“I hope he doesn’t have autism”

“I hope he doesn’t have autism” is a real-live quote from a real-live pediatrician.

OMG OMG OMG.

Are you kidding me right now?!?!?!?!

When the mom of a kiddo I work with told me what her pediatrician had said, I was dumbfounded for a couple of different reasons. And then, as I peeled back the layers of my indignation, here’s what I came up with:

1. Current research takes a long time to seep into practices and attitudes.

2. Even though we expect them to know, some doctors don’t understand very much about autism.

3. Regardless of the diagnosis, it’s the same child we’re talking about.

For a discussion on diagnosis and prognosis, you can watch THIS VIDEO, but here’s a quick recap:

A diagnosis is a way of DESCRIBING what we see so that other professionals will have a common base of understanding. A diagnosis may also inform treatment decisions.

However.

Getting back to this pediatrician’s remark, the problem with a Diagnosis is that it can create a monolith out of a living breathing PERSON. 

I’m not anti-diagnosis: please don’t get me wrong here. In fact, I’m very much PRO-diagnosis when the diagnosis will serve the child. 

An autism diagnosis can be useful in helping families and children get much-needed therapies. And the diagnosis can help get those services paid for by insurance.

A diagnosis – when interpreted with caution -  can help explain why a child is behaving in certain ways. And in some cases, the diagnosis can inform what to do next. 

But a diagnosis can also complicate the matter by sticking a label on and making separate something that we are continuing to discover is probably a neurological difference. 

And, when a diagnosis like autism comes with a lot of judgment and emotional baggage, it’s probably counterproductive for everyone involved.

The baggage comes from the myths and misinformation that continue to prevail:

Autistic people can’t or don’t want to interact with others. 

Autistic people are savants.

Autistic people have difficulty with theory of mind.

Autistic people are not normal.

Autistic people are cognitively impaired.

Autistic people don’t want the same things that “normal” people want.

These are just a few of the myths that current research is debunking. But new information takes awhile to trickle down if people aren’t paying special attention.

So, I’ll try not to throw pediatricians under the bus as a group (we need them and they are mostly wonderful. But here’s what I will say: 

In the early years, a pediatrician is mostly concerned with Keeping the Tiny Humans Alive. Childhood diseases, COVID, etc - there’s plenty for your pediatrician to worry about on your behalf. They may not have the bandwidth or the inclination to educate themselves on developmental differences.

So, your pediatrician might not be the best person to advise you on the question of whether your child demonstrates characteristics of autism. And, they might not be the person with whom you want to have that conversation. (And then again, they might: if your pediatrician is well-informed and comfortable with discussing developmental differences, go for it!)

If you’re getting signals from your pediatrician that they are minimizing your concerns or that they are uncomfortable discussing your questions, seek help elsewhere. A speech-language pathologist (speech therapist) is a great place to start. Even though SLPs don’t diagnose autism, they do identify the communication issues that come along with autism. A developmental pediatrician can be hard to find, but might also be a good lead. A child psychologist with a specialty in Autism - also good.

PS - Our Raising Orchid Kids Practical Strategies class begins July 14th. This 6-week class will help you and your Orchid Child to better understand each other and help to take the stress and frustration out of your home. Visit https://www.raisingorchidkids.com for more info.