Autism Vs eccentric personality

[BlooDeBloop]

Context: A health care worker suggested my 12yo DS may have asd. He is socially extremely awkward at school but copes in his way and brushes off taunts etc. There are some anxiety issues we deal with. He is certainly quirky. Many of the males on my side of the family can fairly be described as eccentric or oddball (...actually this is a good description of me too 😆).

Question: what is this autism spectrum that potentially includes my DS at one end and on the other includes non verbal or highly violent people needing full time, respite care into teens and beyond? Or even the more common presentation we see on TV, the rocking, meltdown prone, OCD type of person. I just don't see the connection. Depression presents on a scale but one end looks like the other end just more extreme. ASD is highly variable. Indeed, this is reflected by the commonly quoted 'if you've met one person with autism, you've met one person with autism' i.e. no two cases are the same. If none are the same how can we be sure we're dealing with the same thing when we diagnose and talk about autism?

Can anyone explain?

Chris packhams documentary based on 4 stories is the best I've seen :) I recommend people watch this.

If it literally never caused him an issue - then it isn’t one.

But... what happens when he’s not a child? When he needs to get through university, when he needs to interview for jobs, have relationships

If there’s still no issue then, they’d there’s still no issue, but not causing a child difficulties doesn’t mean there won’t be any later.

Thank you for your reply. If you don't mind sharing, in what ways has a diagnosis improved your son's life? I'm still struggling to understand what this could bring my DS. School seems to have zilch meaningful support. For example, it would be great to have time spent on developing social skills. But I already know that is not going to be on offer 😔

The medical description of autism and the people who meet the criteria for being autistic has changed wildly through the different versions of the DSM and many of those diagnosed now wouldn’t have met the criteria pre-1990s.

As someone who is autistic and was weighing up having my daughter assessed I was advised by a progressive private clinic that a well rounded autistic individual wouldn’t meet the criteria for autism spectrum disorder. I was relieved to see there’s finally acknowledgment in the medical community between an autistic individual who is disabled by their differences and those who are not.

Do you not have the Google?

This exact question has been asked on here multiple times, I can only presume Google is awash with similar.

I (ND) can answer your question. The trained medical professionals apply the DSM5 criteria to the results of the assessments that have been carried out.

@BlooDeBloop

It’s great that your DS is happy. It isn’t a medical issue. ASD is a developmental difference and is diagnosed by a clinical psychologist, not a psychiatrist (medical doctor).

It’s really very hard to get on in life without socialising, and inability to do so is a clear deficit and represents real limitations in functioning. Even (stereotypically speaking) top academics and computer whizzes need these skills, although workplaces can nowadays make accommodations. DS1 likes socialising, but this might change I guess.

Oh course. But in reality we all struggle all the time, just not as systematically as (I imagine) those with asd. What I mean is he will always have problems. So will I. So will many others. Struggling with aspects of life isn't a diagnostic criterion of asd in itself. But there is a scale of disability or impairment of course with a threshold for asd. I think it is important to be clear that the threshold won't be hard and fast.

Ah. Now ah. This is interesting.

“I was advised by a progressive private clinic that a well rounded autistic individual wouldn’t meet the criteria for autism spectrum disorder.”

What does that mean? Like someone who is masking and coping who has a diagnosis of autism going for a do over wouldn’t get diagnosed?

Ability to mask through a diagnostic appointment doesn’t mean you are not autistic. It has the clinical validity of a visually impaired person memorising the letters on the opticians chart.

While you are Googling, Google Ableism. You could even add internalised ableism.

I know you weren’t asking me... but...

My DS had social skills classes, not through school - from speech therapists, it was a group they went to weekly in school holidays.

He also went to a youth club for teenagers on the autistic spectrum - which was brilliant for him, we’d tried mainstream activities and because he seemed fine to them to start with, they didn’t cope when he had an issue.

He got separate accommodation for exams as well, so a small quiet room.

Then lots of support at uni, including helping him access social events and again things like separate accommodation for exams, an extra point of contact for any issues he was having and specific support for studying (a variety of stuff based on his needs at the time)

When he left uni and was looking for a job he was assessed as having a limited capacity for work so he could claim universal credit and only apply for the jobs he actually had a chance of being able to do rather than being forced to apply and interview for jobs that he’d hit have coped with and wouldn’t have been given anyway. Your stop gap minimum wage jobs mostly rely on the soft skills he doesn’t have.

