Is It Autism or Trauma? Diagnosing Adults on the Spectrum with Dr. Benson Fox, Psy.D.

Hello there, fearfully and wonderfully made human. I'm your host, Diana S. Rice, licensed mental health counselor and certified integrative mental health professional and the voice behind the Holistic Counselor Podcast. Today's episode is one I truly wish had existed years ago, especially when I was working in the school system and walking alongside clients and families who were overwhelmed, confused, and often left in the dark when it came to autism in adolescence and young adults.

To be honest, this isn't my clinical niche, but I've seen the confusion, the heartbreak, and the frustration from families who just want to understand their loved one better. I've also seen how many myths and stigmas still circulate, especially in minority and faith-based communities.

So, when Dr. Stacy Weiner first mentioned a group called Adultting on the Spectrum, led by today's guest, Dr. Benson Fox, I was immediately curious. After a get to know you conversation, I knew this was a voice more people needed to hear. Dr. Fox is a doctor of psychology, a school psychologist, a certified life coach, and a crisis counselor.

He has over 4,000 hours of clinical psychology experience working in three high schools, one elementary school, and one college, providing counseling, consultation, assess assessments, and support for students from kindergarten through young adulthood. He's also served as an HCBS provider, which means he helps people with emotional or de I can never say that word.

Dr. Fox developmental needs right in their homes and communities. He's worked as a DSP, a direct support professional helping individuals with disabilities develop to develop daily life skills. And he's done over 350 hours of crisis response with a thousand plus hours as a coach and mentor and 2,000 plus hours of human humanitarian work supporting youth as a director, mentor, and assistant camp leader.

Currently, he works with Apple Psychological where he runs the adulting on the spectrum group we're going to talk about today. He also provides therapy with East End Psychological. Serves as a professor at Toro College, supports students as a school psychologist and teacher at two yeshiva.

Am I saying that word right?

Got it.

Okay. High schools, and works through bright futures as an HCBS provider. So yes, when I say that his life work revolves around supporting neurodeivergent individuals, I mean it. This episode is a heartfelt conversation meant to clarify what autism actually is, how it's diagnosed in adults and why so many people still don't see it clearly, especially in religious, immigrant, and minority families.

So, let's break the stigma, ask honest questions, and listen well. Dr. Fox, thank you for being on the show.

It's a pleasure to be here. Thank you for having me.

All right, so let's get to it, right? because I know you're a busy man obviously from your bio and so um your work blends psychology, faith and coaching. So what inspired you to step into this kind of work, especially helping adults who feel like they never quite fit in?

Um for sure it's a great question. Let's break down a little bit what each of these different modalities bring to the table, what they are, and then I could show you how I we blend them together. Um, let's start with coaching. Um, since that was in a lot of ways the first one for myself.

Coaching is very goal oriented and actionoriented. It's dealing in the here and now, the present. It's not a healing modality. Um, so you're what you're trying to do is you're trying to take someone wherever they are, however they are, and saying, "What is how do we move forward from here?

What can you do?" And I give them action items each week. And those action items they follow through on, and we, you know, by the next session, we we we go up and we say, "What worked, what didn't, why, you know, what didn't work.

Let's, you know, let's either change the strategy or change the goal." Um, what did work? let's double down on that and let's seek to uh bring more of that into future sessions and a future goals. Um so for example, let's say I see for them that adding a social component can be beneficial for their uh exercise goals.

So we could say maybe we could add social component to some of your other goals too and maybe that can be a good motivator for you just as an example.

Um so that's coaching. In terms of psychology, I see this as a healing modality. This is uh even when you do more behavioral um interventions, you're going you're going to go deeper and trying to understand what the function of the behavior is, which is the why, why you do it, what benefit does it give you in your life, and try to find alternative ways of replacing it.

But I also try to do a deeper approach of trying to use our relationship as a way to bring healing to them for previous relationships as well as to model for them how to be for the be with themselves in their relationship.

So it's a healing modality to help heal their past their their past and current relationships including it's their interpersonal and their intrapersonal meaning their relationship with themselves. Um so that is my goal of psychology.

So how faith factors in and that um I actually did my dissertation on religious resilience um where I where I wrote about how the commonality between many religions such as you know let's say charity um faith trusting God um what other ones uh community um and and several other universal elements universal within religion religious elements are very critical to um a person's mental health and their ability to withstand it.

So one line I like to emphasize is trauma is inevitable, resilience is not. Resilience is not inevitable.

So we have a lot of agency in terms of you know bringing in you know there's some more there are many secular resilience measures such as um exercise, sunlight, social etc. But many of those um you call them secular forms of resilience are also really structured and regimented um and integrate well integrated within within living a religious lifestyle.

Yeah.

So that's what I'm trying to um I try to when it aligns with their religious practices and their religious values. I'm not looking to pro to you know convert anyone to Judaism. It's actually something that I discourage for for that's a whole another rabbit hole.

