‘Diagnostic overshadowing’ happens when professionals and practitioners focus on the person’s disability and fail to explore anything else that can help us understand what goes on for the person.
When diagnostic overshadowing occurs for autistic people; mental and physical health problems, sensory pain, language and communication problems, and social discrimination are attributed to autism only. I have been to SEND tribunals where this comment was made:
“…isn’t that just not their autism?!”
(in case you are curious my response was: “no, it is additional communication needs and it affects their mental health and access to education).
Diagnostic overshadowing is dangerous when everybody lacks any curiosity about what is going on for the person. This is also known as ‘therapeutic disdain’.
When we see autism only (and forget that there is more to all of us than one defining characteristic), we forget to ask ourselves and the person:
Are you in pain?, are you being bullied?, is your sensory environment just too much?, are you confused about x?.
The comment: “isn’t that just their autism?” is dangerous because it assumes autism is status quo. It assumes nothing can be done to enable the person to communicate, learn and relate in a way that is meaningful and useful to them.
The comment: “isn’t it just their autism?!” is the reason why it is argued that person centred and specialist speech & language therapy is not necessary for autistic children or that a child with communication problems cannot access counselling.
If we don’t challenge this statement (or any other statement that indicates ‘diagnostic overshadowing’); the risk is that we remove hope (and support) that the person can develop and thrive in their own way.
It is lazy thinking at best and harmful neglect at worst.