Communities in Collaboration

This week, I had the privilege of presenting at Communities in Collaboration, a regional conference hosted by the Central Minnesota Child Advocacy Center and the Stearns Benton Child Protection Team. The room was full of people I don't often get to sit in the same space with: educators, social workers, county attorneys, mental health clinicians, law enforcement, and family advocates. All there for the same reason.

The conference name stuck with me. Communities in Collaboration. It sounds aspirational, and it is. But it also names something real about how autism identification actually works, or fails to work, in a child's life.

The gap no single professional can close

I spend most of my days working with one person at a time. I'm listening carefully, looking for patterns, building a picture from testing data and developmental history. What I do is specific, and I hope it's helpful. But it's also limited in a particular way: I only see who comes through my door.

Autism, especially in girls, in kids who've learned to mask, in children who've been labeled "anxious" or "defiant" or "just shy", doesn't always find its way to an evaluation. Not because families don't care. But because the people who see these kids every day haven't yet had language for what they're observing, or haven't known where to send them, or haven't felt confident enough in their concern to push for more.

That's the gap that collaboration closes.

My presentation covered autism from the ground up: what it is, how it's diagnosed, what it looks like across ages and genders, and how the current diagnostic process works, including the difference between a school evaluation and a clinical one. We talked about the female phenotype, which remains underidentified and misunderstood even among experienced professionals. We talked about masking, late diagnosis, and the real cost of going unrecognized for years.

We also talked about interventions, what the evidence says, how to think about ABA, speech and occupational therapy, school-based supports, and the role of family psychoeducation. Because identification is only the beginning. What happens next matters just as much.

But the conversation I found most meaningful wasn't about diagnosis at all. It was about what happens in the spaces between professionals, the referral that almost didn't happen, the teacher who wasn't sure it was her place to say something, the parent who finally felt heard because two people on a team had the same concern at the same time.

Why multidisciplinary teams change outcomes

Autism is a neurodevelopmental condition that shows up differently in every environment. At home, a child might be rigid and dysregulated. At school, the same child might hold it together all day and fall apart the moment they walk in the door. In a clinical setting, they might be compliant and pleasant and give no external sign of the energy it costs them to be there.

No single professional sees the whole picture. That's not a failure, it's just the nature of the thing. A neuropsychological evaluation gives me a structured, standardized snapshot. But the teacher who has watched this child for eight months, the occupational therapist who noticed the sensory piece, the school psychologist who's been tracking the behavioral data, they have information I don't have. When those perspectives come together, the picture gets clearer faster.

The families I see who navigate this process most successfully almost always have one thing in common: someone in their life who already knew the language, who could connect the dots, who made a call or sent a letter or said "I think this is worth looking into.

What I hope professionals take back

If you were in that room this week, here's what I most want you to carry with you:

Trust your observations. You don't need a diagnosis to notice that something isn't adding up for a child. Your concern is data. Share it.

Know the referral path. A comprehensive neuropsychological evaluation can clarify a picture that years of partial information have obscured. If a family is chasing answers and hasn't gotten there through school-based channels, clinical evaluation is an option.

The female phenotype is still being missed. If you work with girls who are anxious, perfectionistic, socially motivated but exhausted, and holding it together in ways that feel effortful, autism belongs on your radar. The quieter presentation isn't a less real one.

Collaboration is a clinical skill. The ability to communicate across disciplines, to share what you know, ask what you don't, and pass a family along carefully, is as important as anything in a textbook.

Thank you to the Central MN Child Advocacy Center and the Stearns Benton Child Protection Team for the invitation, and to everyone who showed up and asked hard questions. The work you do, all of it, in every professional role in that room, matters to the families we collectively serve.