There was definitely more, but off the top of my head there’s a few things I can think of.

It’s another one of those threads 🙄 just Google what the word spectrum means in relation to autism. And if it’s been suggested your child might be autistic you need to do a whole lot more research about what each symptom actually means and how of can present.
depression isn’t a spectrum disorder but you’re not correct about that either as with major depression there are often psychotic symptoms such as hearing voices, paranoia, hallucinations etc which don’t occur in affective disorder.

You are right to point this out. Social things will always be life restricting for my DS. It will shape his life and career options. I'm making no bones of it. He is an extreme introvert, shy and socially incompetent. But he likes his life. Unlike me who was also these things (not as extreme) but who wanted to fit in and have friends.

What do you mean by struggle? Most people certainly don’t struggle all the time - I mean, a difficult situation at work, or a relationship breakdown or something, but most of the time, most days aren’t a struggle.

Someone struggling all the time would cause such a high level of stress they’d surely become very depressed or have a breakdown.

Oh and a tiny thing, but that was huge to him... he was put in a break and lunch nurture group at secondary school.

So a group of children (including him) got to spend break and then eat lunch in a classroom together, mostly discussing science and playing board games from what I could work out 🤣 instead of having to mooch about trying to avoid the other teenagers who weren’t into stuff like that.

Very interesting. This could be of value if available to us.

@tabulahrasa your answer sounds really sensible and clear, but I have this little niggle. I’m wondering what the difference is between ‘sucking it up and doing it’ re phone calls, tights, whatever issue, and masking? Not intending to imply anything about you, but thinking how those examples relate to me and my family. I suppose it might depend on the effort involved in sucking it up? But if the consequence of the effort - some kind of breakdown for example - can be delayed for years, and thus the effort be invisible for years, I suppose it’s a sort of shrodinger’s masking until the evidence becomes clear.

My ds is 16 and sounds very like yours. We got him diagnosed 'just in case'. He has been fine all through school so far, hasn't needed any extra support, very high achieving, knows what he wants and works for it but who knows what uni for instance has in store or the workplace, having that diagnosis which he can keep to himself if wants just means that if he does need extra support he has more chance of getting it.

It does entirely depend on the assessor, I work with a demographic of children and adults who have a high level of ASD diagnoses or suspected ASD/ND diagnoses (while we are waiting for appointments and assessments)

Sometimes we can access private assessments for some of them and sometimes not

But Ive seen many an outcome, and attended many an assessment where assessors have specifically dismissed the need for there to repetitive behaviour or actions or routines in order to diagnose.

Some people struggle with intermittent depressive symptoms more or less the whole of their lives. Others with agrophobia. Someone mentioned that phone thing. I have this and my therapist says it is extremely common. There is so much addiction in our society which is a measure of how people struggle imo. I know of plenty of people who struggle with the modern world, commutes, crowds, noise so much it makes them ill. That was what I meant by many people struggling (not all or even the majority, just many). I didn't mean struggle every moment of every day. That would lead to a breakdown, you're right.

And this is what causes burnout. Struggling all the time.

My dd would have hated that. She’d want to discuss art or fashion or Taylor Swift. Again, this is the male thing, although l appreciate you were talking about a boy.

So much for the triad 😆. This information is invaluable as it goes beyond google to the coal face where the real decisions are being made. Thank you for your input.

How old is your daughter? That progressive clinic sounds crap.

I’d assume effort and consequences yes.

I’m only mentioning me as an example of, autistic traits aren’t things nobody else ever does or has issues with, not because I think they’re a big deal - you just spend a lot of time examining normal stuff when you go through getting someone diagnosed, lol.

The job I do is sort of similar to teaching, lots of interaction with a group of people... when I’m at work I’m not relaxed exactly, what people get is a professional version of my personality, but, it’s not not me either and I enjoy my job and I can come home and still want to socialise etc. I don’t need any mental recovery time.

That to me would be the difference between masking and just being NT - if I was having to really work hard at presenting as my professional self, so that it was stressful and then having to come home and recover.