How to not miss the diagnosis of autism spectrum disorder in adults
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- Опубликовано: 18 июн 2024
- Simple and Practical Medical Education (simpleandpractical.com) interviewed Edward Brodkin, MD, about autism spectrum disorders in adults (on April 1, 2021). Dr. Brodkin is Director of the Adult Autism Spectrum Program at Penn Medicine and Co-Director of the Autism Spectrum Program of Excellence at the University of Pennsylvania. Here are the questions that we posed to Dr. Brodkin during this interview:
1. In adults, how commonis autism spectrum disorder?
2. How does autism spectrum disorder typically present clinically in adults?
3. Are there differences in how it presents in men versus in women?
4. Mental health clinicians have limited time and need to focus on pressing issues like depression, anxiety, insomnia, and suicidality. Why is it important to identify autism spectrum disorder if it is present in our patients?
5. Why does it often go undiagnosed, even by mental health professionals?
6. What exactly should we do to actively screen for autism spectrum disorder in our patients?
7. What kinds of treatments are available for adults with autism spectrum disorder?
8. What resources does Dr. Brodkin recommend for patients with autism spectrum disorder and their families to learn more?
I would not have complained of sensory issues (even though I have them) because I didn't know that I was different than other people and other problems like anxiety and mood problems seem worse. Also I wouldn't have known that a psychiatrist would be interested that socks annoy me or that smells can be so annoying.
Yes...questions should be more like do you feel tags in your clothing, have fabrics you don't like or avoid touching, can you hear certain sounds like florescents or feel sounds or smells in your body. Folks have to ask if they remember being told to stop walking on their toes or "stop moving like that", etc. When one doesn't have intellectual deficits it is easy to mask especially since society will tell you over and over if you are not behaving neurotypical.
@@sweetpea4967 Yeah, society likes to remind me that I am not normal.
Good overview.
36 year old woman with clinically diagnosed autism here; I wasn't diagnosed until age 29. There was little awareness of higher functioning forms of autism, especially in women, when I was growing up in the 1990s. I was simply seen as a quiet, nerdy, quirky type.
As an adult, it became more obvious when I left the safety and predictability of the academic world and entered the working world, which requires greater social and adaptive abilities. Among the things that make my diagnosis clear are my tendency to take humor very literally, a greater need for scheduling and sameness, very intense focus on interests, certain repetitive/soothing stims and motor behaviors, tactlessness/bluntness and slowness to understand more "proper" social cues, and meltdowns when there's simply too much going on in my environment.
When I'm at baseline -- which is easy to maintain in school or church type environments where things are structured, calm, and predictable -- I may not appear "autistic." But in a more rapidly moving and changing environment where greater levels of sociability are required...those are the environments where I struggle.
Clinicians are not trained at all in how to recognize autism in adults. They are thrown by facial expressions and hand gestures when the higher intelligence/functioning have well developed masking strategies. With women especially, they are prone to misdiagnose as personality disorders and, thereby cause harm.
Key point here is to take a more careful history. That means this likely cannot be accomplished in a two hour interview. This misdiagnosis sends a people out without the correct directed therapies. Better evaluation methods than trying to force fit the ADOS to adults needs to be developed.
Additionally, there needs to be training of professionals to work with autistic adults. There are little or no resources for proper help. In order to address the anxiety and depression, you have to start with the autism.
I’m in that boat right now. SSRI’s only caused me more pain and caused me to develop symptoms I never struggled with before.
I am a 20 yr old with Autism. It is so frustrating that doctors don’t believe I have autism despite my sensory issues, difficulties with socializing & the meltdowns. They think it’s bipolar when though I never have highs or lows, it’s a constant mood.
29 years old, was told by several of my friends (all those who were autistic at least) they thought I was already diagnosed because they recognized the traits.
All my previous psychologists and experts on ASD "nah your OCD's not bad enough/you're a woman/you're too old/you don't fit the stereotype/you only have OCD, Depression, Generalized & social anxiety disorder, dyspraxia, avoidant PD and most likely ADHD".
Like...according to you I have most of the comorbidities associated with autism but I can't be autistic because I have those ? Sure Jan.
34 years old and just had my second ASD diagnosis appointment. My first eval went pretty poorly, as I had little knowledge of the encompassing traits for ASD. I was also not understanding the evaluator very well during our meeting and left out a lot of details to evidence supporting those traits. To be honest, I didn't realize the evaluation was being done when it was; I wasn't sure to go into details. It felt pretty devastating being undiagnosed. Though, credit to that evaluator, I have already been diagnosed with different anxiety disorders coming from my military time, so I ended up reading into the dsm-5 to pretty much learn as much as I can about the traits and common elements of having ASD. I can't find anything on there (regarding autism) that does not describe me like a biography to my life. So, I had another appointment recently which seemed to be much better done and better explained. This has definitely been a struggle for me, so I really appreciate seeing a video like this.
Nervous to get a true diagnosis, due to being afriad of completely shutting down and giving up...
Finally realized I may be autistic in my twenties. The more I research the more it makes sense. I have taken several online AQ tests, all have shown "likely aspergers syndrome." Now in my early 30's I feel I struggle with everything..
After several years of being convinced that I am, my mom told a story about how I didnt speak until I was about 18 months old. Interesting, thats one of the common connections with early onset....
life just sucks...
Thank you for this video, this is so important to get out there. As a 40 year old woman currently going through the diagnostic process, it's been a very long and frustrating road to get here.
How is the process going? Any info on the price out of pocket?
@@JChurchua Thankfully my insurance covers it and just requires a copay for each visit. I feel extremely fortunate! So far I've only had my intake, waiting on my testing appointments. Just a couple more months, ugh.
@@poxyfairy So, this isnt a one session thing?
Sounds like itll be real expensive for me without any insurance... damnit!!
@@JChurchua Yeah, mine is 4 appointments. Two are 4-6 hours of testing/interviews. I'm sure you could get a diagnosis without the testing, if you can find the right person. I wish this wasn't so expensive, our system is so broken.
@@poxyfairy Well, I came across it in doing my own research. "why am i so weird." Aspergers hits so many nails on the head! So, I dug deaper and have taken AQ tests off different websites. Each and every one suggests Aspergers as well. All my family, and my ex of a 10 years relationship(3 months broken) are "normal." Not only do they not understand my issues(or the relationship issues) They wont fully accept me telling them I am Autistic, without the clinical, professional diagnosis. I fully understand that too..
EXCELLENT VIDEO! I’m 42 years old AND resonate 1,000% to this!!
Very informative. Thank you.
I’m 45 and think I have undiagnosed ASD. Debating whether to get a formal diagnosis or not.
You married? Have a "normal" life? just keep moving forwars.
Im 33, Think I am Undiagnosed autistic and have struggled forever and no one realises why. I finally realized I think I am ASD1, and since afew family stories have corresponded with that being factual.
Im afriad getting a diagnosis now will cause me to fall apart, rather than bring closure...
@@JChurchua I’ve since been and spoken to my Dr and have been referred for a diagnosis.
I’ve had a lot of struggles, particularly with almost every person I know saying I’ve said and done things that I haven’t said and done. Either every person in the world is a pathological lier, or there’s something in the way I communicate and interact with other people.
To answer your questions, yes I’m married, she thinks I have ASD too. I don’t see having ASD as a bad thing, it would be a huge positive for me.
Great info here
Nice video
I know that some people with asd have no sensory issues.Is it true?
I don't really know how to thank you Dr odija on RUclips for making me to live like my fellow mates and for curing me from diabetes.... thank you so much may God always strengthen you and your work..