Often, autism is recognized early in childhood—parents, teachers, or healthcare providers recognize symptoms or areas of difficulty and refer a child for testing, which results in the child getting a diagnosis of Autism, which then enables them to benefit from supports and services. 

But sometimes it isn’t.

This is especially true for people who grew up before autism became more well-known by the general public. Older teenagers and adults who might easily be recognized as autistic if they were young children now may have fallen through the cracks if their parents or doctors were not familiar with the signs of autism. Especially if they were pretty high functioning, or learned how to get along, or appeared as if they were getting along with others.

Also Read: Why Are So Many Adults Getting Diagnosed With Autism?

Limited Options for Adults Seeking Evaluation

Many psychology clinics and specialists are overloaded and have significant waitlists for evaluations, but what is worse, many of these clinics are for children only. For older adolescents or adults, they simply cannot be seen in these centers. This creates a real dilemma for adults who suspect they may have undiagnosed autism or who may need an updated evaluation for autism.

Why is an Adult Autism Diagnosis more Difficult?

There are three main reasons why getting an autism evaluation as an adult is more difficult.

1. Psychologists Often Overlook Adult Autism

First, many psychologists who do adult assessment do not focus on autism, and their reference for what autism is may be based on severe and more stereotypical cases, which have been identified early in childhood due to severe needs.

Though it would be incredibly rare to find a psychologist who “didn’t assess” for conditions like ADHD or mood disorders like anxiety and depression, many psychologists do not get the training on more complex or subtle presentations of autism and simply do not address it.

This is a significant problem, since a psychologist like this could assess an individual, and the issue of autism would not be examined or, in many cases, even brought up to the family. 

Adults who are wondering about an autism diagnosis and seeking an evaluation for the first time have often learned many “tricks” to get by socially, which is often described by “masking” or “camouflaging” symptoms. Many of these individuals may have people-watched or watched television shows in attempts to learn how to be successful socially, to the point where many of the “autistic” symptoms are less visible.

2. Masking Symptoms Makes Autism Harder to See

The second reason why autism diagnosis for adults is more challenging than for children is that some providers focus only on what they can see and miss the opportunity to ask about the internal experience that individuals have, such as social discomfort or attempts to mask and minimize symptoms. Due to this, they may not appear to meet the criteria for autism spectrum disorder.

While some people may feel that if they are able to manage these symptoms, they do not need a diagnosis, I disagree. Just as medical conditions such as diabetes and high blood pressure can sometimes be improved and managed successfully with a combination of diet and exercise, these conditions need to be continuously monitored; if a person needs to constantly remember what they have trained themselves to do and needs to use logic and “tricks” to be socially successful, I believe a diagnosis of autism is often warranted and helpful.

3. Most Autism Assessments Are Designed for Children

Third, many autism clinics focus on children, and most standardized assessment measures are centered on childhood. Training programs that focus on autism tend to work exclusively with children, leaving many professionals to learn how to extend this knowledge to adults on their own. Even now, some pediatricians advise parents to wait until their child is 2 or 3 for evaluation.

Parents who follow this guidance miss out on early opportunities to change the trajectory of their child’s future, and when they do attempt to schedule an evaluation, they often look at a waitlist of up to a year before they can get answers. Sometimes parents are the ones delaying an evaluation. They may fear the answers an evaluation would provide, or their priorities are in other areas.

Also Read: Benefits of an Adult Autism Diagnosis

Why a Diagnosis Still Matters for Adults?

Some parents may not recognize the importance of a formal diagnosis and the doors it can open in terms of therapies and accommodations in and out of school. With children, a report is almost always necessary to help justify a child’s participation in supports and services, such as various types of therapy and school accommodations. With adults, this may not be necessary, so the need for autism evaluation in adults is sometimes not recognized or understood by all providers.

Overall, I believe that in many cases, there are adults who would benefit from evaluation for autism spectrum disorder. If you are looking for a psychologist who understands autism in older adolescents and adults, ranging from those with severe needs to those who have been able to teach themselves to be successful despite their brain differences, consider reaching out to me for assistance.

Need Professional Support?

Dr. Jessica Myszak has had over 10 years of experience evaluating children and adults with autism. She has recently transitioned into offering telehealth evaluations. She can work with families who reside in Arizona, Colorado, Delaware, Georgia, Illinois, Missouri, Nebraska, New Hampshire, Nevada, Oklahoma, Tennessee, Texas, Utah, Pennsylvania, Virginia, and North Carolina (effective 3/1/2021). If you are interested in learning more about potentially working with her, you can visit her website here or email her here to get the process started.

