Functional diagnosing of challenging behaviour in adolescents with ASD in a clinical setting

Purpose: To introduce the notion of diagnosing as an broad process of assessment not to be confused with classifying psychopathology into DSM or ICD terms. Methods: Comorbidity in Autism Spectrum Disorder is more rule than exception. In clinical practice women with ASD challenging internalizing problems (suicidal/self harm) and externalizing behaviour (aggression-substance abuse) pose gross problems to teams that are not used to work with this category of patients. The literature will be reviewed and in a series of case presentations we will depict the situation. In doing that I will broaden the focus of the diagnostic process: This includes the individual diagnostic profile: Psychopathology and neuropsychological profile but also a functional assessment of the impact of behaviours of the patient on fellow patients and staff and family thus leading to a systemic analysis of patterns of interactions between all involved, that need to be addressed in order to foster change for the better. Conclusions: A true diagnostic appraisal is an essential step in order to define what is needed for and from the patient but also from and within the staff in cooperation with the relatives to break out of the vicious circle of powerlessness that the challenging behaviour of women with ASD may induce.rn