Diagnostic Overshadowing

In PlainSpeak for the Lay Reader

Diagnostic overshadowing happens when doctors or healthcare workers focus so much on a person's autism that they miss other health problems the person might have. This can mean that other illnesses or conditions are not noticed or treated properly.

Key Points:

1. Mixing Up Symptoms: Sometimes, signs of other health problems are mistaken as just part of autism. For example, if an autistic person feels very anxious or has stomach pain, it might be seen as just them acting up due to autism instead of a separate issue.

2. Communication Barriers: Many autistic people find it hard to explain their feelings or symptoms and may have other communication challenges. This can make it harder for doctors to understand what's really going on.

3. Assumptions: Doctors might assume all problems are because of autism and not look for other causes. This can lead to missed diagnoses. Usually any acting up behaviors is redirected back to behavior therapy, when they actually needed different solutions.

4. Lack of Training: Not all doctors know how to spot other health problems in autistic people. They might need more training to do this well.

5. Poor Treatment: If other health issues are not found, the person might not get the right treatment. This can affect their immediate and long term health and well-being.

Examples:

• Mental Health: If an autistic person is feeling very sad or has depression, it might be ignored because it's thought to be just part of their autism.

• Physical Health: If an autistic person has pain in their stomach, it might be seen as just a behavior issue rather than a real medical problem.

How to Fix This:

1. Thorough Check-Ups: Doctors should look at the whole person and not just their autism. They should check for other health issues and underlying issues too.

2. Better Training: Doctors should learn more about how to spot other health problems in autistic people.

3. Clear Communication: Finding better ways for autistic people to share how they feel can help doctors understand their symptoms better.

4. Awareness: Helping everyone, including caregivers and educators, and professionals understand that autistic people can have other health problems too.

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Diagnostic Overshadowing

Diagnostic overshadowing in Autism occurs when the symptoms and behaviors associated with autism obscure or overshadow the presence of other mental or physical health conditions. This can lead to misdiagnosis, underdiagnosis, or delayed diagnosis of other conditions, ultimately impacting the individual's overall care and treatment outcomes.

Key Points

1. Misattribution of Symptoms: Symptoms that might indicate another disorder are often interpreted as part of the autism, leading to misattribution. For example, anxiety, depression, or gastrointestinal issues might be seen merely as behaviors or characteristics of autism.

2. Challenges in Communication: Communication challenges and Alexithymia faced by many autistics can make it harder for healthcare providers to identify additional conditions.

3. Biases and Assumptions: Healthcare providers may have implicit biases or assumptions about autism that lead them to overlook other conditions. They might assume that all behavioral issues or health complaints are related to autism without considering other potential causes.

4. Lack of Specialized Training: Not all healthcare providers are trained to recognize the complex interplay of autism and co-occurring conditions. This lack of specialized training can result in diagnostic overshadowing.

5. Impact on Quality of Care: Diagnostic overshadowing can result in inadequate treatment plans. If other conditions are not recognized, the autistic might not receive appropriate interventions or therapies that address their full range of health needs.

Examples 

• Mental Health: An autistic person might also have depression, but their low mood and social withdrawal may be seen as just part of their autism or obstinate or noncompliance, delaying the correct diagnosis and treatment of depression.

• Physical Health: An autistic experiencing pain or discomfort due to a medical condition like GI  issues might have their symptoms attributed to behavioral issues, leading to inadequate medical evaluation and treatment.

Addressing Diagnostic Overshadowing:

1. Comprehensive Assessments: Conducting thorough and holistic assessments that consider both autism and potential co-occurring conditions.
2. Training for Providers: Educating healthcare providers about the risks of diagnostic overshadowing and training them to recognize and differentiate symptoms.
3. Effective Communication: Developing better communication strategies to help autistics express their symptoms and concerns.
4. Awareness and Advocacy: Raising awareness among caregivers, educators, and clinicians about the importance of looking beyond autism to identify other health issues.

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Diagnostic Overshadowing

Autism Lexicon: Diagnostic Overshadowing

Diagnostic overshadowing in autism occurs when the symptoms and behaviors associated with autism obscure or overshadow the presence of other mental or physical health conditions. This can lead to misdiagnosis, underdiagnosis, or delayed diagnosis of other conditions, ultimately impacting the individual's overall care and treatment outcomes. 

PlainSpeak: Diagnostic overshadowing in autism is when doctors focus too much on autism and miss other health problems because they think it must be all because of autism.  

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The Autism - Parkinson's Connection

Research has found some evidence of a potential link between autism and Parkinson and that autistics are at higher risk for PD as they age. 

No surprise really as many autistics (like me) already have many movement-disorder-like movements, which really impacts our everyday functioning and which currently gets lost in the world of Autism dx overshadowing where everything is attributed to "autism" so nothing more need be done. 

Urgent need for research and translatable solutions