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I am an "autism expert". Ask me anything.

554 replies

AutismProf · 18/05/2023 21:18

Worked in autism assessment, diagnosis and intervention on the education side for 20+ years. Ask me anything.

However, please note that I cannot personally do anything about waiting lists for diagnosis, or the education system, and I won't be blamed for these!

OP posts:
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AutismProf · 23/05/2023 21:36

ihearsnow · 23/05/2023 20:54

If you're not autistic, you are not an expert

Ok

I hate this idea that lived experience is the only validity. I do have lived experience.

If I haven't got a brain tumour, can I be an expert brain surgeon? If I am not an engine, can I be an expert engineer?

OP posts:
PixiesAndUnicorns · 23/05/2023 21:32

Hi, we have one family member diagnosed with autism and quite a few undiagnosed but likely suspects! I’ve also really enjoyed this thread, thank you so much for taking the time to answer so many questions.

I always worry that I’m going to miss something important, either physically or emotionally, with DS (14, diagnosed when he was 5). Physically, he often doesn’t notice sensory stuff like pain. Today for example, he has a very unusual bruise pattern on his upper arm but doesn’t know where it came from and didn’t know it was there until asked about it. Emotionally, he never voluntarily speaks about feelings or about things that happen, and it’s different to just not wanting to talk, because he’s always happy to chat. It’s quite hard to explain. I wonder if it’s partly on a social level, in the sense that sometimes he’s just not quite sure what’s going on and if it’s bad or not. I recently heard about alexythymia and think maybe this best describes a lot of it.

So my question is… do you have any advice on how to support his ability to identify and feel able to express physical and emotional feelings?

AutismProf · 23/05/2023 21:29

ohnonowwhat · 19/05/2023 00:00

Do you think that modern society is contributing or even causing? As in current education expectations, food choices, socialising trends or anything else... Would it be / is it as prevalent in more 'simple' societies of natural food, strong communities and predefined social / labour roles etc? Sorry, so many questions...!!

There's an earlier post that touches on this, but yes.

If you think about the world a few hundred years ago and for all of prior humanity - people lived mostly in small communities where they would know most people and most people would know them. Lives were simpler in sensory terms - no screens, no cars, no bright lights, no planes, no harsh chemical smells of disinfectant or perfume. People were often born into trades. Being otherworldly was interpreted as religious or even sanctified - you could retreat from life and be a monk or nun, or a hermit. If you were wealthy, or male, you weren't really expected to have skills of looking after yourself. Someone else would provide food, clothes etc....

Modern post- Gove education, compounded by lockdowns, is causing a mental health emergency. Referrals to camhs went up, iirc, 81 percent 2017 to 2019, then a further 60 percent 2020-23. I am not great at maths, but I think that means where 100 referrals were made in 2016, in 2022 there would be 100+81+(60/100 of 181) = 289 referrals. I think this is a combination of social media and the online world, and the deliberately harder, overpacked curriculum with no proper routine arrangements for those who struggle academically (did you know, a perfectly decent mathematician, doing everything necessary at age 16 to pass their maths GCSE, will get about 25 percent on the higher paper? Imagine what it does to you mentally to not be able to do 75 percent of a paper - you really wouldn't feel like you were any good at maths, would you?)

Autism isn't "caused" by all this. People were always and have always been autistic. It's just that they didn't clash with the expectations of their environment so routinely; the world was by and large, in some ways, less ill fitted for ND people. (Plus there was no language for autism, outside of "eccentric", "loner" type words).

OP posts:
QuitChewingMyPlectrum · 23/05/2023 21:27

TenseTessa · 23/05/2023 19:57

@AutismProf
Hello
Thanks for running such an interesting AMA

Someone asked you about books for ND adults parenting ND children. You mentioned looking into your network- wondered if you found anything?

Thank you

Search for Pooky Knightsmith - book in progress but she provides excellent advice

AutismProf · 23/05/2023 21:12

ohnonowwhat · 18/05/2023 23:53

Do you think 'everybody has autistic traits' and everybody's on a spectrum with only those who have them worst being classed as autistic? Or is it more that some people are neurotypical / normal and others are neurodivergent / autistic / odd. Do you think these terms are helpful or might there be a better way of labelling people, if indeed labels are necessary?

