Understanding Autism Spectrum Disorder: Early Signs, Myths & Mental Health with Dr. Myah Gittelson

Summary

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Podcast Summary: "Understanding Autism Spectrum Disorder: Early Signs, Myths & Mental Health"

Podcast: We're Out of Time
Host: Richard Taite
Guest: Dr. Myah Gittelson (Clinical Psychologist, ASD & ADHD Specialist)
Date: September 9, 2025

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Main Theme & Purpose

This episode dives into Autism Spectrum Disorder (ASD) with Dr. Myah Gittelson, focusing on early signs, diagnostic changes, myths, gender differences (especially the overlooked female phenotype), and the intersection of autism with addiction and mental health. The conversation also highlights shifts in social acceptance, struggles with the labeling of neurodivergent children, misdiagnosis, and the often-confusing landscape of diagnostics and treatment.

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Key Discussion Points & Insights

1. Defining Autism and Diagnostic Evolution

• The Spectrum Is Broad: ASD manifests differently among individuals. Dr. Gittelson discusses how the “female phenotype” is understudied, with early research focusing exclusively on boys ([00:06]; [07:24]).
• Diagnostic Criteria Have Changed: With the DSM-5 in 2013, clinicians can now simultaneously diagnose both autism and ADHD, previously restricted to either/or ([02:51]; [03:35]).
  • Quote: “So prior, you could only have one or the other... So there was more ADHD diagnoses, [and] less autism diagnosis.” – Dr. Gittelson [03:20]
• Numbers Are Rising: The broader definition and social acceptance have led to a perceived increase in diagnoses. Greater awareness and changing cultural attitudes mean more people—especially girls and minority populations—get assessed ([16:25]; [17:00]).
  • Quote: “I think also our numbers are increasing because this population used to not come see us.” – Dr. Gittelson [16:58]

2. Persistent Myths & Stigma

• The Vaccine Myth: Dr. Gittelson is clear: the vaccine-autism link is debunked—90% of cases are genetic ([01:56]; [00:06]).
  • Quote: “We have found that 90% of cases of autism are linked to genetics.” – Dr. Gittelson [01:56]
• “Labeling” vs. “Diagnosing”: The group debates whether a diagnosis is a helpful tool or a stigmatizing label. Dr. Gittelson reframes diagnosis as a guide, not a life sentence ([12:18]; [13:36]).
  • Quote: “Who is to say that we are socializing the right way and [autistic people are] socializing the wrong way?” – Dr. Gittelson [13:36]

3. Gender Differences: The Female Phenotype

• Underdiagnosed Girls: Early research ignored girls, leading to systemic underdiagnosis. Girls’ autistic interests may center on socially acceptable themes—like makeup or social media—making symptoms less obvious ([07:24]; [08:19]).
  • Quote: “No girl that I've seen has a restricted interest in trains. ...girls, makeup, clothing, social media stuff... Which for our society is... acceptable.” – Dr. Gittelson [08:19]
• Societal Blind Spots: Behaviors in girls may be misattributed to personality or social norms, rather than seen as neurodivergence ([08:50]).

4. Autism, Addiction & Mental Health

• Vulnerability to Substance Use: ASD youth are susceptible to addiction, often using substances as social coping mechanisms. Peer acceptance comes at the cost of manipulation or exploitation ([09:49]; [10:19]).
  • Quote: “When they get a taste of a substance ... they can socialize... they're being accepted. ...The group wants them around right when they didn’t want them before.” – Dr. Gittelson [09:49]
• Overlap with Other Diagnoses: ASD in girls is frequently misdiagnosed as bipolar disorder or eating disorders, due to emotional dysregulation and issues like sensory overwhelm ([19:25]; [20:09]; [21:26]).

5. Misdiagnosis and Systemic Shortcomings

• Complex Diagnoses: Dr. Gittelson often sees individuals mislabeled with bipolar disorder or ADHD. She walks parents through nuanced, careful diagnostic processes, emphasizing symptom context and impact ([19:25]; [24:29]).
• Insurance & System Barriers: Some ASD presentations lack official DSM codes, creating issues with insurance and school accommodations ([22:56]; [30:44]).
• Impact of Diagnosis: Accurate diagnosis informs necessary accommodations (like IEPs at school), ensures appropriate expectations, and reduces misunderstanding ([31:26]).
  • Quote: “To be clear and to be concise and to be accurate is important because it has to match the narrative for the people to understand.” – Dr. Gittelson [31:26]

6. Advances, Challenges & The Role of AI

• AI in Diagnosis? There’s lively debate over whether AI can streamline and improve diagnostic accuracy, though Dr. Gittelson cautions that empathy and context can't be fully automated ([21:44]; [22:10]; [29:15]).
  • Quote: “Maybe AI can fix... personal bias and emotion in it, right?” – Dr. Gittelson [30:06]

