Autistic Traits in a Neurotypical Person.

[Proa]

I was posting on another thread about autism and was told categorically that a neurotypical person cannot have traits of autism. My question is, why? It is accepted that autism is a spectrum and many have spiky profiles, so why would it not be true that some neurotypical people would possess similar spiky profiles, some being in line with autistic traits, yet not meet the threshold for an autism diagnosis.

Autism assessments are somewhat subjective (questionnaires, interviews etc) so surely there would be some people who would be on the cusp of diagnosis or who have traits but those traits do not impact their lives severely enough to be diagnosable?

In order to be diagnosed with autism, there are three categories (see photo) that the person must possess, and these criteria must ‘impair daily functioning’. Is it no possible that an otherwise neurotypical person could fit into 1 or 2 categories, thus being on the ‘cusp’ or have traits, yet not be diagnosed with autism as they don’t have the triad of impairments?

Is it not also possible that a neurotypical parent of a neurodiverse child could have ‘traits’, but these traits come out more obviously or strongly in the child, thus leading to an autism diagnosis?

I write this as a parent of an autistic and ADHD child. I have ‘traits’ of neurodiversity, which both myself and others can identify in me, yet I do not believe I reach the threshold to be diagnosed autistic and the traits I have certainly do not impair my everyday life. Many of the traits I possess I can see in my child, but his symptoms are amplified and more pronounced, to the point he needs support (I do not).

I just don’t understand why it’s out of the realm of possibility that someone could have strong ‘traits’ or symptoms of autism, yet not reach the threshold for diagnosis.

AIBU?

One of my sons has quite a few traits that would be shared with autistic people. He has specific interests that he learns everything about and then loves to tell you everything about them, he is academically gifted, has hyper focus, he can find it difficult to put himself in someone else’s shoes. However, none of these have ever caused him any issues. He isn’t anxious and can NOT do these things if he chooses not to.

That sounds much more like ADHD than OCD. Random intense interests, followed by obsessive researching, followed by complete disinterest is very commonly reported behaviour in ADHDers. I often text my DH random facts about the latest random thing that's caught my attention in the middle of the night when I've been up obsessively researching it until 3 in the morning but when he mentions it the next day, I've completely lost interest! But that alone wouldn't get you a diagnosis of course, you'd need many other traits/difficulties.

OCD is more characterised by unwanted, unpleasant and repetitive thoughts about something that usually prompts compulsive actions in an attempt to stop or neutralise said thoughts. Accompanied by a lot of anxiety and sometimes low mood. Nothing to do with researching the Russian hamster at 3am in the morning. Unless you are doing it because intrusive thoughts are making you anxious and researching something to try to stop that (something seen in BDD which is very similar to OCD and one possible compulsive behaviour is obsessively researching cosmetic surgery). I don't think that's the case here from what you've said. Sounds more like dopamine seeking behaviour and inability to direct your attention as seen in ADHDers.

I have many autistic traits, but the process of investigating a diagnosis is too much of a stress, so my self diagnosis is "socially inept and crap at being human".

"Ive come to the conclusion I’m the hyper focused adhd. As they have to do everything right now."

That's not correct. That's not what hyperfocus is. Hyperfocus is one part of the inability to be able to focus attention where you need it. You cannot control hyperfocus. It comes on when it wants to and it can be a very negative thing as when hyperfocussed you can forget everything else including sleeping, eating and drinking and other more important things you need to do. You will also only hyperfocus on things you are interested in. It definitely does not mean being able to keep on top of your inbox! And it's also not consistent.

The twin to hyperfocus is distractibility, inability to concentrate, not being able to get started on tasks and not being able to finish tasks.

There is also not a type of ADHD called hyperfocus ADHD. There are three types: impulsive/hyperactive, inattentive and combined. You need a number of traits to be diagnosed with one of the types not just hyperfocus (which it doesn't sound like you are describing anyway).

People with ADHD need structure but usually don't like it being imposed and can't maintain routine and structure. Similarly they may not be able to cope with clutter but will struggle to keep order and keep things tidy. People with autism usually like routine and structure and can get quite anxious if their routine is disrupted. However this could also apply to someone with severe anxiety; some people who are anxious use routine and structure to try to get control of external things in the hope of controlling the internal (or so they don't get overwhelmed).

ADHDers also generally like a deadline. It kicks their brain into gear!

You can have the traits above whether or not you are autistic.

But if you're not autistic - i.e. meeting threshold for diagnosis - they're not autistic traits. You need to describe them differently.

I could have epilepsy and see auras. People who have migraines and see auras don't have epileptic traits.

You can absolutely have and need to address some of those traits, but the language you are using could come across to some people as minimising the experience of autism for people with a diagnosis.

The Levels aren’t commonly used in UK, but yes, you are correct that the definitive cut-off point for autism is certainly rather fluid / vague.

You will find quite a lot of somewhat pedantic debates and strong opinions about what ‘counts’ as autism and what doesn’t, and what autism is and it isn’t, along with the insistence that autism is an all or nothing diagnosis, which unsurprisingly is actually a rather black and white and classically autistic way of looking at things.

My opinion is that we are still very much lacking in understanding of what autism really is, and at the moment it’s really an umbrella diagnosis, encompassing a huge diversity of need. Knowing that somebody is autistic is rather meaningless until you’ve met them, as there can be almost nothing in common between two people with the same diagnosis.

JFC every day there is someone else who is trying to say they are ND with absolutely nothing to back up that, and minimising what those with ASD actually have to contend with daily and the assessment pathway people (esp kids) have to go through, just to be sure.
People need to give it a rest!

