June 19, 2024 • 10 mins
There are many adults with autism, but they just don't know it yet. Part of the reason is what we're going to bring out in the next few minutes. I was diagnosed as autistic as an adult, and there were reasons it was missed in my childhood. Let's talk about that.
According to the DSM-5-TR, the diagnostic criteria for autism spectrum disorder include persistent deficits in social communication and social interaction across multiple contexts. These can be misconstrued. For example, I don't have problems having conversations; I just hate small talk. During testing, I realized I prefer direct communication and can talk for ages about topics of keen interest.
Deficits in non-verbal communicative behaviors used for social interaction is another criterion. This ranges from poorly integrated verbal and non-verbal communication to abnormalities in eye contact and body language. For instance, I'm not a big fan of eye contact; it feels like a threat. People who know me understand I'm listening even if I'm not making direct eye contact.
Maintaining and understanding relationships can also be challenging. I don't have many friends, and I often don't maintain relationships because they don't align with my interests. It's not about being adverse to relationships but rather not wanting to engage in activities that don't interest me.
Restricted repetitive patterns of behavior, interests, or activities are also part of the diagnostic criteria. This can include stereotyped or repetitive motor movements, use of objects or speech, insistence on sameness, highly restricted interests, and hyper or hypo activity to sensory input.
Symptoms must be present in the early developmental period but may not become fully manifest until social demands exceed limited capacities. This means you might have had symptoms as a child, but they weren't noticeable until social pressures increased.
Autism can exist without intellectual or language impairments. It's important to understand that you can be highly intellectual and still be autistic. The severity levels range from requiring support to substantial support.
If you think you might be autistic, it's okay to get checked out. Advocate for yourself and bring your concerns to your doctor. Remember, it's not about just feeling different; it's about understanding and managing your unique experiences.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
There are many adults with autism, but they just don't know it yet.
Part of the reason is what we're going to bring out in the next few minutes.
I was diagnosed as autistic as an adult, and there was reasons it was missed in my childhood.
Let's talk about that. According to the DSM-5-TR, the diagnostic criteria for
autism spectrum disorder has persistent deficits in social communication and
(00:25):
social interaction across multiple contexts, sex,
which is the impact of having a deficit in social, emotional reciprocity,
abnormal social approach and failure to have normal back and forth conversation.
This can be misconstrued.
I don't have problems having conversations. I just hate small talk,
which came up during the testing. I'm not a big fan of the small talk,
(00:47):
like just get to the point.
And if you're on a topic, which we call hot topics, then we can talk for ages.
So don't let it fool you if you're thinking, well you can talk in public
is it about things that you already have a keen interest and do
you enjoy small talk if you in small talk quite
quickly we need to move on deficits and non-verbal communicative communicative
(01:07):
behaviors used for social interaction this ranges from poorly integrated verbal
and non-verbal communication abnormalities in eye contact and body language
or deficits in understanding the use of gestures don't let that overwhelm you
it simply means this we act different.
Granted, but that's a lot of people. So that one, we're just going to put on
the shelf. That's a lot of people.
(01:27):
I'm not a big fan of eye contact. To me, it seems like a threat.
If you're going to stare at me in the eye, I am going to look at you in the
eye. I can look at people in the eye, but it's, do you do that normally?
What I found out is that I don't make eye contact all the time.
Now, most people know me, so they know I'm not, and they know I'm still listening,
but that can be a symptom.
So it's kind of a looking away quite constantly, maybe Maybe looking at the
(01:49):
forehead, looking at the nose, but you don't make that direct eye contact.
That's a big one for me, but you can fake it.
Don't let the difference between you masking and staring at somebody in the
eye and thinking about it, right?
So if you're staring at somebody in the eyes and they're looking at you in the
eyes and the whole time, you're just kind of like, man, I wish they would look away.
That counts. Make sure you bring that up.
(02:11):
Number three, deficits in developing and maintaining and understanding relationships.
That's a difficult one to answer because everyone has relationships.
I don't have many. I can just look now and I can count my friends on one hand
if I can actually call all of them friends.
So it's not always in creating the relationship, but sometimes in maintaining.
And for me, it's just, I just don't want to.
A lot of the former relationships were just...
(02:33):
In essence, a waste of time. It was just doing the normal stuff.