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Notable Quotes & Memorable Moments

• “Clarity is power. Why is everything so goddamn ambiguous?” – Guest 1 [04:35]
• “It's acceptable to be obsessive about makeup because you're a girl.” – Dr. Gittelson [08:46]
• “They're getting manipulated, they're getting taken advantage of. They don't get it that they are, but the group wants them around right when they didn’t want them before. So that's one reason why they're at a higher percentage...” – Dr. Gittelson [10:19]
• “I try not to think of it or, you know, use the word label because it comes with a negative connotation.” – Dr. Gittelson [13:36]
• “My clinical interview always talks about, what is your concern... and the parent scold me by saying, none of this is a concern.” – Dr. Gittelson [14:24]
• “I’m kind of jealous sometimes when I hear influencers... that don’t have a degree or a license... What they can say, it’s an epidemic.” – Dr. Gittelson [26:17]

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Timestamps for Important Segments

• 00:06 – Genetics & Gender in Autism: Dr. Gittelson introduces the female phenotype; role of genetics
• 01:56 – Vaccine Myth Debunked: The genetics of autism & the debunked vaccine connection
• 02:51 – Changing Diagnostic Criteria: The shift to allow co-diagnosis of autism and ADHD
• 07:24 – Female Phenotype: How autism presents differently in girls
• 09:49 – Autism & Addiction: Substance use as a socializing tool for teens with ASD
• 13:36 – Labels, Gifts, and Socialization: Reframing the diagnosis as positive and questioning who decides what’s “normal”
• 16:25 – Cultural Change: Cultural stigma fading, younger generations seeking diagnoses
• 19:25 – Misdiagnosis as Bipolar: ASD in women mistaken for bipolar due to emotional dysregulation
• 21:44 – Diagnostic Misses & Technology: Could AI help clinicians avoid misdiagnosis?
• 30:44 – Importance of Precise Diagnosis: How school and treatment outcomes depend on the right label

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Flow & Tone

The conversation is unscripted, candid, occasionally irreverent, and driven by both professional experience and personal passion. The hosts push for clarity, challenging outdated norms, while Dr. Gittelson champions a nuanced, human-centered approach.

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Resources & Contact

• Dr. Myah Gittelson's website: doctormyagittelson.com ([33:24])
• Gittelson Psychology Services: Dr. Gittelson’s growing psychology practice ([33:42])

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This episode is a must-listen for parents, educators, and clinicians seeking updated, compassionate understanding of ASD—especially for girls and marginalized groups. The hosts challenge system inertia and push for empathy, clarity, and broader social progress in mental health care.

Transcript

[Richard Tate]

Doctor Maya Gittleson, a clinical psychologist specializing in child development, joins the we're out of Time podcast.

[Dr. Maya Gittleson]

There's one autism spectrum disorder, but there are different presentations. One that I'm very passionate about is female phenotype. Autism was researched on boys. No girls were in the study. Now, especially when we broadened the term of the spectrum, you were able to capture some girls that were having some similar themes going on, but they were not expressing it the way as we know boys express it. I think now we're still looking, looking for a cause. We have found that 90% of cases of autism are linked to genetics.

[Richard Tate]

We want to extend a heartfelt thank you to our listeners because of your incredible support. We're out of Time has reached number one on Apple's mental health podcast chart, number two on the health and fitness chart, and number 26 overall. We couldn't have done this without you. Thank you for being part of this journey with us. Thank you for listening to the we're out of Time podcast with Richard Tate. If you haven't already, please follow the podcast rate and review. And if you're getting value out of we're out of Time, share it with someone else.

[Dr. Maya Gittleson]

You know, if someone has a problem with substance use use disorder, please call one call placement. That's 888-831-1581. And if we can't help you, we'll make a referral to someone who can. Please, we're out of time.

[Guest 1 (possibly a co-host or commentator)]

Dr. Maya Gittleson, thank you for coming today. I really appreciate it. Dr. Maya Gittleson is the most successful psychologist in Los Angeles that deals with autism and ADHD in children. So it's a pleasure to have you. Thank you. Thank you so much for coming.

[Guest 2 (possibly a co-host or commentator)]

This is such a hot button topic today with our new health leaders. Yes, anti vaxxers causes of autism. Jenny McCarthy, how do you navigate these choppy waters these days?

[Dr. Maya Gittleson]

So this is nothing new. We've already gone through the wave of vaccines being pinpointed as a cause and debunked. I think now we're still looking for a cause. We have found that 90% of cases of autism are linked to genetics. So searching for this external environmental factor like vaccines or something else, I'm not sure if we're going to find out because 90% of the cases have already been determined linked to genetics. So if we are looking to cure autism or find something to eradicate this disorder, this disability, I'm not sure until we can change our genetics that we can do that.

