To think perhaps my son isn’t autistic but instead modern society is too challenging for him to cope with.

[SpinningTops]

My son is 7 and on the long waiting list for an autism assessment.

Sometimes I wonder whether he would cope absolutely fine if he was an 80s or 90s child. Maybe it’s rose tinted glasses but modern life seems so chaotic and jam packed, so much to learn at school etc.

He’s in a small class at school and seeing the number of children struggling, so many with ‘special jobs’ to just get them into the classroom, makes me think something is wrong with the system rather than all these children being neurodiverse. And this is an absolutely wonderful school which outwardly he says he loves.

It’s just something I’ve been thinking more and more about recently …

Then how do we know what they all have is autism and the same thing?

DS coped absolutely fine at primary school. he was still diagnosed with Aspergers at 10 though. ASD is not about whether you can cope of not. He was always extremely academic and is now working as a software engineer.

Because they will have issues with social communication ie talk at you especially on favourite topics, difficulty with eye contact in stressful situations, difficulty reading facial expressions, difficulty finding the right place to join in a conversation, blunt and very honest way of speaking, take things literally. They may struggle with transitions, think in a very black and white way, have sensory issues.
It's more about building up a picture than saying do they do this one specific thing and that equals autism.

Well I’d guess all the people who were scanned as autistic had met the diagnostic criteria for autism.

You say there is no evidence that there is a different wiring in the brain. I am gently trying to suggest that there is in fact evidence which you seem keen to argue with.

I’m not saying there is a particularly wired brain that makes someone autistic. But, for example, it’s not unreasonable to suggest that maybe someone’s auditory cortex is wired in a way that makes sounds feel louder / overwhelming to them. Therefore they have sensitivity to sensory input which would fit into the diagnostic criteria. That alone would not make them autistic. I, personally am sensitive to sound, and perhaps have some other traits but I would not meet the diagnostic criteria for autism because I do not have traits in many of the areas. But aome people will have enough differences in wiring for this to manifest as ‘autism’.

Therefore autistic people may have differently wired brains. So will neurotypical people but the autistic person’s is different enough to cause difficulties in enough areas of life to be ‘autism’.

Because there are diagnostic criteria, the same as for every other diagnosable condition in the world.

Then how does that diagnostic criteria cover both (eg) a non verbal toddler, and a 40 year old professional scientist? What overlaps do they have?

Saying there is natural variation in people’s brains and how they perceive the world isn’t the same as saying they divide into 2 categories, either ‘NT’ or ‘ND’. I’m just not seeing it, until we have scanned everyone’s brains and found at least a general profile of one and the other, there’s no reason to create such a binary.

ASD is not about whether you can cope of not

I’m even more confused now!

Because they both have brains I guess. How do you determine eyesight in both a non verbal toddler and a 40 year old professional scientist?

They don't divide into two categories, that's a shorthand. It's a spectrum. You know that.

I think it's helpful to compare to a widely accepted and objectively testable condition to explain this. Down's Syndrome is testable because it arises from a whole or partial extra chromosome 21. However, the way that the presence of the extra chromosome will be evident is variable. Some individuals will be able to pass GCSEs, work, and own their own home. Some will need support workers checking in on them a couple of times per week. Some will require shared accommodation with daily support workers but can be left overnight. Some will require full time care in a group home. Some will require 2:1 support at all times. Some will be physically robust. Some will have hip dysplasia. Some will have normal heart function, some complications requiring medication, others heart defects requiring surgery. Some will have behavioural challenges, others not. Some will have extensive speech and language therapy needs and others will just have a slightly altered voice because of their enlarged tongue. Some will develop early onset dementia. They all have the same condition.

ASD and ADHD are similar. To get a diagnosis for ASD the criteria are and not 'or'. The subject has to have difficulties in several domains. Their difficulties might be most severe in one domain and relatively mild in another, but they must have difficulties in all of the areas.

ADHD has three hallmarks. Inattention, impulsivity, and hyperactivity. A subject doesn't need to fulfil all 3 areas, but their difficulties must be so significant that it affects daily function, the difficulties must have been present from childhood, and the difficulties must be present in at least two settings. So a child who displays behaviour at school but not at home, or home but not school, would not meet the diagnostic criteria.