No, I don't think everybody is on a spectrum as in a linear "not at all autistic" to "most autistic ever" person. The spectrum is more like a wheel to mr. I will try to attach an example graphic. I do think it's possible to have issues in a few areas of the "spectrum wheel" but for this not to constitute autism....for example, I have some sensory issues, I cannot stand to be sticky, it makes me shudder. I also have done executive functioning issues around planning and task prioritization. But I don't have enough issues of neurovariation to "tick all the boxes" to make me autistic.

I am an "autism expert". Ask me anything.
OP posts:
AutismProf · 23/05/2023 21:05

AriannasGuitarCase · 18/05/2023 23:43

Op, your title irked me as I don't believe anyone can be an 'autism expert' but I'm glad I read on, and I just want to thank you for your well thought out and measured replies

Thankyou :)

OP posts:
AutismProf · 23/05/2023 21:04

QuitChewingMyPlectrum · 18/05/2023 23:38

@AutismProf
I always click on these threads with more than a little trepidation.
Thank you. You've restored my faith in at least part of humanity.
The world needs more like you.
For what it's worth, from personal experience fulfilling relationships can be found. I am very happily married to a NT and we have a lovely life.

Lovely to hear! Thankyou for the kind words too.

OP posts:
AutismProf · 23/05/2023 21:00

InattentiveADHD · 18/05/2023 23:36

Ummm I think that's a mistake personally. Obviously we should not be trying to force autistic people to mask and act like NTs, but my DS (who is autistic and has ADHD) really benefited from social skills support (perhaps this is a better focus that "training") from both me, CAMHS and his school. He was able to learn the rules that NTs pick up naturally without being taught. He went from having no friends at all and not coping at at school and having an absolutely miserable time, to having a good group of friends and doing well at school (there were other interventions that helped with this of course), but being able to have some chance of navigating the complex world of teenage communication made his life so much better (he says this himself, this isn't just coming from me!). As a adult he has a good social life and is married! Not teaching autistic people social skills is like sending someone off to Japan and expecting them to be able to speak to people, and read the road signs! Bottom line is, we live in an NT world whether we like it or not. Obviously in an ideal world everyone would accept everyone else along with their quirks and their nuances, and treat everyone the same but that's just not reality. We can try and move society towards being more accepting of difference but society moves at an incredibly slow pace so that doesn't help ND people now. Especially when it comes to friendships - people want those to be easy. They don't want to make an effort (and that's not a criticism - people have busy lives, they don't need to have to work to form friendships also!). And TBH I can't see that ever changing - people either like people or they don't, and people naturally "avoid' people who feel odd or different to them. I am ND also - I was severely bullied throughout school and have a serious MH condition as a result and still have difficulty trusting people enough to form/maintain friendships now. I wish I had had some social skills support in school, it could have made a huge difference to me - I used to see my DS running into social situations making all the mistakes that I did (I used to think - that's exactly how I was! It was quite eye-opening!); he's in a very different place to me now as he had support and was able to learn the skills (or social language if you like) that no-one ever taught me. Just wanted to provide an alternate perspective as my DS's experience of social skills support which was very positive (i fact, it was life-changing) and led to a huge improvement in his MH , which is very different to your perspective.....perhaps it depends partly on the way it's done.....

I don't think our positions are mutually exclusive. As you say, autistic people need coping skills enough to live in the world as it is.

Some support in social understanding of the NT world is helpful, but not with the subtext of "this is the right way, if you learn this right way all will be well, your natural way is the wrong way". The balance is in fitting someone for life, versus trying to train them out of their natural nature. Offering autistic people the chance to experience friendships in which masking is unnecessary, where your friend doesn't take offence or take it personally if you tell them you are too peopled out to talk much today, where you can connect deeply over specialist subjects, isn't selling them short. It's a positive.

I guess in your analogy, I promote the idea that an English person living in Japan knows enough of Japanese culture and language that they can make themselves understood and understand the basic cultural rules sufficiently that they won't draw high levels of negative attention. However, it's fine for them to seek out other English expats for their close friendships, where they speak English and eat English foods without guilt or shame, rather than feeling like unless they can move through Japan indistinguishable from a natal Japanese person, there is something wrong with them and they have failed in living in Japan.

OP posts:
ihearsnow · 23/05/2023 20:54

If you're not autistic, you are not an expert

AutismProf · 23/05/2023 20:48

TenseTessa · 23/05/2023 19:57

@AutismProf
Hello
Thanks for running such an interesting AMA

Someone asked you about books for ND adults parenting ND children. You mentioned looking into your network- wondered if you found anything?