Everything that parents are experiencing, kids are too. Kids are affected by the stress that their parents have in their lives. Whether it is the mild frustration of being cooped up too many days in a row or the panic of not knowing where the money for food and rent is going to come from, children are affected by what their parents say and what their parents don’t say, as early as before they are even born.

Children at Greater Risk

Vulnerable Children Without School Support

The most at-risk children—those who get many of their meals from school and rely on teachers to notice when something is wrong—are now home full-time. Many have few resources and, in some heartbreaking cases, are stuck with their abusers.

Children With Disabilities

Children with disabilities are also more at risk right now. Those who receive accommodations and services at school—such as speech therapy, behavioral therapy, or structured interventions—are likely to regress without regular access to these services at home.

Read More: Share Your Insights to Help Improve Autism Research

Mental Health and Emotional Impact

Unknown Long-Term Effects

It’s too soon to fully understand the extent of the problems that will occur. Kids who already struggle with mood disorders like anxiety or depression may either improve or worsen, depending on how safe and supported they feel at home.

Impact on Teenagers and Older Kids

Older children and teenagers—who are at a stage where their peers are most important—will likely struggle the most. And the longer this situation continues, the more challenging it may become.

Educational Disruptions

A Messy Shift to Online Learning

The quick move to online learning during spring was chaotic for many school systems. It remains uncertain whether more preparation will lead to better outcomes this fall and whether students will learn what they typically would in a traditional classroom.

No “Normal” in Education Right Now

Even sending students to physical schools is far from normal. With masks, social distancing, and constant fear of germs, there is no simple or standard option available. This fall brings uncharted territory for everyone.

The Irony of the Internet

Ironically, the internet—something that has long been a source of concern—has now become a safe way for children and adolescents to connect with peers and teachers and to feel less isolated.

The Direct Impact of COVID-19

Some kids will get sick. Some will get sick. Others may not experience severe symptoms but may unknowingly pass the virus to loved ones, who might become very ill or even die. These children will experience trauma, and it will be significant. While we don’t know exactly how many will be affected, the impact will touch many families—and it is heartbreaking.

Read More: Assessing Autism in High Masking Adults for Accuracy

What Can We Do to Help?

Connect with Families

If you have children and families in your life, connect with them in any way you can. Being a friend or mentor to a child—or even to a struggling parent—can make a world of difference.

Even small interactions, like a phone or Zoom call, offer kids chances to take turns, negotiate, and practice social skills, which can benefit them greatly.

Community and Church Involvement

Churches and community organizations have a great opportunity right now. With regular activities like sports, travel, and events being paused or altered, families need new ways to feel secure and supported. Creating opportunities for connection and routine can help bring a sense of normalcy and positivity to their week.

Practice Kindness and Understanding

Most importantly, practice kindness and avoid judging others. Nobody truly understands what someone else is going through during this time. It’s easy to judge someone’s Facebook posts, political views, or actions—but that helps no one.

We will go much farther by working together. Bite your tongue when necessary and go out of your way to be kind and supportive when you can.

FAQs

1.     How does parental stress affect children during COVID-19?

Children are deeply impacted by their parents’ emotional state. Even if parents try to hide stress, children can sense anxiety, fear, and frustration. This can affect their mental health and development.

2.     What challenges are children with disabilities facing during the pandemic?

Children who rely on school-based services such as speech or behavioral therapy are now missing out, which may lead to regression in their progress.

3.     Are teenagers more affected by social isolation?

Yes. Teenagers and older children are at a developmental stage where peer relationships are critical. Social isolation can lead to emotional distress and may worsen mental health conditions.

4.     Is online learning helping children stay on track?

While online learning helps maintain continuity, many students are not receiving the same quality or consistency of education as they would in a traditional classroom.

5.     What is the role of the internet in supporting children right now?

Though once a source of concern, the internet now plays a vital role in helping kids stay connected to peers and teachers, reducing feelings of isolation.

Conclusion

This is a difficult and uncertain time for everyone—especially children. They’re not only absorbing the stress of the adults around them but also facing their unique challenges. Whether it’s emotional health, educational struggles, or the direct impact of illness, the effects of COVID-19 on children are serious and far-reaching.

While there are no easy answers, there are ways we can help: stay connected, offer kindness, and support the families around us. Even small efforts can make a lasting difference in a child’s life.

Need an Autism Evaluation?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.

Screens are everywhere—technology has changed our lives, and it is having new and unpredictable impacts on our children.

Why Face-to-Face Interaction Matters in Early Years?