It wasn't at my keen interest, so I can let that go.
It's not that I'm negative, adverse towards them. I just don't care to be around them all that much.
Now, B, those are the first three in A. Here's B.
Restricted repetitive patterns of behavior, interests, or activities as manifested
by at least two of these four. Two of the four.
(02:57):
Stereotyped or repetitive motor movements, use of objects or speech.
Now, pay attention to all of it.
So it's not just the movements, right? It's not just walking on the toes, but the use of objects.
Do you have little pet objects, little things that you carry around for whatever reason?
There might be a reason or speech. Do you have little sayings that you come
up with that only you get and only you understand, but you still might say them?
(03:18):
Watch for little things like that. Number two, insistence on sameness.
They say it's got to be an inflexible adherence to routines.
When you're young, maybe as an adult, you've learned to mask.
So you're You're not so inflexible, but you still would like things to be according to plan.
People might call you cantankerous. They might think you're just being rude,
but you just prefer the routine and it can come on in a lot of different ways.
(03:41):
Number three, here's a big one. Highly restricted, fixated interests that are
abnormal in intensity or focus. What does abnormal mean there?
So yeah, I'm highly, highly focused on things that I have a preoccupation on.
And sometimes that means I'm
not going to be focused on things that I should be paying attention to.
Highly restricted and fixated. So you have maybe two, maybe three keen interests
(04:03):
that you really just run to a lot.
And number four gets underreported. That's why we made a short about it.
Hyper or hypo activity to sensory input or unusual interest in sensory aspects
of the environment, lights, pain, temperature.
Now, remember, this is hypo or hyper. I've had both. I operate in both.
There's times when I'm hyper reactive, right?
(04:25):
So there's hyper activity, Like when we talked about in the OCD insiders,
the floors and the cracks in the floors, there's a hyper reactivity, right?
There's a physiological response, but then there's the hypo.
Sometimes it doesn't even bother me. I have both in the same system.
Watch for both. Maybe you have one, maybe you have the other.
Certain lights. There's a computer I used to sit in front of and had that.
I forgot what it's called, but a certain light that comes from that computer
screen, I would get sick.
(04:47):
Then no, as soon as I walk away from the screen, I'd feel better.
So I sit back down until I realized it's the light in that screen that was actually making me sick.
I was having a physiological response to the light.
Something to pay attention to. Number letter C.
Symptoms must be present in the early development period. Now pay attention
to this. This is where a lot of people miss. This is why I was not diagnosed as a kid.
(05:09):
Symptoms must be present in the early developmental period, but may not become
fully manifest until social demands exceed limited capacities,
which simply means this.
You had it as a kid. It was there. But until the social situation pressures
you, you don't really know it's there.
You're able to hide it basically as a child so it doesn't get seen.
(05:31):
And if it doesn't get seen as a child, most doctors just throw it out there
to say, well, you should have been diagnosed as a kid and they don't even look
anymore. But if the social demands now are exceeding your capacity to quote
unquote fake it and to be normal, then it starts to emerge.
So make sure you understand that. So when you talk to your doctors,
they understand. I had to educate my doctors.
(05:54):
And let's see, letter E. These disturbances are not better explained by intellectual disability.
Okay. Now I know I skipped D, but it goes into clinically significant impairment.
So here's where it got fun for me, the specifiers.
Most of the time when you talk about autism, there's either an intellectual
impairment or a language impairment, but now these are specifiers. So pay attention.
(06:20):
You can be actually highly intellectual. You can be intelligent and not have
any speech impairments and still be autistic.
I think what they're doing and what we know they did is they lumped together
Asperger's and autism, and they kind of made it just one spectrum.
But if the stereotype, now the stereotype or the dominant number of people have
(06:41):
both intellectual and language impairments and you don't have it,
you're going to assume you're not autistic and you can be autistic and still
have a high IQ and not sound like it. Okay.
It's right there under the specifiers. And in fact, I have a specifier that
says without language impairment and without accompanying intellectual impairment.
But if that's, if you're thinking like I used to, those are supposed to be symptoms.
(07:02):
And without those two, what are we doing here? Wrong. You can still be autistic.
Now there's severity levels requiring support, requiring substantial support,
requiring very substantial support.
So most people are on level one, right? You require some support.
I didn't even think about it, but there are certain things that I would do and
certain things I wouldn't do.