Other conditions exist. Some people can have sensory processing disorder. They don't have ASD if they don't also have limits on their social function and restricted patterns of behaviour. Some people can have social communication disorders. They don't have ASD if they don't also have restricted patterns of behaviour.

Liking routine, disliking noise, disliking crowds, etc., aren't, on their own, Autism. It's when those things interfere with an individual's ability to function and they're combined with restricted social-emotional reciprocity, that they are Autism.

This is why brains will look different.

This is another helpful way of seeing it. Each person will have a different pattern of difficulties.

I'm sure there's some kind of introduction to Autism course you could take if you're genuinely interested

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Third time lucky!

Op if you were saying a much older age I’d agree but age 7 there’s still a lot of the play and fun aspect

There are different assessment processes. For the two year old the process will be very observational. A two year old won't have learned to mask behaviour or learned coping strategies, so their behaviour can be observed and developmental milestones tell us what 'typical' is. The professionals have training to differentiate between frustration behaviours and delays in development Vs disordered development.

A 40 year old professional scientist will be evaluated differently. But most people with ASD don't know that the way they experience life isn't the way everyone experiences life, and even if they do, their explanations often highlight their difficulties.

The assessment process is detailed. When DD2 was assessed, she used the word 'ambushed' 3 times in her explanation of a picture book, which the assessors said was unusual. Bearing in mind that they use the same picture book with all the people they are assessing.

Most girls with ADHD do not stick out like a sore thumb because they are often incredibly good at masking, especially if they are very bright. I was at an all girls grammar school in the 1980s. I can’t honestly think of anyone who seemed like they had ADHD. I did. Whenever I tell anyone, they are extremely surprised.

We do know that ADHD is often inherited and there are some prenatal factors (can’t remember what) that increase the likelihood.

We also know that people with ADHD are more vulnerable to excessive screen use because it gives a dopamine hit. ADHD adults typically do a lot of doom scrolling and many of us love computer/phone games.

i would also think that excessive screen use can amplify some typical ADHD traits - poor focus and short attention span. So in that sense you are probably correct to a degree.

i would imagine most parents witb a mixture of ADHD and NT kids will say that with hindsight that the ADHD kid had lots of traits as a baby. For example my DC2 gave up daytime naps at 9 months and still wanted to get up and play at 4am. They also quite obviously had some sensory issues.

if you have ADHD, you are born with it. It is a neurodievelopmental difference. So in summary I can see that excessive screen use might make people mimic some ADHD behaviours or might amplify the traits if they do have ADHD. I do not belief that screen use causes ADHD because it is a brain difference that we are born with.

There is an irritating assumption that ‘NT’ people just sail through life, finding everything easy, which of course is not the case.

@HearMeOutt especially with the long waiting lists for diagnosis in UK I doubt many toddlers are getting diagnosed anyway (it took three years for my son to reach the top of the waiting list, by which time he was in school)

But here are a few suggestions - need for routine and strict routines, also a love of rules can apply to both toddlers and adults

Special interests which are quite obsessive can apply to both toddlers and adults

Difficulties communicating with others can apply to both toddlers and adults

Oh and also trouble getting to sleep. If you’re not on SEN groups you won’t know about the children who can’t get to sleep and wake up multiple times a night, or how sleep deprived their parents are.

I suppose it could help if you frame it as a "privilege", like all the others. Ie, not all white men sail through life, but white privilege and male privilege definitely exist.

You may find out, upon further enquiry, that the non verbal toddler and the 40 year old scientist are one and the same person.

As part of the adult autism assessment, the applicant's parents are asked to provide information about their childhood (if possible).

That's nonsense though. Thete is absolutely no assumption of that, and there is especially no assumption of that relative to neurodivergent people. Your comment has 'straight pride' vibes.

Yessss. As an example from my family, it turned out being highly distressed by not being able to get socks to the exact same height on each shin wasn't just a quirk that needed shouted out of a child, but actively impacted on the child's ability to function normally and move on in the morning before leaving the house. She could not move on until she had it right 🙃Things like that form part of the later diagnosis.

Other children might also have liked to have their socks at the same height but wouldn't melt down over it. And that's the difference.

And the child with the socks may not have the exact same issue as an adult but there will be other indicators.

I'm thinking of someone I dated who was quite senior in a global software company but didn't talk until he was 3....