Is It Really Autism?
There are many symptoms of Autism Spectrum Disorder (ASD) that people readily talk about, including avoiding eye contact, difficulty with transitions, abnormal social approach and conversation, deficit in developing and maintaining relationships, and repetitive behaviors. However, sometimes children-young adults are successful in their school environments and at times appear to be getting better at some of these “autistic-like” behaviors. Often individuals with high functioning autism spectrum disorder (HFASD) go undetected throughout their childhood and only realize there is a significant problem in late adolescence or early adulthood when their coping skills do not match the increased stress and demands of adulthood responsibilities. Without accurate diagnoses and support, these individuals often develop additional mental health problems, including symptoms of depression and anxiety that exacerbate the underlying problem that has been present throughout their early developmental period. Getting diagnosed leads to receiving the support necessary to continue to be happy and flourishing throughout the lifespan.
Did you know that there are many ASD symptoms that may be better accounted for as a different disorder, such as Social Communication Disorder, Nonverbal Learning Disorder (NLD), or a Social Anxiety Disorder? A Social Communication Disorder is different from ASD in that these individuals are lacking (and never demonstrated in their developmental history) the restricted, repetitive patterns of behavior, interests, or activities necessary for an ASD diagnosis. Children/adults with Social Communication Disorder have difficulties in effective communication, participating in social activities, developing friendships and interpersonal relationships and often have problems in academic achievement or occupational performance due to their social problems.
Nonverbal Learning Disorder is often overlooked and not recognized because it is not listed as an official diagnosis in the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). However, many people who appear to be on the autism spectrum have additional difficulties in visual-spatial processing and motor development that are characteristic of NLD. There are three categories of dysfunction that present themselves in individuals with NLD: (1) motoric (e.g., lack of coordination, severe balance problems and/or difficulties with fine graphomotor skills), (2) visual-spatial-organizational (e.g., lack of image, poor visual recall, faulty spatial perceptions, and/or difficulties with spatial relations), (3) social (e.g., lack of ability to comprehend nonverbal communication, difficulties adjusting to transitions and novel situations, an/or significant deficits in social judgment and social interaction). In their early years, children with NLD often appear confused despite a high intelligence and high scores on receptive and expressive language measures. In addition, individuals with NLD have proficient verbal processing skills, but have extreme difficulty receiving and comprehending nonverbal information and therefore cope by relying upon language as their principal means of social relating, information gathering and relief from anxiety. Due to their high verbal skills, individuals with NLD often go undiagnosed for many years.
Children with Social Anxiety Disorder often exhibit behaviors that may appear to be autistic-like because of their unusual responses, including freezing, shrinking, clinging, failing to speak when spoken to, and avoidance of social situations. An important difference between ASD and Social Anxiety Disorder responses is the intense fear and scrutiny that individuals with Social Anxiety Disorder feel in social situations. Individuals with Social Anxiety Disorder believe they are constantly being evaluated and will likely be embarrassed or humiliated by their own actions at any time. More often individuals with ASD are indifferent to the approaches of others and will often engage in their own interests/activities despite the norm. However, it is important to note that many people with ASD develop symptoms of anxiety as they become unable to cope with increasing social demands. Social Anxiety Disorder is treated differently than ASD.
So, how is a parent or adult able to determine which diagnosis is appropriate for them? Many symptoms overlap in many different diagnoses. However, each person is unique with a different biological framework, a different developmental progression, and a different supportive network. All of these factors combine when determining an accurate diagnosis. With accurate diagnosis comes clarity, understanding, and the ability to move forward. Getting tested is essential in finding the accurate diagnosis and beginning a new, informed life with appropriate supports.