(07:23):
And people just picked up around me. They just knew like for whatever reason,
for the longest time I had friends that would come over and pay my bills.
They would stay out on the table. I'd get them. I'd sit them down.
I meant to to get to them, I never did.
And so people just said, hey, and I trusted them. They had access to my bank
account and they just took care of that for me.
I really appreciated that so I could get back to my areas of interest.
It was that severe and people recognized it, but we just didn't talk about it.
(07:45):
It was just what happened.
You could be different. Where do people support you? Where are you requiring
support? Where are you lacking?
Do you have those keen interests that you love to get back to?
And sometimes you forget about other stuff because you're in those keen interests.
Do not forget about the sensory input. Do you have unusual sensory aspects?
You feel temperatures different. Do things feel different? Do cloth feel different?
(08:09):
Do you find yourself just feeling cloth or blankets or pillows?
As a child, I used to get in trouble for just twisting the blanket.
It was one of my things. I used to just twist the blanket. I just liked the
way it felt on my hand. Didn't know why. Didn't ask.
But as a child, I would always twist that blanket. My dad would say,
stop twisting that blanket.
So I'd stop until he wasn't looking. Then I would start again.
It became a habit. It was a sensory input.
(08:29):
These are things that came out later. Because for me, the sensory input got
worse as I got older. It didn't get better.
The lights were having a greater impact on me. The cloth and the things.
Like I can't wear certain shirts like cotton. I can't wear cotton shirts or
anything like that. That, for you, it can be different. But I want you to pay attention.
You could be an adult with autism and not know it because of the quote-unquote
(08:52):
stereotypical presentation of autism online or on TV shows. And we're going
to do a whole podcast about that.
There's a couple of good representations on TV, but most are not.
But I want you to think about some of those things. Think about if you've been missed.
It's not about just feeling different. And there's a couple of autism tests.
There's an autism spectrum quotient test online. I've taken it probably about
(09:12):
10, 15 times. I've actually felt it a few times.
I answer different sometimes just for the fun of it Go ahead and use them,
Because I showed those results to my uh psychologist and she used them She was
she was really wise in that and then we were able to get the actual official diagnosis later on
But if you think you are If you think you are just could be an indication that
you might be and it's okay to get checked out It's okay to find out So remember
(09:36):
you have to advocate for yourself bring up to your doctors.
Hey, yes, I can have I can have social norm. I can have conversation,
but I just don't. I used to go home angry, anxious and depressed after being
in social situations. My doctor picked up on that.
I want you to pick up on that. See, it's not like you can't be out there and
you can even fit in and everybody thinks.
But when you come home, you're drained. And when they go home, they're exhilarated.
(09:59):
When you come home, you're just tapped out because you were masking the entire
time. It felt like people were draining from you because you're smiling and
you want to get back to your fixed interest You want to do what you want to do?
You don't want to make eye contact and so it drains you as a child.
You have meltdowns As adults you just have breakdowns So be privy to some of
these things we'll dive back into it later on but for now call morbidity city turning off the lights.
There are many adults with autism, but they just don't know it yet.
Part of the reason is what we're going to bring out in the next few minutes.
I was diagnosed as autistic as an adult, and there was reasons it was missed in my childhood.
Let's talk about that. According to the DSM-5-TR, the diagnostic criteria for
autism spectrum disorder has persistent deficits in social communication and
(00:25):
social interaction across multiple contexts, sex,
which is the impact of having a deficit in social, emotional reciprocity,
abnormal social approach and failure to have normal back and forth conversation.
This can be misconstrued.
I don't have problems having conversations. I just hate small talk,
which came up during the testing. I'm not a big fan of the small talk,
(00:47):
like just get to the point.
And if you're on a topic, which we call hot topics, then we can talk for ages.
So don't let it fool you if you're thinking, well you can talk in public
is it about things that you already have a keen interest and do
you enjoy small talk if you in small talk quite
quickly we need to move on deficits and non-verbal communicative communicative
(01:07):
behaviors used for social interaction this ranges from poorly integrated verbal
and non-verbal communication abnormalities in eye contact and body language
or deficits in understanding the use of gestures don't let that overwhelm you
it simply means this we act different.
Granted, but that's a lot of people. So that one, we're just going to put on
the shelf. That's a lot of people.