[Guest 2 (possibly a co-host or commentator)]

Is there more autism spectrum Neurodivergent. I want to make sure I say it correctly. But is it because we're just getting better at diagnoses?

[Dr. Maya Gittleson]

There's a couple of reasons. One is that we changed the diagnosis, of course, to make it more broad, to capture more individuals. We also decided in 2013 with the DSM 5 that now we're able to make a diagnosis of both autism and adhd. Before that, it was specified that you could only have one or the other.

[Guest 1 (possibly a co-host or commentator)]

In the DSM 4.

[Dr. Maya Gittleson]

Right.

[Guest 1 (possibly a co-host or commentator)]

So these people are prior, painful.

[Dr. Maya Gittleson]

So prior, you could only have one or the other it specified. So which diagnosis do you think parents would like to hear more? Right. So there was more ADHD diagnoses, less autism diagnosis. Right.

[Guest 2 (possibly a co-host or commentator)]

When was that? What Was fully unaware of that?

[Dr. Maya Gittleson]

The change shifted in 2013 with the DSM 5.

[Guest 2 (possibly a co-host or commentator)]

Okay.

[Dr. Maya Gittleson]

So now we're told as clinicians, you can have both. And they're actually making a change, hopefully soon. They're trying to look at blending the two together to have a diagnosis that talks to both diagnoses and one descriptor name. So it's no longer you having two coexisting. You have one name.

[Guest 1 (possibly a co-host or commentator)]

This is the. This is such bullshit. These are the same people, okay, that came up with substance use disorder. I mean, what difference does it make if you have two diagnoses or one combined? I mean, I just hate these people.

[Guest 2 (possibly a co-host or commentator)]

I get.

[Guest 1 (possibly a co-host or commentator)]

They're the worst.

[Guest 2 (possibly a co-host or commentator)]

When you come from a place that you do, which is, like, down and dirty, what's your affliction? How many get you treated? You know, you come from a place of experience. You come from a place of, you know, of just confronting people and getting them into.

[Guest 1 (possibly a co-host or commentator)]

Clarity is power. Why is everything so goddamn ambiguous? Clarity is power. What's the problem? What's the solution? Fix the problem.

[Dr. Maya Gittleson]

Right, but clarity comes with a diagnosis.

[Guest 1 (possibly a co-host or commentator)]

No, no, absolutely. But where you muddle it down. Okay. Where it gets all muddled. Did I use that word right?

[Guest 2 (possibly a co-host or commentator)]

Yeah.

[Guest 1 (possibly a co-host or commentator)]

Okay, well, I'm 58. I've never used the word, so I don't even know how it came out of my mouth. What I don't like is, why do you have to combine two diagnoses to make people feel more comfortable? Isn't it. Isn't it more important to be honest and straight with people and say, this is your issue specifically, not this and this. This is your issue specifically, and this is the way you deal with it?

[Dr. Maya Gittleson]

No, 100%, and I'm very straightforward with that.

[Guest 1 (possibly a co-host or commentator)]

You are. What I'm pointing out is the dsm, the People that do that, that deal with the criteria of everything, right. These guys, okay, have their head on wrong. You people have your head on wrong. Okay, seriously. I mean, I'd like to get back to common sense, where we can identify a medical issue. Right, without the woke influence. Right? And just deal with the medical issue without it being a socially acceptable thing. It's like. It's like you can't save your ass and your face at the same time. It's one of those. All right, rant over.

[Dr. Maya Gittleson]

Okay, but the other issue first. We had those differentials, right? So you can only have one or the other. So then when you said you could have both, of course numbers are going to go up.

[Guest 2 (possibly a co-host or commentator)]

Sure.

[Dr. Maya Gittleson]

Right. Because now it's okay to have autism and then also have adhd, so your numbers go up.

[Guest 1 (possibly a co-host or commentator)]

Can I ask you a quick question? Not to interrupt, but what happens if you have adhd, autism, and restless leg syndrome? Is it all the same? Why don't we just put it all in one group? Seriously. And then we can do the heartburn thing, too. With Pepcid, we can do the. We can have it all together, right? And then we can have sleep disorders.

[Dr. Maya Gittleson]

We can put.

[Guest 1 (possibly a co-host or commentator)]

We can put everything together. Hey, guys. Put everything together.

[Dr. Maya Gittleson]

See, I don't do that. That's why I like to make a diagnosis of autism spectrum disorder, because a lot of people come in anxiety, they come in with adhd, they come in with sensory. Sensory integration disorder. And I'm like, wait, why do you have a laundry list of diagnoses? All of this is under the umbrella of autism.

[Guest 1 (possibly a co-host or commentator)]

When there are 72 autisms.

[Dr. Maya Gittleson]

Pretty much there's different presentations. So there's one autism spectrum disorder. Right? But there are different presentations. One that I'm very passionate about is female phenotype. So I focus a lot in my practice.

