The Rise in Autism Diagnoses: Or is it Childhood Emotional Neglect?
What’s really behind the explosion of autism traits and diagnoses? Is it just neurodiversity, or could it be emotional neglect and trauma from when we were kids?
Lately, it seems like everyone’s talking about neurodiversity, especially autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and attention deficit disorder (ADD).
Sure, we’re more aware now, and the diagnostic tools are better, but here’s a big question: could some of what we’re seeing as “autism traits” actually be because of the deep, often overlooked impact of emotional neglect and trauma from childhood?
This post is all about diving into that tricky question. We’ll compare traits found in neurodevelopmental conditions with those that pop up from childhood trauma and emotional neglect. We’ll explore how these experiences mess with our nervous system, influence how we act and relate to others as adults, and lead to those limiting beliefs and coping strategies we use to try and feel better.
First, let’s get a handle on neurodevelopmental diagnoses: ASD, ADD, and ADHD.
Before we start comparing, it’s good to understand what the diagnostic criteria and common psychological, emotional, and behavioural traits for ASD, ADD, and ADHD actually are.
Autism Spectrum Disorder (ASD)
ASD is a condition that affects how the brain develops, showing up as ongoing difficulties with social communication and interaction in all sorts of situations, plus restricted, repetitive patterns of behaviour, interests, or activities.
(It’s also often linked to poor emotional intelligence, regulation, and dysfunction, which I’m seeing more and more clients for, whether they have ASD/ADHD/ADD, or Childhood Emotional Neglect.) – Author: Bob Brotchie
Key Diagnostic Criteria (DSM-5 highlights)
Ongoing difficulties with social communication and interaction:
- Struggles with back-and-forth social interactions (e.g., unusual social approaches, not really engaging in conversation, not sharing interests or emotions, or totally avoiding social interaction).
- Problems with nonverbal communication used in social settings (e.g., verbal and nonverbal cues don’t quite match up, unusual eye contact and body language, not understanding or using gestures well, or no facial expressions and nonverbal communication at all).
- Trouble developing, keeping, and understanding relationships (e.g., finding it hard to adjust behaviour for different social situations, difficulty with imaginative play or making friends, or just no interest in peers).
Restricted, repetitive patterns of behaviour, interests, or activities:
- Repetitive movements, using objects in a repetitive way, or repeating speech (e.g., simple body movements, lining up toys, echoing words, using unusual phrases).
- Insistence on things being the same, rigid routines, or ritualised verbal or nonverbal behaviours (e.g., getting really upset over small changes, struggling with transitions, rigid ways of thinking, specific greeting rituals, needing to take the same route or eat the same food every day).
- Very narrow, intense interests that are unusual in their focus (e.g., strong attachment to or obsession with odd objects, overly focused or repetitive interests).
- Unusual reactions to sensory input or unique interests in sensory aspects of the environment (e.g., not seeming to react to pain/temperature, getting upset by specific sounds or textures, excessive smelling or touching of objects, being fascinated by lights or movement).
Common Traits: Social awkwardness, not quite getting social cues, intense focus on particular interests, repetitive behaviours, being sensitive to sensory input, finding change difficult, and sometimes struggling to show emotions.
Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is a brain-based disorder characterised by ongoing inattention and/or hyperactivity-impulsivity that gets in the way of daily life or development.
Key Diagnostic Criteria (DSM-5 highlights):
- Inattention:
- Often misses details or makes careless mistakes.
- Often finds it hard to stay focused on tasks or play.
- Often seems not to listen when spoken to directly.
- Often doesn’t follow through on instructions and doesn’t finish tasks.
- Often struggles to organise tasks and activities.
- Often avoids, dislikes, or is hesitant to do tasks that need sustained mental effort.
- Often loses things needed for tasks or activities.
- Is often easily distracted by outside things.
- Is often forgetful in daily life.
Hyperactivity and Impulsivity:
- Often fidgets with hands or feet, or squirms in their seat.
- Often leaves their seat when they’re supposed to stay seated.