(01:27):
I'm not a big fan of eye contact. To me, it seems like a threat.
If you're going to stare at me in the eye, I am going to look at you in the
eye. I can look at people in the eye, but it's, do you do that normally?
What I found out is that I don't make eye contact all the time.
Now, most people know me, so they know I'm not, and they know I'm still listening,
but that can be a symptom.
So it's kind of a looking away quite constantly, maybe Maybe looking at the
(01:49):
forehead, looking at the nose, but you don't make that direct eye contact.
That's a big one for me, but you can fake it.
Don't let the difference between you masking and staring at somebody in the
eye and thinking about it, right?
So if you're staring at somebody in the eyes and they're looking at you in the
eyes and the whole time, you're just kind of like, man, I wish they would look away.
That counts. Make sure you bring that up.
(02:11):
Number three, deficits in developing and maintaining and understanding relationships.
That's a difficult one to answer because everyone has relationships.
I don't have many. I can just look now and I can count my friends on one hand
if I can actually call all of them friends.
So it's not always in creating the relationship, but sometimes in maintaining.
And for me, it's just, I just don't want to.
A lot of the former relationships were just...
(02:33):
In essence, a waste of time. It was just doing the normal stuff.
It wasn't at my keen interest, so I can let that go.
It's not that I'm negative, adverse towards them. I just don't care to be around them all that much.
Now, B, those are the first three in A. Here's B.
Restricted repetitive patterns of behavior, interests, or activities as manifested
by at least two of these four. Two of the four.
(02:57):
Stereotyped or repetitive motor movements, use of objects or speech.
Now, pay attention to all of it.
So it's not just the movements, right? It's not just walking on the toes, but the use of objects.
Do you have little pet objects, little things that you carry around for whatever reason?
There might be a reason or speech. Do you have little sayings that you come
up with that only you get and only you understand, but you still might say them?
(03:18):
Watch for little things like that. Number two, insistence on sameness.
They say it's got to be an inflexible adherence to routines.
When you're young, maybe as an adult, you've learned to mask.
So you're You're not so inflexible, but you still would like things to be according to plan.
People might call you cantankerous. They might think you're just being rude,
but you just prefer the routine and it can come on in a lot of different ways.
(03:41):
Number three, here's a big one. Highly restricted, fixated interests that are
abnormal in intensity or focus. What does abnormal mean there?
So yeah, I'm highly, highly focused on things that I have a preoccupation on.
And sometimes that means I'm
not going to be focused on things that I should be paying attention to.
Highly restricted and fixated. So you have maybe two, maybe three keen interests
(04:03):
that you really just run to a lot.
And number four gets underreported. That's why we made a short about it.
Hyper or hypo activity to sensory input or unusual interest in sensory aspects
of the environment, lights, pain, temperature.
Now, remember, this is hypo or hyper. I've had both. I operate in both.
There's times when I'm hyper reactive, right?
(04:25):
So there's hyper activity, Like when we talked about in the OCD insiders,
the floors and the cracks in the floors, there's a hyper reactivity, right?
There's a physiological response, but then there's the hypo.
Sometimes it doesn't even bother me. I have both in the same system.
Watch for both. Maybe you have one, maybe you have the other.
Certain lights. There's a computer I used to sit in front of and had that.
I forgot what it's called, but a certain light that comes from that computer
screen, I would get sick.
(04:47):
Then no, as soon as I walk away from the screen, I'd feel better.
So I sit back down until I realized it's the light in that screen that was actually making me sick.
I was having a physiological response to the light.
Something to pay attention to. Number letter C.
Symptoms must be present in the early development period. Now pay attention
to this. This is where a lot of people miss. This is why I was not diagnosed as a kid.
(05:09):
Symptoms must be present in the early developmental period, but may not become
fully manifest until social demands exceed limited capacities,
which simply means this.
You had it as a kid. It was there. But until the social situation pressures
you, you don't really know it's there.
You're able to hide it basically as a child so it doesn't get seen.
(05:31):
And if it doesn't get seen as a child, most doctors just throw it out there
to say, well, you should have been diagnosed as a kid and they don't even look
anymore. But if the social demands now are exceeding your capacity to quote
unquote fake it and to be normal, then it starts to emerge.
So make sure you understand that. So when you talk to your doctors,
they understand. I had to educate my doctors.