But um I

which we could go into any rabbit hole you want Dr. Fox honestly because

this is the beauty of this this format right this platform is that because I'm curious about that too um

you're right because I am known as a Christian therapist but I don't I think the word you were about to say pro stethylize or whatever right

yeah I couldn't pronounce it so I gave up

I mean neither so we're we're in this together but you're right like we come in with our faith but clinically speaking ethically speaking Um, that is not I mean if they want it, we will have that but we don't push it. That's not what we push.

I love that.

I don't impose it, right? I don't impose it. But I do if they're open to it and that aligns with them. I think it's a very big and I've not seen this with my patients a very big benefit for them to incorporate religious and for many religious people it's also like the elephant in the room so to speak.

It's the it's the most central part of their lives. every all their decisions, all their values, all their goals, aspirations, etc., their family life, social life, it all kind of centers around their religion.

So for me to ignore that is a form can be a form of othering in a sense where I I will ignore a massive part of someone's identity because out of fear of imposing it when it's really could be that we're aligned and then we can bring it to the forefront and use it as a resource

or to improve their um resilience and mental health. Yes, Dr. You know that makes so much sense. And and when they come to you, right? I mean, because if you worked, you worked in the public school system, right?

Yes. Uh Lindberg High School, Valley Stream Elementary School, uh as well as Ulip Wimir High School,

right? So that's not the Yeshiva High School. That's some Can you explain that a little for me, please? Because I'm like I said the word and I said it right, which yay, but I don't know. I mean I'm not in that culture

for sure. So most yeshivas have some split of their day where half the day is spent on Judeaic studies and the other half the day is spent on secular studies.

So the vast majority of of of yeshivas fulfill secular requirements and actually have better um academic outcomes than a typical public school um in terms of both job performance and in terms of grades. So, um there is that to it. Um they're many times very expensive.

They can cost, you know, 10 to $25,000 a year. Um but and and many times it's not seen as an option for an Orthodox Jewish family to send their child to to public school. And unfortunately, the cost of the private school is actually not taxdeductible.

So it's a actually a massive financial strain on a on a Orthodox Jewish family because they tend to have three at least three or four children. Many times it could be five, six, seven, eight children. I'm one I'm one of eight just to give you.

Yeah. So so it could be a massive financial strain, but the benefit is is that it's not seen as really a viable option. Seen as a way to sustain the religious lifestyle. It feels like a must to send them into an environment that is that not just promotes it but even like there's a space for it which there really isn't so much in in a public school setting.

No. Yeah. And I understand from um you know working with ca Catholics like you have your Catholic high schools and then you have your I mean I don't know if they do half the day just doing biblical Catholic Bible and then the Protestant too, right?

So you're that's kind of it's cultural to keep it in the culture and you're learning about your culture and religious study as well and I and I know they have that also in the Muslim community as well. And so I mean I I understand that because we are meant to be I mean the thousands and thousands I mean that's how we're made to be in community.

I don't care if it's the Vikings or you know right or the tribes in Africa. You know, technology has brought a lot of people together and it's also diluted our sense of connection in a massive way in the name of comfort and convenience.

So that's a big problem today is you know the move away from religion while you know increasing technology has you know there's been a massive breakdown in social, familial and communal connections.

Yeah. which is the primary source of resilience for most people.

That's right. It is um it is my primary source of resilience from everything I've gone through. But I have this question for you now because I know in in being a Christian counselor what I'm seeing I see a lot of people hurt by their faith community to a place they're deconstructing.

Do you have that in your faith community too or no? Do you see that at all? Do you know what I mean by construct it.

They want nothing to do. They've seen the hypocrisy enough in the in the strict religion, high controlling religion faith. They are over it. They are deconstructing ex I mean, if you look up #x evangelicals, you're you're going to be like, what? I don't know if they have that that's happening with you or if people are coming to you, but I know that many are coming trying to disentangle what human beings have done with the word with sacred scripture.

Yeah. And do you see what I'm talking about now?

I I see what you're talking about. Um, so let me address that for a minute. I would say that the vast majority of Orthodox Jews are very happy in their religion, find a lot of meaning and purpose,

um, get a lot of resilience from it. Um, but like any type of commitment, you know, it's going to come and with trade-offs. You know, I I like to say to my clients a lot, yes, and no is yes. When you say yes to one thing, you're saying no to something else because now there's not enough space for that in your day.

So you could say, I want to do meditation, I want to do journaling and this, but now are you going to have time to work out or now you're going to have time to have social gatherings? So engagements. So no yes is no, and no is yes.

Meaning when you're willing to say no to something, you're allowing yourself to maintain space for the things that are important to you. So when you add more things to your priority list, you're also deprioritizing other aspects of your life. Um, so, so it's the same thing for with for religion.