- Often runs around or climbs in inappropriate situations.
- Often can’t play or do leisure activities quietly.
- Is often “on the go,” acting as if “driven by a motor.”
- Often talks too much.
- Often blurts out answers before questions are finished.
- Often has trouble waiting their turn.
- Often interrupts or intrudes on others.
Common Traits: Difficulty focusing, being impulsive, restlessness, disorganisation, trouble managing emotions, and challenges with planning and time management.
Attention Deficit Disorder (ADD)
Historically, “ADD” was used for inattentive symptoms without the hyperactivity. While people still use “ADD,” the official DSM-5 diagnosis is ADHD, with presentations like “predominantly inattentive presentation,” “predominantly hyperactive/impulsive presentation,” or “combined presentation.”
Common Traits (Predominantly Inattentive Presentation): Similar to ADHD’s inattention traits, but with less or no obvious hyperactivity. Folks might seem dreamy, easily distracted, and have trouble finishing tasks.
The Cauldron of Childhood Emotional Neglect and Trauma
Now, let’s shift our focus to the deep impact of childhood emotional neglect and trauma. These experiences, whether obvious or subtle, can really change how a child develops, shaping their nervous system, emotional regulation, and how they see the world.
Emotional Neglect?
Emotional neglect happens when a parent or caregiver consistently fails to meet a child’s emotional needs. It’s not always about bad intentions; it can come from a parent’s own unresolved trauma, mental health struggles, or simply not being emotionally aware.
Covert Emotional Neglect: This is often subtle and harder to spot. For example:
- Parents who are physically there but emotionally distant.
- Parents who dismiss a child’s feelings (“Don’t be sad,” “You’re too sensitive”).
- Parents who put their own needs before the child’s.
- A lack of emotional connection, where parents don’t recognise or respond to a child’s emotional states.
Overt Emotional Neglect: This is more obvious and includes:
- Ignoring a child’s cries or bids for attention, often seen in “sleep training” where the baby learns no one is coming and gives up.
- Failing to offer comfort or reassurance.
- Dismissing a child’s achievements or struggles.
Trauma
Childhood trauma covers a range of really upsetting or disturbing experiences that overwhelm a child’s ability to cope. This can include:
- Acute Trauma: Single, overwhelming events like a car accident, a natural disaster, or suddenly losing a caregiver.
- Chronic Trauma: Repeated and long-term exposure to highly stressful events, like ongoing abuse (physical, emotional, sexual), neglect, domestic violence, or living in a chaotic environment.
- Complex Post-Traumatic Stress Disorder (C-PTSD): This develops from prolonged, repeated trauma, often in childhood, when someone has little to no chance of escape. It affects more than just typical PTSD, impacting self-perception, emotional regulation, relationships, and how they make sense of things.
- Post-Traumatic Stress Disorder (PTSD): This can develop after a traumatic event. Symptoms include intrusive thoughts, avoidance, negative changes in thinking and mood, and changes in how easily someone is startled or reacts.
Developmental Impact of Childhood Psychological Injuries
The effects of emotional neglect and trauma on a developing child are far-reaching:
- Nervous System Dysregulation: Constant stress and trauma can mess with the developing brain, leading to an overactive “fight, flight, or freeze” response. This might show up as being hyper-alert, anxious, having trouble calming down, or feeling emotionally numb.
- Attachment Insecurity: Consistent emotional neglect or inconsistent caregiving messes up the formation of secure attachment. Children might develop anxious, avoidant, or disorganised attachment styles, which affects their ability to form healthy relationships later in life.
- Poor Emotional Intelligence: Without consistent emotional mirroring and guidance, children struggle to identify, understand, and manage their own emotions and those of others. This can lead to emotional dysregulation, difficulty with empathy, and challenges in social interactions.
- Limiting Beliefs: Traumatic experiences can embed deep-seated negative beliefs about oneself, others, and the world. These might include “I am unlovable,” “I am not good enough,” “The world is a dangerous place,” or “I can’t trust anyone.” These beliefs contribute to low self-esteem, anxiety, and depression.
