People Don’t Believe I May Have Autism

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Reader’s Question

I’m a 25-year-old adult, and I believe that I have undiagnosed “high functioning” Autism. I was not able to attend public school because I couldn’t learn like a normal child, and reviewing my history corresponds almost perfectly to a list of the diagnostic criteria for Autism, including language delays (I wasn’t able to speak until I was five years old). I have difficulty interacting with people, and I’ve been told it is because of overly formal speech bordering on pomposity, misunderstanding figurative language, and difficulty identifying facial expressions and communicating my emotions.

My entire life, I’ve had severe communication defects, social problems, obsessive and narrow interests, few friends, and absolutely no romantic relationships. I also have a problem of speaking to myself involuntarily and at random times, while repeating things I’ve heard; this fits the description of delayed echolalia, although some misinterpret this as psychosis. People call me ‘sociopathic,’ supposedly because I lack facial expressions and I intellectualize everything; this hurts my feelings, because I know I am not. If I tell them I think I am Autistic, most say that this is impossible, because I would be more severely impaired.

I have studied abnormal psychology, which is one of my obsessive interests. Due to my problems with social isolation and managing anxiety, it is extremely difficult for me to see a psychiatrist or psychologist; the one time I did, my knowledge of the topic made him think that I was trying to get some specific diagnosis for an ulterior motive, and I didn’t know how to explain otherwise, so I stopped seeing him.

The reason I believe that I was never diagnosed as a child is because I was allowed to remain isolated by being homeschooled, and my parents don’t really believe in psychiatry or in mental disorders. My question is whether there would be any benefit in seeking a diagnosis or treatment this late in life?

Psychologist’s Reply

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the book outlining official psychiatric diagnoses and their criteria. In the latest revision (5th edition) one of the changes was to place all of the separate forms or degrees of autism under one umbrella diagnosis: Autism Spectrum Disorder. The change reflects the view that there are numerous levels of functioning or severity related to the constellation of symptoms associated with autism. So, your conclusion seems plausible based on your description. Indeed, people often refer to Asperger Syndrome as a label for cases of mild impairment, mostly having to do with difficulties being able to experience things from other peoples’ perspectives.

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Now, the real question is whether this knowledge should change how you live, and whether to seek an official diagnosis and treatment. In childhood, the goal of diagnosis and treatment is to do what is possible to keep the child from being ineffectively educated by being enrolled in traditional school settings, and to help remediate behavioral and social deficits. In your case, it sounds as though you’re a successful adult and have overcome childhood learning problems. The only remaining issues seem to be interpersonal and social in nature. So, if you believe you might benefit from social skills training with a qualified professional, then pursuing such help might be worthwhile. Otherwise, enjoy your life and take pride in the obstacles you’ve overcome.

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