There are trade-offs and sacrifices to when you're spending time in prayers, it's time maybe you want want to to watch TV or do something else that you found more pleasurable.

Yeah.

Um, however, I would say that it's well worth it. And I would just say to answer your question most directly, I would say,

you know, I would say at least 90% of the Orthox world are very happy in this space. But I'd say like any other movement, etc., you know, if the people running it is you say that we're all human. So when people are put in positions of power, it's possible for people to become corrupted by that.

And there's no one there's no religion, there's no um process or there's nothing to do about that. That is kind of the human condition. And the amount of people who do that are a tiny minority. The vast majority of people like who devote themselves um as rabbis or just you know learned orthodox Jews are people who could have gone into much more lucrative fields um and end up playing were wearing many hats.

They end up playing the role of doing pastoral counseling for marriages, for families, for individuals obviously without any charge as well as being a mentor, role model, um fundraiser, um they give the sermon and then they also have to mean you know and they go to every single happy and sad occasion.

So they are people that have no time and give of their hearts and souls to their communities. There are people who have been burnt by those and those people are very loud.

Um, and they're not it's not just one or two people, you know, and it is something that the Orthodox Jewish community, you know, addresses, but it's not I would say that it's not any more or less than the amount of people who've been burnt by their public school teachers or their, you know, so again, people

any leadership

power any leadership any power corrupts and doesn't corrupt everyone

unfortunately and that's it's a sad reality. doesn't excuse anything but you know and there are some people you know who assimilate and kind of leave their religion behind orthodox Jews as well but there and there are other people who kind of were raised not religious and they joined the exact kind of dynamic and fluid

um but the vast majority I would say are are not

it's not a

the Orthodox Jewish community is rapidly expanding although the Jewish community overall is actually kind of um stagnant because there's a lot of assimilation within the reform conservative elements.

Wow. Yeah. Thank you for that because that that just goes to show listener like no matter what faith community or I mean you see it in politician or politics like we don't hear about good the polit or lawyers or or you know different things where we're seeing you know we see these things that happen and that these are human beings and and it is the intention of the heart Dr.

Fox right the intention of the heart that God only knows. So there are people that will take a pulpit to utilize it just so they can you know communal narcissism right and

and then you have genuine people who really really care about others and if you've been hurt by any religion that means open your own text your religious text and figure out what what that means to you and what your faith is because resilience I'm telling you we're I always say this Dr.

Fox on my show. We're biology, psychology, and theology. A bio psycho Theo.

I love it.

Right. And we have to figure out those aspects of us of our ourselves. All right. So, now that of course I went into a let's let's say a foxhole instead of a rabbit hole with you. Um, you know, I want to really clear this up for listeners because, um, what I hear a lot on TikTok or just with with young people, we take diagnosis that we professionals, clinical professionals, right?

And we just like throw it. He's such a narcissist. Oh, she's got bipolar. Oh, he's on he's an aspie. Um, or he's on the, you know, on the spectrum. and they don't really know what they're, you know, I get it because of pop psychology on TikTok, but I really want the listener to understand what is autism spectrum disorder.

How do you defined it, right? Um, and then and and in a way that makes sense because sometimes we could get really clinical and and have clinic ease,

you know, we speak in that clinic ease, but I want, you know, for everyday listener to really understand what that is. Yeah, there's a lot there's rampid confusion on the topic of diagnosis and let me do my best to break this down and um give a little bit more clarity when it comes to this topic.

Uh first thing I'll I'll lead off with this is that I don't like diagnosis. Um I find diagnosis traps traps people. People don't understand and this is a myth about diagnosis is that people think diagnoses are for life and they are not.

Oh, say that again. I'm going to amen you now.

Diagnosis are not for life. And that's not just true for anxiety disorder, um, you know, anx many disorders or depression, which we can understand people could rise out of. But we're talking about ADHD. Legally, actually, people don't know this that a legally a diagnosis is only considered valid for three years before the person has to be re-evaluated to to to clarify if they still have it.

Many people with ADHD in adulthood their symptoms go away. Many people I almost half I would say that can happen to um even within childhood ADHD many times can be confused with normal developmental etc. I know we're not talking about ADHD but I'm using go

as an example to demonstrate how people are very confused that people think diagnoses are lifelong. They are not.

They they have to be to be clinically valid. they have to be redone every reevaluated every 3 years. When it comes to the process of re-evaluation, it's a very important point that to understand is that um when it comes to this process that not all diagnoses are created equal and unfortunately other than it being done by a certain level of lensure for the person who get provides the diagnosis, it there is almost no regulations of what actually is required to go into it.

So that creates a lot of people. Some people there are a lot of these clinics you could go to that you could get diagnosed with ASD and this is how it would happen. You go in for one 45 or 60 minute session. They they ask you a few questions.

