I really got the impression the psychologist was cherrypicking information (especially in the parent interview) just to check things off the diagnostic criteria. Everything he did that vaguely sounded like an ASD symptom was attributed to ASD, with no real thought as to whether it actually is or not. I compared her report to the DSM-5 criteria, I didn't get the impression she was actually applying the criteria properly, just doing her own thing and then invoking its name at the end as if it was some magic spell.
Her diagnostic report claimed our son (who was about to start school) needed all this special education help (timers in school, sensory diet, etc), and she really wanted us to give it to his school. The report sounded like a bad caricature of our son. We decided not to give it to the school and not tell them anything about it. And his teacher tells us he is going very well.
She also put him down in the report as being ASD Level 2, but she told us verbally she only thought he was Level 1, but she always puts people down as Level 2 or above because that's the cut-off for Australian government disability funding ("NDIS List A").
He's mostly normal kid, rather like myself at the same age. He's very intelligent, social stuff isn't his strong suit (but so what, it's never been mine either.) He's very shy, but my wife says she was even worse at his age. We did go through a period last year when his behaviour was becoming rather unmanageable (aggression, defiance, hyperactivity), but he's much much better now (so much so that we took him off his ADHD meds) and I think a lot of those behaviour problems were due to family stresses (new baby), parental mental illness (I have anxiety/depression, and I suspect my wife does too, although she resists diagnosis), sub-optimal parenting skills, rather than ASD and/or ADHD and/or whatever.
When people say that ASD is being overdiagnosed, and I look at what this psychologist did, I think it really is.
Turns out I had Aspergers. So at age 15 I was diagnosed, and then participated in a few brain studies which confirmed it. I stayed off the medication and went through therapy focusing on life skills and human relationship training (how to talk to and interact with huerotyipicals).
Since then my life has been pretty good. It’s had its ups and downs, but a wonderful journey into my 30s.
In my case I was on the spectrum, but the whole experience has made me very skeptical of psychologists. I sometimes think about how many terrible programmers there are. I think the same spread of skills probably exists in every profession. Unfortunately, in psychology if you’re bad at your job, you end up ruining lives.
Like anything else, it’s best to shop around.
I was diagnosed with ADHD three times as a child, my parents never believed it and chose to never tell me or get me the help or medication or accommodation I needed because "I was fine". By god, I'm getting treated now and holy hell life would've been a billion times more enjoyable and productive if they'd just listened, or even told me later so that I could decide. I know you're just trying to do the best you can, but jeez this is sad - if you doubt the diagnosis, fine - get a second opinion, and a third, but think that if they're all the same, you went there for a reason and they're probably right.
> if you doubt the diagnosis, fine - get a second opinion
We actually tried to get a second opinion. We went to another psychologist for one, she booked us in, but then her superiors cancelled it. They said if a child has been diagnosed as having ASD Level 2, they didn't want to repeat the assessment since there was a risk they might get undiagnosed or only diagnosed as Level 1, which would remove his eligibility for government disability funding (NDIS). (Which we still haven't applied for, because we aren't convinced he needs it, and don't know what to spend it on anyway.) They wanted us to go to see some paediatrician they like, who is actually a colleague of our son's existing one.
Instead we took him back to his existing paediatrician. He said he too was a bit sceptical about the diagnosis, but that psychological diagnosis isn't an entirely objective process, and it doesn't really matter whether he has ASD or not, and it would be a waste of time to repeat the assessment, so we should just do nothing about it for 6-12 months, and see how he goes, and consider repeating the assessment in another 2-3 years.
As an adult with Asperger's/Autism in a full-time job -- I agree that your child might not need the funding. But at this point, it is probably too early to tell.
I can also imagine a situation where a person with Autism was relying on, say, a bus funded by NDIS as part of their routine, was re-diagnosed as L1, had their routine disrupted, and came back to the psychiatrist and had a meltdown in the office. You'd only need one or two of these experiences to decide on a blanket policy to not rediagnose folks.
I'd say everything else you just said describes us as well (stress, parental mental illness, etc), but I can't attribute her behavior to those things. That's just how she's always been, and there's nothing wrong with that.
How old is your kid? If they are as high-functioning as you claim, then you should involve them in the decision-making about what to do. ("Do you want me to tell your teachers you have autism?", "Would you like plain food at school?", etc.)
When I was in school, the written "Individual Education Plan" said that I got an extra 30 minutes per hour on tests. In practice, this starts a conversation between the teachers that says, "this student needs special handling for tests". In practice, the accommodation I requested (and usually got) was permission to walk out of a test or exam as soon as I finished (sometimes half an hour early).
We haven't told him about either the ADHD or the ASD diagnosis. We will tell him the full story when he is older (both what he was diagnosed with, and why we are sceptical about the diagnoses.)
Since we haven't told the school about any of his diagnoses, he obviously doesn't get any special consideration for them. But he enjoys school, he reports no problems and neither does his teacher.
Thank god your son has a parent like you though — some medicate the personality out of their child, holding on to the shoddy diagnosis.
I hope as a society we can change all this — currently working on experimental assessments using direct brain data (eeg) to provide a bit of “truth” to the process.
 NICHQ Vanderbilt Assessment Scale—Informant
This is a good article about the differences:
That's not to say some kids aren't both. But the rush to diagnose kids, along with the relatively simplistic diagnosis process many psychologists use can lead to misdiagnosis.
I'd rather have been allowed to fail out of school than grow up a straight-A Addict.
Talking about medicine in general, Australia uses ICD-10-AM, which is the Australian national modification of ICD-10. By comparison, the US uses ICD-10-CM, which is the US national modification of ICD-10. Not sure exactly what the differences are – while the ICD-10 and ICD-10-CM code lists are freely available, you have to pay $$$ to even see the ICD-10-AM code list online (or go find a printed copy in a medical school library)
Get a second and third opinions.