Autism: Why Is It Sometimes Overlooked?

Early diagnosis and intervention for individuals with Autism can help establish meaningful treatment goals in therapy and ensure that the needs of the individual are being met. It can also make a significant difference in understanding an individual’s perspective and alleviate the stress and confusion that may come with misdiagnosis. Often an individual with Autism may receive several diagnoses such as ADHD, Oppositional Defiance Disorder, or an anxiety disorder before reaching an accurate diagnosis. While many of these disorders can overlap, an autism diagnosis that may be more appropriate is sometimes overlooked. Misdiagnosis can lead to improper treatment and cause additional stress and frustration for the individuals and families involved. An accurate diagnosis is key in providing individuals with the tools they would benefit the most from and prevents further escalation of symptoms.

What is Autism?

The American Psychiatric Association defines Autism as “a complex developmental condition involving persistent challenges with social communication, restricted interests, and repetitive behavior.” (2023). An individual with Autism has a different way of thinking and processing their world. Autism is not exclusive to only one population or group of people and can present differently from individual to individual. There are several common misconceptions and harmful stereotypes that often result in a delayed Autism diagnosis. Some of these negative assumptions are that to be Autistic you have little to no emotion, lack empathy, or have no social relationships. Individuals with Autism have expressed just how untrue that perception is. The TED Talk by Ethan Lisi “What it’s really like to have Autism” goes into detail in how wrong these misconceptions are and is a must watch for anyone looking to better understand Autism.

How Autism Can Present Differently

Autism is often overlooked as a diagnosis when an individual uses “masking” by camouflaging behaviors or difficulties. Sometimes an individual can get by in these situations and it becomes more apparent there are some concerns once the demand or environment exceeds the skill level or ability of the individual to continue masking. It can make behaviors or concerns seem to “come out of nowhere” when they may have been there all along. The ability to mask does not mean that there are still no concerns or difficulties the individual is experiencing. The presentation of Autism looks different between individuals and even differs between genders. Autism research and guidelines largely focused on boys and can cause girls with autism to be missed. Girls with autism may not exhibit the same degree of repetitive interests or behavior or their fixed interests may be viewed as socially more acceptable than what would usually raise concerns in boys presenting with autism. This can cause girls to be overlooked when considering an autism diagnosis because they don’t fit the stereotypes people have when thinking about autism.

Distinguishing Autism between Other Diagnosis

There are several diagnoses that can present similarly to Autism. It is important when discussing presenting problems and symptoms to try and distinguish the “why” of what is happening. For example, an individual with social anxiety experiences fear in social or performance situations that they think could result in embarrassment or scrutiny. While an individual with autism may have difficulties in social situations because of sensory reasons such as loud sounds, bright lights, or the amount of people that manifest in the similar behaviors. It is important to distinguish what these behaviors are trying to communicate to us and the best method of helping them through these difficult moments. If you have questions about autism and similar diagnoses speak with your therapist or other medical professionals to help determine the best evaluations and next steps.

by: Dawn Ruane

LAC References American Psychiatric Association. (2023). What is Autism Spectrum Disorder? – What Is Autism Spectrum Disorder? families/autism/what-is-autism-spectrum-disorder

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