They give a questionnaire or two to the parent or teacher and call it a day and then this person walks away from the office and then they get the letter and they could use that for any legal means to show that they get access any services um whether in a in in a school setting and on their IEP individualized education plan for their a to get HCBS services etc etc.

So again this is that is almost almost nothing is going into that diagnosis. Um and then there are people who will do it after let's say you have like three like three to five sessions and there are some people that could go even much longer than that and we'll do uh what other things can they do other than questionnaires.

Well, first of all, there are different there's the Vinland um Vinland, there's the the the ASQ, there's there are many different ones to that and it's art. diagnosis is an art and to know which type of questionnaires to do um which things to rule out is not something that I could just like oh do this it there's a lot of clinical judgment that is applied um and there's a lot of things you want to be ruling

out and since there's a lot of coorbidities for example if a person um shows certain social deficits is that due to a social anxiety disorder is that due to a lack of um social engagements Is that due to um you know ASD?

It could be from a lot of those things. And then when you're coming to diagnosis, there's three things that I'd want the listeners to know. There's frequency, duration, um there's frequency, duration, and intensity. So, for example, if I let's say I had a hard day and I feel depressed, do I have major depressive disorder?

You do not. Um even if you felt very depressed, you do not have it. Um, let's say you have felt the depress for a few days, a week, you still don't have it. There's a specific amount of duration. Duration is how long that you need to be feeling the symptoms for.

Now which symptoms you know so with most diagnoses there's a few core symptoms and then there's like a list of a few auxiliary ones that you need to might not be the best word but a few uh maybe secondary symptoms would be a good word to say that you need to have one or two symptoms plus another let's say five of a list of 10 um that you're showing the correct amount of frequency duration and intensity.

Frequency is how many times. Duration is how long. Intensity is how strong or intense the symptom is. So if a person's feeling mildly depressed, that's not usually enough to get major depressive disorder.

Right?

Someone's feeling um you know anxiety uh once a week, they're not going to be diagnosed with generalized anxiety, GAD, generalized anxiety disorder. Um, so and and then there's also time frames for certain diagnoses that they need to happen within the certain critical periods either before or after them in order for it to be considered valid, you know.

So, for example, um, ASD, I think if it's diagnosed before the age of two or three, I usually get people coming to me for that, it's not clinically valid. Um ADHD is not typically diagnosed before the age of six or seven because before that the symptoms are too similar to that of just being you know usually boys are over diagnosed with ADHD almost four to six times I think as frequently as as their female counterparts.

Yeah. So, a lot of typical boy behavior is similar to that of ADHD, you know, um, you know, is they run around, you know, they're very hyperactive. Well, a lot of boys are hyperactive. It doesn't mean that they have a clinical diagnosis. So, the time frame for when it is done is also a factor in addition to frequency, intensity, and duration.

And then there's this aspect that most diagnoses are only valid clinic legally valid for three years. And also the last point just to summarize that the last point is that um not all diagnoses have the same process. I know at Apple Psychological we have a more comprehensive process but it's also more expensive

and that's why a lot of people they prefer oh I go for one appointment it's covered by insurance and that's great but often times what you're not you shouldn't feel so confident in that diagnosis. You don't know the level of accuracy in that and the diagnosis informs intervention.

So if you get the wrong diagnosis, it's not just okay, but now I get extra services. That's great. Are those services geared towards the deficits, right, and the struggles and challenges of your child. So that's where getting maybe paying a little extra,

right,

to get to have other things ruled out. Maybe it's an IQ issue, maybe it's a learning disability, maybe there are other things that we need to look at before giving a this diagnosis, which for many people will internalize as a lifelong condition.

Right on, Dr. Yeah. And I've seen it with and you got to think about it. It's not only like in the psychological field. It's also in the physical field. I'm always saying get a second opinion. Get a second opinion. I know it might not, you know, it might cost a little, but you're going to pay at the end if you don't really do the thorough work ahead of time.

And some people don't know because guess what? They trust us, Dr. Fox. They trust the doctor in your name. They trust my all these letters behind my name, right?

and my experiences but honestly I don't know if this is how you see it but a family can kind of knows in within themselves like what they are needing they have to sometimes trust that's the resiliency that's the empowerment right of like they live with themselves 24 hours a day seven days a week who would know them the best not me

absolutely absolutely I see the the my clients the patients they're always I could call them the experts of their own lives um and I'm just there to hold their hand along only a small part of their journey. Um, there's a Jewish phrasing, it's called Adam.

It's that's in Hebrew. It means everyone knows the bitterness in their heart.

Um, and I would not I would extend that to say people don't just don't just know that means they know their their core issues and like what's making them feel their misery.

Um, but I think it's also people know also their way out. I think that, you know, I believe as a religious person there's a certain maybe divine stream of consciousness that God wants us to tell us right from wrong and what what we need to do to heal and become better, make them grow.