Infants and young children learn by observing and interacting with their environment. They smile, you smile. They coo or say a word, and you talk back to them. They drop a toy and you pick it up again, and again, and again…. Screens are not responsive to children in the way that people and some other objects in the environment are.

Whether it is a ball that rolls off the table or a parent imitating the child’s gestures in a back-and-forth manner, it is important for children to be learning rules about how the world works and learning to make sense of their environment. Being over-involved in screens takes time away from these activities, and children miss out on learning opportunities.

In a similar way, young children learn many social skills early in their lives, and social interactions build upon each other. Babies learn early on how to elicit reactions from people—by smiling, making eye contact, and imitating the actions of others. When they engage in these behaviors, the world becomes friendlier, more predictable, and an exciting place to explore.

What happens when they smile at an iPad? Nothing. Children who are spending a lot of time using screens are losing out on opportunities to acquire these social skills, or are not having as many opportunities to practice these social skills, which leads these areas to be underdeveloped.

Also Read: An Overview of Psychological Testing for Your Child

Instant Gratification, Patience, and Creativity

Additionally, children learn from an early age a balance patience versus instant gratification. Screens provide constant instant gratification, with the lights, colors, and often fast-paced action. Many apps and games have a variable style of reinforcement, which, similar to slot machines in a casino, is extremely addictive.

Patience is not an innate ability but an acquired skill that takes practice, and children who get constant instant gratification do not have opportunities to learn patience, potentially resulting in behavior problems in other areas. Another skill that is affected by the overuse of entertainment is creativity.

Creativity develops when kids are bored. And boredom is something that all of us seem to be experiencing less and less of—when you have a phone in your pocket, or you can cue up whatever show you want on TV without having to wait through any commercials, the idea of waiting and downtime becomes almost intolerable for many.

From Research to Real Life: Risks of Excess Screen Time

There has been some research on how screen time affects young children, but all of this is correlational. Scientists are not able to randomly assign children to either watch a bunch of TVs or not, so it can be difficult to know what is a direct result of screen time versus a risk factor that may actually lead to more screen time.

Regardless of what comes first, studies have shown that excessive TV viewing is linked to the inability to pay attention and think clearly, poor eating habits, and behavioral problems. Higher amounts of screen time are also associated with language delays, poor sleep, impaired executive function, and a decrease in parent-child engagement.

Why Screen Time That Seems to Work Can Backfire?

I think what is extra tricky about screen time is that it seems like it works so well for kids, including those with behavior problems and attention problems. It’s almost like magic. Rather than arguing or whining or throwing a tantrum, they are just sitting quietly and not causing any problems. I know you have all seen those families in restaurants where kids are each on their own device, and honestly, sometimes the parents are too, and no one is even acknowledging each other.

Also Read: Helping Children Adjust After Social Distancing Ends

The problem is that for extra difficult kids, whether they have learning or attention, or behavior difficulties, it can be a very slippery slope to more and more screen time because the kids and the parents both know what will happen when the parent says Time to put it away, and they don’t want to deal with the consequence. And so these most vulnerable kids, who arguably need the MOST attention and one-on-one support, are sometimes getting some of the least.

What Early Brain Research Suggests?

A study in 2019 scanned the brains of children 3 to 5 years old and found that those who used screens more than the recommended one hour a day without parental involvement had lower levels of development in the brain’s white matter — an area key to the development of language, literacy, and cognitive skills.

Social Media Pressure and Teen Mental Health

As kids get older, it gets more complicated. Rather than videos and play-based apps, pre-teens and teenagers spend more and more time on social media, where popularity and social connections are out there for everyone to see. Social media can be like a drug, where both kids and adults strive to get posts for more and more likes, or they can be evidence of being left out in a way that was never so visible before. I don’t know about you, but I am glad I didn’t grow up with social media.

And I’m already worrying about how it’s going to affect my daughters. It’s one thing to find out on Monday that you didn’t get invited to a party that took place over the weekend. It’s quite another to see picture after picture uploaded on Facebook or Instagram, or whatever is the newest, hottest thing at the moment, and you are being excluded.

Bullying can take place in both subtle and overt ways, and what is especially problematic is that the bullies don’t even see the impact of their actions in a way that may lead to any change. Part of developing empathy is seeing how people react to our actions. When people can say whatever they want without any regard for how that impacts their target, they may say even more the next time.

Suicide is the second leading cause of death among teenagers in the United States, according to the Centers for Disease Control and Prevention. A CDC study found that teen suicide jumped 56% from 2007 to 2017. Many family members of teens lost to suicide talk about the impact social media had on their loved ones. It’s not all just bullying, either.

