Expert: James Michael Roan - 11/30/2007

Question
QUESTION: James,

am a young male professional living in the Southeastern United States who's

never been diagnosed with any psychological condition or disorder. I

apologize for not giving my name but I do not live in the most tolerant place

on earth...



I have been trying to learn more about myself and why I have always felt

different from my peers. My oddities are as follows:



1. I find social interaction very difficult, don't like it, and find myself avoiding

it without even thinking about it. I often have trouble with eye contact - I can

force myself to do it but it requires conscious effort and makes me

uncomfortable. In fact, I frequently find myself staring at a person's mouth

during a conversation. I am terrible at small talk and often find myself

struggling to keep up a conversation with someone I don't know very well or

have just met.



2. I don't know if I have a photographic memory or not but I can remember

anything I read virtually word for word. If I close my eyes I can almost see the

page and the words on it. School was never a problem for me at the

gradeschool, college, or the professional school level. I almost never studied

and made almost all As. I also have a very logical and analytical mind - I

often have to force myself to look at any problem or situation from another

perspective.

    I have also been called "hyper-observant" by my friends and relatives. I

take conscious notice of any little detail - from a pebble stuck in the bottom

of someone's shoe to cigarette butts on the ground. Fortunately, in my

profession this tends to be useful but I cannot turn it off, I have no control

over it.

  I also tend to notice patterns in places where I know none are intended.

The air holes in the ceiling tiles in my office for example, are like miniature

constellations to me. Also the tiles in my bathroom floor - they are simply

small white tiles laid out in a grid but my mind begins to force them into

different formations and shapes.

  I am also able to concentrate on one thing or subject for long periods of

time without breaks and it often requires someone calling my name two or

three times for someone to pull me out of it.



3. I am very sensitive to smell, touch, sound, and light. I jump easily at

sounds that do not cause the same reaction in those around me. I also notice

small sounds that others do not or before they do. The same goes for smells

(minus being startled of course). I also do not like bright lights; I never use an

overhead  light when a lamp is available and I tend to keep my office and

apartment relatively dark and almost never open the blinds.



Meanwhile, there are other ways in which I may not fit the mold. I am, despite

being very sensitive, a physically affectionate person with women I have

dated and some members of my family. I am also pretty good at putting

myself in someone else's shoes and can be a fairly  compassionate person.



I realize that you cannot diagnose me over the internet but I was hoping you

could at least tell me if I'm barking up the wrong tree or not. My whole life I

have been treated like an alien from another planet and in the last few years

I've been on a quest to find out why.



Thanks and sorry for the long post.



ANSWER: Hi;

Well, some of your behaviors might fit within a mild form of Asperger's syndrome (AS). I suggest you go to my website (www.autismspectrumdisorderfoundation.org) and take the Childhood Asperger's Syndrome Test (CAST). It was also used in a research study on its ability to screen for AS. A score of > 24 was thought to indicate moderate to high risk for AS. The CAST link also contains the scoring? Let me know.

Also, to rule out a nonverbal learning disability (NVLD):

1. Do you have a noticeable left-side body weakness?

2. Do you get lost fairly easily compared to others you know?

3. Are you terrible at visual-spatial tasks such as putting puzzles together?

Let me know the CAST results and we can go from here.

Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: James,

Thank you for your prompt response. I could not find the CAST test - only the M-CHAT test which appears to be for parents trying to diagnose the behaviors of thier very young children. Is this the test you mean?

In answer to your other questions:

1. No. In fact I am left-handed and, if anything, am noticably stronger on my left side.

2. My sense of direction is pretty good and I hardly ever get lost.

3. I tend to be very good at visual-spatial tasks and have tested highly in that area in IQ tests in the past.

Thanks again.

ANSWER: Hi;

Sorry. I thought our webmaster had made the changes by now.

I think you can rule out a nonverbal learning disability based on your answers. Go here to take the CAST and score it (http://www.autismresearchcentre.com/tests/cast_test.asp). Also send the questions with your answers if you can do that.

Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: James,

Here you go. I took the test and scored an 18, assuming I counted/scored it
correctly. I will say though that when I could answer the question about
myself at the age of 25 I did but where the question was about childhood
activities I did my best to remember my tendencies, etc. during my
elementary school years. As such, there's probably a significant margin of
error in the results. Nevertheless, here's the questions along with my
answers:

1. Does s/he join in playing games with other children easily?   No

2. Does s/he come up to you spontaneously for a chat?      Yes

3. Was s/he speaking by 2 years old?          Yes

4. Does s/he enjoy sports?          No

5. Is it important to him/her to fit in with the peer group?      Yes

6. Does s/he appear to notice unusual details that
  others miss?          Yes

7. Does s/he tend to take things literally?          Yes

8. When s/he was 3 years old, did s/he spend a lot of time
   pretending (e.g., play-acting being a superhero, or
   holding teddy’s tea parties)?          Yes

9. Does s/he like to do things over and over again,
  in the same way all the time?          Yes

10. Does s/he find it easy to interact with other
    children?          No

11. Can s/he keep a two-way conversation going?      Yes


12. Can s/he read appropriately for his/her age?         Yes   

13. Does s/he mostly have the same interests as
   his/her peers?          No

14. Does s/he have an interest which takes up so much
     time that s/he does little else?          Yes

15. Does s/he have friends, rather than just acquaintances?   Yes

16. Does s/he often bring you things s/he is interested
    in to show you?          Yes      

17. Does s/he enjoy joking around?          Yes      

18. Does s/he have difficulty understanding the rules
     for polite behaviour?          Yes      

19. Does s/he appear to have an unusual memory for
    details?          Yes      

20. Is his/her voice unusual (e.g., overly adult, flat, or
    very monotonous)?          Yes      

21. Are people important to him/her?          No

22. Can s/he dress him/herself?          Yes      

23. Is s/he good at turn-taking in conversation?         Yes      

24. Does s/he play imaginatively with other
    children, and engage in role-play?          No

25. Does s/he often do or say things that are tactless
     or socially inappropriate?          Yes   

26. Can s/he count to 50 without leaving out any
    numbers?          Yes   

27. Does s/he make normal eye-contact?          No

28. Does s/he have any unusual and repetitive
    movements?          No

29. Is his/her social behaviour very one-sided and
    always on his/her own terms?          No

30. Does s/he sometimes say “you” or “s/he” when
    s/he means “I”?          No

31. Does s/he prefer imaginative activities such as
    play-acting or story-telling, rather than numbers
    or lists of facts?          No

32. Does s/he sometimes lose the listener because of
    not explaining what s/he is talking about?         Yes

33. Can s/he ride a bicycle (even if with stabilisers)?      Yes      

34. Does s/he try to impose routines on him/herself,
    or on others, in such a way that it causes problems?      Yes

35. Does s/he care how s/he is perceived by the rest of
    the group?          Yes      

36. Does s/he often turn conversations to his/her
    favourite subject rather than following what the other
    person wants to talk about?          Yes   

37. Does s/he have odd or unusual phrases?         No


SPECIAL NEEDS SECTION
Please complete as appropriate

38. Have teachers/health visitors ever expressed any
    concerns about his/her development?         No

If Yes, please
specify..................................................................................................


39.  Has s/he ever been diagnosed with any of the following?:

Language delay          No

Hyperactivity/Attention Deficit Disorder (ADHD)      No

Hearing or visual difficulties          No

Autism Spectrum Condition, incl. Asperger’s Syndrome      No

A physical disability          No

Other (please specify)          No  

Answer
Hi;

It appears that you are at a fairly high risk for Asperger's syndrome. I am NOT diagnosing here. I would be happy to answer any other questions you may have.

Just a note: I have always viewed Asperger's syndrome as more a cognitive profile than a syndrome or disorder. It has as many positives as negatives I think.

Kind regards,
James