Um, but even from a psychic perspective, maybe a conscience, etc. that a person can access and give them like a little internal truth meter of what what is right and wrong, what's truth, faith, uh, fact and fiction. um that that could be a guide to to living your life and figuring out what's wrong and what the answers are.

And now that problem with using that is sometimes you you lack objectivity and sometimes the pain in your life can blind you to that. And that's probably the main benefit I mean quoteunquote expertise that I bring is that objectivity and the experience I have of seeing many other people in a similar circumstance

to give them that um clarity.

Right. That's that's the the honor and the gift of this field for me anyway is to walk alongside a human being and and not do the work for them and not tell them what to do because that's not my job is to give advice.

It is to say here's some tools that we learned professionally and clinically that can help you. Let's see what's going to work for your biocsycho Theo, you know,

makes a lot of sense,

right? So, let's talk about autism like your group. Um, tell me how that started like and why that.

I think there's a big need for it. Um, I ran an adulting group. It wasn't adulting, it was a high school setting, but it was all members of this community.

Um, and I've worked with them a lot. Um, so I work in a group practice and I thought that would be a good fit for this population because of my background. Um there was actually other groups that were start that we tried um we do have other groups that are are ongoing as well but truth is is that because I think there's a the need for it um that a lot of people in this members of this population are very isolated.

So other groups, let's say if you make a divorce group or this or that, many of them they have friends and they have other things going on for them. But because and it's really like a sad thing, but a lot of the the social fear and a lot of the symptoms that are um in intrinsic to this population are also the things that prevent them from getting that support.

So can we talk about that? What do you mean by the what are the symptoms? What do you mean by that? and and

so sure there's you know one of the symptoms is is is rigidity um some of them are are terms of social deficits um there's per proverative behaviors thoughts interests perverative means that they um they keep repeating it without it being um looping around you know so those are some of the some of the core ones and obviously within those could be further broken down to specific social deficits um such as you know lack of um eye

contact in terms of you know not knowing when conversations begin and end sometimes a lack of personal space uh respecting personal space it could be um you know moving too quickly in a relationship um I've had I've worked with people that have that and it goes on and on um in terms of the rigidity that again it happens in their thoughts and this is something that's very sad is that they many people with with ASD that

they suffer terribly when they are criticized because the the criticism gets play played over in their head again and again and again and it doesn't stop and they don't necessarily have those emotional regulation skills to offset that and manage that better.

So there's a lot of um there is a certain frozen stage of development of certain um you know adoles adolescent infantile tendencies you know that can that's many times as present as well

but you know those are all the negative symptoms um there also are tendencies for them to be more honest I have found more unfiltered but in a way that again some ways that could be a social deficit in other ways it makes them more pure it makes them more

trustworthy Um, I found them overall to be higher IQ and be exceptional memories. Um, as well as um, some of them, you know, they're smarter than me. They they I have to like slow some of them down.

And again, it could also play into a social deficit that they'll use words that and not be aware that the words they're using, the people around them can't understand them. um they they don't have that adaptation, but it's there and that's a strength that they have that they're able to now and and there is a range again because the DSM4 versus DSM5 they they took some of the aspects that were primarily

asberers. They took asberers out. Yeah.

Put it into ASC. So, and now they made it low functioning and high functioning. It's created a lot of confusion. Yes. where some people um really their deficits are primarily social and they're being grouped together with some people who could who are barely verbal.

Um again, I I love these SS. They're beautiful souls, but there's a massive difference in in functionality between someone who's ASD and is barely verbal and can't and is a really almost impossible for them to connect to another person um to someone that's pretty much in terms of strengths and weaknesses um normative in so many ways except for specific, you know, exceptional memory is maybe very bright but also has a lot of these social deficits and now they're all being called that.

So this is this is where the DSM when I say I don't like diagnosis, one reason is because of the lifelong nature that people perceive it to be. But another reason is because of this.

Yeah. No, for sure. I mean like I know when I first encountered autism was when I was working at a place called Broward Children's Center and that's before I was even a therapist.

I was in a special special ed uh teacher like assistant and you know I was like I I didn't see as many as I've done now I think because now we're diagnosing more and understanding more right because sometimes you have a lot of different uh thought processes of like why all of a sudden there's so many like back in the day there was one out of 10,000 and then now it's like one out of a hundred.

I don't even know the I'm don't don't quote me on that cuz but I know I've heard different people that are professionals have their theories, right? So what is your theory on like you know autism and and the why happens to the brain?

Like to me I'm like okay there's still human beings that have are able to be on this earth to provide their purpose.

Absolutely. The why uh that's very tricky. There's no known answer. Um so anything that I will be saying or anything anyone else is saying is speculation to be clear. Um however um I I do have an opinion. Most people will attribute it to genetic factors.