Thank you

Sorry, no, though someone on the thread said they were working on something...I found a couple of blogs, is all.

OP posts:
TenseTessa · 23/05/2023 19:57

@AutismProf
Hello
Thanks for running such an interesting AMA

Someone asked you about books for ND adults parenting ND children. You mentioned looking into your network- wondered if you found anything?

Thank you

bumblebeebuzzy · 23/05/2023 18:56

AutismProf · 23/05/2023 18:45

NT - neurotypical. The more common brain type.
ND - neurodivergent - the less common brain type that includes the developmental conditions such as ADHD, autism, dyslexia, dyspraxia (developmental coordination disorder), developmental language disorder, etc.

Thank you for explaining!

AutismProf · 23/05/2023 18:45

NT - neurotypical. The more common brain type.
ND - neurodivergent - the less common brain type that includes the developmental conditions such as ADHD, autism, dyslexia, dyspraxia (developmental coordination disorder), developmental language disorder, etc.

OP posts:
bumblebeebuzzy · 23/05/2023 18:38

AutismProf · 23/05/2023 18:23

Stepping out of response order to say to bumblebeebuzzy

You can't prevent autism in pregnancy, but I guess you reduce your chances of having an autistic child if you are NT, your partner is NT, and everyone in your family is NT. Plus if you don't have a prem baby, a baby with a genetic condition, learning disabilities etc. But that is largely beyond our control, thank heavens.

There have been studies looking into attempting to reduce likelihood of autism. Autism Speaks in America used to fund a lot of research, and in the UK we had the PACT research about 10 years ago which attempted to reduce "severity of symptoms" initially but has morphed into a way of (benignly) increasing communication attunement between parents and autistic children.

There have always been programmes such as ABA and son-rise (now renamed but I can't recall new name) that have made claims about reducing autism "symptoms".

However, nowadays, there are more people - particularly autistic people - saying that such approaches as ABA are dehumanising at worst, and just encourage better masking at best, and that it's ok to be autistic. My view is that some small aspects of ABA, such as PECS, used kindly and with clear purpose, can be a way to help autistic children who otherwise have no way of being predictably understood to have a way to express their needs; but I am not in favour generally of extinguishing behaviours etc unless these are harmful to the youngster or dangerous.

I appreciate that autism is a vast spectrum and that caring for youngsters who will need life long 24 hour care is not something that most people who embark on parenthood would have in their vision and expectation list. But just like everyone else, autistic people vary enormously in their talents, passions, roles, and lives. Imagine if we had stamped out autism hundreds of years ago - no Mozart, no Newton, no Emily Dickinson, no Einstein, no Tesla, no Bill Gates, no Pokémon.....
I would not change my autistic children (though I might make my son magically less avoidant of showering!). They deserve life, they are valid and wonderful and loved.

Sorry what is NT?

bumblebeebuzzy · 23/05/2023 18:38

AutismProf · 23/05/2023 18:23

Stepping out of response order to say to bumblebeebuzzy

You can't prevent autism in pregnancy, but I guess you reduce your chances of having an autistic child if you are NT, your partner is NT, and everyone in your family is NT. Plus if you don't have a prem baby, a baby with a genetic condition, learning disabilities etc. But that is largely beyond our control, thank heavens.

There have been studies looking into attempting to reduce likelihood of autism. Autism Speaks in America used to fund a lot of research, and in the UK we had the PACT research about 10 years ago which attempted to reduce "severity of symptoms" initially but has morphed into a way of (benignly) increasing communication attunement between parents and autistic children.

There have always been programmes such as ABA and son-rise (now renamed but I can't recall new name) that have made claims about reducing autism "symptoms".

However, nowadays, there are more people - particularly autistic people - saying that such approaches as ABA are dehumanising at worst, and just encourage better masking at best, and that it's ok to be autistic. My view is that some small aspects of ABA, such as PECS, used kindly and with clear purpose, can be a way to help autistic children who otherwise have no way of being predictably understood to have a way to express their needs; but I am not in favour generally of extinguishing behaviours etc unless these are harmful to the youngster or dangerous.

