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Overlooked informal test for autism

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IsabellaLinton
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02 May 2021, 8:35 pm

firemonkey wrote:
My wife used to say I grind my teeth at night. There's also this that I'm not sure is ASD related. That clicking sound when you move your jaw. Difficulty opening your mouth wide. I tend to feel like I want to gag when I try to open my mouth wide.


Yup. I was referred to a maxillofacial surgeon (jaw surgeon) about all my TMD and jaw issues. He wanted to do botox injections into my TMJ to relax the muscle. Um, no thanks!

Do you also get cracking sounds if you rotate your head in a big circle? lol - I sound like snap, crackle, and pop!


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firemonkey
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02 May 2021, 9:17 pm

For me it's more like a crunching sound . Another one is taste. I don't know about anyone else but mine can vary in intensity. A coffee with 2 sweeteners can be very sweet one time, and the next time far from sweet.



Jiheisho
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02 May 2021, 10:13 pm

IsabellaLinton wrote:
Jiheisho wrote:
starkid wrote:
I don't know why but it seems like many people overlook the associated medical issues, such as

lack of manual dexterity
chronic sleep problems
IBS
weak or absent sensations of pain, hunger, or need to use the bathroom
headaches associated with noise or visual stimulation
nausea caused by certain odors or food textures
Irlen syndrome
superhuman hearing

and so on. These kinds of experiences are easier than psychological and social traits for a person to self-identify, so it's curious that they rarely seem to come up.


Because none of them are an indication of autism.


I disagree, Jiheisho.

The DSM5 diagnostic criteria for ASD includes: "Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)."

starkid's list gives many specific examples or manifestations of sensory "hyper-reactivity and / or sensory hypo-sensitivity" as well as "adverse responses" to sensory stimuli, as defined in the DSM5.

Her examples describe ways in which sensory dysregulation has adverse effects on our daily lives: "Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning." (from DSM5)

Specifically:

- Chronic sleep problems
Insomnia is often related to "sensory hyper-reactivity" or an "adverse sensory response" (to sound, light, texture etc).
It's also related to stress from sensory / social overload, and the "hyper-reactivity" of our limbic systems (fight / flight).
This affects our daily lives.

- Weak or absent sensations
This is known as sensory "hypo-reactivity", or "apparent indifference to pain / temperature".
This is similar to having a sensory shutdown. For some of us it's permanent in relation to our body sensations.
This "indifference to pain / temperature" (DSM5) puts us at risk of injury and affects our daily lives.
I work with an autism Occupational Therapist for this phenomenon - it's called having poor Interoception awareness.

- Headaches with noise or visual stimulation
Headaches are caused by "hyper-reactivity" and an "adverse response" to sensory stimuli (sound, smell, and light).
This affects our daily lives.

- Nausea from odors and textures
Nausea is caused by "sensory hyper-reactivity" and an "adverse response" to sensory stimuli (smell and touch).
This affects our daily lives.

- Irlen Syndrome
Irlen = "sensory hyper- or hypo-reactivity" to light and sensory stimuli (colour contrast, print material, visual stimuli).
It's an "adverse response" to our visual environment as described in the DSM5.
This affects our daily lives and it's often related to Photophobia:

- Photophobia
Photophobia is caused by "sensory hyper-reactivity" to sensory stimuli (bright light).
Bright light causes sensory and visual overload since there is too much visual information for our brain to process.
Our brains can't process seeing so many colours / things at once in daylight, or brightly-lit environments.
That's why many of us feel more comfortable in the dark, seeing and processing fewer things at once.
We also hyper-react to small details, and sensory stimuli such as the quick flickering of fluorescent lights.
It connects to our involuntary "fascination with lights and movement" (DSM5) because we can't ignore the flicker. ^
This affects our daily lives.

- Super-human hearing
Also known as Hyperacusis (hyper-reactivity to sound stimuli).
Hyperacusis is often concurrent with Misophonia (physical pain or emotional / rage responses to sound stimuli).
This affects our daily lives (insomnia, inability to socialise, agoraphobia, etc.)

The DSM doesn't talk about gut disorders such as IBS but there's a known correlation with ASD and digestion.
IBS is our digestive system being "hyper- or hypo-reactive" to the food stimuli, and to physiological stress.

Anecdotal evidence also shows we have issues with balance and proprioception (dexterity and fine / gross motor control).
This is related to the way our brains process visual and spatial information ("hyper- and hypo-reactivity" to input).
It's an "adverse response" in reaction to an overwhelmed nervous system.
It affects our daily lives.


Let me be a bit more specific. These are not indications of autism as not everyone with autism suffer from those. Yes, I have sensory sensitivities, but not those listed. Chronic sleep problems in and of themselves are not an indicator of autism. IBS and other intestinal issues are also not an indicator of autism.

Sure, they can be comorbid. Sensory issues can relate to those. But if we are seeking a methodology to identify someone with autism, it will not be very good diagnostic criteria. Those would have completely missed me, for example. So as an informal test for autism, I cannot agree that the list would be helpful. It could also end in misdiagnosis as those criteria are also in other condtions.



