Sunday, July 8, 2012

Diagnosis!! I've been waiting my whole life for this!

This is a "copy" of the results I received June 6, 2012, after undergoing the testing for Asperger's. Obviously, it was concluded that I do, indeed, have Asperger's, as I have thought for quite some time, and as my mother thought for much longer. I'm rather glad of it, it makes a whole lot of things in my life, both past and present, make sense.
This might be a little "clinical" and a long read, but can help you give an insight to what I'm dealing with, and "who I am" to an extent. I have added some notes along the way, labeled (NOTE: ......)


Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV)
The Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) is a standard, widely used measure of intelligence. It provides a good estimate of current level of intellectual functioning and is designed to asses multiple activities.
Ericka appeared to understand the test instructions and there were no apparently visual auditory, or motor impairments observed. The obtained test scores appeared to be a valid estimate of Ericka's current intellectual functioning. 
(Note: I cannot replicate the graph they list, so I will rewrite it: the order of the line will be Scale, IQ Score, 95% Confidence Interval, Percentile Rank, and Qualitative Description.)

  • Verbal Comprehension : 108 : 102-113 : 70 : Average
  • Perceptual Reasoning : 111 : 104-117 : 77           High Average
  • Working Memory : 117 : 109-123 : 87 :               High Average
  • Processing Speed : 124 : 113-130 : 95 :       Superior
  • Full Scale : 117 : 113-121 : 87 :                           High Average
  • General Ability : 111 : 106-116 : 77 :                   High Average
(Wait, my IQ is 117? I'm especially fascinated by the processing speed of 124.... Wow.)

Subtest Scores Summary
Verbal Comprehension Subtests Summary
(Subtest : Scaled Score)
Similarities : 10
Vocabulary : 12
Information : 13

Perceptual Reasoning Subtests Summary
Block Design : 15
Matrix Reasoning : 8
Visual Puzzles : 13

Working Memory Subtests Summary
Digit Span : 14
Arithmetic : 12

Processing Speed Subtests Summary
Symbol Search : 14
Coding : 15

*Scaled scores between 7 and 13 are considered low to high average.

Ericka's Full Scale score is in the High Average range. She scored higher than approximately 87 out of 100 individuals her age on the combined tasks.

On the Indexes, Ericka performed in the Average range on the Verbal Comprehension Index (VCI). Her performance, which was better than that of approximately 70 out of 100 individuals, is an indication of how well Ericka performs on tasks measuring verbally acquired knowledge. On the Perceptual Reasoning Index (PRI), Ericka performed in the High average range, or above that of approximately 77 out of 100 individuals. Her performance on the PRI is a measure of her nonverbal reasoning skills, attentiveness to detail, and eye-hand coordination. Ericka presents a diverse set of nonverbal abilities, performing much better on some nonverbal tasks than others.

The degree of variability is unusual for individuals her age and may be noticeable to those who know her well.

On the Working Memory Index (WMI), Ericka performed in the High Average range, which is above that of about 87 out of 100 individuals. This index provides an indication of how well an individual can manage multitask demands.

Ericka's Processing Speed Index (PSI) score, which was within the Superior range, provides a measure of her ability to process visual information quickly. She scored above approximately 95 out of 100 individuals on the PSI. 

(Processing Speed Index, in the way the examiner put it, is like in football, you have to make that pass, with quick thinking. MY example was - when I'm reading music notes ahead of what I'm playing. Examiner also said it also can cause me to make quick decisions based on things I know, and those decisions can be hard to change, whether it be about people or other decisions, etc.)

Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2)
The MMPI-2 is a standardized, self-report questionnaire that provides quantitative measures of an individual's emotional adjustment and test taking approach. Ericka produced a valid test result.

Individuals with a profile similar to Ericka's often have high standards and a strong need to achieve, but they feel that they fall short of their expectations and then blame themselves harshly. Ericka may feel quite insecure and/or pessimistic about the future. She may also feel inferior to others, has little self-confidence, and does not always feel capable of solving her problems.

Ericka endorsed a number of items suggesting that she is experiencing low morale and a depressed mood. She reports a preoccupation with feeling guilty and unworthy. She feels that she deserves to be punished for wrongs she has committed. Ericka feels currently regretful and unhappy about many aspects of life, and she seems plagued by anxiety and worry about the future. At times, Ericka may feel a strong sense of hopelessness.

