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

[AutismProf]

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!

I've felt I am autistic for a long while. Very shy, anxious, low self esteem, look (and apparently come across) years younger than I am. Single and have trouble making friends although I never did when I was younger. Odd voice.
But other things don't fit. As in, I don't mind change and in fact, often welcome it. Good imagination, can see things from different viewpoints, can structure my time well and can cope with high levels of stress at work. High empathy and can 'read' verbal cues well. So I'd be interested to hear what you think.

Hi OP, as others have said, thank you for your time and your very thoughtful, eloquent responses.

I am also a professional working in this field, in the NHS . I find the biggest challenge is to assess children for Autism/ADHD when there is also significant overlapping trauma and attachment issues in their developmental history, for instance significant domestic violence or parental loss in early childhood, as several of the features of Autism and ADHD overlap with other conditions . We do use the Coventry grid interview alongside the other usual measures ADOS , ADi-R etc and am familiar with the work of Rudy Dallos and co who talk a lot about the ‘both and’ of Autism and attachment issues , rather than the ‘either or’. However it can be a long and complex process to try to carefully disentangle the influence of various factors in the developmental history and I am very aware that the final diagnosis/formulation has an impact on the type of help and support the young person and family will have going forward, so I am always keen to ‘get it right’ for the child and family. I was just wondering what your take is on these sort of complex assessments and how you might approach them. Thank you.

@AutismProf thank you very much for your reply. Interestingly we do have an EHCP and EOTAS is our preference as my daughter is in autistic burnout, has not left the house since October or regularly attended school since lockdown and finds school traumatic but the LA are adamant mainstream is the way even though her current school say they cannot meet her needs. However their specialist teacher who carried out her assessment (rather than an EP) agreed mainstream was possible.
Advice taken on board and off to tribunal we go.
Great thread by the way.

Yes, slow processing speed here as well. English is also really hard.

Can I just say, in case any sencos or other EPs read this: slow processing speed is not what causes autistic students to struggle with essay based subjects!!

If a child (14) has gone through an ADOS assessment and been diagnosed with ASD, can the diagnosis be wrong?

If it helps, school, child and parent all answered the questionnaires. The results of each were all within 2 to 3 marks of each other.

It’s certainly a contributory factor though.

My dd is ASD. She got 8’s in English and is doing A level Eng Lit.

Hi OP, I've found this thread really useful - thank you.

My daughter's being assessed for EHCP. She's 10, year 5.

The local authority are well organised (nice online portal) but understaffed (no case officer allocated and next week is week 4). They have till 23rd June to let us know if they're issuing.

They originally refused to assess and we had to take them to SENDIST.

They've requested ed psychology advice but no-one's contacted us.

Do you think it's feasible ed psych could be done in time?

Is it better to get a private ed psych report or to let them go over the legal dates?

I've already paid for a private occupational therapy report (tried to get them to do it but no response).

Interesting thread! In your opinion, how much crossover in symptoms is there between trauma/attachment experienced children, and children with autism?

We’ve had issues with SENCOs leaping straight to suggesting autism, when paediatricians feel the behaviours are more consistent with trauma. Examples are things like hypervigilance, hand flapping, anxiety, friendship issues.

I am inclined to trust the paediatrician, but sometimes wonder whether I’m missing an opportunity to give support, by attributing everything to trauma.
(Trauma experience was severe during 0-24 months.)

Can I just say, in case any sencos or other EPs read this: slow processing speed is not what causes autistic students to struggle with essay based subjects!!

So true. My literally genius brother can't do this stuff at all. It's because the questions are ambiguous and - in his eyes - pointless because the people asking them know already that there is no definitive answer so what is the point? Just endless discussion for no purpose. 😆 Plus executive functioning issues etc, and struggling to maintain focus on something that is not of any intellectual interest to him personally. Analysing language in an unhelpful way with people deliberately obscuring meanings instead of just saying what they mean and he finds it all too tiresome to engage even if he wants to.

Didn't mean to imply ALL autistic students struggle with essay based subjects. (I know an autistic young person just finishing a history degree).
However, when they do this is often attributed to processing speed.

Of course processing speed can be a factor but no one otherwise of mainstream or able cognitively has processing is so slow that they can write a quarter or an eighth of the expected amount. If this was the case they would need delivery at very slow speed too, but most of this cohort cope fine with understanding the knowledge - it's getting it out on paper that's the problem. This is much more likely to do with communication load - giving an opinion or a justification or discussing motivation of a character is higher "risk" than a short correct answer. It triggers anxiety and a freeze response.