Edna3362
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03 May 2021, 12:08 am

The point of this thread is not the list of traits that are overshadowed.

The point is that the informal indication of 'autism' is more focused about social awkwardness, social anxiety and anxiety in general than anything else.

Nevermind actual language and communication topics.

Or why is this -- that includes internal and external interferences that translates into behaviors, which actually affects development and daily living.

While it is true not all those with the same interferences are affected, it doesn't mean the interferences are not there at all nor anyone can afford to have it and live with little to no problems.



Also the fact that said traits are not well discussed here and around. :lol:

It doesn't matter whether or not it is associated with autism, nor that the case is that not everyone has it.
It only matters that if someone is dealing with it and is having issues with it.

And besides... :twisted:
Comorbidities should be at least taken into priority in many autism accounts.


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IsabellaLinton
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03 May 2021, 12:21 am

Jiheisho wrote:
These are not indications of autism as not everyone with autism suffer from those ... Chronic sleep problems in and of themselves are not an indicator of autism. IBS and other intestinal issues are also not an indicator of autism.

Sure, they can be comorbid. Sensory issues can relate to those. But if we are seeking a methodology to identify someone with autism, it will not be very good diagnostic criteria. Those would have completely missed me, for example. So as an informal test for autism, I cannot agree that the list would be helpful. It could also end in misdiagnosis as those criteria are also in other condtions.


I understand what you're saying, but the same is true of social problems. Social difficulties "in an of themselves" are not an inticator of autism. Having difficulty with non-verbal communication "in and of itself" is not an indicator of autism, either. There are autistic people - even here on WP - who describe themselves as extroverted, or say that they've developed many coping skills to get by in social situations. Others say they have high levels of empathy and that they are good communicators with strong relationships and leadership skills.

Clearly there's a wide range of behaviours and traits among autistic people, and that's why it's a spectrum. The key is to have characteristics from Parts A and B, or to have more emphasis on the wide range of traits we might demonstrate, which includes Part B in all its curious manifestations. The clinical, diagnostic criteria are fine in my opinion but I think the self-assessment tools like AQ should have more questions pertaining to stims, repetitive behaviours, routines, inflexibility, and sensory processing disorders.


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firemonkey
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03 May 2021, 3:11 am

From 2014, but still interesting.

Autism plus vs autism pure

Quote:
Abstract The reported prevalence of autism is going up
and up. We propose that some—even much—of the
increase in the rate of autism spectrum disorder (ASD) is
driven by ‘‘Autism Plus’’. Autism Plus refers to autism
with comorbidities (including intellectual developmental
disorder, language disorder, and attention-deficit/hyperactivity
disorder), and this is what is now being diagnosed
by clinicians as ASD. In clinical practice, a diagnosis of
ASD much more often entails that the child will receive
support at school and in the community, which is not the
case for other diagnoses. In the past the comorbidities were
given diagnostic priority and the ‘‘autistic features’’ might,
or might not be mentioned as the ‘‘plus bit’’ in the diagnostic
summary. It is high time that the comorbidities,
sometimes even more important than the autism, came
back on the diagnostic agenda. Autism is but one of the
Early Symptomatic Syndromes Eliciting Neurodevelopmental
Clinical Examination (ESSENCE), not the one and
only.

https://sci-hub.st/10.1007/s10803-014-2163-1



firemonkey
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03 May 2021, 3:37 am

I, like no doubt many others, have done the comparison thing. Wondering how I can be an autistic person as I can't totally identify with John,Julia,Tanya & Tom etc. There's the diagnostic 'must haves' and then there's the 'may or may not haves' that are found more frequently in those with ASD compared to the general population. That raises the question of subtypes. All connected by 'must haves' but separated by the 'may or may not haves'.

As person with ASD + severe mental illness I'm going to be quite different than a person who doesn't also have severe mental illness.



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03 May 2021, 4:22 am

Funny. Technically speaking, you can be a social genius, yet still have autism if you have a bunch of other impairments on the list, like executive function disorder plus sensory processing issues plus repetitive behavior. In reality, these people either don't exist, or don't bother/need a diagnosis. The social issues are the core and crux of autism.

Anything else is secondary, and these may all be individual manifestations and ailments caused by the social issues. I don't think autism by itself causes anxiety. It's a side effect of the social issues. But it leads to anxiety which can then lead to individualized ailments, not necessarily autism-specif but unique to the individual.



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04 May 2021, 1:06 am

I have social difficulties, though not as much as some people.

I also have poor coordination
I'm a night owl
Digestive issues
Sensitivity to light
Sensitivity to sound

I'm 23 and can barely tie my shoes. I do a double knot, but the shoe is loose enough that I can slip it on and off without messing with it after that. Frankly some of the more "physical" or medical stuff was what made me start taking the idea of me having autism even more seriously. Autism has so much explanatory power for my social, physical, executive function, and emotional difficulties. Something I've noticed with autism (purely through my completely untrained reading of various anecdotes) is developing quickly in some ways and slowly in others. A quick Google search immediately pulls up an article from autism awareness center "The Uneven Cognitive Profile" so maybe I'm onto something there.



firemonkey
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04 May 2021, 9:32 am

MidnightRose wrote:
A quick Google search immediately pulls up an article from autism awareness center "The Uneven Cognitive Profile" so maybe I'm onto something there.


