Dr. Jeremy Sharp (01:19)Hey folks, welcome back to the podcast. Hey, today I’m talking about autism again. I’ve been doing a lot of episodes on autism recently just because there are so many questions that are coming up around autism assessment and research is continuing to develop and new research is emerging. And so today we continue that theme with Dr. Wen Lawson. Dr. Wen is Audi HD, dyslexic and dyspraxic. He’s passionate about all things autism. He’s a British psychologist, a qualified social worker, well-known autistic researcher, author, speaker, and poet. Wen is a key theorist of the monotropism theory of autism, and he’s an adjunct associate professor with Curtin University in Western Australia. We talk about many different things that fall under Wen’s umbrella. And the title of episode, which is beyond the DSM, what we’re missing in the diagnostic criteria, I think is pretty accurate. So we dive pretty deep into Wynn’s theory on monotropism and how that drives a lot of the characteristics of autism. We talk about sensory concerns. We talk about object permanence. We talk about how monotropism shows up in different ways. We of course talk about camouflaging and different different aspects of autism in different populations and many other things. This was a fascinating episode. We of course also touch on the clinical aspects of Wynn’s ideas and how we can shift our practice to accommodate and integrate some of these ideas. So as always plenty to latch onto here and there are many things that you could put into play pretty immediately if you would like to in your practice. Speaking of practices, Crafted Practice is quickly coming up. It’s late July. We’re getting really getting down to it. I think at the time this episode goes out, there should be another week or two left in registration. I don’t know if at this point, because I’m recording so far in advance, whether there will be spots available or not, but I’m really looking forward to it. If there are spots available, go check it out. You know, we’re talking about the theme this year is the sustainable CEO. We’re great at the clinical work, but I think we built practices that in large part depend entirely on our presence for many of us. And this year at the retreat, we’re going to focus on how to maintain your clinical reputation, but let go of a lot of that grunt work through workflow autonomy. So we have a few, I mean, I hope we have a few spots left, but you’ll have to go double check to make sure. The registration deadline is June 14th at midnight. So go check it out. It’s the testingpsychologist.com slash crafted practice. If you’re ready to make that shift. Love to have you. All right. Let’s jump to my conversation with Dr. Wann Lawson. Dr. Jeremy Sharp (04:29)When Hey, welcome to the podcast. Wenn Lawson (04:32)Thank you. It’s really good to be here. Dr. Jeremy Sharp (04:34)Yeah, likewise. Good to have you, especially, I know we’re working with a bit of a time difference here and with you being over in Europe. So I appreciate you taking some time out of your evening to chat with me for a little bit. Wenn Lawson (04:47)Yeah, no, I feel privileged. Thanks, Jeremy. Dr. Jeremy Sharp (04:50)Yeah, yeah. Well, I’ll start with a question that I always start with, which is, you know, of all the things that you could care about and spend your time on, what is it about this topic that is compelling for you? Wenn Lawson (05:04)I’m an autistic adult and ADHD, dyslexic, dyspraxic and a other things. So for me, it’s really important that the world that I’m part of and that my kids and their kids are part of understand what it’s like living as an autistic person and plus other issues. So I’m incredibly passionate about this topic. It’s where I work in and teach and study. research and ride about. Dr. Jeremy Sharp (05:32)Mm-hmm. Mm-hmm. I feel like that’s where things become the most powerful when there’s that overlap between personal and professional. Wenn Lawson (05:39)Yeah, absolutely. And the team at the university where I’m part of Curtin University in Western Australia, they’re as dedicated as I am. And we support each other. There’s a lot of mutual support. There’s a lot of autistic people in our research team. So very hands on. People talk about lived experience and I want to say living. I’m not dead yet. Dr. Jeremy Sharp (06:05)Ha ha. Wenn Lawson (06:06)very much living experience yeah yeah yeah Dr. Jeremy Sharp (06:08)Uh-huh. Uh-huh. It’s happening. Yeah. In the moment for sure. And continually changing and evolving. Yes. Well, I want to, I want to just jump right into it. I know you have a lot to share on many topics related to, to autism. So maybe we just jumped to the diagnostic framework right off the bat. I mean, there’s been a lot of discussion over I don’t know, past