Is my child/student on the Autism Spectrum? As an adult, am I?
These are questions many adults, parents, and students are asking at this time. Social media sites, YouTube channels, and any number of books and public statements by well-known individuals have made discussions of autism very common. Many people have realized that they can identify with one or more symptoms that are reported to be key features of Autism Spectrum Disorder (the current formal name for the medical diagnosis of autism, often abbreviated as "ASD"). "Self-diagnosis" of ASD is even being openly encouraged by some, and describing one's self or a loved one as "on the spectrum" has become far more common. Persons wanting confirmation (via formal diagnosis with ASD) of self-identified autism are now a significant portion of the group of potential clients seeking assessment from psychologists.
However, there are some very good reasons for caution here. First, for the same reason that not every person who has trouble paying attention has ADHD, or not every person who coughs has COVID-19, not every person who identifies with selected symptoms of Autism Spectrum Disorder/ASD truly has autism. Individual symptoms of ASD (and ADHD, and any number of other conditions) are often nonspecific, which means the same symptom can have many different causes. Using ADHD as an example, attention deficits surely can be due to ADHD, but might also be due to depression, problems with sleep, concussion injury, or a variety of potentially treatable health conditions. Returning to ASD, the social interaction difficulties that are a primary symptom might also be due to a history of disruptive experiences (e.g., abuse or trauma as a child, difficulty bonding with caregivers due to repeated separations), unsuspected sensory challenges (e.g., unsuspected hearing loss or Sensory Processing Disorder), certain types of learning disability, normal personality factors, and/or a longstanding, but unsuspected mental health condition (e.g., anxiety, depression, etc.). The repetitive actions often seen in ASD might reflect understandable nervousness, a treatable medical condition (such as Tic Disorder), the compulsive behaviors sometimes seen in OCD, or the hyperactivity sometimes seen in ADHD. The same types of alternative causes are possible for most other symptoms used in the diagnosis of ASD. All of these other potential causes may need to be ruled out as the primary causes of the symptoms, before ASD can be appropriately diagnosed as the cause.
According to the current diagnostic guidelines developed by the American Psychiatric Association, Autism Spectrum Disorder/ASD is defined as causing "clinically significant impairment in social, occupational, or other important areas of functioning." Significant friendships, a successful employment history, educational success, success in primary relationships with partners, children, and extended family members, or professional accomplishments that require social competence might all therefore be inconsistent with a formal diagnosis of ASD. Also, according to current diagnostic criteria, clear symptoms of ASD must also be "present during the early developmental period". Meeting these criteria therefore requires a thorough look at a person's developmental history and current functioning across multiple life contexts -- home, work, school, and in various social situations. While some writers and online sharers would contest the idea that autism is even a disability, it most certainly CAN be, as the parents and other loved ones of seriously affected children and adults can attest.
Seemingly unaware of how powerfully limiting Autism Spectrum Disorder/ASD can be for some affected children and adults, many adolescents and adults are currently identifying strongly with a popular view of what autism is, and claiming the label for themselves or their loved ones. At many levels, this is both understandable and admirable. Wanting to feel part of group of supportive persons who share similar challenges is a way of seeking growth, as most people truly WANT and NEED to feel accepted for who they are -- and surely SHOULD BE! It is also undeniably true that many of us too often feel we must intentionally hide feelings or behaviors others may not understand, or have a negative reaction to, a coping behavior sometimes referred to as "masking". However, neither of these coping styles is unique to ASD, and perhaps more importantly, they require both social awareness and self-awareness, traits that are often (at least according to current diagnostic criteria) actually impaired in persons with ASD. Social distress, discomfort in social situations, and difficulty establishing relationships are very painful, and seeking support may be a very positive act of self-care, but there are other ways to do so that don't involve taking on a label. Counseling, one such option, is highly recommended, and many excellent therapists are specifically neurodiversity-affirming.
To reiterate, at this time, accepting a medical diagnosis of Autism Spectrum Disorder/ASD involves acknowledging the presence of a lifelong developmental condition that, by definition, profoundly affects multiple aspects of a person's functioning in clinically significant ways. For this reason, THERE MAY BE IMPLICATIONS OF BEING GIVEN AN AUTISM DIAGNOSIS THAT CAN'T BE ANTICIPATED. Will an ASD diagnosis prevent you or your loved one from reaching some goal, or taking some type of job, in the future? From entering military service? From running for public office? From gaining a promotion at work? From flying a plane? From being admitted to a graduate program? From receiving a loan? From establishing affordable health insurance coverage? It is very difficult to predict societal attitudes and related laws and conventions, all of which change over time.