A search a good number of years ago re my uneven cognitive profile was what led me to non-verbal learning disorder, and from there autism.



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04 May 2021, 10:00 am

At my age, sensory issues are more debilitating than social problems. Over many years, I've learned to interact well enough to pass for NT-- which I couldn't in my 20s--but nothing is going to improve the sensory issues.


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04 May 2021, 10:57 am

IsabellaLinton wrote:
Jiheisho wrote:
These are not indications of autism as not everyone with autism suffer from those ... Chronic sleep problems in and of themselves are not an indicator of autism. IBS and other intestinal issues are also not an indicator of autism.

Sure, they can be comorbid. Sensory issues can relate to those. But if we are seeking a methodology to identify someone with autism, it will not be very good diagnostic criteria. Those would have completely missed me, for example. So as an informal test for autism, I cannot agree that the list would be helpful. It could also end in misdiagnosis as those criteria are also in other condtions.


I understand what you're saying, but the same is true of social problems. Social difficulties "in an of themselves" are not an inticator of autism. Having difficulty with non-verbal communication "in and of itself" is not an indicator of autism, either. There are autistic people - even here on WP - who describe themselves as extroverted, or say that they've developed many coping skills to get by in social situations. Others say they have high levels of empathy and that they are good communicators with strong relationships and leadership skills.

Clearly there's a wide range of behaviours and traits among autistic people, and that's why it's a spectrum. The key is to have characteristics from Parts A and B, or to have more emphasis on the wide range of traits we might demonstrate, which includes Part B in all its curious manifestations. The clinical, diagnostic criteria are fine in my opinion but I think the self-assessment tools like AQ should have more questions pertaining to stims, repetitive behaviours, routines, inflexibility, and sensory processing disorders.


I agree that the DSM-5 has better criteria. It also requires all aspects of the condition be measured, whatever form they take.

The AQ has also been a general tool that identifies risk of ASD, but does not diagnose the condition. And this is a dilemma of assessment tools, how do you identify a person with ASD that is unaware they have ASD where it needs to not only assess attributes related to ASD but also attributes that are not? It needs to minimize false positives and false negatives. And do that in a very diverse population--cognitive difference does not lead to specific behaviors, as we well know. But AQ is not the only assessment tool. Folks are developing eye-tracking tools to spot the risk of ASD in infants, which is great as it eliminates the cognitive bias in the test taker.

In an imperfect world, we have imperfect solutions. Fortunately, people are working on solutions with evidence-based approaches.



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12 May 2021, 2:25 am

Jiheisho wrote:
I agree that the DSM-5 has better criteria. It also requires all aspects of the condition be measured, whatever form they take.

The AQ has also been a general tool that identifies risk of ASD, but does not diagnose the condition. And this is a dilemma of assessment tools, how do you identify a person with ASD that is unaware they have ASD where it needs to not only assess attributes related to ASD but also attributes that are not?

None of this is relevant to this thread. Like it says in the thread title, I'm talking about informal indications of autism. My list is meant to be compared to online questionnaires, autistic trait lists, and self-exploration, not the actual formal diagnostic criteria. But some of the medical issues I listed actually do fulfill formal diagnostic criteria.



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12 May 2021, 2:50 am

ezbzbfcg2 wrote:
Funny. Technically speaking, you can be a social genius, yet still have autism if you have a bunch of other impairments on the list,

That's blatantly incorrect. Social impairments are fundamental to diagnostic criteria for autism in DSM and ICD. Unless you are somewhere people don't use those tools.

Quote:
The social issues are the core and crux of autism.

The people who wrote the DSM disagree with you. They disagree so much, they created a whole new diagnosis for people who have social/communication issues but not the repetitive/restrictive behaviors of autism.

Quote:
Anything else is secondary, and these may all be individual manifestations and ailments caused by the social issues.

No. Can social issues cause a person to hear frequencies other humans can't hear? Atypical sensory perception is fundamental to autism as it is currently understood by the people who know most about how it manifests across populations. Neurological issues, which are present from early childhood, are not caused by social issues. It's possible that IBS, insomnia, etc. are related to social issues, but not sensory issues.



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01 Jun 2021, 11:00 pm

Udinaas wrote:
I'm not trying to dismiss the medical issues but I don't want to gatekeep the community against people that might need help.

It took me forever to figure out how to respond to this comment of yours because the comment doesn't seem on-topic.

You do not have the power to gatekeep the entire autism community (assuming that's the community you meant).



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02 Jun 2021, 6:00 am

The list of medical problems was very helpful to me when self-diagnosing, because I was in doubt due to having social problems but no repetitive behaviors, and no obvious sensory sensitivities. The list of medical problems helped me understand that I DO have sensory sensitivities, they are just invisible in my daily life but eventually they cause health problems, sometimes quite serious ones, and now I know why most of those problems disappeared after I quit city and job. I still need painkillers after a sunny day though.

I agree that medical list should go together with the "social" list. It is relevant and helpful.