being a mom
What My Daughterâ€™s Diagnosis Has Taught Me About Autism
Well, Mommyish friends, itâ€™s time for me to eat a little humble pie. Six months ago, I vented some spleen about people making snap diagnoses of my daughter for being introverted. At the time, I was frustrated that weâ€™d done basic screenings multiple times, always getting the response that there didnâ€™t seem to be an issue.
But at the beginning of December, we got a diagnosis, and yes, Alicia is on the autism spectrum.
It has been an interesting journey, because we came to her diagnosis in a very roundabout way. As I wrote over the summer, speech therapy seemed to be making a big difference to Alicia. In the fall, she was referred to a program at our regional hospital, which would offer a more in-depth assessment of her speech and language â€“ and the assessment showed that, in addition to the sounds she was pronouncing incorrectly, there were some subtle oddities in her language use that needed further investigation.
We got lucky and got a cancellation spot at the pediatricianâ€™s office; a month after that, Alicia had a developmental assessment (a process that is probably worth writing about all on its own!) At the end of the assessment, we had our diagnosis of autism spectrum disorder, a referral to a preschool intervention program, and, unsurprisingly, an awful lot of questions.
As is my way, Iâ€™ve been reading everything I can get my hands on about ASD. And although I have a great deal still to learn, both generally and with regards to the specifics of Aliciaâ€™s situation, I wanted to share the things Iâ€™ve already learned from her diagnosis.
Â Autism Doesnâ€™t Look The Way We Think
Our image of kids on the spectrum is based on the extremes. When you think of an autistic child, you might imagine a non-verbal child melting down from sensory overload, or one of the savants you read about who can do college-level math in elementary school. That image has been slanted by how kids were diagnosed in the past: unless they really struggled with day to day life, or demonstrated a startling ability, they simply werenâ€™t diagnosed at all.
Aliciaâ€™s developmental assessment team gave me a list of suggested websites to consult, and one of them led me to a 2014 CDC report on autism which shows an incidence rate of 1 in 68 kids. You donâ€™t have to be a math savant to realize that means there are an awful lot of autistic kids (and adults) out there. Until the diagnostic criteria changed â€“ a change thatâ€™s pretty recent â€“ people who didnâ€™t have trouble functioning or start playing the piano like a virtuoso at 4 were just considered the oddball kids, the ones who followed a different drummer. Thinking about it now, Iâ€™d guess that I know several adults who might have been diagnosed with ASD if they were kids today.
My impression of what autism looks like wasnâ€™t wrong for some kids; it just wasnâ€™t right for all cases.
The Screening Questions Can Be Deceptive
Part of my frustration with getting the autism screening questions over and over was that none of them applied to Alicia. She never missed a milestone. She showed and looked for affection. She didnâ€™t flap her hands or rock. She didnâ€™t have frequent meltdowns â€“ in fact, she had far, far fewer than her drama queen older brother. And she was certainly interested in playing with other kids, although she did best with small groups. The only â€œred flagâ€ by most screening tests was late toilet training, but considering her brother was also a late trainer, I put that down to genetics more than anything. Out of curiosity, I did a quick screening test on one of my recommended sites; Alicia scored as low risk for ASD.
The issues that Alicia demonstrates are a lot more subtle than that. For example, she has trouble telling people a story: she doesnâ€™t understand that you donâ€™t know what she knows, or what order to give information. She has trouble focusing on people long enough to understand instructions, or to have a social interaction that goes deeper than a quick hello. And her imaginary world â€“ which is vivid and quite amazingly complex â€“ is often more interesting to her than a person right next to her trying to get her attention.
Iâ€™ve heard that some of this probably stems from how ASD manifests differently in girls than in boys, which may be true. But what it meant for us was confusion: every time a anyone brought up the possibility of ASD, the checklists we were given seemed to rule it out.
Autism Is Not A Personality Type
In retrospect, Iâ€™m kicking myself for not getting this earlier. Alicia being introverted didnâ€™t rule out Alicia being on the spectrum â€“ after all, there are introverted autistic people and extraverted autistic people. Just like any other personality descriptor you can throw out there, theyâ€™re not mutually exclusive.
I think Aliciaâ€™s introversion (which I recognize as an echo of my own) muddied the waters for me. I understood what it was like to only want to deal with a few kids at a time, or to need quiet time in my room to â€œrecharge my batteries.â€ But looking at it now, Iâ€™d venture to guess that sheâ€™s closer to the middle of the introvert/extravert scale than I would have thought.