Erin Lamb has been a speech language pathologist for 26 years. She runs a Baltimore nonprofit with its own school for autistic kids. She has a Ph.D. She still missed her own daughter's autism.

Why does autism get missed in girls? Most of the foundational autism research was done on boys. As Erin puts it, everything she knew about autism she learned from boys in the 90s, because that's what the research was done on. That research shaped the training, and the training shaped what people picture when they hear the word autism. Girls who talk early, who mask well, or whose struggles get read as anxiety often reach their teens before anyone says it out loud.

This is a Seen and Heard episode, so Erin gets the floor. She walks Rob through what a day actually looks like in a house with a kid in autistic burnout, with a PDA profile and ARFID, where separation anxiety is the most clinically significant thing in the room. She's honest about what it costs her. "People are like, what are you doing this weekend? And my answer is always caregiving. Because I do not know. I cannot plan."

Then she tells us what changed. She calls it outsourcing the panic. If the school professional isn't panicking, why is she? She handed the worry to the people whose job it is to worry, and her daughter started coming back to her within weeks.

She also gives the best description of an autistic kid this show has had. In the wrong environment it's like parenting all the kids from Willy Wonka at once. In the right one, with the right accommodations and supports, her kid is Charlie.

WHAT YOU'LL HEAR

• Why a speech language pathologist with 26 years of practice missed autism in her own daughter
• What a day really looks like with a kid in autistic burnout, a PDA profile, and ARFID
• What outsourcing the panic means, and how she started doing it
• Who her daughter actually is: the Lorax, Willy Wonka, and Charlie
• What she wishes the outside world, and the autism community, understood

TERMS FROM THIS EPISODE

Autism in girls: autism is underdiagnosed in girls largely because the foundational research was conducted on boys, so the diagnostic picture most clinicians trained on describes boys. Girls who mask well or present as anxious are routinely missed.

PDA, pathological demand avoidance: a profile in which an autistic person's nervous system treats demands as threats, even small or pleasant ones. Approaches that add pressure usually make it worse.

ARFID, avoidant restrictive food intake disorder: more than picky eating. A child avoids whole categories of food by texture, smell, or fear, to the point that nutrition and growth are affected.

Autistic burnout: exhaustion and loss of previously held skills following a long stretch of masking, sensory overload, and unmet needs. Recovery takes fewer demands and real rest, not more pushing.

Outsourcing the panic: Erin's strategy of handing specific worries to the professionals whose job it is to hold them, instead of carrying every worry herself.

ABOUT ERIN LAMB

Erin Lamb is the President and CEO of Gateway Maryland, the Baltimore nonprofit formerly known as HASA, which has served Maryland families for nearly 100 years. She's a licensed speech language pathologist, holds a Ph.D. in public policy, and is the mom of two neurodivergent teenage daughters.

SPONSOR

This episode is sponsored by Mightier, a biofeedback emotional-regulation gaming program for kids, developed and tested at Boston Children's Hospital. Kids wear a heart-rate monitor and play games that get harder when they get dysregulated and easier as they calm down, so they practice regulating themselves in the moment. Read Rob's full review at theautismdad.com/mightier-review and use code theautismdad22 for 10% off. #ad

RESOURCES

• Gateway Maryland: gatewaymaryland.org
• Rob's full Mightier review: theautismdad.com/mightier-review
• More Seen and Heard episodes: listen.theautismdad.com

Find Rob at theautismdad.com, and on Facebook, Instagram, TikTok, and YouTube at The Autism Dad.