The Assessment and Diagnosis of Adult Female Asperger Syndrome/High-Functioning Autism

The Assessment and Diagnosis of Adult Females on the Spectrum

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Updated 11/12/2016

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Pathways to a diagnosis for an adult

The most common pathways to diagnosis include:1. After the diagnosis of a family member, usually a child

  1. The client already has one or more children diagnosed with an Autism Spectrum Condition

  2. The client had been encouraged by their work or education environment, their parents or their partner to get an assessment

  3. The client initiated professional help for depression, anxiety, an eating disorder, bi-polar disorder, schizophenia and subsequently received a diagnosis of Autism or Asperger Syndrome

  4. The client had been reading about "male" Asperger Syndrome, did not identify with the male-biased information, and then came across information about female autism or female asperger syndrome, and then identify with many of the characteristics

  5. The client has been mandated for assessment

  6. The client has been either identified as or charged with stalking, obsessions over people

  7. The client has become in trouble with the law in relation to cybercrime and cyberstalking

What is involved in the diagnostic and assessment process? 

The Assessment and Diagnosis of adult female Asperger Syndrome/High-Functioning Autism tends be quite a complex process. Generally speaking, the diagnostic process involves the following:

1. An interview to discuss family history, developmental history, childhood, teen life and early adult life. Questions are asked that have been modified to look for compensatory mechanisms.

2. Why the person believes they may have Asperger Syndrome

3. The clients presenting issues and current life context

4. Completion of one or more formal assessments together. The reason I complete the assessments with the client is because I gain much more information from the client by exploring some of the items in greater detail. Any confusion on the client's behalf regarding the items can also be clarified.

5. A review of a 4 page autobiographical description written by the client of their experiences from their earliest memories until around age 25. This is usually sent via e-mail before the first appointment. The autobiographical account is discussed with the client in terms of hallmark diagnostic features and qualitative themes. In addition, 1-4 description(s) from someone/others who know the client well is also invaluable in helping with the diagnostic process.

6. Perusal of photographs of the client when they were a child. This may help the client remember events and the actual photographs may also provide valuable clues.

7. Perusal of any talents and gifts (for example, artwork, poetry, writings, books, degrees, creative endeavors, jewellery making, photography, singing, etc.), by the client

8. Perusal of any previous reports or diagnoses, IQ tests

9. Perusal of school report cards and/or report card comments

10. A discussion or with a parent or family member, if possible

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Masking and Chameleon Behaviors (Compensatory Strategies)

11. Observations of facial expressions, masking expressions, chameleon behaviors, body language, repetitive behaviors, tone, pitch and volume of voice and personal appearance. An investigation of social strategies, scripting and other compensatory strategies.

12.  An investigation of face reading/mind reading and understanding of non-verbal body language

  1. An investigation of sensory sensitivities

  2. An interview with a family member, partner or someone else who knows the client well.

  3. One or 2 descriptions of the clients in terms of strengths and challenges by someone who knows the client well

  4. The results of the assessment are discussed and if a diagnosis is made, time is also spend on a "now what?" section, which involves future recommendations. Support is discussed in terms of social, emotional, career, family, and resources. A diagnostic letter or report is usually supplied to the client or to the clients doctor.

The diagnosis of adult female Asperger Syndrome is only the beginning. It is never too late to receive a diagnosis nor it too late to receive intervention or make changes in ones life or begin a new hobby, interest or career.

A diagnosis is only the beginning. The "What Next" section is the RoadMap for ones's future.

My "What Next" Section?

  1. Awareness and knowledge of the diagnosis

  2. Education

  3. Attitude and a positive identity. Creating a strengths and talents list and/or if unknown trying common strengths known to people with Autism

  4. Addressing any challenges

  5. Finding out how she thinks and learns (i.e. pattern, verbal/word or visual thinker OR for example auditory learner)

  6. Making environmental and/or academic accommodations

  7. Understanding the unique sensory profile and creating and using a sensory management kit

  8. Discussing and problem work, family or academic challenges

  9. Discussing the pros and cons of self-disclosure

  10. Understanding learning difference or disabilities

  11. Working of self-esteem and self-identity issues

  12. Addressing any co-existing conditions of disorders (for e.g. personality disorder, bi-polar disorder, eating disorder)

  13. Addressing and improving communication issues with family members, partner, and children

Further problem solving sessions may take place and focused on presenting concerns and/or priorities, which vary depending on the stage of life and the age of the client. Tania is available for fee-based diagnostic impressions assessments, support, intervention via in-clinic or Skype/Facetime/Phone consultation. Please email Tania at tania@aspiengirl.com

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Tania Marshall. 2013-2017.  All rights reserved. Duplication in whole or part is forbidden. Thank you.