[Guest 2 (possibly a co-host or commentator)]

Explain that to him.

[Dr. Maya Gittleson]

Okay, so female phenotype, explain it to them. So autism was researched on boys, Right? We all know that. You probably, if you Google and go online, you've read anything about autism, it talks about how the first research to come up with the DSM and to come up with the criteria was on boys. No. No girls were in the study. Right? So then, now, especially when we broadened the term of the spectrum, you were able to capture some girls that were having some similar themes going on, but they were not expressing it the way as we know boys express it. So what?

[Guest 2 (possibly a co-host or commentator)]

Can you give an example?

[Dr. Maya Gittleson]

So interest. So restricted interest. No girl that I've seen has a restricted interest in trains. A lot of boys that I'LL diagnose, have a restricted interest in trains or cars, girls, makeup, clothing, social media stuff. They get very restricted and very obsessive about those things. Which for our society is. Okay, right? It's acceptable.

[Guest 2 (possibly a co-host or commentator)]

That's really.

[Dr. Maya Gittleson]

It's acceptable to be obsessive about makeup because you're a girl.

[Guest 2 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

It's acceptable in a way to have a eating disorder because you're a girl. But when I look at an eating disorder and I look at girls, I'm finding the spectrum. Their restricted interest is landing in those areas. Food and you know.

[Guest 2 (possibly a co-host or commentator)]

Sure. And the cell phone addiction. I'm sure plenty of non spectrum kids are addicted to their cell phone.

[Dr. Maya Gittleson]

Right. I mean, that's a whole nother discussion. Because a lot of neurodivergent individuals are gonna have a hard time shifting so shifting attention. So when you're on your cell phone, they can't just shift their brain off. So when they're with trains, when they're on their cell phone, whatever it is that they choose or they land on is hyperfocus, hyper fixation, perseveration and unable to shift.

[Guest 1 (possibly a co-host or commentator)]

Is there a higher propensity for drug addiction and alcoholism in kids on the spectrum? That.

[Dr. Maya Gittleson]

Okay, yeah, there is, but it's not what you think. So my, in my practice, what I see is that they don't know how to socialize. Right. And it comes really hard for them and they're not accepted. And some of them don't care. You know, they're like, don't have the desire or motivation. Some of them do or don't know how. When they get a taste of a substance, guess what happens? They can socialize.

[Guest 2 (possibly a co-host or commentator)]

Sure. Comfortableness with self.

[Dr. Maya Gittleson]

And now, whoa, I'm this new person. I like this. People like this person. There's no reason to stop because now they're comfortable. They're not. They're being accepted. They have a group to hang out with, related. Even though the group usually is using them for money to buy the substances. That's a whole nother thing. They're getting manipulated, they're getting taken advantage of. They don't get it that they are, but the group wants them around right when they didn't want them before. So that's one reason why they're at a higher percentage in my social acceptance. But they're not really being socially accepted. That's kind of the iron.

[Guest 1 (possibly a co-host or commentator)]

No, they, they. But compared to what they knew beforehand, it is really good.

[Dr. Maya Gittleson]

So you can have restricted interest, hyper focus, be fixated. You can do some repetitive behaviors. If it's impacting and pairing. And a lot of the times I'm seeing young kids, it's interfering with development. So at that point we step in because they need intervention. And for intervention, it's helpful to have a diagnosis, to know and to how to be effective, to have a diagnosis, to kind of guide you through that.

[Guest 2 (possibly a co-host or commentator)]

You've described literally 40% of my colleagues. There's so much neurodivergency in medicine and these people are super high. You give me, I'll take the resident or the medical student that is hyper focused, wants their note to be perfect, goes over it, over it, over it, goes back to the patient, asks some questions and follow up, comes back, goes back, comes back. I mean, they are high functioning. And I'm like, if this kid had a diagnosis at a young age and all of a sudden in their head they. And I want to be very clear, I am not disparaging what you do at all. It's that, you know, every parent sphere of. Do I want my kid to have a label? And if this kid gets a label at a young age as being neurodivergent.

[Dr. Maya Gittleson]

See, I don't see it as a label.

[Guest 2 (possibly a co-host or commentator)]

Okay, Okay.

[Guest 1 (possibly a co-host or commentator)]

I just want to say something, okay? It's a gift. Okay? In my experience, autism, everybody I've ever met on the spectrum, they're my best employees, they're my smartest employees. Okay? It is a gift. Now, socially, it's a little tough and they get hammered in that area. But it is more than made up for, okay? With the competency and the individual gifts that they have, it is. I mean, there's a guy in the, in the room right now. He's the biggest, he's the smartest person in any room he walks into. And I don't care who's in the room. So the labeling, what you're talking about is that was from when we were kids. Now she's got it on lockdown. She can say, oh, this is, this is what it is. But here's the good news, right? You're gifted here. You're you. I mean, you're special here. You can't be touched here. You got a little issues here. And we'll work on them, okay? Just like in practice, in sports, right? Okay. You work on the stuff that you're weak at. You can't work on it in the game because you're on automatic pilot. You're going to go to your strengths. Right? It's the same thing.

