Uta Frith, women, autism, and what Dr Stock, Helen Lewis etc think...

[Missproportionate]

Helen Lewis and Kathleen Stock have both commented on this article on X, both slightly ambiguously, as if they aren't sure what to think.

Wondered what anyone on here thinks about this? I am also ambiguous, but full disclosure: I have been diagnosed with autism at the age of 50, I haven't told very many people because I see a lot of identifying as 'neurospicy' online, and it seems to be connected to the whole 'I'm not normal, oh no I'm special' idea that I think has parallels with the queer community. I don't want to be on that bandwagon, I just want to make sense of myself.

I was diagnosed through a long process with several professionals, and a 3 hour interview with me, and a 3 hour interview with my mum about me as a child. I fitted in all the separate areas of criteria. I doubt people I work with or interact with superficially would guess ( but they may find me irritating or insensitive or interrupting - I find it hard to tell).

But it worries me a bit that women who are autistic might be seen as 'not real' and lumped in with the trans community in some way. But then how does that
then work? because as has been observed many times, girls who present with gender dysphoria are very often diagnosed/undiagnosed autistic. I think we should be leaning into attending to the autism in girls, and how an autistic girl might find being trans attractive as a way to 'solve' their feelings of not belonging. If we start to question the genuineness of their autism, we risk failing those girls even more. Don't we?

I don't know what to think.

Uta Frith interview in TLS

Brainworm that’s so interesting. I’ve often wondered what a school really designed for autism looks like and wondered if in fact it would improve things for NT children as well, in the way that provision for physical disability often improves things for everyone.

For my ds masking is more around him trying to hide self regulation strategies that were taught to him by OT to replace harmful behaviours because he does have self awareness that they make him look different. Its not helpful for him to be masking those.

He also does a lot of scripting social situations which is something thats part of masking. His school do things like going to the shops having rehearsed the things you might get asked at a till in english lessons. They are taught how to do the social norms. This is helpful as he can access more life.

Interestingly I read a study which now I cant find, that some severely disabled people who were thought to have little self awareness stimmed less with unfamiliar people or formal settings (not not at all and not all of them) i realised that the preverbal 20 year old i look after (he has about 15 words) he's incontinent and tube fed says 'thank you' to me at because he knows its expected but he doesnt know what it means.

So i think masking comes at different levels.

Well, yes.

I did have an interesting conversation with an autistic pupil once where he said that he hated sitting at grouped tables where you have to face other pupils, he much preferred rows facing the front. He said that if the object of group work was for pupils to learn things it was wasted on him as he was so stressed by having to work with other pupils that he never learned anything.

I do think that 'learning to work with others' is something that needs to be a part of school though. If I do any group work as a maths teacher (very rarely, tbh) I do allow autistic pupils to work on their own.

Tbh I hated grouped tables with a passion. Wanted to listen to the teacher or to think and work at my own pace. I wasn’t at all good at working with others but I certainly didn’t learn it that way. Best progress in that area for me was in drama or music (orchestra) and later on in sport.

The concept of universal design applies, whereby adjustments put in place for specific groups tend to benefit many more than the target group.

Lots of children who have social, emotional and mental health needs (SEMH) benefit from lots of the environmental adjustments that benefit autistic pupils.

A key difference is the emotion processing interventions that benefit those whose adverse childhood experiences (ACE) underpin their challenges.

50% of autistic pupils have alexthymia - difficulties experiencing, recognising and processing emotions. Those with SEMH arising from ACE also have difficulties processing emotions but effective intervention requires a different focus.

The autism advocates who are demanding no differentiation within the autism umbrella often appears to reflect monotheism (intense, single focus). The corresponding instance that there is no place from ‘non autistics’ to have any kind of say in autism diagnosis/ labels overlooks the harms that can be done by wrongly attributing autism to children who are in desperate need of care that would not be good for autistic people and so would never be offered to them if/ once diagnosed as autistic

Monotheism must be an autocorrect, what mono- word is it? I’d be interested to know?

🤣 Whoops.

Monotropism. Intense focus or interest in specific features or aspects as opposed to wider focus.

Monotropism ?

Sorry cross post.

Though I noticed online that the term is being described frequently as flow state - which is something we can all experience when deeply engaged in the things we really enjoy.

Anyone who engages in or works within the arts particularly for example.

I find the concept of masking interesting. I'm a teacher, I 'perform' being a teacher all day. I pretend to care about things like wearing your blazer. I greet students with enthusiasm at the door even when I'm knackered and all I want to do is go home. I use scripts for addressing stuff like poor behaviour 'you can choose to put the mini skateboard away or I can take it and put it on my desk for the rest of the lesson'. I think people who know me would be surprised to see my teacher self as it is not me.

Is that masking? Or something else?

I think autistic people can get into a flow state when engaged in their special interest but I've also heard that it can calm their brain to e.g. monologue about it.

Group singing is supposed to be great for achieving a flow state. I don't think it's a coincidence that a lot of religious ceremonies involve group singing.

If I’m honest, Uta is right about the term being problematic as it is very likely that there needs to be a clearer framing of what it is and isn’t. Which would hopefully lead to more precise terminology.

I remember a while ago that something like functional anxiety / depression were doing the rounds on SM, is in, you’d be getting through the day holding it all together, doing what you had to do, and then collapsing at home, feeling despair and suicidal thoughts. But getting up the next day and doing all again. Because you had to. Is that masking?