(05:54):
And let's see, letter E. These disturbances are not better explained by intellectual disability.
Okay. Now I know I skipped D, but it goes into clinically significant impairment.
So here's where it got fun for me, the specifiers.
Most of the time when you talk about autism, there's either an intellectual
impairment or a language impairment, but now these are specifiers. So pay attention.
(06:20):
You can be actually highly intellectual. You can be intelligent and not have
any speech impairments and still be autistic.
I think what they're doing and what we know they did is they lumped together
Asperger's and autism, and they kind of made it just one spectrum.
But if the stereotype, now the stereotype or the dominant number of people have
(06:41):
both intellectual and language impairments and you don't have it,
you're going to assume you're not autistic and you can be autistic and still
have a high IQ and not sound like it. Okay.
It's right there under the specifiers. And in fact, I have a specifier that
says without language impairment and without accompanying intellectual impairment.
But if that's, if you're thinking like I used to, those are supposed to be symptoms.
(07:02):
And without those two, what are we doing here? Wrong. You can still be autistic.
Now there's severity levels requiring support, requiring substantial support,
requiring very substantial support.
So most people are on level one, right? You require some support.
I didn't even think about it, but there are certain things that I would do and
certain things I wouldn't do.
(07:23):
And people just picked up around me. They just knew like for whatever reason,
for the longest time I had friends that would come over and pay my bills.
They would stay out on the table. I'd get them. I'd sit them down.
I meant to to get to them, I never did.
And so people just said, hey, and I trusted them. They had access to my bank
account and they just took care of that for me.
I really appreciated that so I could get back to my areas of interest.
It was that severe and people recognized it, but we just didn't talk about it.
(07:45):
It was just what happened.
You could be different. Where do people support you? Where are you requiring
support? Where are you lacking?
Do you have those keen interests that you love to get back to?
And sometimes you forget about other stuff because you're in those keen interests.
Do not forget about the sensory input. Do you have unusual sensory aspects?
You feel temperatures different. Do things feel different? Do cloth feel different?
(08:09):
Do you find yourself just feeling cloth or blankets or pillows?
As a child, I used to get in trouble for just twisting the blanket.
It was one of my things. I used to just twist the blanket. I just liked the
way it felt on my hand. Didn't know why. Didn't ask.
But as a child, I would always twist that blanket. My dad would say,
stop twisting that blanket.
So I'd stop until he wasn't looking. Then I would start again.
It became a habit. It was a sensory input.
(08:29):
These are things that came out later. Because for me, the sensory input got
worse as I got older. It didn't get better.
The lights were having a greater impact on me. The cloth and the things.
Like I can't wear certain shirts like cotton. I can't wear cotton shirts or
anything like that. That, for you, it can be different. But I want you to pay attention.
You could be an adult with autism and not know it because of the quote-unquote
(08:52):
stereotypical presentation of autism online or on TV shows. And we're going
to do a whole podcast about that.
There's a couple of good representations on TV, but most are not.
But I want you to think about some of those things. Think about if you've been missed.
It's not about just feeling different. And there's a couple of autism tests.
There's an autism spectrum quotient test online. I've taken it probably about
(09:12):
10, 15 times. I've actually felt it a few times.
I answer different sometimes just for the fun of it Go ahead and use them,
Because I showed those results to my uh psychologist and she used them She was
she was really wise in that and then we were able to get the actual official diagnosis later on
But if you think you are If you think you are just could be an indication that
you might be and it's okay to get checked out It's okay to find out So remember
(09:36):
you have to advocate for yourself bring up to your doctors.
Hey, yes, I can have I can have social norm. I can have conversation,
but I just don't. I used to go home angry, anxious and depressed after being
in social situations. My doctor picked up on that.
I want you to pick up on that. See, it's not like you can't be out there and
you can even fit in and everybody thinks.
But when you come home, you're drained. And when they go home, they're exhilarated.
(09:59):
When you come home, you're just tapped out because you were masking the entire
time. It felt like people were draining from you because you're smiling and
you want to get back to your fixed interest You want to do what you want to do?
You don't want to make eye contact and so it drains you as a child.
You have meltdowns As adults you just have breakdowns So be privy to some of
these things we'll dive back into it later on but for now call morbidity city turning off the lights.
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