Diagnosis

"Mr. and Mrs. Cheesman, Ms. Simpson and I have conducted an extensive and thorough interview with your daughter, and we've gone over her record with a fine tooth comb.  What I want to know is, has she always been like this?  Has she been in therapy before?  Because with this symptom set, in my opinion she should have been in treatment long before this, before she got out of hand."

"Well, she had been in the juvenile system and remanded to Fort Starch."
"What I'm talking about is comprehensive psychiatric therapy.  Fort Starch attempts to provide behavioral modification.  The type of therapy I'm talking about is one-on-one counseling and possibly some medication to control her hormones.  It's clear to me that she's got some kind of imbalance going on in her brain."
I sighed.  "I see."

"Here's what I think is going on with your daughter, Mrs. Cheesman.  I think she is autistic.  Autism is a spectrum disorder, characterized by different levels of severity.  In my opinion, your daughter seems to fit the diagnostic criteria for Asperger's syndrome and oppositional defiant disorder.  Asperger's is a milder form of autism that's marked by a combination of high intelligence and exceptional difficulties with social skills, both of which Sierra has clearly demonstrated.  She's also demonstrated a consistent pattern of violence, arguing, and disruptive behavior towards authority figures, which is a sign of ODD.  She's having difficulty communicating and expressing her emotions in an appropriate manner, and she seems to default to whatever is most comfortable to her, and that is violence.  Obviously more testing is needed, but those are my conclusions at this point.  When Ms. Simpson talked to Sierra, she mentioned an alien abduction that occurred when she was twelve?"

"The first time Sierra told me that story was when we were at freshman orientation for university.  It was my very first time hearing it and it was apparently the first time she told it.  We have trouble believing her because she's told so many tall tales.  Everything out of her mouth is a story.  It's hard to tell what's real with her."

"Ms. Simpson said she told it in such a way that she seems fairly credible.  And she's not a woman given to hyperbole.  It's gotten to the point where, if I were to polygraph her on the incident, she'd flat line it.  In other words, this is so ingrained in her psyche that she actually believes that this happened.   What seems to have occurred, as happens to a lot of kids like this is, when they have so much difficulty 'fitting in' at school and possibly at home, they create their own worlds where they go to for that kind of stimulation, complete with imaginary friends and the like.  Your daughter, when she talks about the aliens and the bots and the futuristic beings, has apparently put herself in that environment, one that's of her own making.  Combine all that with the new situation she's been thrust in, the changes occurring in her life with college and her own burgeoning young adulthood, with its unique set of issues and pressures, and you get this reaction that you're seeing.  It's a tough time for her. It's difficult for a lot of young people, even those who don't have your daughter's issues.
"We'll definitely work with her, and I've arranged for a life coach to come in and talk with her, also, to see how she can help her with choosing a career path.  We can do this, I believe in it."