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We went through the ASD diagnostic process with our son, and it left us very sceptical about the whole thing. I was never convinced he had ASD (and I'm still not), but some psychologist talked us into it.

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.

I think a lot of psychologists really have no clue. I was diagnosed with bi-polar II when I was 10, then major depressive disorder, then adhd, the oppositional defiance disorder. I was put on so many different medications which fucked me up and stole my adolescents from me. I ended up a ward of the state and cycled through more than a few mental institutions in my teens. Then I met someone who was like “I think this kids previous shrinks fucked up. I’m taking him off all the medication and then I’m going to observe him and find a diagnosis.”

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.

No, of course it's completely logical generalise the whole field of psychology and the diagnosis and treatment of complex mental disorders from the singular experience you had - especially when they've told you they're trying to get you the most help they can from various government bureaucracies. It's also perfectly logical to just take a face value your child's teacher's opinion that "they're fine" when they've got 20+ other children to worry about and monitor. Don't worry, you're the parent and you always know best - and you're sure to tell other people too. /s

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.

(same person, new throwaway, forgot password to the previous one)

> 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.

The NDIS funding might be useful when your child is an adult, in the event that your child has difficulty finding and keeping a full-time job.

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.

Fair enough. I'm sorry for being so harsh and sarcastic in my initial response; that was uncalled for.

My 5-year-old daughter was just diagnosed with ASD. I was beyond skeptical through the entire process -- until I started seeing what they were seeing. If you go back and watch videos of her when she was younger you see it then, too. She's an incredible kid, intelligent, curious, goofy. I am still not sure I've really accepted it, but the help she's getting is really helping her. Unless you're a psychologist I don't think you should be "convinced". Get a second opinion if you don't believe it. Don't let your pride get in the way of teaching your son the _healthy_ coping mechanisms he might need.

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.

I am an adult who was diagnosed with Asperger's in 5th grade.

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).

He's 5. He's just started kindergarten.

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.

It’s pretty wild that a parent and teacher survey[0], with least likely to most likely responses, is considered “truth” to diagnose adhd (the only diagnosis I’ve fully studied, but I believe depression and Austim are similar).

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.

[0] NICHQ Vanderbilt Assessment Scale—Informant


What's important is to remain open to the possibility, because if you're wrong, your child is in for a world of hurt. I did very well in school, was a model student, and continued to do so until I was so exhausted by high school that I just stopped trying. I had no idea I was autistic, so I couldn't explain what was going on when I started missing classes to be alone, and going from a straight a student to doing only what was necessary to reach a c+.

One thing that's maybe worth looking into is gifted children, overexcitabilities and asynchronous development. It very common to misdiagnose young gifted children with ADHD, Aspergers and other behavioural disorders. This is because at a young age the symptoms are very similar and it generally requires a more indepth interview with the child to tell the differences.

This is a good article about the differences: https://www.davidsongifted.org/Search-Database/entry/A10900

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.

You may want to look into Pathological Demand Avoidance. It's very new, and has basically no awareness outside of the UK, but it seems to describe a class of people (including myself), who exhibit symptoms similar to people who are classically autistic or have aspergers, but with much better social skills.

Webpage: https://www.autism.org.uk/about/what-is/pda.aspx

Book: https://www.amazon.com/Understanding-Pathological-Avoidance-...

I never recovered from the addictive ADHD medication I was put on as a child.

I'd rather have been allowed to fail out of school than grow up a straight-A Addict.

DSM is a US standard, does Australia have a different standard?

Almost every country uses the ICD-10.

For ASD diagnosis in particular, Australia mostly uses DSM-5 rather than ICD-10. Most professionals are now diagnosing just ASD (per DSM-5), rather than the DSM-IV-TR/ICD-10 diagnoses of autism, Aspergers, PDD-NOS, CDD, etc.

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)

From the psychologist's perspective, it seems like she might actually think she was doing you a favor because of the disability funding...

From a parent's perspective, it would have been nice if she'd asked us first "Would you like the most accurate possible diagnosis, or would you like an 'overcooked' one which maximises the odds of you getting approved for government disability funding?" She just assumed we wanted the second without even asking us.

To the contrary, she told you what the actual diagnosis was and why she put on paper what she put.

Get a second and third opinions.

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