[Dr. Maya Gittleson]

Yeah. I try not to think of it or, you know, use the Word label because it comes with a negative connotation. And I always say in my practice, who is to say that we are socializing the right way and they're socializing the wrong way?

[Guest 2 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

Why? Who determines that our way of socializing and being and seeing the world is the right way and that their way, because it doesn't match ours, is the wrong or negative way? So I. That's where I start a lot with parents.

[Guest 1 (possibly a co-host or commentator)]

What's.

[Guest 2 (possibly a co-host or commentator)]

What's, like, the most common. When a parent comes in with their kid, would you say is the most common concern that they have? I know it's such a broad question, but a few of them just, like, my child's doing this, and therefore I'm concerned that they potentially.

[Dr. Maya Gittleson]

So more recently, I was a little schooled by a parent about that question. So my clinical interview always talks about, what is your concern. Right. We're just trained that way as a clinician. Like, tell me your presenting problem. Why are you here today? And the parent scold me by saying, like, none of this is a concern. My. This is what my child's doing, but it's not a concern for me.

[Guest 1 (possibly a co-host or commentator)]

I love that parent.

[Guest 2 (possibly a co-host or commentator)]

How do you answer that?

[Dr. Maya Gittleson]

Like I said I would. They really stopped me. Um, it was hard to regroup from that in that moment to have a comeback, because they're 100% right.

[Guest 1 (possibly a co-host or commentator)]

The comeback is I absolutely love you. And you are exactly correct. That's the answer.

[Guest 2 (possibly a co-host or commentator)]

But if there's, as you said, if there's impairment in development because of.

[Dr. Maya Gittleson]

Right. And of course, that's what we talk about. And that was my next segue to them is, okay, well how is it impacting and things like that. But a lot of the parents I do see, I should say 50, 50 will come in already affirming this, already feeling good. You know, let's just tell me the game plan here. You know, And I think that speaks to the new generation.

[Guest 1 (possibly a co-host or commentator)]

Yeah, they just want to know what to expect and how to deal with it as it comes up. It's just like any other. You know what I love? I love that any parent that ends up in front of her, I feel good about their parenting skills. Like, they're good people. Like, they saw an issue, they don't know about it, and they go to get a professional's best thinking. And, you know, the parents that do that for their kids are heroes. Because that didn't happen for my brother at all. And if it did happen for him, he'd still be here for sure. Yeah.

[Dr. Maya Gittleson]

And that's true. Also, it's a cultural piece. Right. So in the past, culturally it was taboo. And the newer generation of the same cultures are now speaking up to their elders saying, I'm sorry, we are taking our child to see someone. And so this is a big conversation I have with lots of different people from a diverse population that are now. And that's why I think also our numbers are increasing because this population used to not come see us.

[Guest 2 (possibly a co-host or commentator)]

So it's more acceptable to go.

[Dr. Maya Gittleson]

They're making it. I mean, their elders are still saying it's not acceptable, but they're saying we don't care. And so this generation speaking up, which again, sometimes in this newer generation, I'm butting heads a little bit with some of the things that they're speaking up about. But for this piece, I love it that they're speaking up about mental health and they're coming. And that's why again, I think some numbers are increasing because of that too.

[Guest 2 (possibly a co-host or commentator)]

So you make the diagnosis?

[Dr. Maya Gittleson]

Yes.

[Guest 2 (possibly a co-host or commentator)]

Is your follow up and treat? I don't want to say treatment because I don't know, I don't want to use that as a blanket statement. But is it, Are you following up with the parent? Are you following up with the child? Are you following up with both as a unit together? What does it look like? So, and it's a broad question.

[Dr. Maya Gittleson]

Yeah. In my practice is set up a lot for the diagnostic process. So I'm starting to do more treatment. I don't have a lot of time. And with these children too, they're in school. So in the how my practice is set up, in the morning I see three to four kids to do an evaluation to determine the differential of the diagnosis, making a diagnosis, not making a diagnosis. And then in the afternoon, I hold groups so I can work with more girls specifically to capture them in a holistic way, but not having enough time in my schedule to see all of them individually.

