1. The document discusses diagnosing autism spectrum disorder (ASD) in adults, including background information, diagnostic processes, and support post-diagnosis. 2. It provides an overview of issues adults with ASD often face, such as undiagnosed conditions leading to misunderstanding, and benefits of diagnosis including understanding themselves and finding community. 3. The presentation aims to help psychologists improve their skills and confidence in diagnosing adults with ASD, including high functioning autism and Asperger's syndrome, using comprehensive assessment methods.

1. Areas covered today
Diagnosing Adults with
High Functioning Autism 1. Background information
or Asperger Syndrome 2. Issues for adults suspected of having HFA/AS
3. Diagnostic processes
4. Clinical experience
5. Literature, information, support & resources for
Tanya Breen
professionals
NZPsS Conference August 2011
6. Post diagnosis support
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Asperger’s disorder
Autistic disorder or autism
Pervasive developmental disorder characterised by
(or Asperger syndrome)
impairment in:
Social skills
Essentially the same as autism but:
Communication skills
no clinically significant impairment in langauage
Or by the presence of stereotyped behaviour and
interests no clinically significant delay in cognitive development
or age-appropriate adaptive behaviour
Delay/abnormality before age of 3 in at least one of:
social interaction, language, symbolic/imaginative play
High functioning autism (HFA) simply means “autism
with an IQ 70 or above”
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2. Autism Spectrum Disorder Basic facts
NZ Autism Spectrum Disorder Guideline suggests that
over 40,000 people in NZ have ASD, & most are
Research indicates that after the age of 3, when IQ is undiagnosed adults
accounted for, there is no difference between people
More males than females (but this seems to be
with autistic disorder (autism) & Asperger syndrome
changing)
2008 - NZ Autism Spectrum Disorder Guideline
Probably genetic
2013 - DSM-V will use ASD only
Not related to MMR vaccine
Cannot be “cured”
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Issues for adults Impact varies time/situation
Relationships (friends, partners, children, colleagues)
ASD is a lifelong condition, not only a disorder of Education (academic, organisational & physical
childhood demands)
Pervasive - effects all aspects of life Work (unemployment, under-employment, income)
Often undiagnosed Emotional well-being (self-esteem, depression, anxiety,
abuse)
Diagnostic overshadowing (ADHD, depression)
Health (attention to needs, sensory sensitivity, epilepsy)
Misdiagnosed (atpical schizophrenia, personality
disorder) Rights & responsibilities (citizenship, participation, legal
issues)
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3. Being undiagnosed means Being diagnosed means
Understanding of self & by others
Finding a peer group
Feeling different (“wrong planet”) or crazy Learning how to manage impact of symptoms
Being misunderstood, & often blamed unfairly Getting the right help
Almost constant anxiety Relief to some, shock to others
Isolation “Congratulations It’s Asperger Syndrome” Jen Birch
2003 www.aspergers.co.nz
"Beyond diagnosis: Welcome to the autism spectrum"
ASK Trust 2011 www.asknz.net
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Reason for today’s
But ...
presentation
Few formal or funded pathways for diagnosis exist for Help you increase your skills
adults without an intellectual disability or not “in trouble”
Increase your confidence
Mental health services lack relevant experience &
training Increase the number of psychologists willing/able to
conduct these assessments
Private practitioners lack skills &/or confidence
Improve life experiences of adults with HFA/AS
The experience of adults seeking diagnosis is too often
one of being fobbed off, referred on, or poorly served Please put your name and contact details on the list!
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4. Diagnostic assessment Assessment components
Detailed health, developmental & behavioural history
See NZ ASD Guideline & www.asdguideline.com
Pattern of skills, disabilities & behaviours
Multidisciplinary gold standard, but sole practitioner
possible (supervision & peer support essential) Comprehensive file review
Methodical Medical evaluation
Match complexity of assessment to reason for referral: Direct evaluation (interview &/or observation)
Curiosity vs. Trouble IQ & other cognitive sills
Legal vs. Clinical Adaptive functioning
Referrer / payee Mental health
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Assessment components (ctd) What do I do?
Neurological assessment
Communication & audiology Minimum: interview the person, observe how they
respond in meet/greet & interview, administer screens
Sensory, motor & perceptual
or self-report tests
Vision
Medium: as above, plus interview significant others &
Occupational & physical therapy review historical documents
Social competence Comprehensive: as above, try to cover or have covered
all apects on previous slides, & use “gold standard”
Family resources & needs tests like the Autism Diagnostic Interview - Revised
Consideration of co-morbid & co-existing conditions
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5. Clinical cases Clinical cases
Albert, 70s: retired farmer, adult children, wife saw
Brian, 30s - engineer, married, some relationship article on ASD on “Sunday”, suspect ASD is reason for
issues, son recently diagnosed with ASD, recognition of marital problems - ASD excluded
symptoms in Brian’s behaviour - ASD confirmed
George, late 20s: charged with very serious offence
Sally, 40s: long mental health history, multiple against a person, referral “role of ASD in offence?”,
diagnoses, professional disagreements, interventions long history of antisocial and criminal behaviour,
had little of no effect - ASD confirmed historically autism diagnosed after 1 hour consultation,
- ASD not confirmed
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Key autism journals Other helpful journals
Autism
Mental Retardation and Developmental Disabilities
Autism Research Research Reviews
Focus on Autism and Other Developmental Disabilities Journal of Intellectual and Developmental Disability
Research in Autism Spectrum Disorders Journal of Intellectual Disability Research
Journal of Autism and Developmental Disorders Journal of Applied Research in Intellectual Disabilities
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6. Information, support & Information, support &
resources for professionals resources for professionals
Altogether Autism www.altogetherautism.org.nz
National contract for ASD information provision Ministry of Health sponsored website on ASD
recognition & referral www.asdguideline.com
Expert searching of Internet (17/8/11: 81,400,000
Google hits for autism &14,100,000 for Asperger) Research Autism - website aimed at anyone people
with ASD, parents & carers, service providers and
Tailor made information packages (including reading policy makers. Big, up-to-date, & scientifically reliable
lists, recommended texts) www.researchautism.net
Access to clinical consultant & team of ASD experts Autism New Zealand bookshop and library
ASD Provider Database (please put names on list) www.autismnz.org.nz
Circulates information on training
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Post diagnosis support
Thank you & questions
Learning about ASD & how it affects the individual &
family Tanya Breen
Consultant Clinical Psychologist
Hard copy information
tanya@tanyabreen.co.nz
Information on ASD (books and first person accounts,
reputable websites, You Tube)
Clinical Consultant, Altogether Autism
Networking with other people with ASD (national and tanyabreen@altogetherautism.org.nz
international websites, ASD organisations)
Contact Altogether Autism for an information pack Please put your name on the list!
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