I think that must be true, op. My dd has been through an asd assessment recently and scored well over the threshold in 2 of the 3 areas. Conclusion is she might have asd but she might not (from camhs). I'm not sure either way and imagine time will tell but certainly she has clearly got some of the traits that ordinarily would make up a certain diagnosis.

I was assessed for autism as a teen, as I have a trait. It was decided i wasn't, so I am neurotypical with an ASD trait. I do have a husband who was diagnosed at 4, so I'm familiar with ASD.

@thirtyseven37 Surely the questionnaire that you / your family fills out about traits is subjective?

When I had the interview for my children I gave many, many examples of situations when they had done something, or said something that fit the question. You can't just say 'oh yeah, they're like this...'

They must have misunderstood because of course its perfectly possible to have what are thought of as autistic traits but not reach the threshold for diagnosis.

@Lougle The pre-screening questionnaire which the practitioners use to decide whether to assess or not in the first place e.g ‘I find it easy to do more than one thing at a time.’ Options are:

Definitely agree
somewhat agree
neither agree nor disagree
somewhat disagree
definitely disagree

That is subjective according to the individual, same as the family & friends questionnaire.

I think you definitely have traits. I do but I'm not sure whether I would qualify for requiring support although I do think I need some adjustments at work.

My DD's first diagnosis from the psychiatrist was 'clinically significant autistic traits'. She was re-tested by the same person a few years later and now has an ASD diagnosis. But I figured if that was her diagnosis from an autism specialist psychiatrist, then 'autistic traits' must be a thing. That said, I'm sure the term is way over used.

I have a number of traits as do my husband and DC. Mumsnet would 100% diagnose my DC I'm sure of that. But I'm sure we're not autistic because whilst we are all introverts we don't struggle socially when we chose to socialise and we can read social cues. In fact I'm incredibly adept at reading people. I've seen it suggested on here that this in itself is a 'special interest' but I don't buy that. If you don't have struggles with socialising/relating to others/reading people then you are not autistic. I think there has been an awful lot of diagnostic creep in the last 10 years, and added the concept of masking means that it is a lot more subjective. I understand the concept of masking for adults (the Chris Packhams of the world). But that involves a lot of 'study' and effort on their part. I've yet to see good evidence that young children can truly mask key autistic traits. Yet every other parent I know are convinced their DC are ND and are masking at school (I don't exaggerate when I say that, it's become ridiculous). When I think of the autistic people I know, it's completely blomin obvious.

Yes, as I said on the other thread, we see this a lot with the children we work with in that it will be down to the assessor as to whether they felt that overall, despite only meeting threshold in 2 out of the 3 areas, it was indicative of ASD overall.

Different assessors work differently in that way.

But that is just screening. And they have positive and negative questions. You can game the questionnaire, but only if you know enough about ASD. The ADOS is very specific and the things they pick up on, I don't think you can game. For example, the assessors noted that my daughter used a particular word 3 times in her description of the picture story. It stuck out to them because it was unusual for her age and it was unusual in the context of the story. The assessment is that subtle. Things like eye contact, intonation, reciprocity of conversation, etc.

Autism is genetic. People with family members who are autistic are most likely autistic themselves. They might not realise because the behaviours to them are what they are used to so think nothing is ‘wrong’. We also tend to gravitate to people like ourselves so asd or adhd will often end up marrying hence the children then having it.

The current theory is that its genetic, but its not known right now why that gene has that mutation within. Genes also dont account for all the instances and there is no genetic test for ASD (thats reliable)

And as on the other thread, people are mixing up genetic, with inherited.

I think the way the symptoms are expressed under stress can mask or expose ASD

I wonder whether If you marry the right person, land in the right job, have a fortunate set of circumstances or good systems for avoiding stressors, you might never meet the significant difficulty threshold.

My in laws are interesting - no diagnoses among them partly because no one recognised their own difficulties as they were normal in the family. Now SW are getting involved around the edges, due to MiL having a long hospital stay and the unusual presentation of visiting family. They broke usual protocol to speak to me because the visiting NoKs were neither asking for nor sharing any information.

This is me, except the chatty and social part. I need to know and like you before I can be chatty. I dont like big crowds or loud noises.

But they don’t just use the questionnaire, there is other info too. Then when you get through to assessment the family history form is a lot more in depth and comes with a very long( 3 hour in my case) appointment in my case for my dc followed by the ADOS and 2 other very long appointments with my dc alone and supporting evidence from professionals working with them.

Would also like to add my dc and I all have ASC and ADHD NHS disgnosis with different professionals. We all present differently (and similarly) and all had ADOS done by different professionals. We have all got a diagnosis. There is no right or wrong way to ADOS imvho.

@NewtonGig I am familiar with the assessment, my son went through it (as well as ADHD assessment). I was merely responding to the person who said the ASD assessment is not at all subjective, and pointing out that actually, there are elements of it that are.

My son didn’t reach the CAMHS threshold for ADHD assessment, yet he did privately, and has subsequently been diagnosed. That shows it is somewhat subjective based on the practitioner. My son is obviously, clearly ADHD (more so than autistic!), yet because he didn’t meet their specific threshold for severity and need, he didn’t get the diagnosis.

There is lots of variant within assessment. I have sat in and supported children through ASD assessments for nearly 20 years, both NHS and private. They differ hugely, different areas, different approaches, different systems around the assessor, different depending on whether the parents are there or not.

In addition some children, for long boring reasons, have a multitude of assessments by different practitioners with different outcomes, all contradicting each other.