I don't I think that genetic factors usually in my view is more of a copout because it points it points to something that's not in the control. Um I think that for many people it could be trauma based in a very early stage of development and you know it could be that they didn't get specific very early milestones and then in my view what happens is they get frozen in certain part elements of their psyche um and psychological profile get frozen in those very infantile states.

Um and then they have a very hard time adultting or even going from infant going from baby to infant to infant child and child adolescent adolescence to teenager teenager to young adult and then young adult to adult. So every everywhere path along the way and there could be our psyches are very splintered.

So when someone's I'm saying that aspects of it get um frozen I don't mean that all of them all aspects get frozen. It could be specific cognitive processes get frozen or specific ways of processing emotion or very specific ways of uh it could be just their humor you know it you know so our our psyche as a human being is is is near infinitely complex diverse

um and you know has so has countless um it's like a glass thing you drop on the floor it's there's there's no there's endless shards you know

so you know and I think that there's when a person goes through something at a very early stage of development it creates a splintering um you know and and that that trauma it's such a you know you know parents many times you know play some type of role but it could also be uh I think it's possible for it to be in let's say someone goes through a very traumatic uh neonatal care you know

u be that someone's child birth that that they had a very traumatic you know so there are other elements that I think it's not necessarily at the feet of of the parents I'm pointing a finger at.

No, right. We're not blaming them.

That's what that's what I'm being clear about that there there could be many many sources in my for where this early sources of a trauma

um you know can happen from that's not doesn't necessarily point to anything specific.

Right.

And and that's um something because I know like I've had friends with children that have been diagnosed with autism. when I was a preschool teacher, I saw it like I wasn't a therapist at the time, but you know the one the the child that and this is I'm going to go now into um minorities misunderstandings and and religious um the part of that because what I saw was um young kids that I I could tell they were on the spectrum like they couldn't make eye contact.

They weren't verbally coming to where they needed to be at all. But then the parents would beat the crap out of them. Okay? And that's a cultural thing.

So it's not like I, you know, this is I wasn't a therapist and it's not, how do I say cuz I'm in down and I think you understand what I'm talking about because some of our cultures is like why aren't you looking into the eyes of the grandma, you know, and and they're saying it in the language that they're from, you know, and so and it isn't totally child abuse where I had to call DCF either.

It's a cultural aspect of our I know in my culture. I'm a Latina, right?

Legal. You know, hitting is legal in in New York State and most states.

What?

Hitting a child is legal.

Really?

Yes.

I I guess Yeah, you're right. Like Yeah. And then

Well, unless it causes specific right um specific scratching in specific sensitive areas. um but overall is considered to be frowned upon society but but ultimately CPS will not take a case or you know in different states it's called different things but yeah take a case that has that um but that doesn't mean it's not traumatic and doesn't mean that you know a lot of as you said the intentions of the heart make all the difference so

some children no one likes to you know have um corporal punishment physical discipline I you know I think that there is a place for it actually that that can be a positive thing, but there's there very few people who could do it right where where the where they're fully in control.

If there's any rage or anger that that the child senses in it, that's going to cause massive destruction.

So, how many of us can in a heart of hearts say that we're doing it from a place of complete calm and no aspect of the fact that we were insulted by our child that they they they poked at us and they got us, you know, they got us good and now we're there's a there's some aspect of pettiness or some aspect of loss of control or anger, etc. that's mixed in there.

If there's even a hint of that, then what you're doing is destroying your child's psyche. Um the protector is becoming the perpetrator

and source

the source of stability is is becoming the source of chaos.

Um you know and then there's and then it creates massive confusion um you know etc etc and who they and then there's the reverberations of that. Who are you going to turn to now if you have a hard going through a hard time?

Well not not not that now just for mom because of of that now they don't have someone to turn to. Now, what are the repercussions of that of that? Now, they're processing things inside themselves in ways that are not healthy because they're a child and they don't know how to process things in healthy way.

So, then and then what are the consequences of that? Now, they're most likely to get bullied. Now, they're more likely to not have So, so and then it goes down from there. Um, so yes, that can be one example of something that's like that.

But, um, you're mentioning the faith-based community. So, um, I'll speak from the Orthodox Jewish community. Um I will say that the Orthodox Jewish community overall that we are for good reason I would argue slow to adopt societal like new things and changes and I think that was to our credit when it came to let's say television smartphones internet because these things now even many public schools and private schools are banning them and a lot of these yeshivas never allowed them in the first place.

So that that slow adoptance that style of them and the few that did now are for sure they're they're not allowed and the school that I work for Ramba Mifa they this year disallowed all devices you know in the school setting because everyone's eyes have become open to the damage that this has caused.

So the orthodox Jewish approach of kind of being a little bit slow to societal change for many things

was very beneficial to the society.

However, when it came to mental health that was not the best thing. However, I happen to work for some Orthodox Jewish, you know, um, Bright Futures, FSSNY is owned by Orthodox Jew and they and OHL and I could go on and on with many many many services that are actually geared towards this the neurody divergent community um other other diagnoses as well.