especially 10 years maybe around our current diagnostic framework with the DSM-5 and does it fit, does it not fit? They made some changes for the DSM-5. I would just, you know, it’s kind of an open question. I would love to just get your thoughts on the current diagnostic framework and how it’s worked. Wenn Lawson (06:51)Yes, it’s the DSM-5 with its revisions in 2022, still doesn’t have the kind of subtleties that it needs for diagnosing a lot of people. So if you’re a female, you may miss out on a diagnosis. If you’re very able, whatever gender you are, it might not be picked up. Dr. Jeremy Sharp (07:03)Hmm. Wenn Lawson (07:14)And it’s actually really important that it is recognized because otherwise as autistic people, we’re very hard on ourselves. We’re not good at self-compassion and other people have a expectation and benchmarks that we’re supposed to reach. And there might be a lot of reasons, especially sensory stuff, which is included in the DSM five, which was not ever there in previous versions of the DSM. So it’s really. really good that they mention this, that there’s sensory stuff. There’s a lot of things that are not mentioned. They don’t really talk about interoception, our internal senses. They don’t talk about the issues we have with object permanence. They don’t talk about the differences that come from being single-minded. They talk about rituals and being perhaps obsessed, is the word people use. obsessions and I prefer passions. They don’t go into explaining what’s behind the diagnostic criteria criteria. So that’s the bit that’s missing, but it’s a good starting point. But if you’re not trained and you’re not, familiar with how autism presents in a variety of different people, different genders, different ages and so on, you could easily overlook a lot of people. so been a lot of overshadowing, a lot of misdiagnosis and stuff like that because of not the DSM just doesn’t go into those more subtle expressions. If you have ID or an intellectual disability, which is a separate thing, it’s not autism, but it can co-occur, then it’s easier to see that there’s something different about this person. And unfortunately, then people start talking about profound autism and separating it from autism per se, which makes me a bit sad because you can be a very able autistic person in some ways, but have a lot of spiky dips. So I’m, I have a PhD, but I can’t do my own shopping. So it gets a little difficult when people start separating those things out. The DSM five doesn’t go into those. Dr. Jeremy Sharp (09:25)Mm-hmm. Wenn Lawson (09:27)enough detail, it talks about the levels of one, two and three, which are pretty rigid. And there’s a lot of movement between those you can go through level one, two and three in the same day. When you’re assigned the level, that assessment, it may not actually pan out in your life. And people need to be aware of all those things they need to know and be familiar with autism and autistic people. Dr. Jeremy Sharp (09:50)Yeah, yeah. We get a lot of questions from folks around the levels and it’s always a hard question. Um, you know, it seems like, well, I mean, parents and adults want to know, you know, parents about their kids and then adults about themselves. And it’s always a tough question. It does feel like we’re like throwing darts at a dartboard in some fashion where we’re just sort of guessing based on the information we have. But like you said, that might shift, you know, functioning shifts throughout the day. Right. Wenn Lawson (10:15)Yeah, it’s the information you have on that day with that person at that time and can be quite different in another situation. ⁓ And that’s not accounted for. Dr. Jeremy Sharp (10:22)Yeah. Yeah. Right. Right. So let me ask you a little bit more, you know, in this diagnostic framework, I know there’s a lot of, there is a lot of talk around, I’ll say different. types of autism for lack of a better term. That’s not right. But you know, you, you mentioned sort of like profound autism, quote unquote, like the, maybe like the nonverbal, you know, high, high support needs sort of individuals. Then there maybe is a distinction with, Wenn Lawson (10:46)Alright. Dr. Jeremy Sharp (10:53)lower support need individuals or like you said, subtle presentation. And then there’s some discussion around like, is there a female autism phenotype? So is there a, like a different type for women? And I’m obviously simplifying and you know, kind of amplifying at the same time, but how do you sort of, yeah. Wenn Lawson (11:03)Yeah, yeah. Yeah. But it’s good. It’s good to have those conversations. But everybody is so different. And, you know, women have usually not always they have a double X chromosome and sociability is coded in the tip of the X chromosome. So women come primed with a doubl
