Q. How Do Experts Diagnose Asperger Syndrome in Adults?

A. Dr. Shana Nichols of the Fay J. Lindner Center for Autism on Long Island in New York specializes in diagnosing and treating teens and adults with Asperger Syndrome. While she uses several specific diagnostic tools to identify specific symptoms, she says that even those tools are somewhat out of date, as is the DSM IV, a psychiatric diagnostic manual, which was last updated in 1994. "We've learned an enormous amount since then," she says.

When adults come to the Lindner Center for a diagnosis, Dr. Nichols begins her exam with an IQ test. Since people with AS have normal or above normal IQs, this is a good place to start. She also administers an assessment of adaptive skills which tests the patient's ability to manage complex social situations....

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Thank you!  Hmm, I could handle that, I think...

<hugs>

Athie

It's not unusual, says Nichols, for a patient to come in expecting an AS diagnosis and to leave with a different diagnosis. "Distinguishing between social phobias or shyness and actual impairment with AS can be very tough for a layperson," she says. Other disorders, such as obsessive compulsive disorder (compulsions, hoarding, needing to do things over and over) or social anxiety can sometimes look like AS. If doctors do pick up on these other disorders, they can recommend appropriate therapy and/or medication.

This is what I worry about.  However I will say that I've asked my last two therapists about Obsessive Compulsive Disorder, thinking I had it, and they didn't see it in me.  Especially my last one.  He said: "Those with OCD are pretty flexible in life except for some rituals which they have a compulsion for."

My routines are more voluntary and I *enjoy* giving into my need for routine, I wonder if this is the difference between OCD and AS.

Perhaps the greater concern is that it just turns out that I only have Social Anxiety.  But I feel I have proved to many on AFF, at least, that my problem is beyond simple social anxiety.

I also think there is a danger that a person can be mis-diagnosed as "simply" having an avoidant personality, social shyness or obssessive-compulsive disorder when they in fact have AS. Then, they could be put under pressure to have therapy that might not really suit their needs.

Of course, but this diagnostician in particular seems to understand the difference, and sounds like he knows a lot more about differentiating what looks the same on the surface, than would most shrinks etc. who would not be able to tell AS from social phobia in an adult.

Yes, my last therapist only seemed to think that "avoidance" was my problem.  It is clear to me that it goes beyond that.

It is just one aspect of the condition. "Avoidance" is often a survival mechanism and is done in an effort to prevent being overstimulated.