[Guest 2 (possibly a co-host or commentator)]

Right in. What I do in working at Carrera is I like to do a full health assessment of people that really doesn't focus on the addiction piece. So we'll have Dr. Smith who really will, you know, depending on the patient, I'll do it as well too. But if he's taking care of the addiction piece and treatment, which, you know, in terms of detoxing people can be very straightforward, cookie cutter. But I'm looking at and delving into personal trauma, medical trauma for women, obstetric trauma, surgical trauma, and the untreated. A lot of people allude to this. I was diagnosed with adhd As a kid, I got put on Adderall, I got put on Vyvanse. They're not on it at present. They come in almost universally. Meth is their drug of choice. Pink cocaine now is getting mixed in there just because it's designer and vogue and in the news. But they self medicate with meth for understandable reasons. No, right. Yeah, yeah.

[Dr. Maya Gittleson]

I think for women, I also get a lot of bipolar, so I'm getting known for this specialty of focusing on women. Right. Female phenotype of asd. So I've gotten all different ages coming to me from all different places. And one of the things I find in common is that they've in their history have had this bipolar diagnosis.

[Guest 2 (possibly a co-host or commentator)]

So somebody, a pediatrician or whoever. Psychiatrist.

[Dr. Maya Gittleson]

Yeah. Or they were hospitalized or whichever their situation is. But they're coming with this in their history. A bipolar diagnosis. Right. But there are things that they're telling me are fitting. Asd.

[Guest 2 (possibly a co-host or commentator)]

Can you give me an example?

[Dr. Maya Gittleson]

So when you have asd, you have a hard time regulating emotions.

[Guest 1 (possibly a co-host or commentator)]

ASD is what autism structure.

[Guest 2 (possibly a co-host or commentator)]

Okay.

[Dr. Maya Gittleson]

So when you have asd, you have a hard time regulating your emotions. So someone can be triggered by something in their environment or situation that causes their emotions to get very heightened and dysregulated and they're unable to regulate in that time. Sometimes they do a stemming behavior to then regulate or a sensory input behavior that regulates them and then they're okay. So in the outside world, without medication. Right, right, without medication. But in that heightened emotional experience, they maybe are going to do something that's impulsive and they harm themselves and they wind up in the hospital and, oh, this has to be a girl with bipolar because she went from this state. This state. Now she, you know, and having that change and that cycle must be bipolar.

[Guest 2 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

No one's asking her about, how do you process sensory information? Do you get overstimulated by noise? Do clothing materials bother you? How is your feeding, your food choices? And you find more and more when you ask those questions.

[Guest 2 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

I don't think we did a great job of that in the years past, but I think we're doing better now. And again, that adds to that question. Why are the numbers rising? Because we misdiagnosed them and now they're having a different diagnosis again captured under asd, but before they were bipolar.

[Guest 2 (possibly a co-host or commentator)]

Yeah, we got zero of this in med school.

[Guest 1 (possibly a co-host or commentator)]

Are we using. Are we using AI to go down a checklist and.

[Guest 2 (possibly a co-host or commentator)]

Really good point.

[Guest 1 (possibly a co-host or commentator)]

And really make certain, because it seems to me like the human error piece like she just said it. Well, they've been to all these other people and they get it right and then they come to you and you've got to ask the questions. Wouldn't it be easier to have an AI application that knocks all of this out?

[Dr. Maya Gittleson]

Yeah, possible. But the problem was we didn't learn this in, I mean, I didn't learn all this in my training at school. You're not being taught this at med school. So when a psychiatrist is seeing them, you know, we go to. Again, what I was saying before, I use a lot of experience in my practice versus research or textbook. So these people that they're seeing are led more by default because that's their training by research and textbook. If it's not written in a research book or research study or a textbook, it doesn't exist. Like when I came up with saying I'm seeing female phenotype asd, everyone's like, it's not in the dsm, it doesn't exist. You can't put that down. And I'm like, but then we're not going to be able to service this person because this.

[Guest 1 (possibly a co-host or commentator)]

What do you mean you can't put it down? You can't put it down? Hold on a second.

[Dr. Maya Gittleson]

Doesn't have a code, it doesn't have a lot.

[Guest 1 (possibly a co-host or commentator)]

That means is that you can't bill insurance for it, okay? But you can do whatever the hell you want. If you see a diagnosis that isn't in the DSM because they're idiots, then it doesn't matter, okay? You still get to treat that person. You just don't get to bill for it because insurance companies are going to always find a reason to deny you anyway. Deny, deny, Delay, Delay, right. I mean, it's just so it doesn't matter if it's in the DSM or not. If, okay, you're not, if you're not planning on getting reimbursed by an insurance company, you can still do the right thing.

[Guest 2 (possibly a co-host or commentator)]

So you have like a 15 year old who's got a diagnosis, she's self harming, she's been labeled bipolar. You do your thing and do a screen for her. You even see like, you know, I'm putting my gynecologist hat on and saying a 15 year old PMDD, like how that's mixed into the equation, that often gets overlooked.

[Guest 1 (possibly a co-host or commentator)]

Really?

