privately, the provider re-invests any profit into providing services for autistic people.

I looked up 'formulation' and it seems this is a psycho-social group decision-making process, combining narrative accounts with evidence derived from the application of ASD diagnostic criteria. This approach aims to reduce the risk of individual bias by promoting creative thinking and collaborative problem solving.  

Needless to say I am looking forward to finding out what diagnostic decision has been reached. It will be fascinating to see if the professionals agree with the conclusions I reached by reading, reflecting, and talking to people in this community!

There are varied formats for assessment so it would be interesting to know what other people's experiences have been. 

  • Pffft can't quote you, but I agree with you on all of the above. Especially thenpart about anxiety, depression and autism being linked and the connection with overload!

    And I agree with the mask. You need it to function but being aware of needing it really stinks!

  • This is really interesting. Frustratingly my iPad won't let me insert quotes as this would make it easier to respond to some of your observations. 

    My employment situation is complex. I have five contracts in three departments with the same employer. One is permanent - 10 hrs per week, one is a rolling contract 18.5 hrs per week, and then I have three casual contracts for additional hours 'as and when required'. 

    Another complicating factor is that I have some hearing loss and an incurable progressive condition affecting my hands. I have struggled with certain tasks in one of my jobs, especially minute taking at lunchtime meetings - lipreading when tired and handwriting were hard. 

    Perhaps due to my rather direct communication style I have annoyed one of my bosses. She actually said she thought I was using my health conditions to get out of doing tasks I didn't like. That wasn't the case, but it didn't help that I had been honest about not liking admin tasks. 

    Problems with this manager escalated immediately prior to my diagnosis and I consulted my Trade Union. She spoke to me very harshly the day after my dog died and tried to coerce me into agreeing to take minutes at a certain number of meetings a year. I would not agree. She also wanted to interrogate me about an accident report I had submitted. On advice given by my Trade Union I declined to do this without someone representing me being in the room. 

    I was so anxious that I walked excessively thereby injuring my tendon. This has meant having to take several weeks off work. In many ways this has been a good thing. I would have found it very difficult coping with this manager with the heightened emotion of getting diagnosed. 

    When my manager tried to undermine me by blaming all the problems on the way I speak to people I told her that I thought I might be autistic. She dismissed this as a ridiculous idea, saying I was far too articulate for that to be possible. 

    Now I have got a diagnosis it is difficullt to know what to do. The manager in my permanent 10 hrs per week job is really nice and supportive. While I have been off she has replied to my emails kept me up to date with things and been very encouraging. Perhaps unsurprisingly the hostile manager has ignored emails and not provided any information that would help me prepare to return to work.  

    On the advice of my Union I have disclosed my diagnosis to my supportive manager, but asked her not to share this with the hostile one at the moment. I now recognise that multiple changes in my working environment were very problematic for me and that I would not feel able to return to work with the hostile manager without some kind of mediation.  

    Incidentally other people in the team have expressed concerns about her behaviour - it's the classic scenario where some team members are put on a pedestal and others are put in the naughty corner. 

    I tie my brain up in knots trying to work out what to do. Five contracts in multiple locations is probably not a good idea in any case. It would be much less stressful to have one job in one place. I have just applied for another job, although I am having to work hard on self confidence given the deficit model of ASD diagnosis. 

    When I was a social worker I tried to make sure that any discussion of limitations was balanced by a focus on strengths and capabilities. For the purposes of the ASD assessment. I have been running my life story through my head picking out examples of when things went wrong. Now I am playing it through again paying attention to all the positive things. 

    This has become a very long ramble through things, but it has been really helpful for me to get it down in writing. Thank you so much for prompting this with your observations. 

  • Something I do need to consider is this. Knowing what I now know do I continue with my existing employment in the hope that adjustments can be made, or do I put my energy into finding a benign working environment? 

    That's very subjective. I haven't been in the position to put it into practice, as I've been mentally ill, and haven't worked in a while. I'd say you've got to look at where you work and the type of people around you. I've worked in places like building sites, factories, warehouses, demolition sites, and some offices where it wouldn't have been the best thing to do. I was always considered "weird", or "a bit of a nutter", and had it said to me. It didn't bother me, they weren't being arseholes about it. If I was to be insulted about being autistic though, I'd be getting my P45 instantly. I've only been directly insulted over it once by a so called "friend", and my reaction was pretty nasty. I've also worked in other places where it would have been fine, as far as I can tell.

    Perhaps a working environment where I can be myself safely is an impossible dream.

    Not necessarily, I've spoke to a few people who have had positive experiences. I have a mentor, who has a pretty stressful, high responsibility position. She said that she made "requests" and not "demands", and is careful not to use her condition as "currency". My friend runs a factory, and one of his favourite employees has ASD. He said that the kid is amazing at his job, but he will have overload. He just lets the kid go off, and release his tension, then reset. He said all of the other workers like him, and he is probably the best worker he's had on his factory floor. My friend is totally oblivious to autism, but he understands the kid. I think that if you are reasonable, polite, and don't over play it, it seems very possible, and could be something solid. But, like I said it's subjective, unfortunately.

    they know you and you don't need to take measures.

