Same child, different perspectives of his issues

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Compare these two italicised paragraphs quoted here from the blog "We Are Like Your Child".


Here is a diagnostic report from a professional on an autistic child defining all observations in negative terms:

X appears to have impairments in communication and social interactions. In addition, he was reported to have several restricted and repetitive behaviors. Specifically, he was noted to have difficulties engaging in a social conversation, high pitched vocal tone, impairments in use of eye contact, difficulties socializing and interacting with other children, and limited emotional reciprocity. He also collects rocks, has an inflexible adherence to routines, displays heightened sensitivities to light and loud noises, and finds it hard to cope with changes to his daily routine.


Here is a contrast paragraph using the same material from a perspective of positive interpretation:


X has differences in his communication style and social interactions. He prefers to engage in behaviors that are comfortable for him. Specifically, these include conversations that remain on topic and relevant to him. He prefers not to make eye contact because it is uncomfortable for him, and he prefers interacting with children who are older or younger than him, rather than only interacting with his age mates who can be less predictable. He loves collecting rocks because he is interested in the different shapes and substances that rocks are composed of. X prefers predictability in his daily routine, and enjoys being in sensory friendly environments.


In life, very often, what you see depends on where you stand. I this this is a particularly clear example which speaks volumes really.

But it's saying the exact same thing, just worded differently. The message is the same. I don't see why someone who's evaluating a child for autism would be personal in the report. My report is similar in wording and I don't think it's negative, it's informative. Rather than have all the positive language in there, does it not just make more sense to get to the point? It's not their job to make each diagnostic report personal, nor should it be. I don't see why they should cloud the message with positive language so not to offend anyone. It makes looking for the meaning harder.

They are saying the same thing but poles apart.

The first says problem after problem, which requires correction, and is equivalent to a cure mindset. For the parent of a child the implications are that "this item is defective".

The second is a bit too fluffy and ignores that any of these issues are a problem, with acceptance being the key mode.

Somewhere in the middle would be more ideal.

This is why ASD's are so difficult to diagnose.

There are times when I do believe that so-called Aspergian/Autistic/whatever characteristics are, actually, manifestations of "normal human variation."

This is why it's best to consider, in a diagnosis, if these "characteristics" cause "significant difficulty in everyday life, which makes the person unhappy."

Then we must think about the need for "services" because, at times, this erstwhile happy Aspergian person is rejected by the Greater Society because of his/her differences, and is thereby made unhappy by this rejection.

It's a double-edged sword, really. I really wish, in my heart of hearts, that people would just leave each other alone, and allow each other to function--absent an actual threat to any one person.

So what if a person dresses oddly--what harm does it do anybody?

So what if a person has esoteric interests--what harm does it do anybody?

So what if a person is shy--what harm does it to anybody.

Ad Nauseum.

I like the "normal human variation" idea in many cases.

There is a lot of truth in this comment, and I tend to agree with it. Unfortunately, when it comes to an ASD (or any other) diagnosis, you are at the mercy of the assessing clinician. From personal experience I know that this can be very negative.

Of the two assessments, the second is far preferable and likely (at least in most cases) to have a positive effect over time. If it were followed up with an honest discussion between the clinical team and the person and their family, to identify where problems occur, to take a more holistic approach and agree support where needed, then this would be very helpful.

Both reports were vague in some areas. I would have liked to know what the "deficits" in communication were and what exactly was "comfortable" for him. I don't usually have to record observational data, but when I have, I've put in sample quotes and then noted something like "communicates mostly in questions" or "high pitched voice" or "only looks at me if I'm not looking at him." Like, specifics. If I wrote something about my opinion I wouldn't be able to follow it later. If I wrote "social deficits" that would have no meaning.

If I had to pick between them I would pick the positive toned one, but I've read through so much negative literature that I would be able to read between the lines of the negative one.

A clinician needs to use clinical language, but very difficult for the average person who needs to understand, assess and react to it. It might be a good idea to translate to normal language with less of a negative tone.

