Dr. Donna Henderson discusses changes in autism assessment, empowering therapists, equity in masking, and the double empathy problem. The conversation explores the PDA profile within the autism spectrum and challenges of unmasking in educational settings.
Autism assessment is shifting towards subjective experiences over test scores for a more accurate diagnosis approach.
PDA involves a biological drive for autonomy, emphasizing the complexity of demands faced by individuals.
Deep dives
Understanding Behavior vs. PDA
Behavioral problems or resistance to demands in a child do not immediately indicate PDA (Pathological Demand Avoidance). PDA involves developing criteria beyond mere avoidance, emphasizing autonomy challenges faced by individuals. Distinguishing between behavioral challenges and PDA highlights the complexity of neurodiverse behaviors.
Evolution of Autism Assessment
The landscape of autism assessment is undergoing significant evolution, particularly in understanding those with low support needs. Traditional testing methods are being reevaluated, focusing less on standardized tests and more on personal experiences and subjective narratives for a more holistic assessment approach. A shift towards understanding individual stories offers hope for improved assessment accuracy.
Adapting Clinical Practices for Autism Diagnosis
Clinicians are adapting by moving away from rigid testing methods towards a more narrative-focused approach, especially in neuropsychology. The emphasis is shifting from observable behaviors to inner experiences, requiring therapists to courageously explore and diagnose autism where appropriate. Encouraging therapists to diagnose autism and empower them to recognize diverse neurological profiles is essential for accurate assessments.
Camouflaging in Neurodivergent Individuals
Camouflaging in neurodivergent individuals involves conscious and unconscious processes to fit societal norms. Examples include masking sensory needs or social behaviors to navigate societal expectations. Understanding and navigating camouflaging behaviors, particularly in social contexts, require awareness of individual differences and the impact of masking on neurodivergent individuals' well-being.
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 216.
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.
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.