Getting a Diagnosis for Asperger's Syndrome
Getting a diagnosis of Asperger's syndrome — or, under current diagnostic guidelines, Autism Spectrum Disorder (ASD) Level 1 — can be a long process. Understanding what that process involves can help you navigate it more effectively.
Why Seek a Diagnosis?
Some people ask whether a formal diagnosis is really necessary, especially for adults who have already developed their own coping strategies. There is no single right answer. Common reasons people pursue a diagnosis include:
- Access to services, supports, and accommodations in school or the workplace
- Understanding why certain things have always been difficult
- Connecting with a community of people who share similar experiences
- Relief from years of not knowing why they feel different
- Helping family members understand their needs better
Who Can Diagnose Asperger's?
A diagnosis must be made by a licensed clinician with expertise in autism spectrum conditions. This typically includes:
- Psychologists (especially clinical or neuropsychologists)
- Psychiatrists
- Developmental pediatricians (particularly for children)
- Neurologists with autism expertise (less common but possible)
General practitioners (family doctors) do not typically diagnose Asperger's, but they can be a good starting point for a referral.
The Evaluation Process
There is no single test for Asperger's. Diagnosis is based on a comprehensive evaluation that typically includes:
Clinical Interview
The evaluator will ask detailed questions about developmental history, current challenges, social functioning, sensory experiences, and behavior patterns. For adults, this often involves questions about childhood as well as the present.
Standardized Assessment Tools
Several structured tests and observation tools are used, including:
- ADOS-2 (Autism Diagnostic Observation Schedule): A structured observation and interaction assessment, often considered the gold standard.
- ADI-R (Autism Diagnostic Interview-Revised): A detailed interview, usually conducted with a parent or caregiver.
- Various rating scales and questionnaires such as the Autism Quotient (AQ) or Asperger Syndrome Diagnostic Scale.
Review of History
Evaluators often review school records, medical records, and prior psychological reports. For children, input from teachers and parents is usually sought.
Ruling Out Other Conditions
Several conditions can share features with Asperger's, including ADHD, anxiety disorders, OCD, and certain learning disabilities. Part of the evaluation is distinguishing between these, or identifying conditions that co-exist alongside Asperger's.
Adult Diagnosis
Getting diagnosed as an adult can be more complicated. Many clinicians are less experienced with adult presentations, and the diagnostic tools were often developed and validated on children. Adults also tend to have developed masking and coping strategies that can obscure the underlying pattern. If you are seeking an adult diagnosis, it is worth looking specifically for a clinician who has experience with adult autism assessments.
After the Diagnosis
A diagnosis is a starting point, not an ending point. After receiving a diagnosis, you may be entitled to various accommodations and supports depending on your country, state, age, and circumstances. Many people find it helpful to connect with a therapist familiar with autism spectrum conditions to work through what the diagnosis means for them and to develop strategies going forward.