According to her response content, Ericka is rather high-strung and wonders if she feels things more, or more intensely, than others do. Ericka may feel quite lonely and misunderstood at times. She endorses statements that show some inability to control her anger, and she may verbally attack others when she is angry. Ericka appears to be somewhat passive and dependent in interpersonal  relationships and does not speak up for herself. She avoids confrontation and seeks nurturance from others, often at the price of her own independence. Ericka also tends to blame herself for interpersonal problems. Ericka may seem to require an excessive amount of emotional support from her spouse. She appears to be rather shy and inhibited in social situations, and she may avoid others for fear of being hurt.

Ericka has very few friends, and others think she is hard to get to know. She is quiet, submissive, and conventional, and she lacks self-confidence in dealing with other people. Individuals with this passive and withdrawing lifestyle are often unable to assert themselves appropriately and are frequently taken advantage of by others.

Million Clinical Multiaxial Inventory, Third Edition (MCMI-III)
The MCMI-III is a standardized, self-report questionnaire that provides a quantitative measure of an individual's personality traits. Ericka's test results are valid.

The MCMI-III pattern achieved by Ericka suggests an ongoing conflict between her desire to develop secure and warm relationships and a fear of having to relate to others she cannot or will not trust. Ericka wants to be close and affectionate with others but anticipates disillusionment from such relationships. She may lack self-esteem and expect to be humiliated. Others may have either deprecated or disapproved of her self-expressive attempts. Ericka's relations with others may often be petulant and passively aggressive, causing others to view her possibly as a sulky, irritable, and argumentative person. Occasionally, Ericka may attack others capriciously for their lack of support and for what she sees as their unreasonable expectations and demands. To bind her anger and thereby protect herself against further isolation, she may become anxiously depressed and withdraw into her own world. It would appear that Ericka's daydreaming and moodiness frequently evoke negative reactions from others, which only serve to reinforce her withdrawal tendencies.

Ericka may feel that she is unable to muster the wherewithal to overcome the deficits she sees in her life or to achieve the support she desires from others. Hence, she may vacillate, turning first against herself, expressing feelings of unworthiness and uselessness, then turning against others, acting petulant and irresponsibly. Feeling unappreciated and demeaned by others, she may find that withdrawing and daydreaming provides her with some satisfactions that are otherwise unattainable. 

Autism Diagnostic Observation Schedule, Module 4 (ADOS)
The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured and standardized assessment of communication and social interaction for individuals who have been referred because of possible autism spectrum disorders. The ADOS includes developmentally appropriate opportunities for informal interaction with examiner, examiner-structured situations, and performance-based tasks that have specific directions. Based on the presence/absence and quality of the individual's observed behaviors during the ADOS, ratings are assigned and scores are calculated. These are used to help determine the quality of functioning in three developmental areas related to autism spectrum disorders: Communication, Reciprocal Social Interaction, and a third area which encompasses various behaviors including imagination and stereotyped behaviors and restricted interests.

In the area of Communication, the cut-off for demonstrating traits of an autism spectrum disorder is a score of 2 and the cut-off for demonstrating traits of autism is a score of 3. Ericka obtained a score of 2. Ericka did demonstrate appropriate use of language, and she did not demonstrate speech abnormalities, echolalia, or stereotyped use of words. Ericka was able to spontaneously share information, as well as able to use gestures to supplement her communication. However, little reciprocal conversation was sustained by Ericka. She tended to follow her own train of thought rather than participate in an interchange, even when prompted. 

In the area of Reciprocal Social Interactions, the cut-off for demonstrating traits of an autism spectrum disorder is 4 and the cut-off for demonstrating traits of autism is a score of 6. Ericka obtained a score of 6. Ericka was able to make eye contact when this evaluator spoke to her, but this eye contact was not sustained when Ericka began talking, nor did Ericka "check in" using eye contact to see how this evaluator was responding to her. Ericka displayed strong empathy for animals and children, but her understanding of adult emotions and behaviors appeared intellectualized. Ericka described several situations where, much to her surprise, others had to explain to her that her behaviors were having a strong negative impact on them. Ericka did display a variety of emotions and facial expressions, but she did not direct these expressions toward this evaluator during testing. This evaluator provided many prompts and pauses for Ericka to engage in reciprocal conversation, but Ericka did not seem to pick up on these cues, nor did she initiate conversation.