Add in issues with executive functioning around task initiation, any ambiguity in the purpose of the task, where marks are assigned, slow motor speed of writing etc and it adds up to a significant impact on ability to produce results in a short time frame, such as under exam conditions.

Oh no, I know! I have degrees in literature and politicis, philosophy, and economics. I was responding to your post on the reasons why some autistic people struggle with those types of subjects, depending on their profile.

My brother that I referred to liked facts only. Studied sciences and maths and became a computer scientist. Textbook male Asperger's.

Wow! You've broken this down and explained me in the way I've never articulated in my head, let alone out loud. I struggled with essays and school because of this. Meanwhile I can write and engage for England if the opposite is the case. Same as my dc.

Thanks for this @InanimateObjects I'll be keeping it as reference.

@PenanceAdair so glad it helped! I remember us discussing it as teenagers and this is how he described it. I remember seeing out of the window of my form room, his French teacher literally chasing him across the courtyard and him running away (coursework). And then his English teacher turned up at our house in the summer holidays. 😆 He was perfectly academically capable of doing it standing on his head but he just couldn't, and didn't want to! For those reasons. And it didn't matter because he is absolutely amazing at what he does do. If only education could be more diverse and allow children to pursue their particular talents and interests and avoid all of that.

I'll add processing speed and slow motor writing speed are factors as well but the above really hones in on the crux of the matter in my and dc's cases, I believe.

I so agree.

Really interesting that explanation of slow writing due to communication overload my DD struggles with this 100% but her primary school just couldn’t “get it” until I had to complain that keeping her in repeatedly to finish her written work at lunchtime was so utterly counterproductive when she would then just explode with emotional overload. She’s literally dropped multiple subjects in year7 due to overload they are all writing heavy yet she’s in top set maths..using a laptop to type in English has helped though. I wish school could understand this more!

Try not to worry. Said brother studied physics, maths, further maths and chemistry A levels, then a first in software engineering and now earns around £200k... his lack of interest in English literature hasn't held him back (just in case anybody takes this the wrong way, I am not being disparaging here - one of my degrees is in literature so I'm not saying it doesn't have value also, just that people should be able to pursue their own talents and interests!).

Equally I am proof that an autistic kid who also went through the hell of '90s school but undiagnosed can be successful, very different area and career but similar kind of earnings now. The damage to mental health though to both of us, living through that with no adjustments or support or self-understanding was huge. So to any parents who are unsure whether to pursue diagnosis, please do so. It would have been life-changing for me and my brother if we'd had that.

This is really bad, just awful and I'd have hoped things would have changed by now. Do you have a diagnosis? Support in schools is meant to be based on needs but from the experiences I've had with my kids and those of autistic friends with autistic kids, it isn't the reality and they will often do nothing much at all until diagnosis is confirmed, then it changes. Not enough, but for them to be not getting this at all, not listening to what you are telling them and not making appropriate adjustments is unacceptable. There is an SEN code for schools that specifically requires them to listen to parents. To pressure an autistic kid even more and make her carry on until she is overwhelmed is borderline abusive and I'd be writing to the Governors if it was me. And involving the LA. (Sorry if you have already done all this - some schools are just terrible 😔).

Completely agree. And thank you. 😊

Regarding timetabling, large mainstream secondaries can't generally give a year 7 (or anyone else under 6th form) "free periods" unless there's someone to supervise them.

That is more likely to be the issue than a desire to force students to study subjects they can't cope with.

Not great but there it is.

That's down to different profiles though. Everything I did for degrees was mainly essay-based subjects (although the opposite for my later professional qualification). I loved music, art, writing, words, concepts, logic. My brother loved concrete facts, maths, statistics, science. In my opinion the main problem with the structure of the curriculum for autistic kids is it is way too prescriptive and doesn't let them follow their interests.

I once did a history A level in two weeks: signed up to it through OU and did nothing for two years at all, so took two weeks off work and spent two weeks reading all the stuff then did the exam and got an A (no A*s in those days). What is common is people can hyperfocus and absorb a lot of stuff very fast on what is interesting to them. If it's not interesting, it will be an uphill battle.

I don't know why our education system is so determined to force everyone to become a jack of all trades (although obviously a basic grounding in everything is necessary but again, could be achieved in far less time for the academically able). I doubt Mozart was bothered that he wasn't clued up on physics or that Einstein was upset he hadn't contributed much to economic theory or that Sartre was worried he wasn't proficient at ballet or that Picasso was stressing that he wasn't a skilled chemist or that Newton was worried that he hadn't written many essays about ancient history. We should allow everyone to be different and pursue their strengths and then we would all flourish.