Concerns about the assessment process

Hi all, I'm currently looking in to getting assessed for ASD and ADHD (preferably a combined AuDHD assessment) and I have a bunch of concerns and I'm overthinking a lot. I know the tools are there for a reason and there are so many "high-functioning" individuals that get diagnosed. However, my worries are as follows:

a) I'm worried I wont choose the "right" place -- this sounds kinda silly and I'm aware of that, but I can't help but worry I'll end up choosing the wrong person or establishment. I know all these places have trained psychologists and they offer assessments for a reason, but I get a little worried if it's more of an unknown/random psychology practice rather than some larger organisation (which would be Aspect here in Aus primarily). This is really for no explainable reason other than I'm just very petrified of accidentally doing the "wrong" thing and that it will lead to a misdiagnosis.

b) I'm worried about my parent/s reports about me (ADI-R) -- I've struggled with internalising a LOT of my hardships since primary school, and it has always taken a lot for me to admit when I'm struggling to my parents, most notably as a teen. When talking to a psychologists previously, my mum was able to identify sensory sensitivies and sensory seeking behaviour (not liking the sound of others chewing, fear of fireworks, sticking my finger into a hole on my mobile as a baby, etc) and that kinda made me feel a bit happy/recognised, especially the mention of what I did as a baby, since I'm worried that all my memories of "symptoms" are just anxious tendencies. For context I've been diagnosed with GAD only relatively recently but have basically been struggling with it since primary school but never got the courage to ask for help until I basically had a breakdown and couldn't hold it in anymore. Notable anxious internalisation of my experiences include not telling my mum when my 2 closest friends at school stopped being friends with me in primary (was literally crying after a call with them, but didn't tell my mum until like 2 days after and changed the story to not give away I kept it from her), and to deal with sensory overload, particularly in load environments, I had a tendency to just zone out to numb out the noise, which honestly didn't even really work. Basically the main point is I'm scared that my parents will not be able to accurately name/list/talk about my experiences up until now, and I suspect if anyone, I would have inherited it from my dad, but he's the type to ignore all issues and not get tested for anything (he avoided getting his liver checked out and basically sayd "if I cant see an issue there isn't one") so I feel like he'll brush things off as "normal" (he also hates people chewing loudly/with their mouths open, but at least my mum was able to recognise that as a sensory sensitivity). 

c) I'm worried about how masking/anxiety will (or if it will) interfere with the ADOS-2 -- As stated before, I have GAD, and its pretty severe, it's improved a little over time, but I still struggle significantly with anxiety including hypervigilance, excessive reassurance seeking, overthinking/overanalysing, and fear of/anxious when perceived. I can unmask easily around my boyfriend and can generally feel more comfortable around people I'm closer to, but even in my psychology sessions with my regular psychologist my body language is still very closed off (as noted many times by her), and I do feel very anxious in therapy sessions. I'm worried that throughout the ADOS-2 I will naturally be more anxious, closed-off, and reserved in terms of body language and behaviour (suppressing stims, or being more subtle, or on the other hand - not suppressing stims but instead anxiously fidgeting because I'm too anxious to be at ease/calm in order to be able to naturally stim as a stim not as an anxious fidget - I don't even know if that makes sense???). I fear that this will end up in a misdiagnosis or overlooking of other symptoms because my brain is preoccupied being anxious. I'd like to unmask to give the assessor full understanding, but I also don't want it to be unnatural and forced. I know the ADOS-2 works and the people are trained to use it in various presentations of autism but I've also been told that I'm probably just anxious, not autistic, which I never feel like aligns truly, I always feel like its not just anxiety. Due to internalisation and struggles with naming and recounting my emotions I also find it difficult to communicate my symptoms, which has also currently led me to not be diagnosed with depression despite knowing that I'm struggling a LOT in my day to day life, I just found it extremely difficult to communicate when asked to describe my symptoms, I went mind blank.

This was primarily a whole big rant but I just don't know what to expect. I know I shouldn't research too much into the ADOS-2 because knowing what to expect for that may hinder my results.. but god forbid I be curious about the specific details of the assessment and want to know exactly what I'll be made to do. I'm also under the assumption that they don't do a direct interview with you but I think I'm wrong on that? I don't know if they make you do questionnaires either but I also have all the questionnaires I've done docummented so I do trust/hope that all that will help get a deeper understanding.

TL;DR: I'm paranoid about choosing the "wrong" place, worried I won't meet the threshold/have inaccurate score in the ADI-R because of my parents, and worried the ADOS-2 won't accurately catch on to me truly

Parents
  • Good morning from America, appiejoolover!

    ASD/ADHD/GAD/MDD here. At my assessment, my psychiatrist was able to identify all four conditions, though she did say she considered me “borderline” Autistic. I’m going to try and ease some of your fears as best as I can. Overall: If you think you’re Autistic, you probably are.

    1. Okay, reframe it like this: If you chose the “wrong place,” then you can get a second opinion at the “right place.” There’s nothing wrong with going through the process again if you don’t feel like the answer was correct.

    2. Remember that your parents’ testimony is only one part of the assessment. (Oh while we’re here, fun fact! That’s actually not a required portion of the assessment in America. I didn’t have to bring in any reps to testify for me.) Even if your dad’s like “Oh they’re fine they never showed signs of Autism as a kid,” that can be easily explained if you note that you masked as a child. You’re not going to bomb the assessment just because of your parents’ testimony. In my unprofessional opinion, they can only help.

    3. Biggest advice I have for an assessment is to write down your Autistic traits BEFORE the assessment and bring it in! Especially if you have GAD. It’s easy to mask in the assessment and forget what you normally do when you’re unmasked while you’re being drilled with questions. That doesn’t mean that you have to stim and talk with run-on tangents and other Autistic things like that. As long as you can mention it, that should suffice.

    TL;DR: Get a second opinion if needed, your parents can only help, and write down your traits for the appointment!

Reply
  • Good morning from America, appiejoolover!

    ASD/ADHD/GAD/MDD here. At my assessment, my psychiatrist was able to identify all four conditions, though she did say she considered me “borderline” Autistic. I’m going to try and ease some of your fears as best as I can. Overall: If you think you’re Autistic, you probably are.

    1. Okay, reframe it like this: If you chose the “wrong place,” then you can get a second opinion at the “right place.” There’s nothing wrong with going through the process again if you don’t feel like the answer was correct.

    2. Remember that your parents’ testimony is only one part of the assessment. (Oh while we’re here, fun fact! That’s actually not a required portion of the assessment in America. I didn’t have to bring in any reps to testify for me.) Even if your dad’s like “Oh they’re fine they never showed signs of Autism as a kid,” that can be easily explained if you note that you masked as a child. You’re not going to bomb the assessment just because of your parents’ testimony. In my unprofessional opinion, they can only help.

    3. Biggest advice I have for an assessment is to write down your Autistic traits BEFORE the assessment and bring it in! Especially if you have GAD. It’s easy to mask in the assessment and forget what you normally do when you’re unmasked while you’re being drilled with questions. That doesn’t mean that you have to stim and talk with run-on tangents and other Autistic things like that. As long as you can mention it, that should suffice.

    TL;DR: Get a second opinion if needed, your parents can only help, and write down your traits for the appointment!

Children