ASD surely can manifest differently at different points in life, but as noted above, the current formal diagnostic criteria state that symptoms are always present in some form from early childhood on. This requirement for developmental history can be a true source of frustration for mature adults seeking diagnosis, as they may no longer have access to school records, medical records, or loved ones who can describe their functioning during childhood. Nevertheless, at this time, it may be unwise to accept an ASD diagnosis not based on reliable evidence of lifelong difficulties. While some who seek diagnosis would assert their right to speak for themselves, with no need of past evidence other than their own childhood memories, this can be problematic: Given all the conversation about autism online and in the general culture at this time, people may come to assessment to seek confirmation of what they already believe to be true... and such a person may, without meaning to or even realizing they are doing so, tend to "over-report" symptoms they believe to be due to ASD. This may result in inaccurate diagnosis that may unexpectedly prove detrimental to the person receiving the diagnosis.
Social trends pass, but labels can persist. Seek out a professional for evaluation that will look objectively and compassionately at the challenges you face, do a full assessment that takes your early life history into account, and considers ALL potential causes of your difficulties. This strategy can help you find the best possible support, and ensure a stronger, happier future. Accurate and helpful diagnosis requires a truly objective view of symptoms and possible causes... it is NOT MEANT to simply provide affirmation of what someone has already decided "must" be true. Seeking information is important, but please be open to other explanations, which may serve you or your loved one better in the long run.
Persons affected by ASD face, through absolutely no fault of their own, many, many challenges, and are fully deserving of respect and ongoing support. The formal diagnostic criteria used to identify persons with ASD have changed over time, and will likely change again, to incorporate new information, and neurodiversity activists sharing from a place of lived experience are surely contributing critical information to aid that process. However, one piece of maintaining true respect and support for those who are most seriously affected by ASD and their loved ones is not casually overusing the term "autism".
These are questions many adults, parents, and students are asking at this time. Social media sites, YouTube channels, and any number of books and public statements by well-known individuals have made discussions of autism very common. Many people have realized that they can identify with one or more symptoms that are reported to be key features of Autism Spectrum Disorder (the current formal name for the medical diagnosis of autism, often abbreviated as "ASD"). "Self-diagnosis" of ASD is even being openly encouraged by some, and describing one's self or a loved one as "on the spectrum" has become far more common. Persons wanting confirmation (via formal diagnosis with ASD) of self-identified autism are now a significant portion of the group of potential clients seeking assessment from psychologists.
However, there are some very good reasons for caution here. First, for the same reason that not every person who has trouble paying attention has ADHD, or not every person who coughs has COVID-19, not every person who identifies with selected symptoms of Autism Spectrum Disorder/ASD truly has autism. Individual symptoms of ASD (and ADHD, and any number of other conditions) are often nonspecific, which means the same symptom can have many different causes. Using ADHD as an example, attention deficits surely can be due to ADHD, but might also be due to depression, problems with sleep, concussion injury, or a variety of potentially treatable health conditions. Returning to ASD, the social interaction difficulties that are a primary symptom might also be due to a history of disruptive experiences (e.g., abuse or trauma as a child, difficulty bonding with caregivers due to repeated separations), unsuspected sensory challenges (e.g., unsuspected hearing loss or Sensory Processing Disorder), certain types of learning disability, normal personality factors, and/or a longstanding, but unsuspected mental health condition (e.g., anxiety, depression, etc.). The repetitive actions often seen in ASD might reflect understandable nervousness, a treatable medical condition (such as Tic Disorder), the compulsive behaviors sometimes seen in OCD, or the hyperactivity sometimes seen in ADHD. The same types of alternative causes are possible for most other symptoms used in the diagnosis of ASD. All of these other potential causes may need to be ruled out as the primary causes of the symptoms, before ASD can be appropriately diagnosed as the cause.