I do HCVS services through this this they are the ones who figured out how to access the Medicaid service and how to bill and etc how to make make sense for everyone. So, and a lot of these services now are well integrated into the yeshivas.

Now,

not all of them,

but I work as a school psychologist in a yeshiva. Most the n at least the vast majority of us now have mental health staff incorporated into the building, you know, and they have a lot of these services mixed in. So I think it's a little bit I know it could speak for at least the community that I've been exposed to that there's been it is be it has become very integrated.

Um there is some stigma

of course but I would say that at this point where the community is it's no longer a major obstacle for treatment for reaching out the support. So I will say that I would probably say about maybe 1015 years ago it was but now now it's no I would say it's still still a problem but it's not a I would not say that most people are not getting treatment you know some people it's still issue but not for most

I yeah it does I also realize that there are some people getting um they're being diagnosed later on in life with autism There's uh I don't know if you know because I we're talking about it a lot more. I mean there I think we talked about like Atypical the show and um uh Love on the Spectrum I think it's the other one on Netflix right

you know stuff like that where we're talking about it and people are seeing themselves in these characters or saying oh you know and that's the thing too is like what is a personality quirk like some people are quirky and what is a true being on the spectrum like how do we distinguish that

I think that there's a lot of overdiagnosis when it comes comes to these fields. Um you have to understand the incentive structure. Um what I was mentioning before that

is to offer diagnoses on the cheap because then you get good volume and the people again then can access services and gain accommodations. There's a big accommodations culture. You have to be honest about that.

Um so when you're saying that a lot of people are getting diagnosed later I think some of that is can even be to gain access to this be feel a part of this community or to gain accommodations or resources that in my view should not be dependent on a diagnosis that why can't we give that support it's just it becomes a question of funding and that's that's a sad thing when people feel like they need to get labeled in order to be able to get the support and that they need.

Why can't we just address the symptoms without the label? So that would be my critique. But of course there are some people that you know because mental health as a whole and specifically this community was not there was lack of testing for sure and there wasn't um this wasn't normalized.

This wasn't a thing to do. There wasn't even adequate funding. Now there's so many organizations it's integrated well into Medicaid and and many other public services um agencies etc that now um offer so much support now respit services etc etc so there's a lot it's it's everything all these things are multifaceted

but um yeah so I think that that kind of rounds out a little bit of the different pieces to this

yeah so as we wind down our our episode together I I just want to leave the listener because somebody might be listening going I think my son might have it or my daughter or you know I don't know maybe I do I I don't know or oh my goodness this is where would they where can they start where where you know because with with Dr.

Google out there and too much information. What has helped you and your patients, your clients really? Like is there a workbook? Is there a book to to read? Is there any resources that you can mention that is kind of like where if I'm in Florida like I can get because I know you're in New York and you have your license only in New York.

Oh no. Are you licensed in Florida too?

I am not.

Oh dang. But is there other people that work with um autism? Yes, that they Yes, that we have clinicians that work with this population based in Florida.

Okay, good. And so I will put that in the show notes, but is there anything that that came to mind when I was asking that question?

I mean, first of all, I would follow parental intuition. Um, so you know, I would focus on the rigidity, the proveration, um, cognitive, emotional interests. Um I would also focus and this the social aspect as well. So I would say those are the three kind of more quer aspects of it.

Um if you see a combination of those etc. Um don't try to self diagnose um get a re get a thorough comprehensive evaluation that also rules out IQ ADHD anxiety disorders etc. many other things that

OCD

OCD very good. Yes. OCD and a lot of other symptoms that you know and it could be a coorbidity. It could be more than one thing. People many people with with ASD also do not get properly diagnosed with other things as well because everything goes into that bucket.

But the truth is there could be coorbidities meaning it could be more than one diagnosis. But there also could be that's just the other one and this one is it's masking that that other one. So, um it's important to get a comprehensive diagnosis, one where they do, um IQ testing, they're doing achievement testing, where they're doing a questionnaire that goes they able to test in both the more than one questionnaire in both the home and school settings, more than one setting.

Um many, you know, more than one just one hour of a clinical interview. So, these are the questions when you're trying to ascertain if that don't just go based on the price tag. Um, you know, but you want these are the questions you want to be asking the one who's doing an evaluation.

What is their procedures and protocols? And don't and don't feel like that they they may try to like just do their push their authority. No, these are very fair questions before you

get this um that's going to

that's going to inform how you move forward in terms of working with your child. So these are very important um things ways to guide people in terms of navigating the evaluation process.

Okay.

Is there any like national support groups that you know of or any kind of I mean you have your group but it's you know like people are listening they're like no it's true like I love that you have this adulting on the spectrum because what I'm hearing is you bring them together and they get to be in a community of understanding that we each we all are helping each other but we all have we're working through

or wrestling because I hate like I said I hate diagnosing too and being putting someone in a little box, you know?

