Does anyone else ever have skepticism over too many dx?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

[Anonymous]

My DC has ASD and ADHD and we do need different supports to work through them. I think both are correct and how we handle issues can be different depending on what seems to be the driver.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

You are mistaken!

-Adult who was a kid who did mask to that extent

[Anonymous]

Anonymous wrote:

Anonymous wrote:There are also evaluators who insist on certain dx’s despite some of the criteria not being met. It drives me crazy. They are too quick to jump to ASD when a kid seems quirky.

It's in vogue right now to identify "subtle" cases of ASD, based on the notion that these kids bear a significant mental health burden due to masking. And I am sure many kids do benefit from getting supports identified but I wonder if for others it becomes a needless source of stress and confusion.

that’s such a bizarre project. if the case is that “subtle” then the child doesn’t have to do much to fit in. the whole “masking” discourse seems to have taken something true (it can be taxing to be socially uncomfortable) to mean that there is a kind of hidden autism that has few actual symptoms.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

so the kid isn’t actually masking then? they are having difficulties at school but internalizing instead of externalizing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

You are mistaken!

-Adult who was a kid who did mask to that extent

I’m sorry, it’s just not possible that a kid with that laundry list of issues has not problem at school or in social settings outside the house.

[Anonymous]

It's an artificant of certain problems being privileged and awarded special treatment, usually due to the high social class of people who have thise problems and want to maintat their status. So the high class people are "twice exceptional", while people with same or different problems but lower class are treated like they are bad or stupid.

For some reason, society can't just be inclusive to everyone while rewarding people who demonstrate more useful talent.

[Anonymous]

What is the difference between "neurodivergent" "masking" and "neutotypical" "etiquette"?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

But pp I think you are talking more about hiding anxiety and depression, not hiding who you are fundamentally as a person.
Anxiety and depression yes are symptoms of an environment causing stress. But the masking discourse centers around the idea that some kids can appear so neurotypical that their autism - a diagnosis defined by social deficits - is not apparent to anyone else. I think that what you’re saying is that kids can completely hide their behaviors but it causes them stress. I think others are disputing that it’s possible to completely conceal them so they are 100% not evident. I don’t think anyone is disputing that kids are trying (and we all wish they did not have to try). I think people are disputing that they are in any way succeeding.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

But pp I think you are talking more about hiding anxiety and depression, not hiding who you are fundamentally as a person.
Anxiety and depression yes are symptoms of an environment causing stress. But the masking discourse centers around the idea that some kids can appear so neurotypical that their autism - a diagnosis defined by social deficits - is not apparent to anyone else. I think that what you’re saying is that kids can completely hide their behaviors but it causes them stress. I think others are disputing that it’s possible to completely conceal them so they are 100% not evident. I don’t think anyone is disputing that kids are trying (and we all wish they did not have to try). I think people are disputing that they are in any way succeeding.

I think the ASD is evident in subtle cases but it doesn't look like what people think it does. For example a person with ASD may be able to use eye contact, but they are acutely aware of it and it makes them uncomfortable. Some symptoms may not be apparent to others but they are apparent to the person experiencing them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

But pp I think you are talking more about hiding anxiety and depression, not hiding who you are fundamentally as a person.
Anxiety and depression yes are symptoms of an environment causing stress. But the masking discourse centers around the idea that some kids can appear so neurotypical that their autism - a diagnosis defined by social deficits - is not apparent to anyone else. I think that what you’re saying is that kids can completely hide their behaviors but it causes them stress. I think others are disputing that it’s possible to completely conceal them so they are 100% not evident. I don’t think anyone is disputing that kids are trying (and we all wish they did not have to try). I think people are disputing that they are in any way succeeding.

I think the ASD is evident in subtle cases but it doesn't look like what people think it does. For example a person with ASD may be able to use eye contact, but they are acutely aware of it and it makes them uncomfortable. Some symptoms may not be apparent to others but they are apparent to the person experiencing them.

This is the whole argument.
If someone has asd that is imperceptible to others for the 8-9h a day they are at school - for many years - is that truly autism? I don’t know the answer I’m just clarifying that the masking skepticism is NOT based on skepticism about the desire or the effort to conceal ‘behaviors’, it’s skepticism that any human being would actually be able to successfully pretend all day every day that they don’t have autism to the degree that it is undetected by teachers and classmates.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

But pp I think you are talking more about hiding anxiety and depression, not hiding who you are fundamentally as a person.
Anxiety and depression yes are symptoms of an environment causing stress. But the masking discourse centers around the idea that some kids can appear so neurotypical that their autism - a diagnosis defined by social deficits - is not apparent to anyone else. I think that what you’re saying is that kids can completely hide their behaviors but it causes them stress. I think others are disputing that it’s possible to completely conceal them so they are 100% not evident. I don’t think anyone is disputing that kids are trying (and we all wish they did not have to try). I think people are disputing that they are in any way succeeding.