Also Read: An Overview of Behavioral Disorders in Children

Part of the danger of the internet is that you can find whatever you are looking for—whether the perfect recipe for mashed potatoes, how to change the oil in your car, or, on a more negative side, how to fool your family into believing you don’t have an eating disorder, or how to complete a successful suicide.

As adults, we—most of us—have the sense to think critically about what we are learning, and not follow a rabbit hole that will lead to things we do not want to know. But teenagers are still learning and maturing, and sometimes they can have a very difficult time seeing past the struggles they are feeling at a particular moment.

Use the Good—But Set Firm Boundaries

All this being said, there are lots of negative aspects to screen time and social media, but there are also lots of great positives. There are wonderful groups and communities where people can support one another and find connections that may not be available locally. It’s just like any other ‘new technology’ we as humans have developed over time—fire, automobiles, electricity—all have the capacity to help us tremendously, but also the ability to destroy us if used inappropriately.

Knowing all of this, we are working against teams of people who are researching exactly how to keep kids as engaged for as long as they possibly can. These are very smart people with lots of resources, and they are good at what they do. And it’s not just what we tell our kids—it’s also what we are showing them—since kids learn even more from what they observe than from what we tell them.

None of us is perfect. But I implore you to think about how you use technology in your home, not only what the rules for your children are, but what rules you have for yourself. There are tremendous opportunities with the internet, but also significant risks. If you don’t choose your boundaries, someone else will, and they will not necessarily have your best interest at heart.

Understanding What’s Normal (and What’s Not)

When you’re raising a child, it can be difficult to know what is normal and what is not. It can be a very fuzzy line, and many unusual behaviors can come and go quickly.

Is there a specific length of time that should concern you? Or is it more related to the severity of the behavior?

Trusting Your Gut Instinct

One of the best indicators of when to seek help is if you feel in your gut that something may be wrong. Even if you can’t pinpoint exactly what it is that’s making you uncomfortable, comparing your child’s behavior to that of peers or siblings may help you distinguish what is typical from what is atypical.

Read More: Chicago Parent Support Group for Autism and ADHD

Feedback from Others Can Be Valuable

Sometimes teachers or other family members may recognize concerning behaviors and bring them up to you. This can understandably be hurtful and difficult to hear, but if you trust the person who brings it up, it may be worth paying attention.

You might not choose to act right away, but it’s often difficult to recognize what we aren’t familiar with. Also, consider that it may have taken some courage for that individual to speak up—they may have something important to say.

Recognizing When Your Behavior Is Impacted

All children are different, but if you find yourself significantly adjusting your behavior to avoid potential meltdowns, it may be time to seek help.

This isn’t about small adjustments like avoiding outings during nap time. But if your child will only eat one very specific type of food and you’re driving through Wendy’s daily, or if you’re tiptoeing around the house to avoid placing any demands on them—these are signs that early support may help.

Getting help sooner can make your child more adaptable, and in turn, make your life easier.

Read More: Is it AuDHD When to Consider an ADHD Evaluation with Autism?

How Professional Support Can Help

I offer Parent-Child Interaction Therapy (PCIT) to children and their parents. This is a behavioral parent-coaching model that helps:

• Strengthen the parent-child relationship

• Establish consistent and effective discipline

• Support young children in managing strong emotions

Working with a specialist who understands young children can help parents gain clarity, understand what their children need, and be guided toward the right services.

FAQs

How do I know if my child’s behavior is concerning?

If your gut is telling you something feels off, or if you’re constantly adjusting your life to avoid meltdowns, these can be indicators that help may be needed.

Should I listen to feedback from teachers or relatives?

Yes—if the person is someone you trust, it’s worth considering their observations. They may notice things that are hard for you to see from up close.

What is Parent-Child Interaction Therapy?

PCIT is a type of behavioral therapy that involves coaching parents in real-time interactions with their children. It focuses on strengthening relationships and improving behavior management.

When should I seek help?

You don’t need to wait until things get worse. Early support can benefit both you and your child, especially if behaviors are affecting everyday life.

Conclusion

Raising a child comes with challenges, and it’s not always easy to know when to seek help. Trust your instincts, listen to those you trust, and pay attention to how your child’s behavior affects your day-to-day life.

Seeking support doesn’t mean something is “wrong”—it means you’re ready to give your child (and yourself) the tools to thrive. Working with a child specialist can make a world of difference, helping you build a healthier, happier home environment.

Need an Autism Evaluation?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.