So, to me, it's like, no, we're together in this trying to figure this out together with to help each other succeed in this life.

Yes.

So, do you know of any other resources or anything like that?

So, yeah. So I will say that first of all in the school setting there's a lot of accommodations that um and adjustments that that that a school can provide someone that that meets this criteria. Now in a school setting there's something called classifications that makes life more more complicated.

But if you're coming with a diagnosis to school, they're likely to in a a cse meeting to classify you with some type of learning disability, which will gain you access to an IEP, individualized education plan. So, there's a lot of resources within the school setting that you'll gain access to.

That could look like additional academic counseling, um, school-based counseling, meaning um it could look like preferential seating. It could look like working in a more um higher staff to student ratio in classrooms, more time on tests, potentially an aid you could gain access to.

So there's a lot of resources. I would say the primary source for resources would be through the school if that is if you're dealing with someone that's um by the way through the age of 21, some some states 22, able to continue to get free services from the school setting.

So that would be my primary suggestion. Um I would also say that I also do HCBS services which again so if you're coming with that diagnosis you're able to they're able to bill through Medicaid with and really any insurance um you're able to get home community based services which you're able to get you can get somewhere between two hours to 15 16 hours a week of a provider who can

take someone let's say someone's very low function you could still take them and go work out with them. You could go do um to give them parent um um parenting sessions. You could do um take them to a carnival or this and that.

Okay. We offer some just rest bit in the day that you know it's very exhausting being a parent.

So that's HCBS

HCBS services home communitybased services

right

that they could either come to your home you could take they could take out them out to the to the community. So that's also a massive resource where it could be many many hours every week. Is that an organization? Is there like a website?

No. So, HCBS services is a is the name of a service. It'd be like saying therapy.

Oh, okay.

So, I'm trying to figure out where to find that because I I don't know.

So, if you So, there are different agencies that know that would able that you could just they will just give you a provider like I work for FSSNY that's in New York. they have that s that agency that that can make the process very seamless for you.

They will deal with all the paperwork, etc. But technically, you could actually access it really directly through

through um your health insurance, but I wouldn't suggest that because it's it's a maze of papers. I would go through work through one of these agencies. There's also another one in New York um called Yelled. Okay.

Um um I know I know a lot of the Jewish ones because that's in my community.

Um

name them. Let's name them because to me like I'm gonna put everything. Not you don't have to name them all if you don't want to. It's just I I want

I know yelled yell yalda there's fssny. Those are two I know. Uh I know oh is another one. It's a Jewish word for tent. So it's actually you know get applies all these organizations that run. It's Jewish organizations but it's for the not they're non-discriminatory.

Anyone can gain access to these their help. Um, so OHL has those are the three I would say main ones in my community.

Um, but you know I think that if you if you know the name of the service and you could say HCBS services near me and Google that I'm sure that these agencies know advert know how to advertise well. They are businesses.

Yeah.

And I think that you would be led to one and I don't know if there's one that's better than the other. Um,

well, that's what I'm going to do when I hang up with you.

Well, after I finish with my other clients, uh in the evening when I do the show notes, I'm going to research for my my c my area down here in South Florida or the Florida because I can't do the whole country or the whole world, but whatever we could do to to just give some resources and and and have the person advocate for themselves because honestly like you know I I universities must have that too because I know that there's high functioning autistic young adults in the colleges that are able to go to college.

Most colleges have um I worked in a college. I was I was a um college um psychologist counselor. Um I worked as intern there and they they offer not only they offer an incredible amount of supervision. I got almost five and a half hours a week of supervision from so there's it's very high quality services that you'd get in the college setting um where you could get at least a year or two of of individual and group

um different forms of therapy. Some of them are interpersonal processing groups or coping skills groups, social skills groups. If it's a social skills group, it may not be exclusively that population, but you're dealing with people with at least share that symptom. could that could be a point of commonality and connection.

Okay. Yeah. All right. Dr. Fox, thank you so much for your time. Is there anything you want to say before we end?

Well, listen, I work for um Apple Psychological. So if anyone is listening for for individual therapy, for family therapy, um for again for a more comprehensive diagnosis that rules out other things, um or if you want adulting in the spectrum group, definitely reach out to apple psychological.com.

Um where there's many different types of counselors, male, female, different levels of experience, different backgrounds um that we could get you set up and get you the care that you may need and definitely deserve. Um, and listen, my name is Dr. Benson Fox.

I'm a psychologist. You go on my website, drbensonfox um.com and I look forward to be able to be service you individually or a child or a friend of someone you know, be there for you um in your family.

Awesome, Dr. Fox. So, thank you so much for being here with me. And listener, please do not forget to trust in the Lord, guard your heart, and renew your mind. Bye. And now for the disclaimer to make sure you understand that you are responsible for you.

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