According to the current diagnostic guidelines developed by the American Psychiatric Association, Autism Spectrum Disorder/ASD is defined as causing "clinically significant impairment in social, occupational, or other important areas of functioning." Significant friendships, a successful employment history, educational success, success in primary relationships with partners, children, and extended family members, or professional accomplishments that require social competence might all therefore be inconsistent with a formal diagnosis of ASD. Also, according to current diagnostic criteria, clear symptoms of ASD must also be "present during the early developmental period". Meeting these criteria therefore requires a thorough look at a person's developmental history and current functioning across multiple life contexts -- home, work, school, and in various social situations. While some writers and online sharers would contest the idea that autism is even a disability, it most certainly CAN be, as the parents and other loved ones of seriously affected children and adults can attest.
Seemingly unaware of how powerfully limiting Autism Spectrum Disorder/ASD can be for some affected children and adults, many adolescents and adults are currently identifying strongly with a popular view of what autism is, and claiming the label for themselves or their loved ones. At many levels, this is both understandable and admirable. Wanting to feel part of group of supportive persons who share similar challenges is a way of seeking growth, as most people truly WANT and NEED to feel accepted for who they are -- and surely SHOULD BE! It is also undeniably true that many of us too often feel we must intentionally hide feelings or behaviors others may not understand, or have a negative reaction to, a coping behavior sometimes referred to as "masking". However, neither of these coping styles is unique to ASD, and perhaps more importantly, they require both social awareness and self-awareness, traits that are often (at least according to current diagnostic criteria) actually impaired in persons with ASD. Social distress, discomfort in social situations, and difficulty establishing relationships are very painful, and seeking support may be a very positive act of self-care, but there are other ways to do so that don't involve taking on a label. Counseling, one such option, is highly recommended, and many excellent therapists are specifically neurodiversity-affirming.
To reiterate, at this time, accepting a medical diagnosis of Autism Spectrum Disorder/ASD involves acknowledging the presence of a lifelong developmental condition that, by definition, profoundly affects multiple aspects of a person's functioning in clinically significant ways. For this reason, THERE MAY BE IMPLICATIONS OF BEING GIVEN AN AUTISM DIAGNOSIS THAT CAN'T BE ANTICIPATED. Will an ASD diagnosis prevent you or your loved one from reaching some goal, or taking some type of job, in the future? From entering military service? From running for public office? From gaining a promotion at work? From flying a plane? From being admitted to a graduate program? From receiving a loan? From establishing affordable health insurance coverage? It is very difficult to predict societal attitudes and related laws and conventions, all of which change over time.
ASD surely can manifest differently at different points in life, but as noted above, the current formal diagnostic criteria state that symptoms are always present in some form from early childhood on. This requirement for developmental history can be a true source of frustration for mature adults seeking diagnosis, as they may no longer have access to school records, medical records, or loved ones who can describe their functioning during childhood. Nevertheless, at this time, it may be unwise to accept an ASD diagnosis not based on reliable evidence of lifelong difficulties. While some who seek diagnosis would assert their right to speak for themselves, with no need of past evidence other than their own childhood memories, this can be problematic: Given all the conversation about autism online and in the general culture at this time, people may come to assessment to seek confirmation of what they already believe to be true... and such a person may, without meaning to or even realizing they are doing so, tend to "over-report" symptoms they believe to be due to ASD. This may result in inaccurate diagnosis that may unexpectedly prove detrimental to the person receiving the diagnosis.
Social trends pass, but labels can persist. Seek out a professional for evaluation that will look objectively and compassionately at the challenges you face, do a full assessment that takes your early life history into account, and considers ALL potential causes of your difficulties. This strategy can help you find the best possible support, and ensure a stronger, happier future. Accurate and helpful diagnosis requires a truly objective view of symptoms and possible causes... it is NOT MEANT to simply provide affirmation of what someone has already decided "must" be true. Seeking information is important, but please be open to other explanations, which may serve you or your loved one better in the long run.
Persons affected by ASD face, through absolutely no fault of their own, many, many challenges, and are fully deserving of respect and ongoing support. The formal diagnostic criteria used to identify persons with ASD have changed over time, and will likely change again, to incorporate new information, and neurodiversity activists sharing from a place of lived experience are surely contributing critical information to aid that process. However, one piece of maintaining true respect and support for those who are most seriously affected by ASD and their loved ones is not casually overusing the term "autism".