- Safety behaviours: To cope with psychological suffering, children develop “safety behaviours” – strategies to protect themselves from perceived threats or pain. These can include people-pleasing, perfectionism, avoidance, social withdrawal, or even self-harm. While these behaviours offer temporary relief, they often hinder genuine connection and personal growth.
The Adult with Childhood Trauma and Emotional Neglect
The impact of these childhood psychological injuries extends well into adulthood, significantly affecting various aspects of life:
- Relationship Challenges: Adults with a history of emotional neglect or trauma often struggle with intimacy, trust, and healthy communication. They may repeat unhealthy relationship patterns, fearing abandonment or engulfment. Attachment styles formed in childhood continue to influence adult relationships, leading to difficulties with attunement and secure connection.
- Parenting Challenges: If adults with unresolved childhood trauma become parents, they may unintentionally emotionally injure their own children. Triggers from their past can lead to emotional dysregulation, harsh parenting, or a lack of emotional presence, perpetuating a cycle of intergenerational trauma.
- Emotional Dysregulation: Difficulty managing intense emotions is a hallmark of childhood trauma. Adults may experience frequent mood swings, intense anger, anxiety, or depression. They might resort to unhealthy coping mechanisms like addiction to numb their pain.
- Poor Emotional Intelligence: The inability to understand and express emotions effectively can lead to misunderstandings, conflict, and isolation in adult relationships.
- Addiction: Substance abuse, gambling, or other addictive behaviours can be a way to self-medicate the pain and emptiness left by childhood trauma and neglect.
- Anger: Suppressed or unacknowledged anger from childhood can erupt in adulthood, leading to explosive outbursts or chronic irritability.
- Anxiety and Depression: These are common manifestations of unresolved trauma and limiting beliefs. The constant state of hypervigilance or emotional numbness can lead to chronic anxiety, while feelings of hopelessness and worthlessness contribute to depression.
- Low Self-Esteem: A pervasive sense of inadequacy and self-doubt often stems from a childhood where one’s emotional needs were not met or one was made to feel unworthy.
- Poorer Overall Health: Chronic stress and emotional dysregulation have a tangible impact on physical health, contributing to increased risk of chronic diseases, autoimmune disorders, and weakened immune function.
- Social Anxiety: This often comes from having had to be ‘someone other than yourself’ as a child.
The Overlap: Similarities Between Trauma/Neglect and Neurodiversity
This is really the heart of what we’re exploring: how similar the traits can be between people with neurodivergence and those who’ve experienced childhood trauma and emotional neglect. It’s super important to say that this comparison isn’t about pathologising trauma or suggesting that neurodiversity is “caused” by trauma.
Instead, it’s about showing how the ways these things show up can look incredibly alike, which might lead to misunderstandings or not recognising the real underlying issues soon enough.
This isn’t a totally exhaustive look, but I know people want quick, easy-to-digest info these days, so I’ve tried to cover the most important distinctions for you. These are just my opinions, unless I’ve said otherwise.
And just to be clear, none of this is meant to diagnose or treat anything; it’s just to inform you and point you toward thinking about further investigation. Do leave a comment if you’d like links to specific resources or want to know more!
Bob Brotchie is a counsellor, mindset consultant and creator of "Conscious Living by Design"™. He writes for Anglia Counselling, a company he founded in 2012, is featured on various other websites and introduces us to many guest writers all covering topics related to mental health and wellbeing.
Bob provides bespoke counselling services to individuals and couples in the privacy and comfort of a truly welcoming environment at his Anglia Counselling company office, located near Newmarket in Suffolk, England. Bob also provides professional online counselling, for local, national, and international clients. The therapeutic models offered are bespoke to the client’s needs, especially those in receipt of 'childhood emotional neglect' (CEN), whilst integrating a mindful approach to psychotherapy and cognitive behaviour therapy (CBT) principles, those becoming ever more important for those with neurodivergent traits. For clients experiencing trauma and/or phobia, Bob offers EMDR (Eye Movement Desensitisation and Reprocessing).
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