[Guest 2 (possibly a co-host or commentator)]

What's PMDD is premenstrual Dysphoric Disorder. So pms, you guys all do that, right? So you get the sense based on your screen that this person is misdiagnosed. A self harmer, bipolar, on medication. Like, are you going to then go to the parent and say, I think your daughter's misdiagnosed?

[Dr. Maya Gittleson]

No, I don't say that.

[Guest 2 (possibly a co-host or commentator)]

Okay. Because that would be a really difficult thing to do.

[Dr. Maya Gittleson]

I don't, I don't say they're misdiagnosed. I say that there's something else going on.

[Guest 2 (possibly a co-host or commentator)]

Okay.

[Dr. Maya Gittleson]

There's something that we're missing.

[Guest 1 (possibly a co-host or commentator)]

Well, what happens if they are misdiagnosed?

[Guest 2 (possibly a co-host or commentator)]

There's got to be cases where you flat out are like, this person is.

[Dr. Maya Gittleson]

Not an adult is an easier case than a 15 year old. So I've had a 30 year old woman come to me and all her life she was, you know, in the onset of her struggles, told she was bipolar and put on medication for bipolar.

[Guest 2 (possibly a co-host or commentator)]

Okay.

[Dr. Maya Gittleson]

And now as an adult we can talk candidly that that probably wasn't the diagnosis she wants. She wanted, she came to me to really figure out if she's on the spectrum and she is. And we can kind of go back and say you probably were misdiagnosed. And that's an easier question than to tell a parent their child's been misdiagnosed or to go against another physician. I try not to say that the physician is wrong or their findings are wrong and they made the conclusion with the information that they had.

[Guest 2 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

And they didn't maybe go in a place or ask certain questions.

[Guest 1 (possibly a co-host or commentator)]

So why don't you say that? I mean, you can, you can explain. I mean, look, I don't know, okay? But if it was me and there was a misdiagnosis, I'd say, okay. The same thing I'd say about anything in treatment. Okay? They got it wrong. This is why, this is where you are and this is what we're going to do to fix it. The end.

[Guest 2 (possibly a co-host or commentator)]

It's not that cut and dry though, is it?

[Dr. Maya Gittleson]

It's hard.

[Guest 2 (possibly a co-host or commentator)]

I don't disagree with that.

[Guest 1 (possibly a co-host or commentator)]

No, no, no, no, of course not.

[Dr. Maya Gittleson]

It's hard as a clinician. I mean, you're not a clinician. So it's hard. It's great for you to say that. And if I was.

[Guest 2 (possibly a co-host or commentator)]

He's actually very good at saying that. I'm not being humorous here. He's very good at saying that in a way with somebody who needs to hear the truth about their behaviors and their actions. You're right. I think that's probably one of the best there is at it.

[Guest 1 (possibly a co-host or commentator)]

That's the first compliment you ever gave me.

[Guest 2 (possibly a co-host or commentator)]

That's not true.

[Dr. Maya Gittleson]

I mean, I'm kind of Jealous Sometimes when I hear influencers or others that are in social media and they don't have a degree or a license, yes, I'm jealous. What they can say, it's an epidemic.

[Guest 2 (possibly a co-host or commentator)]

I mean, that's like. That's a whole other podcast, right?

[Dr. Maya Gittleson]

But it's. It's amazing what they're able to say. So I'm bound to be careful because I want to be respectful to the other clinician.

[Guest 2 (possibly a co-host or commentator)]

Clinician. What, so you have this. What you perceive is probably something else going on.

[Dr. Maya Gittleson]

Right?

[Guest 2 (possibly a co-host or commentator)]

Do you ever do clinician to clinician where you'll talk to a psychiatrist or talk to the other caregiver?

[Guest 1 (possibly a co-host or commentator)]

Oh, this is going to be good. Yeah. Hold on. Do you ever call the bozo that got it wrong and say, we don't have to say bozo and say, hey, buddy, okay. I wanted to give you some information. Okay. And then see how that wound lands with that ego. Right? And then I give me one story about, please, God, give me one.

[Dr. Maya Gittleson]

I never picked up the phone. But I am the person that is known in the Valley, in San Fernando Valley, that does the differential. So the differential is someone has already evaluated this child and they've given a diagnosis that doesn't maybe fit what the parents are saying, it doesn't fit for what the interventions need to be. And they come to me, why are we still struggling here? We did this. My greatest is they pay 10 grand or 8 grand for a neuropsych. And I look at the neuropsych, and I can say like, I don't need any of this.

[Guest 2 (possibly a co-host or commentator)]

Do you see patterns among providers where you're like, doc? Because I know for me, I'm going to let you off the hook. When I see Dr. A's evaluation of the abnormal uterine bleeding, I'm like, okay, starting from scratch.

