If it is all due to the wiring of the brain, where do people that have some of the traits fit in?

[Lydia Z]

I took my daughter who is almost 4 to see an autism specialist for her speech delay and some behavior issues. The specialist says, she has some rigid/repetitive behavior and some autistic traits but at the same time she has good eye contact and is good with social/ new situations. He said she would have been diagnosed with PDD/NOS but does not think she is on the spectrum. He also wants us to watch out for conduct disorder? and ADHD once she enters elementary school. I am confused with all this and worried that as she grows older the traits can show up more and she can experience anxiety/depression and suffer because of a specialist who thinks he's doing me a favor by not diagnosing her. I understand when he says she does not have all the traits but she has great difficulty with transitions, she spins herself and her toys, she lines up trains and cars. My question is, If it is all due to the wiring of the brain, where do people that have some of the traits fit in? should they not be diagnosed because half the symptoms? what does that even look like in the brain?

 

[Tom]

The descriptive term 'wiring in the brain' is more like an analogy then evidence based fact. There are studies pointing to different brain characteristics between ASD and NT people, but much is activity levels detected in the brain. No one can give a wiring diagram for autistics. This is because it is still not well understood.

I am not sure my understanding is any better, but think of it as different factors affecting brain development. Some effect it more then others, and there is much variation.

 

[Mary Anne]

Welcome to my world. At nearly age 62 I have lived an entire life with some of the intense autism aspects which have totally screwed up my life. But not enough aspects to make anyone understand that I am on the spectrum. Luckily, there is way more awareness, education, treatments, and understandings for your little girl, whatever may happen as she matures.

 

[Mia]

That's why they refer to it as the autism spectrum. The DSM was very specific about traits. And although autism was originally classified under mental disorders, it was removed from the diagnostic and statistical manual, because it's not a mental illness. The spectrum includes low-functioning all the way to the high functioning.

Fact is, with females, there has not been all that much in the way of studies of them to base classifications on for diagnosis unless they are extremely low functioning. Most of the scientific studies had been done on boys. Unless your child has difficulty with words and speech, and learning and functioning in everyday life and is unable to go to a regular school.

Then it's likely that a specialist will not diagnose ASD, they might for example mention some behavioral difficulties. It really is dependent on the professional doing the evaluation. If you wish to have your child diagnosed, and she presents with many of the traits. Finding someone else to diagnose would be better. Often, females are not diagnosed, because they tend toward being socialized early and have better eye contact and social skills than boys. They differ from the absolute diagnosis, but still have ASD. Find someone else who is less constricted by the DSM, and is able to think beyond its absolute specifications.

 

[Lydia Z]

Welcome to my world. At nearly age 62 I have lived an entire life with some of the intense autism aspects which have totally screwed up my life. But not enough aspects to make anyone understand that I am on the spectrum. Luckily, there is way more awareness, education, treatments, and understandings for your little girl, whatever may happen as she matures.

That is exactly my concern for her as she grows older those traits might disappear or become more. How does one see a child for an hour and determine what they have or not. I was hoping to get a better understanding of what she might have after seeing the specialist but i'm more confused now. I don't know how to help her because I don't understand what triggers those behaviors for her. I am just lost.

 

[Lydia Z]

That's why they refer to it as the autism spectrum. The DSM was very specific about traits. And although autism was originally classified under mental illness, it was removed from the diagnostic and statistical manual, because it's not a mental illness. The spectrum includes low-functioning all the way to the high functioning.

Fact is, with females, there has not been all that much in the way of studies of them to base classifications on for diagnosis unless they are extremely low functioning. Most of the scientific studies had been done on boys. Unless your child has difficulty with words and speech, and learning and functioning in everyday life and is unable to go to a regular school.

Then it's likely that a specialist will not diagnose ASD, they might for example mention some behavioral difficulties. It really is dependent on the professional doing the evaluation. If you wish to have your child diagnosed, and she presents with many of the traits. Finding someone else to diagnose would be better. Often, females are not diagnosed, because they tend toward being socialized early and have better eye contact and social skills than boys. They differ from the absolute diagnosis, but still have ASD. Find someone else who is less constricted by the DSM, and is able to think beyond its absolute specifications.

