Are there valid and reliable adult ASD evaluations out there?

[DynamicDidactic]

Anecdotally, it seems that autism is over-diagnosed (and self-diagnosed). However, are there "good" practitioners out there that aren't just throwing the Dx around? If yes, how do I find those folks (for a referral)?

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[borne_before]

To answer your question, we need to consider the ultimate goal of a formal diagnosis.

Is this an evaluation to secure services in the form of:

• documenting impairment
• guardianship/decision making
• social security
• disability benefits
• your state's long term care insurance program (medicaid)
• your state's division of developmental disabilities (e.g., housing, habilitation, respite)
• vocational rehabilitation
• workplace accommodation

Is this an evaluation to provide diagnostic clarification of underachievement/suffering:

• intellectual disability
• ADHD
• personality disorders
• trauma/abuse/neglect
• psychosis/schizophrenia
• cognitive impairment

Is this an evaluation looking for:

• generating personal insight in a relatively unimpaired individual?
• facilitating attachment to a certain narrative?
• an attempt to escape legal troubles by reason of autism?

There are valid reasons someone might have made it adulthood without a formal diagnosis. Also, what state?

 

[PsychSupreme]

Anecdotally, it seems that autism is over-diagnosed (and self-diagnosed).

Ahem…ADHD in fully grown and mostly functional adults who have made it through college and currently hold down a full-time job…

 

[texanpsychdoc]

I'd like to think I do a decent job....maybe not?

 

[BuckeyeLove]

Ahem…ADHD in fully grown and mostly functional adults who have made it through college and currently hold down a full-time job…

Anecdotally, it's terrifying how many friends i have who are still on stimulants and they were put on them back in 199fking5. I honestly can't even comprehend what taking Adderall every day for 30 years would do to someone's heart. I do know what it's done to their capacity for emotional regulation though (they're all still 12 pretty much).

 

[clausewitz2]

Anecdotally, it's terrifying how many friends i have who are still on stimulants and they were put on them back in 199fking5. I honestly can't even comprehend what taking Adderall every day for 30 years would do to someone's heart. I do know what it's done to their capacity for emotional regulation though (they're all still 12 pretty much).

At therapeutic doses? More or less nothing unless you have certain specific and uncommon arrhythmias. There's all kinds of reasons to be judicious about stimulants but their long-term physical impacts are pretty minimal if you are not injecting, smoking or insufflating them in large quantities.

 

[PsychSupreme]

At therapeutic doses? More or less nothing unless you have certain specific and uncommon arrhythmias. There's all kinds of reasons to be judicious about stimulants but their long-term physical impacts are pretty minimal if you are not injecting, smoking or insufflating them in large quantities.

If anything I’d think it may be slightly beneficial

 

[psychma]

I use the MIGDAS-2. There are some things I don’t like about it, but I think it’s okay. It’s used in conjunction with the dsm-5-tr

 

[psychologynbooks]

my internship site uses the Vineland and CARS2 in addition to cognitive testing like the SB5/CTONI. We sometimes do the ADOS if there’s not enough data to diagnose autism. I’m not sure if these are the best - this is just what we do to get people with autism or ID services through OPWDD

 

[Dazen]

I use the MIGDAS-2. There are some things I don’t like about it, but I think it’s okay. It’s used in conjunction with the dsm-5-tr

Our campus clinic is considering moving to the MIGDAS-2 and I'm very curious to try it out. We generally use the ADOS, clinical interview/collaterals, and the social responsiveness scale plus an intelligence and personality measure to round things out (and probably because we're a training clinic and generally have longer batteries). I have limited experience at this point, but feel like the ADOS is much less effective at identifying the social reciprocity piece for adults than it is for kids and often feel like I'm considering behavioral observations more than the actual scores.

All that to say - would love to hear a bit of elaboration about what you like/dislike about it!