Group work where there is a grade or reward attached is a terrible idea especially at primary level.
If the grade is for the work produced, the most willing or competent person has a choice between doing the bulk of it or trying to sit back and let others do it, knowing the grade is going to suffer. I feel the social nuance of this was lost by any teachers that I had that set it.

The goal of working well as a group often conflicts with the goal of getting a good grade/getting an extra ten minutes of golden time and for this reason I hated it.

I think it's a reasonable question to ask. If autism is characterised by difficulties with social communication (I know there are other features), but a person is able to 'mask' and perform social communication adequately, but finds it tiring, is that really a social communication difficulty?

Because then you get the pushback of 'don't we all fake social communication to some extent to get on in the world'? I mean, it's one of the reasons why alcohol is so popular on nights out - it's a social lubricant.

the underlying fact remains - and I’ve seen this first hand with my own DCs - that boys act out their ASD or ADHD on others, and girls turn it on themselves. Guess who gets the attention? The ones throwing chairs about ….

I haven’t read the full thread OP, but I must object to this. Not all children fit this stereotype! My own DS’s autism wasn’t picked up in nursery or at school for a few years precisely because he was quiet and flew under the radar. The teachers thought he was academically ‘weak’ (he isn’t, but he also has dyslexia which wasn’t identified either). Certainly he never threw chairs about. He had a MH breakdown instead aged 10.

Please don’t make assumptions. We get enough of them from people who have no experience of autism or neurodiversity, without getting them from the autistic community too.

This is a very safe thread, brilliant contributions.

Often the nuance and curiosity is shouted down on forums, MN is notorious for that unfortunately

Also interested in the masking thing which Im not articulate enough to describe why it doesnt make sense to say its evidence of ND as masking is a human trait, a universal one

Me personally, my 'true self' is constantly and utterly miserable and depressed, I could present that to the world as my own self. But who does that benefit, its unpleasant for me and unpleasant for others, so I dont, I fake it, I mask it.

Thanks for this. Are you able to summarise what the thread is saying maybe? I don't know whether it's just that I don't understand enough about psychiatry/neuroscience, but I found it pretty much incomprehensible 😆

My take on masking is that it is a universal human trait that arises from being social animals. Resources are finite and the best way to secure them (through sickness and health) is through group membership.

I think distinctions can be drawn as to why we mask, when we do it and the demand it places on us.

Posters on this board have shared the duress they experience when required to use preferred pronouns and pretend they think TWAW. Being expected to deny their deeply held values, beliefs and experience is intolerable for them. This sounds a lot like the experiences autistic people share with regard to feeling they have to conform to pretty standard social conventions. The fear of ostracism, bullying, being shamed etc. are similar, as is the overwhelm experienced when ‘conforming to expectations’.

Ditto. Either you get a worse result than you can by yourself or you're doing half the other group member work for them. There's no I in team? No, but there is in failure!

I'd bet half of today's boomer ND retirees on good pensions are only where they are now because of desks in rows facing the teachers at school and written timed exams.

Maybe the difference in masking is are they actually communicating what they want to communicate or understanding whats being communicated to them or does it just look to an observer that there was a succeful interaction or to the other person in the conversation.

If its succesful but tiring its could still be a difficulty but maybe its something else?

When i last said my son was masking it was during a hospital appointment. He is over 16 an increasingly deemed to have capacity.

They asked him questions, he politely gave answers and he mimiced their facial expressions, laughed when they did, looked concerned when they did. he suppressed his stimms. It looked like a perfect set of communication and he was exhausted by it.

But he didn't actually understand the questions and if i hadn't been there he wouldnt have been diagnosed with the physical condition. He gave socially appropriate answers, with socially appropriate facial expressions based in what he thought they should by copying the doctor and what he'd rehearsed in school. They bore no relation to reality.

He can have whole interactions that look fine but arent actually genuine communication at all.

I don’t know the validity of this write up about highly sensitive people (est 20-30% of the population) and it’s never made it to the D S M but it seems to cover a lot of what we’ve discussed.

then this is whacked in the middle.

there’s no hope for anyone if this shit isn’t properly researched and evidenced.

I once heard a piece on the radio (possibly? I’m not sure if it was another descriptor) about HSP people from an evolutionary perspective; that this type of person was extremely bonding for social set ups, sensitive to the needs of others, promoting social cohesion etc

https://www.verywellmind.com/highly-sensitive-persons-traits-that-create-more-stress-4126393

Masking is very common in people with dementia. They go to great lengths to cover up their loss of cognitive capacity.

@Fearfulsaints, this has similarities to my DD. She doesn't like to tell medical professionals that she is not fine, as she has leaned that the correct answer to "How are you?" is "Fine thank you, how are you?", which is useless in a clinical setting!

With a recent medical issue, we were told if it's infected she will be in pain. She didn't express feeling pain at any point - either because she has interoception difficulties or because she didn't want to be rude, I don't know - but there were visible manifestations of an infection within a couple of days.

This concept of masking is so tricky. Of course we all mask - I say "Lovely weekend thank you" when the real answer is "Shit weekend up all night with my suicidal daughter", but this does feel different to my DD's copying and pasting what she thinks are correct social responses. All they can look at in the autism assessment is, I guess, how far you get the responses socially wrong (and the self-reports of impact of masking I guess? But I don't think that that is part of the diagnostic criteria.)

Have seen the Fisher/Frith interview described as "harmful rhetoric" online. It is so redolent of the trans #nodebate debacle: "to challenge my thinking is to challenge my identity is to challenge my right to exist".