It isn't that it was my wish for her to be diagnosed but wanting to have a better understanding of the criteria for their diagnosis. Those people that end up having 5 of the criteria and with many of the traits don't qualify to be diagnosis, is that because of insurance/politics reasons or an actual medical reasoning. what reason do they have that a person with 5 of the criteria will have a better grasp of life than that of a person with the 6 criteria and gets diagnosed. It does not make sense to me at all.

 

[Mia]

It isn't that it was my wish for her to be diagnosed but wanting to have a better understanding of the criteria for their diagnosis. Those people that end up having 5 of the criteria and with many of the traits don't qualify to be diagnosis, is that because of insurance/politics reasons or an actual medical reasoning. what reason do they have that a person with 5 of the criteria will have a better grasp of life than that of a person with the 6 criteria and gets diagnosed. It does not make sense to me at all.

There are ASD specialists who understand autism in girls specifically. And they are difficult to find. If you go to a specialist, they might be a generalist who has decided to use only the DSM, which is no longer used in some countries, so someone with autism must have all the traits. Girls tend toward being diagnosed with PDD/NOS or other disorders and rarely autism. Depends on the country, and it's training of psychiatrists, therapists, and whatever school of thought they have decided to use and study. Some accept certain criteria and others do not. Some countries specialists do not recognize ASD.

 

[MrSpock]

Those people that end up having 5 of the criteria and with many of the traits don't qualify to be diagnosis, is that because of insurance/politics reasons or an actual medical reasoning. what reason do they have that a person with 5 of the criteria will have a better grasp of life than that of a person with the 6 criteria and gets diagnosed. It does not make sense to me at all.

If a person with two of the criteria were considered 'normal', and a person with fifty of the criteria were considered autistic I don't imagine you'd have a problem with that. A line must be drawn somewhere. I agree that some arbitrary number is a poor way of distinguishing, the total impact on a person's life would be a much better way, however it's also much more difficult to assess and put a number on that. Different diagnosticians might have wildly different interpretations of that, I suppose that the way that they've adopted is likely to generate more consistent results. A very difficult condition to have different people ascribe consistent labelling to.

This really sucks for you if your purpose is to have your child attend different programmes, or be treated differently in any official capacity. As suggested above, a different health professional may allow you to get around this. If your purpose is to learn how you might better look after your child, I don't think it matters too much what the official status is. Although there are cumulative effects, each autistic trait is it's own thing, and one might profitably adjust things in light of that trait regardless of the presence or absence of other traits or diagnoses, very roughly speaking. Of course to some degree everything effects everything else.

 

[Gracey]

...I don't know how to help her because I don't understand what triggers those behaviors for her. I am just lost...

She’ll be fine, sounds like she has a great mum

Would it be worth asking the assessor what swung it towards conduct disorder or possible adhd and definitely NOT ASD?

Ask for a second opinion?

I’m sorry you didn’t get the answer you’d hoped for and feel more confused than ever.

You know your daughter better than anyone else alive today, should you still suspect the spectrum to explain your daughters development, It would be my own suggestion to treat it as such and research successful methods to help reduce triggers and bring on progress in certain areas.
See if that helps?
If it’s helping over a period of time you may be on the right track
If it doesn’t help, back to the drawing board.

Don’t rule out the other possibilities just yet.
She’s still very young.

Lots of adult females do okay.
They manage well enough.

 

[Mattymatt]

Welcome to my world. At nearly age 62 I have lived an entire life with some of the intense autism aspects which have totally screwed up my life. But not enough aspects to make anyone understand that I am on the spectrum. Luckily, there is way more awareness, education, treatments, and understandings for your little girl, whatever may happen as she matures.

And treatment and understanding of Autism continues to advance by leaps and bounds. She'll be better off than me when she reaches adulthood.

 

[clg114]

It isn't that it was my wish for her to be diagnosed but wanting to have a better understanding of the criteria for their diagnosis. Those people that end up having 5 of the criteria and with many of the traits don't qualify to be diagnosis, is that because of insurance/politics reasons or an actual medical reasoning. what reason do they have that a person with 5 of the criteria will have a better grasp of life than that of a person with the 6 criteria and gets diagnosed. It does not make sense to me at all.

I believe that the DSM-5 was created with more political and economic reasons in mind than medical reasoning. It seems like it is a lot harder to get a diagnosis with the DMS-5 than it was with the DMS-4. Maybe it would help to go to a doctor with a lot of experience with autism.