Dr. Donna Henderson, a seasoned clinical neuropsychologist and co-author of a pivotal autism guide, shares her insights on the evolving assessment of autism. She discusses the shift from rigid testing to understanding individual experiences and the crucial role of therapist empowerment in diagnosis. The conversation dives deep into masking, highlighting its complexities and the quest for balance in supporting neurodiverse individuals. Henderson also unpacks the nuances of Pathological Demand Avoidance (PDA), advocating for a clearer understanding to improve support and reduce stigma.
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insights INSIGHT
Evolving Autism Assessment
Autism assessment is evolving, focusing less on formal test scores and more on subjective experiences.
This shift allows for better understanding of individual stories and perspectives, particularly for those with low support needs.
volunteer_activism ADVICE
Adapting Clinical Practices
Clinicians should rely less on formal tests and more on interview skills to understand inner experiences.
Therapists should be empowered to diagnose autism, as many adults are missed, especially those who mask.
question_answer ANECDOTE
The Burden of Masking
Dr. Henderson's autistic daughter shared how she consciously puts on a happy face upon receiving gifts, even those she likes.
This highlights the often unseen effort of masking, even in seemingly positive situations.
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Dr. Donna Henderson joins Emily Kircher-Morris to talk about the changes in the assessment process for autism, the importance of empowering therapists to diagnose autism, and the need for equity in masking. Their conversation also explores the double empathy problem and the challenges of balancing unmasking with the needs of neurodiverse individuals in educational settings. They also discuss the PDA profile and its place within the autism spectrum. That’s all waiting for you on episode 246. This is a reprise of an earlier chat.
Takeaways
The assessment process for autism is evolving, with a shift towards understanding subjective experience rather than relying solely on test scores.
Therapists are adapting by relying less on formal tests and more on interview skills and understanding inner subjective experiences.
Empowering therapists to diagnose autism is important for identifying and supporting individuals who may have been missed in the past.
Masking and camouflaging are complex behaviors that can have both benefits and drawbacks, and it is important to find a balance that respects individual needs and promotes equity. Pathological Demand Avoidance (PDA) is not simply about avoiding demands, but rather an overriding biological drive for autonomy.
Misdiagnosis and labeling are common for PDAers, leading to potential negative consequences, especially for minority boys.
Understanding the core features of PDA, such as difficulty coping with demands, a wide variety of coping mechanisms, and challenges with social hierarchy, is crucial for accurate diagnosis and support.
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Dr. Donna Henderson has been a clinical neuropsychologist for over 30 years. She is passionate about identifying and supporting autistic individuals, particularly those who camouflage, and she is co-author (with Drs. Sarah Wayland and Jamell White) of two books: Is This Autism? A Guide For Clinicians and Everyone Else and Is This Autism? A Companion Guide For Diagnosing. Dr. Henderson provides neuropsychological evaluations and consultations for children, adolescents, and adults who would like to understand themselves better. She is a sought-after lecturer on the less obvious presentations of autism, autistic girls and women, PDA, and on parenting children with complex profiles. She also provides case consultations and neurodiversity-affirmative training for other healthcare professionals.
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