I appreciate that autism is a vast spectrum and that caring for youngsters who will need life long 24 hour care is not something that most people who embark on parenthood would have in their vision and expectation list. But just like everyone else, autistic people vary enormously in their talents, passions, roles, and lives. Imagine if we had stamped out autism hundreds of years ago - no Mozart, no Newton, no Emily Dickinson, no Einstein, no Tesla, no Bill Gates, no Pokémon.....
I would not change my autistic children (though I might make my son magically less avoidant of showering!). They deserve life, they are valid and wonderful and loved.

I wasn't trying to be rude, was a genuine question on my part as I don't really understand autism hence on this thread to learn Flowers

AutismProf · 23/05/2023 18:23

Stepping out of response order to say to bumblebeebuzzy

You can't prevent autism in pregnancy, but I guess you reduce your chances of having an autistic child if you are NT, your partner is NT, and everyone in your family is NT. Plus if you don't have a prem baby, a baby with a genetic condition, learning disabilities etc. But that is largely beyond our control, thank heavens.

There have been studies looking into attempting to reduce likelihood of autism. Autism Speaks in America used to fund a lot of research, and in the UK we had the PACT research about 10 years ago which attempted to reduce "severity of symptoms" initially but has morphed into a way of (benignly) increasing communication attunement between parents and autistic children.

There have always been programmes such as ABA and son-rise (now renamed but I can't recall new name) that have made claims about reducing autism "symptoms".

However, nowadays, there are more people - particularly autistic people - saying that such approaches as ABA are dehumanising at worst, and just encourage better masking at best, and that it's ok to be autistic. My view is that some small aspects of ABA, such as PECS, used kindly and with clear purpose, can be a way to help autistic children who otherwise have no way of being predictably understood to have a way to express their needs; but I am not in favour generally of extinguishing behaviours etc unless these are harmful to the youngster or dangerous.

I appreciate that autism is a vast spectrum and that caring for youngsters who will need life long 24 hour care is not something that most people who embark on parenthood would have in their vision and expectation list. But just like everyone else, autistic people vary enormously in their talents, passions, roles, and lives. Imagine if we had stamped out autism hundreds of years ago - no Mozart, no Newton, no Emily Dickinson, no Einstein, no Tesla, no Bill Gates, no Pokémon.....
I would not change my autistic children (though I might make my son magically less avoidant of showering!). They deserve life, they are valid and wonderful and loved.

OP posts:
StraightOuttaContext · 23/05/2023 17:47

@bumblebeebuzzy no.

bumblebeebuzzy · 23/05/2023 17:37

Is there a way to prevent autism? when pregnant or raising a child?

kermitthefrogs · 23/05/2023 17:37

What do you think of the parents who are obsessed with getting a diagnosis and even when the child has been assessed as not having autism they still don't stop?

Lougle · 23/05/2023 17:35

@AutismProf has given some of the most expert posts about ASD that I've ever seen. The very fact that she caveats everything so carefully shows that she knows how individual ASD is.

@MyOtherCarIsAPorsche I'd be really interested to know that answer too.

ArseInTheCoOpWindow · 23/05/2023 17:05

@MyOtherCarIsAPorsche interesting. My dd has both, despite there being no history of migraine.

MyOtherCarIsAPorsche · 23/05/2023 17:04

Is there a link between autism and migraine?

RhinestoneCowgirl · 23/05/2023 14:47

I have been lurking @AutismProf this thread is incredibly useful, thank you.

My 14 yr old DD has recently had a MH crisis and CAHMS suggested that her extreme anxiety, plus some sensory issues and encyclopaedic knowledge of eels (current special interest) may indicate some autistic traits/neurodiversity.

From what I have read, CAHMS don't support ASC children with anxiety as it is 'just' part of who they are (I'm probably cynically simplifying that...) But at the same time we are of course desperate to help her. Obviously everyone is different, but are there some useful ways to help her reduce her anxiety?

Dodgeitornot · 23/05/2023 14:04

giggly · 23/05/2023 12:51

Most people
would not consider themselves an expert in anything but themselves. Ive worked with Neurodevelopment disorders for over 20 years and mental health for over 35 but would never consider myself an expert.
What I do know really well is how the services and Trusts/ organisations that I work for operate. I cannot comment on the rest of the UK or make sweeping statements.

Have you actually worked in the area of autism for 35 or 20 years or just generally in neurodevelopmental and mental health problems? If the latter, than of course you're not an expert. You haven't spent years working within one specific area of those two fields. The area of neurodevelopment an mental health is massive.

subsy1 · 23/05/2023 13:25

What should grandparents do to help autistic grandchildren have a better Christmas?