I think this is common for institutions, trying to understand tax documents for example, but just puts an additional barrier in the way.

The most common misunderstanding I have seen, in relation to AS, is the confusion over clinical empathy versus dictionary empathy .

Thank you for responses to date. Interesting variety. Some more context now:

The reason the mother reframed the paragraph was to give information to her child's school teachers about his individual potentials and challenges, without reinforcing stigmas, in the hope that this would help the teachers to play to the child's strengths, rather than see him as a set of weaknesses.

In this situation, (please if you will pretend you are the parent of this ASD child, and a parent on the spectrum as this mother is): which of the two paragraphs (see opening post) would you choose to give the teachers? Why?

Secondly, suppose you are the child. Which one do you want your parent to give to the teachers, and why?

I have noticed with Aspergers children that "less than" self-perception appears to develop and consolidate between the ages of 5 - 9 as they notice and internalise perceptions of themselves based on exclusions from classroom and age group peers - in the playground, in groups, not invited to birthday parties, ridicule for challenges like impaired athletic ability due to co-ordination and muscle weakness. This is when I have seen an increasing sadness in these children's eyes and faces compared to their NT twins or other siblings.

I would definitely agree....especially as to the development of negative self-fulfilling prophecies.

The second paragraph isn't just a re-wording of the first. It actually leaves out several issues/symptoms that the school should know about in order to help the child.
Also, it contains this useless sentence:

Well, duh! Doesn't everybody?

My only issue with the first paragraph is that it's too clinical to share with teachers. It makes the child sound like a lab rat rather than a human. The second paragraph, however, is too hippy-dippy.

So, yeah. Somewhere in the middle would be best.

Oh, also the mention of rock-collecting in the first paragraph seemed bizarre to me.
What's wrong with a kid collecting rocks?

I think the diagnostic report should be reliant on information, not negative or positive terms. The point is to explain the symptoms that are observed, not make anyone feel good or bad.

As a parent I would expect a diagnostic team to give me something that looked like the first paragraph, and what I would do if I were the parent, is to frame it in a way that would be useful to the teacher but word it positively when I can so the teacher did not start off hating my kid.

In fact I did something like that the first couple of years, but the teacher's would usually roll their eyes and ignore it, so I stopped writing things out. Teachers seem to prefer meetings.

This is a system issue, in that an assessment report is written to explain any impairment that might necessitate services that cost money and many educational systems are set up that children need to fit into a mold unless they are identified with something wrong. And if they really don't fit, it becomes appropriate to stop pushing and teach or accept.

My reading of the first paragraph is the evaluator is justifying services. Many aspects of the second paragraph would be appropriate for the recommendations section at the end.

I'm not offended by the evaluator writing the truth, it can be reassuring, if I see something about my child or myself, to be taken seriously rather than told everything's normal, which when I see things aren't working well is confusing, frustrating, and isolating.

There are some negatives about the first paragraph, but the second isn't clear or helpful on its own in an evaluation. Though it could be good as a school or provider report.

First one. Second one is too fluffy and works around the kid's problems. They need to know, but the second is like she's hiding is from them. Also the first one is official so they'd be more likely to take it seriously.

How old is the kid? If he's young and has no self awareness then I, the kid, would not care as I'd be too busy staring at the rocks.

High school kid? Possibly embarrassed. I'd just want to blend in. I felt very awkward when my teachers had to fill in a screening questionnaire about me. At this age I wouldn't like either.

Looking at it again, the first version is jumbled and could easily be rewritten into a more logical order. I feel that a re-write, not a re-wording, of the professional statement and the inclusion of additional information would be the best solution.

In regards to context of schools, more information would be needed as to whether it is a special needs or a standard school. It seems that the parent has tried to remove any negative connotations. It's good to remember that "it's the squeaky wheel that gets the oil" and downplaying issues can result in being ignored, but I guess you learn that the hard way.