    I'd say you hit the nail on the head with "they know you", they could also see things Sunflower has struggled with, and understand her requests for adjustments. On the other hand if the pros outweigh the cons, you might be right about not disclosing.

    I'm almost a year into having my diagnosis now and am still battling with depression.

    I had depression and anxiety leading into it, for a few years. I got my diagnosis and I feel like there is no separating the three. It's not the case, but you get so much information dropped in your lap, you start linking the stuff up. I think sometimes they give you information, and it's like "Here you ALL do this". We don't! There are parts that apply to you as an individual, and parts that just don't at all! It's bloody hard figuring it all out at first! It's best not to lose your personality in the sea of stuuf that you are told! I'm still doing it! Those first few months had me second guessing everything I do!

    That is also due to the fact that you realise what is troubling you and you end up paying more attention to it.

    You summed it up much quicker than me! There's also the stuff you DON'T do, that you are presented with!

    I found the diagnosis useful to be aware of some autie things I might be guilty of so I could fine-tune my mask and hide in plain sight for a bit longer.

    Not sure if that was what I was supposed to do.

    I never knew I had a mask, or if I was using on until it was pointed out! I'm full of tics, I rock sometimes, I also say some stuff that people see as odd, and I sing and speak to myself a lot. Thing is I find it more stressful now I know that there is such a thing as a mask, or if I should use it or not. I didn't do too badly when I didn't know about it, socially, in relationships, or even at work. It's up to you whether you do it or not, it's your life, whatever you find works best for you. Lol, I wish I'd never found out about it to be fair!

  • I can see the appeal of doing that but it's not an option for me. My mask slipped way too much before the assessment and diagnosis process!

    All along I've wanted to understand the drivers for impossibly high levels of anxiety.  I realised the damage anxiety was causing me and didn't just want to treat the symptoms with meds. 

    The first recommendation from the psychologist  is underway.  We've just registered for Relate relationship counselling. Through some wonderful fluke (or perhaps synchronicity!) the guy taking the referral has an adult son with Asperger Syndrome and was so insightful and supportive. 

    The only thing I am clear about is there is no one right way of doing things post diagnosis - we are all so different! 

  • I found the diagnosis useful to be aware of some autie things I might be guilty of so I could fine-tune my mask and hide in plain sight for a bit longer.

    Not sure if that was what I was supposed to do.

  • I'd stick with your present job. It's good to have one, and they know you and you don't need to take measures. Going public with your diagnosis may not have a beneficial effect.

  • I agree!

    I was going to 'warn' that being diagnosed might have a funny effect in the days and weeks after.

    I compared it a bit like the process of mourning with all the different stages.

    After my diagnosis I completely blanked out. Still haven't recovered.

    That is also due to the fact that you realise what is troubling you and you end up paying more attention to it.

    It's also got an effect in your relationship by the way.

  • Thank you. That is good advice. I am glad to have had a few weeks to come to terms with the idea of being autistic. Although I always had a feeling I might be (and indeed wanted to be diagnosed) it throws up issues. 

    Something I do need to consider is this. Knowing what I now know do I continue with my existing employment in the hope that adjustments can be made, or do I put my energy into finding a benign working environment? 

    I think I will start a separate thread about this, as others here seem to be in a similar position. Yesterday's feedback made me realise that the way I see things is different to most people. Perhaps a working environment where I can be myself safely is an impossible dream. 

  • Good to hear you got the answer to the questions you were asking yourself. This will probably get you asking more, but just my take, don't ask yourself too many. You are now diagnosed autistic, just remember, more importantly you are still yourself first. Not being preachy, but from posts here, and from personal experience, there can be a little bit of a fallout. Hope it all is a positive experience!

  • But most of us don't look a thing like Gloria Gaynor...

  • It must be a tremendous relief for you.  I know it was for me when I had my diagnosis.

    Best wishes for the future!  And hope it helps your understanding of yourself, as well as helping everyone else understand you.

  • Sounds like it did you good.

    Don't know whether to congratulate you or the opposite :-)

    But it seems to help you so that's positive!

    My strategy plan sounds just like yours by the way :-)

    • Congratulations, that all sounds really positive. 
  • I don't think any of us doubted it for a minute ..... but isn't it a good feeling to know for sure. Today truly is the first day of the rest of your life, and armed with your new knowledge, hopefully an easier one :-)

  • One of us...one of us.....one of us....Grinning

  • excellent! OFFICIALLY, welcome to the club!

  • I can't seem to edit my original message so I'm adding an update in the thread. The feedback was that I do meet the DSM-5 criteria and I have got a diagnosis of ASD.

    We had a useful discussion about things I can do now to reduce anxiety levels, ways of working on relationship issues, and what to consider in relation to work.

    I am going to get an email summarising today's discussion with the action points we discussed. I also asked for a brief letter confirming my diagnosis I can show to my GP and employer. The full report will follow in a couple of weeks.

    My husband came into the meeting after the first few minutes. I thought it was easier for him to hear things straight from the psychologist rather than me relaying the information to him afterwards.

    I came away from the feedback meeting feeling much more positive. A big part of the strategy is to help me recognise building blocks of anxiety, reduce miscommunication and plan activities to minimise the risk of going into meltdown or burnout.

    Thank you everyone for being so supportive while I have been going through the assessment process.