ASD DIAGNOSIS

​First, we do not like the diagnostic term "Autism Spectrum Disorder" and, instead, much prefer "Autism Spectrum DIFFERENCE". When considering all the strengths and weaknesses, our clients are no more "disordered" than other people.

Secondly, most of our clients do NOT seek to receive a diagnosis, nor do we find much benefit in providing one. It is much more effective to treat whatever unique characteristics which present themselves and avoid the negative effects of labeling and having a fixed mindset.

On the other hand, it can be INCREDIBLY helpful to receive a diagnosis if it can help a couple reinterpret behaviors as a way of experiencing the world as opposed to a sign of bad intent. Other benefits of a diagnosis include:
 

  • a path to self-acceptance,

  • getting answers to bothersome questions that may have been unanswered for years,

  • identifying strengths and how to build on them,

  • access to resources designed to support like-minded individuals, and

  • developing a plan of addressing differences.

CHALLENGES OF AN AUTISM ASSESSMENT


In spite of the benefits, there can be obstacles in getting a diagnosis. These may include: 

  • Masking (i.e., learning to act the way you are expect to behave instead of in a way that is genuine) can lead to core traits being hidden.

  • Excellence in specific areas that cause others to ignore deficits or differences. 

  • There is no blood or genetic test for ASD.

  • Co-existing challenges (e.g., ADHD, general anxiety, OCD, deficits in executive functioning, and depression) that garner attention while the ASD is overlooked).

  • Bias toward recognizing ASD in men over women. See our page on Support for Aspie Women.

ON-LINE ASSESSMENTS

 

In such cases, clients start by taking the following on-line assessments (not definitive tests):

  • Autism Spectrum Quotient (AQ) Test 

    • a result of 26 or higher (50 points total) indicates the possibility of Asperger’s

    • 80% of autistic people score 32 or higher

    • Most non-autistic males score 17 on average

    • Most non-autistic females score 15 on average
       

  • Empathy Quotient (EQ) Test 

    • a result of 30 or below indicates the possibility of Asperger’s

    • 81% of people previously designated Asperger syndrome score 30 or lower

    • Most non-autistic males score 42 on average

    • Most non-autistic females score 47 on average
       

  • Ritvo Autism & Asperger Diagnostic Scale- RAADS-14. (scores of 14 and above out of possible 42 are indicative of possible Asperger's).
     

  • Autism Spectrum Screening Questionnaire (ASSQ) 

    • Score is out of 68.

    • The higher the point total, the greater the likelihood that you show signs of autism spectrum disorder.

    • Score of 51 or higher indicates possibility of ASD and further assessment is recommended.

FORMAL DIAGNOSIS​

When a formal diagnosis is requested and both partners agree that it will be helpful, we use a collaborative process and involve the neurotypical partner in the process as long as this can be handled in an emotionally safe way. This often helps build an understanding of what the diagnosis actually means.

In pursuit of a formal diagnosis, please keep in mind that:

  • A combination of information is required.

  • There is NO individual test or indicator that is definitive.

  • The diagnosis ultimately is based on the clinician's judgment.

 

The following steps are usually involved in the diagnostic process:

  • Discuss your developmental history with a focus on the quality of attachment to family members
     

  • Discuss your development of peer relationships and friendships 
     

  • Make behavioral observations including your social and emotional presentation
     

  • Interviewing your partner regarding the nature of interactions and the quality of attachment
     

  • Observe your self-awareness, perspective-taking and level of insight into social and behavioral issues
     

  • Discuss your ability to understand another person’s feelings, intentions and beliefs
     

  • Ask for your self-report of certain characteristics including:
     

    • Social interactions

    • Special interests (intensity and depth)

    • How change is handled

    • Sensory seeking and avoidant behaviors

    • Use of eye contact

    • Stimming

    • Repetitive behaviors

    • Expressing emotions

    • Maintaining conversations
       

  • Possibly meet with other friends or family members who can provide additional perspective. This is not usually necessary if you are part of couples therapy but can be helpful.
     

  • Assess for related issues such as Attention-Deficit/Hyperactivity Disorder (ADHD), obsessive-compulsive tendencies, general anxiety and depression.
     

  • Line-by-line review of the DSM 5 Diagnostic Criteria with you and your partner.
     

  • When a diagnosis is unclear, more detailed assessment instruments are available (Autism Diagnostic Observation Schedule-2 (ADOS-2) and Autism Diagnostic Interview-Revised (ADI-R) but are not required for a formal diagnosis.

Please note that neurological testing is not required to get a “formal” diagnosis. 

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Hugging Couple in Nature

“Showing kindness towards those who are different and embracing our imperfections as proof of our humanness is the remedy for fear.”  

 

 

Emma Zurcher-Long of Emma’s Hope Book