Saturday, May 21, 2011

Down the Rabbit Hole

I went to see another neuropsychologist regarding social skills training.  My first thought about this was, well, I am just following orders.  I was told to see someone like this... that it is the most important thing and so I should do it.  So off I go, like a reluctant schoolgirl.  Yet another therapist.... blah... blah... blah.
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However, I am glad I did.  Dr. C was pretty nice about the whole thing.  It turns out her nephew has Aspergers so she was able to see the positive side of things.  She thinks I have something along the lines of being on the Autistic Spectrum in a mild way.  Her take on it is that there is a definite there there with the discrepancy of verbal/nonverbal IQ scores.  She sees the Autistic Spectrum as having a unique set of gifts as well as challenges.  So this finding was much easier to digest than my previous neuropsych evals which left me pretty depressed. 

However, she is not sure about the scoring of the neuropsych eval that I got from Columbia-Presbyterian.  They did not get the date of my birth correct.  The birth date on my report was 8 years younger than what I am.  So all my scores have ranked against younger cohort!  This will impact my assessment.  For example,  I am probably much smarter !  Ha Ha!  What will I do with this extra brain power!  Also, the memory scores may be improved as well  (more on this later).  So I am going to call up Columbia Presbyterian and get them to recalibrate my test scores.

We talked about social skills and problems in general.  She had a pretty well rounded view of what can happen with someone with an Aspergers' profile and the stresses of middle aged women.   

We talked a bit about me living in Europe and Asia and the challenges of adjusting to another culture.  I forgot to tell her that at the beginning of living in another country when I didn't understand the language, I would really have to key in on nonverbal cues like facial expressions and body language.

Another interesting note is that she runs across a number of Aspergers men who gravitate towards Asian women.  Some of this is the "blunt affect" of Aspergers finding a home in a culture where expression of emotions are tamped down on.

Finally, she gave me the eye expression test developed by Simon Baron-Cohen.  This test shows a series of eyes with four possible emotions and you are invited to pick the correct emotion.  It is a hard test.  A lot of normal  people miss about 10.   Apparently, people with Aspergers (Aspies as they nick name themselves) have real problems with recognizing faces.  Some can't even remember someone whom they have just met.  Aspies miss between 16 and 28.  I missed 14.  So I guess I am borderline.

We talked a little bit about work and I explained that working in a cubicle is physically very uncomfortable for me.   She doesn't know who designed these things and I said that it was probably some genius over at Wharton who was trying to increase collaboration in the workplace.

Dr C. thinks I would be a candidate for social skills training.  We would look at movies with the sound off and study body language and facial expression.  I think she might also do some cognitive based therapy as well.

There is another twist to the story.  I told Dr. C. that I tend to lip read a bit and that I am working with an audiologist on improving my hearing.  I explained that there was some question as to whether my problem is an auditory problem or a working memory (short term memory)  problem.  She explained that it was important to get this straightened out as it would impact how she would explain things to me.  (For my gentle readers who are new to my story.  I got started on this particular adventure when my audiologist asked me to see a neuropsychologist regarding working memory.  She thinks some of my hearing problems may not be auditory but working memory problems).  Depending on the exact nature of the disorder, she would make a special effort to speak in a way that would help me understand better.  For example, it could be repeating important points exactly or it could mean rephrasing important points.  Different hearing problems or memory issues would indicate a different type of communication.

At any rate, it would be a good thing to, at least, understand the issues of auditory processing vs working memory before trying any social skills therapy.  So back to my audiologist to get some sort of read on this problem.  Also, a call to Columbia to try and straighten out the original neuropsych assessment.

Well. I've definitely fallen down the rabbit hole here.  Do I buy this diagnosis or not?   Stay tuned.
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