Published on 12, July, 2020
Hi Everyone,
I was diagnosed about 6 months and the one thing I get really confused by is the lack of consistent approach to diagnosis and the methods used.
My diagnosis consisted of 2 parts, ADOS performed by a speech and language therapist and ADI by a psychiatrist - my wife was my informant,
On my assessment report it says that to get a successful clinical Autism diagnosis you must meet the criteria of both ADI and ADOS and the assessment must be carried out by a multi discipline assessment team with all disciplines being in agreement. Since my diagnosis I have heard from other Autistic People about their diagnosis process and confused how other clinics (including some NHS trusts) assess with only a single psychologist using ADI style questioning (i am actually really jealous about this as I found ADOS very stressful and left me burnt out for about a week). I wonder if anyone can offer an explanation for the differing requirements for successful assessment? It was suggested to me that it might be because my assessment covers both NICE and DSM requirements but not sure if this is correct or not?
Also wondering if there was impact on support when receiving differing diagnosis. I do know someone in my Autism support group that was refused by Access to work support for reasonable adjustments when starting a new job. Their Autism assessment was performed by the NHS and appears it wasn't accepted as sufficient.
i get the feeling it can be a bit of a lottery how the assessment and follow up support process plays out, but its one of the things that really keeps nagging at me and won't go away until I have recieved an explanation, so really hope some one can shed some light on it :-)
Grogu's Dad said:On my assessment report it says that to get a successful clinical Autism diagnosis you must meet the criteria of both ADI and ADOS and the assessment must be carried out by a multi discipline assessment team with all disciplines being in agreement.
Well, this is factually wrong. That is just some clinicians thinking that their approach is the best, but extending that idea - wrongly - to become "All other approaches are invalid".
Taken verbatim from the NICE guidelines for the assessment of ASD, "Diagnostic assessment, which in the UK uses ICD-10, is often within a multi-disciplinary team but at a minimum is by a qualified clinician, usually a clinical psychologist, psychiatrist or neurologist." From the document: Autism Recognition, referral, diagnosis and management of adults on the autism spectrum, National Clinical Guideline Number 142, p. 25.
I think there is a welter of problems regarding diagnosis and support. The NHS seem to have chosen the most long-winded and expensive method of making adult autism diagnosis. Firstly, it seems to be based on that used for children, with very little modification for application to adults. Secondly, it involves a team of clinicians and takes a long time, therefore it is expensive and allows ridiculous backlogs to build up. This has been recognised by the NHS increasingly paying for private assessments that are quicker and often employ only one, suitably qualified, clinician (the 'Right to Choose' scheme).
Many employers, local governments, social services and educational institutions etc. have no idea what constitutes a valid autism diagnosis and entirely wrongly deny people support that they are fully entitled to. Very often some incompetent pen-pusher makes up erroneous rules, unfortunately, they are not often challenged, as they ought to be.
Martin,
thanks for the explanation makes quite a bit more sense to me now. My assessment was via private medical insurance through work so i didn't have a choice in who i went to.
ADOS is a horrible and stressful assessment method to go through and i know a lot of people write this off as childish, on the plus side of the feedback was extremely positive in identifying communication and sensory issues and a big help towards unmasking.
I was diagnosed by a consultant psychiatrist. The psychiatric approach for adult autism diagnosis seems to place more emphasis on the patient's own history, with tests and direct observation taking a less prominent role. Which suited me, because my masking is pretty flawless; only when I'm exhausted or very, very anxious would my autistic traits be at all noticeable.