High Sensitivity or Something More?
Highly Sensitive Child or Autism?
I'm often asked by parents who follow me on Instagram some variation of: "How do I know if my child is just highly sensitive or if there's something more?"
The answer is you can't really know unless your child has a formal evaluation by a licensed clinician who has been trained to evaluate neurodevelopmental disorders and mental health conditions.
Highly sensitive children present similarly to children with level 1 autism (DSM 5), children with ADHD, children with Sensory Processing Disorder, and children with an abuse or trauma history.
In order to rule out the "something more" we need to know the child's developmental history. A developmental history is taken through an in-depth parental interview and is one component of a substantial autism evaluation and the Bio-Psycho-Social assessment common in child psychotherapy settings.
In addition to a full developmental history that in part looks for the timing of the onset of symptoms (aka traits/behavior) and other important, potentially traumatic, events in the child's life, the clinician observes the child usually through play-based and conversational interaction.
A trained eye may notice the subtleties of an atypical autism presentation (common in girls) and/or what appears to be something else entirely. The observation, combined with the parental interview and other assessment measures, helps the clinician conceptualize the clinical picture and determine if a diagnosis is warranted. They may also decide a referral for an evaluation from another type of provider is necessary (eg. medical doctor).
When Should Parents Seek an Evaluation?
If the traits of what a parent calls "high sensitivity" significantly impact the child's ability to function with everyday life like school, self-care, eating, or social relationships, it's a good idea to seek help from a licensed healthcare provider.
Sometimes what parents think is one thing, is actually something else. Sometimes the internet in its powerful and persuasive ways, leads us to believe our child has something they don't actually have and vice versa.
Sometimes we so badly want to believe our child doesn't have a disorder or a disability, we will label them less serious things like highly sensitive or spirited. There's no shame in this and it's a common stage of parental acceptance.
Sometimes the child's challenges are unrelated to psychology or neurology and the origin is in a medical condition or family environment. Licensed mental health therapists are trained to know when an issue may be out of their scope and they will refer out to the appropriate provider (eg. pediatrician).
Will My Child Get a Diagnosis?
The decision to diagnose conditions that do not have an objective blood test is made by a complex process of weighing all the available information. It's important to understand that no diagnosis will be made if the child's functioning is not compromised to the degree of clinical significance.
A "disorder" (aka diagnosis) is only a disorder if the symptoms significantly compromise the person's ability to function within the domains of everyday life.
If the highly sensitive child is doing ok socially, educationally, and is more or less living life like most children their age, but maybe with a few accommodations and adjustments then their differences are not clinically significant and would not warrant a diagnosis, generally speaking.
In plain language it comes down to: How's your child doing?
If the answer is: Not well, then it's time to seek answers and help.