I think the ASD is evident in subtle cases but it doesn't look like what people think it does. For example a person with ASD may be able to use eye contact, but they are acutely aware of it and it makes them uncomfortable. Some symptoms may not be apparent to others but they are apparent to the person experiencing them.

This is the whole argument.
If someone has asd that is imperceptible to others for the 8-9h a day they are at school - for many years - is that truly autism? I don’t know the answer I’m just clarifying that the masking skepticism is NOT based on skepticism about the desire or the effort to conceal ‘behaviors’, it’s skepticism that any human being would actually be able to successfully pretend all day every day that they don’t have autism to the degree that it is undetected by teachers and classmates.

It depends on your definition of "successfully". If you mean that others can't identify they have autism, I mean people pay thousands to experts for a diagnosis so I don't think it's reasonable to say well everyone needs to be able to know you have autism specifically. They may be showing it in other ways. They may make mistakes and people just think they are being rude. They may be overwhelmed and zone out a lot.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.

I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.

Eyeroll. You think wrong.

would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.

(For clarification, I am the eyeroll PP but not the original PP who said "maybe we're just lousy parents" - although I feel similarly.)

Anecdotes don't equal data and I have only personal experience as I haven't had time to go looking for data, but in my experience, this is exactly what is happening - yes, my kid would deliberately hide his condition, or more specifically his distress, at school. I have watched him tell a counselor - one he knows and trusts - that he's fine now and would take their advice and go back to the classroom, even with me sitting right next to him pointing out that's not what he told me a minute ago, and then the instant the counselor left, he burst into tears and saying "no actually I can't do this! please don't make me go back!" He could hide a full-blown panic attack in the middle of the lunchroom with no one the wiser, until he was in a safe space. He would spend every ounce of energy he had to bottle up his distress and just get through the school day without crying, because he could not stand for people to see him cry. (Never mind that its not physically possible to learn under that level of stress.) And then as soon as he got home, the dam would break and alllllll that distress would come spilling out.

"Behavior issues" are not the only symptoms. Behavior is communication, and behavior issues are signals to the outside world that something is wrong. But the absence of obvious signals doesn't necessarily equal an absence of problems. It just means you may need to look harder to find them. Especially in a typical large classroom environment, one can absolutely have symptoms that fly under the radar because they aren't obvious as "issues" in that environment.

"Deficits in social-emotional reciprocity" can look like talking too much / dominating the conversation, or it can look like not talking at all. "Deficits in nonverbal communicative behaviors" can look like refusal to make eye contact and making strange hand gestures, or it can look like staring straight at you and not moving (and likely not actually absorbing anything you say). "Restricted, repetitive patterns of behavior, interests, or activities" can be less than obvious when the interest itself is not that abnormal, but the intensity or focus is - like the 13yo boy who will talk about Minecraft for 4 hours but who can't hold a typical conversation about anything else.

Which of these is likely to get overlooked in a middle school classroom with 40 kids? Does that mean those symptoms don't "count"? Middle schoolers can be CRUEL - do you blame the kid for learning their peers will make fun of them if they flap their arms or walk on their toes and learn to only do that at home? Do you blame the kid with crippling anxiety for not drawing *any* attention to themselves? Do you blame the kid for trusting their mom enough to say "I hate school so much I wish I could die", but not being able to say that to a school counselor?

so the kid isn’t actually masking then? they are having difficulties at school but internalizing instead of externalizing.

Not the PP, but I think masking and internalizing are pretty much the same thing. A way of pretending to outsiders that you are fine when you aren't. So the problems won't show up on the checklists that teachers complete, making it more difficult to get a diagnosis. And it comes at a very high cost.

[Anonymous]

Many of these things are not actual diagnosis and the actual diagnosis are basically checklists so it's easy to qualify. Sensory issues is not a diagnosis. Its an OT term for billing.

[Anonymous]

Anonymous wrote:Many of these things are not actual diagnosis and the actual diagnosis are basically checklists so it's easy to qualify. Sensory issues is not a diagnosis. Its an OT term for billing.

It's a symptom. It's not a diagnosis but that doesn't mean it's not real.