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Should You Seek A Formal Diagnosis For High-Functioning Autism?

After the question of High-Functioning Autism is initially raised, many men and women wonder, “Should I get an official diagnosis?” For some, doing their own research through books, on the Internet, through support groups and information organizations provides enough answers and the best explanation regarding challenges that one faces as well as the strengths that one possesses. Others want validation from a therapist.

Getting a diagnosis as a grown man or women isn't easy, especially since High-Functioning Autism isn't widely heard of among medical professionals. The typical route for getting diagnosed is to visit a physician and ask for a referral to a therapist, preferably one with experience of diagnosing High-Functioning Autism. If you are already seeing a professional for other reasons (e.g., a therapist because you suffer from anxiety), then you might wish to ask him or her about a referral instead.

It might be difficult to convince your physician that a diagnosis would be either relevant or necessary. So, it’s important to know how to present your case so that your doctor can see (a) why you might have High-Functioning Autism and (b) why having a diagnosis could be helpful.

Make sure the diagnosis is the only thing you are seeing your physician for. If you try to turn it into a consultation about another issue, he or she may not address it fully. A good way to bring up the subject is to mention that you have been reading about High-Functioning Autism.

Next, explain why this is relevant to you. High-Functioning Autism is characterized by something known as the triad of impairments. Individuals with High-Functioning Autism will be affected in some way by each of these impairments. The  Autism Spectrum is very broad, and any two individuals with the condition may present very differently. No one individual will have all the traits, but by-and-large, most individuals with High-Functioning Autism will have problems in several important areas.

Individuals with High-Functioning Autism may be very good at basic communication and letting others know what they think and feel. Their difficulties lie in the social aspects of communication. For example, they may not have many friends and may choose not to socialize much, they may not be socially motivated because they find communication difficult, they may not be aware of what is socially appropriate and have difficulty choosing topics to talk about, or they may have difficulty understanding gestures, body language and facial expressions.

Some of these problems can be seen in the way individuals with High-Functioning Autism present themselves. For example classic traits include anxiety in social situations and resultant nervous tics, difficulties expressing themselves (especially when talking about emotions), difficulty making eye contact, and repetitive speech.

Typical examples of difficulties with social understanding include taking what others say very literally, problems understanding double meanings (e.g., not knowing when others are teasing you), not choosing appropriate topics to talk about, finding “small talk” very difficult, and difficulties in group situations (e.g., going to the bar with a group of buddies).

Lack of imagination in people with High-Functioning Autism can include difficulty imagining alternative outcomes and finding it hard to predict what will happen next. This frequently leads to anxiety. This can present as problems with sequencing tasks so that preparing to go out can be difficult because you can't always remember what to take with you, problems with making plans for the future, having difficulties organizing your life, and an obsession with rigid routines and severe distress when routines are disrupted. Some individuals with High-Functioning Autism over-compensate for this by being extremely meticulous in their planning and having extensive written or mental checklists.

Besides the triad of impairments, individuals with High-Functioning Autism tend to have difficulties which relate to the triad – but are not included within it. These can include:
  • acute anxiety, which can lead to panic attacks and a rigid following of routines
  • clumsiness often linked to a condition known as dyspraxia (this includes difficulties with fine motor coordination such as difficulties writing neatly, and problems with gross motor coordination such as ungainly movements, tripping, and falling frequently)
  • depression and social isolation
  • obsessive compulsive behaviors, often severe enough to be diagnosed as OCD 
  • obsessive interests in just one topic (e.g., they might have one subject about which they are extremely knowledgeable which they want to talk about with everyone they meet)
  • phobias (sometimes individuals with High-Functioning Autism are described as having a social phobia, but they may also be affected by other common fears such as claustrophobia and agoraphobia)

Not having these associated issues doesn’t mean you don’t have High-Functioning Autism, but if you have any of them, you might want to describe them to the doctor in order to back up your case. However, you don't need to describe every single trait you have. Your physician may be more likely to respond if you give one good example. Once you have explained why you think you have High-Functioning Autism, you could also show him/her this article. If your physician disagrees with your argument, ask for the reasons why. If you don't feel comfortable discussing his/her decision, then ask for a second appointment to talk it through.

Diagnosis as an adult can be a mixed blessing. Some individuals decide they are O.K. with being self-diagnosed and decide not to ask for a formal diagnosis. However, for those who DO want a formal diagnosis, there are a variety of benefits:

1. Many individuals suffer the consequences of being constantly misunderstood. Often the fact that someone has High-Functioning Autism can lead to teasing, bullying and social isolation. When the individuals close to you are able to understand that there is a reason for your quirks and difficulties, it is much easier for them to empathize with your dilemma.

2. It can be fun to meet up with others who have the disorder in order to learn about their experiences and share your own. There are many support groups available. Check with your nearest Autism association. Also, you can contact others with High-Functioning Autism through the internet. You don’t have to have a formal diagnosis in order to access this support.

3. Men and women with High-Functioning Autism may need support with day-to-day living. If they are having these needs met, it may be by individuals who don’t understand High-Functioning Autism and the specific difficulties associated with it. With a diagnosis, you may be able to access specific services (if they exist in your area).

4. Many people with High-Functioning Autism have suffered from mental health problems or have been misdiagnosed as having mental health problems (e.g., bipolar, schizophrenia). They have known that they have specific difficulties for a long time without being able to explain them. A formal diagnosis can be a relief because it allows them to learn about their disorder and understand where and why they have difficulties.

5. Additionally, one may use the information derived from a formal diagnosis to:
  • Consider disclosure to family, friends and co-workers
  • Customize one's environment to be more comfortable and accommodating to the strengths and challenges of High-Functioning Autism
  • Do a life review
  • Understand why careers and relationships have - or have not - been successful
  • Find other people with High-Functioning Autism with whom to compare notes 
  • Find people who share similar interests
  • Improve on relationships and pursue better matches
  • Plot a career that matches interests and abilities
  • Plot a course through college
  • Renew or repair relationships that have been negatively affected by High-Functioning Autism
  • Request reasonable accommodations at school or work
  • Take classes part time in order to account for executive functioning and organizational deficits
  • Work differently with helping professionals with an emphasis on concrete coaching help and building of life skills rather than “insight-oriented” therapy

The bottom line is this: If you have High-Functioning Autism and don’t know, it affects you anyway. But, if you do know, you can minimize the negative impact and leverage the positive. Without the knowledge that one has High-Functioning Autism, one often fills that void with other, more damaging explanations like failure, odd, disappointment, not living up to one’s potential, etc.

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