In combining the communication and social interaction scores, the cut-off for an autism spectrum disorder is a score of 7 and the cut-off for autism is a score of 10. Ericka obtained a score of 8.

Ericka did not exhibit sensory issues, excessive interests, or repetitive body movements during her testing session. In tasks that examined for creativity, Ericka did tend toward more literal interpretation of events, although she did exhibit a sense of humor at times.

SUMMARY
Ericka's primary question was, "Do I have Asperger's Disorder?" According to the ADOS-4 test results, Ericka does qualify for this diagnosis. Ericka develops intense interests that consumer her time and energy to the point of negatively impacting her relationships with others. Ericka struggled to develop peer relationships as a child and, although this has improved significantly as an adult, still struggles to navigate and comprehend the complexities of social interactions. Ericka also appears to struggle with social reciprocity. Her way of connecting with another person is to talk about her interests, but Ericka appears to miss some of the cues for listening and/or sharing in a two-way conversation and her ability to make eye contact is inconsistent. It should be noted that Ericka is an intelligent woman, and it appears that she has intellectually acquired several social skills over time. Despite the diagnosis of Asperger's Disorder, Ericka is very high-functioning and has found many ways to compensate for social deficits. It should also be noted that Asperger's Disorder can present slightly differently in women than in men. Ericka displays slightly more empathy and exhibits a wider range of emotions than what might typically be associated with Asperger's Disorder, and this may, in part, explain why this diagnosis was missed in Ericka previously. 

In additional to Asperger's Disorder, Ericka's MMPI-2 and MCMI-III test results showed clinical elevations in the areas of depression, which is consistent with Ericka's self-report. Ericka is being diagnosed with Major Depressive Disorder, Recurrent, milk to moderate. Ericka's depression appears to become more severe in winter months, with more mild experiences of depression in the summer.

Ericka is also currently experiencing anxiety about (Note: not sharing that particular bit of info), but Ericka's sense of worry and rumination appears to be pervasive and extends beyond current circumstances. Ericka's symptoms of anxiety resemble a Generalized Anxiety Disorder and reportedly impact her interpersonal and intrapersonal functioning. However, a diagnosis of anxiety is not rendered when a diagnosis of Asperger's Disorder is present. Nonetheless, the above concerns are significant and would benefit from being addressed and treated as an anxiety disorder would be.

Similarly, Ericka's MMPI-2 ad MCMI-III also suggested many traits categorized as "avoidant" or "obsessive-compulsive". It might be helpful for Ericka's mental health providers to be aware of these tendencies in Ericka. However, Ericka is not being formally diagnosed with avoidant personality disorder or obsessive-compulsive personality disorder as a part of this evaluation. Ericka's avoidant and obsessive-compulsive tendencies are considered auxiliary features of her Asperger's Disorder and do not warrant a separate clinical diagnosis.

(Note: Examiner told me that the reason diagnosis of anxiety, avoidant or obsessive-compulsive is not given is because these things are a part of what Asperger's is. I have these tendencies/diagnoses, in part, but they are not separate from Asperger's, therefore no "extra" diagnosis is given for them.)

I'm pretty glad! This is what I always knew about myself. I always KNEW I was different. We all wish we were special, and I know that to God we are, and He made me this way specifically and for a reason. Now all of the information I KNOW I can relate to myself, maybe I can find out what purpose this is for. Maybe I can find out why I'm different, what strengths I have because I'm different. I know this is a positive thing. :) I have no fear of it. I always have been, am, and always will be an ASPIEGIRL! :) :) 

So there you have it. More discussion on this later. Ask questions if you want. :) I'm starting this blog to be an open book as much as I can. 

3 comments:

  1. We are extremely proud of who you are, and we love you the way you are...but hope that you can start feeling proud of who God made you also...there IS a place that is just right for you.....Now it is up to you to find it and settle comfortably in it...

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  2. Thanks for sharing this with us! We work together better when we know each other better. :)

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  3. You def have me wondering. For sure.

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