[Dr. Maya Gittleson]

Yeah, there are some trends, but really, my trend is when a parent's like, I've already done a neuropsych, paid 8 to $10,000, and I went in the wrong field, and we're still struggling what's going on? Right? And then all the clinicians or the interventionists, I should say, you know, the psycho educational therapist, the speech therapist, they're like, we're all whispering that the neuropsych didn't lead to autism diagnosis. And so they come to me, but why not? Right?

[Guest 1 (possibly a co-host or commentator)]

But why? No, there's got to be a reason that you go through extensive testing, right?

[Guest 2 (possibly a co-host or commentator)]

Right.

[Guest 1 (possibly a co-host or commentator)]

Okay.

[Guest 2 (possibly a co-host or commentator)]

In grand word.

[Guest 1 (possibly a co-host or commentator)]

Well, okay, whatever. Okay. It's your kid. It doesn't matter what it is. But You. You go through this testing, right? And then you can't take the data from the test and come up with something accurate, right? Let me tell you something. That's over, man. That's over this thing, you know, the science is always 10 or 15 years ahead of the practice, but you're using that new AI for your notes and everything else, and it's changed your life.

[Guest 2 (possibly a co-host or commentator)]

100.

[Guest 1 (possibly a co-host or commentator)]

Like, you can get done 10 times more.

[Guest 2 (possibly a co-host or commentator)]

100.

[Guest 1 (possibly a co-host or commentator)]

Okay. Now, I'm just telling you, I hate to be the bearer of bad news, okay? But that stuff's all over, okay? So what you guys got to do is you got to do the research to find out, and it takes five seconds. I'll show you how we do it afterwards, and we'll find you the AI software that will take data from any test and synthesize it down into what exactly the problem is and what the interventions will be. Now, it's. People say it's not right 100% of the time, and that's exact. Hold on. And that's. And that's true. But let me ask you a question. If someone was right 90% of the time, would you take direction from them? Because I sure would.

[Dr. Maya Gittleson]

The testing, though, that we use, it's not as cut and dry, and maybe that's where it starts, right? There's a lot of. And maybe AI can fix this personal bias and emotion in it, right? So if a parent's coming to you and you kind of sense that they don't want to hear asd, they don't want to hear autism, they'll take adhd, they'll take dyslexia, they'll take anxiety, but.

[Guest 1 (possibly a co-host or commentator)]

You can tell them anything, right? I mean, if you've got the kid there who's suffering and they don't want to hear autism, just you just tell them ADHD and you treat the autism, right?

[Dr. Maya Gittleson]

Can't. No. That's very hard because they. You take our reports and you then you explain the child through the report, right? So, for example, a child that's not diagnosed with ASD and goes to the school district for an iep and they see on there, oh, it's just adhd, you're going to get a different set of services, and the end expectations for that child are going to be different from the teacher. So the teacher's going to look at you and say, like, you have the abilities. You don't have autism, so you should be able to do X, Y and Z. You're not doing it. What's wrong with you? Because it's not matching the diagnosis.

[Guest 2 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

So you have the diagnosis to be clear and to be concise and to be accurate is important because it has to match the narrative for the people to understand. So go on back to addiction. One of the reasons why possibly numbers are higher with neurodivergent people for addiction is that they're misunderstood.

[Guest 1 (possibly a co-host or commentator)]

Right.

[Dr. Maya Gittleson]

So they're walking around with maybe the wrong diagnosis and no one understands them.

[Guest 2 (possibly a co-host or commentator)]

That. That, like, saddens my heart that we do that kind of harm because I take it personally that we wronged a child by making an inappropriate diagnosis.

[Guest 1 (possibly a co-host or commentator)]

We wronged a child at a young age by making an inappropriate diagnosis. Because people give a. About what the parents want to hear. And how many times have I said to a parent, hey, I don't give a sh. What you think about this. Listen to me. Okay? You want to. You want your kid back. Listen to me. Okay? It's like Maya, when somebody does that. When a. When a. When. When a parent says that. Okay. Who gives a. What they want to hear? Here's.

[Guest 2 (possibly a co-host or commentator)]

I want to touch on what you said.

[Dr. Maya Gittleson]

Balance. Right. You're all. As a teen.

[Guest 1 (possibly a co-host or commentator)]

Yeah. Though. Because most parents or good parents want what's in the best interest of their child. The end period, end of story. And what this smacks of is I don't want the neighbors to know that my kid is autistic. I don't want my friends to know. I don't want my social. Man. I just can't stand those people.

[Guest 2 (possibly a co-host or commentator)]

But that's really like. Right. Those. You alluded to that at the beginning of the podcast is those kind of labels and that, you know, that tabooness around it is really dissipated a lot, hasn't it?

[Dr. Maya Gittleson]

Has.

[Guest 2 (possibly a co-host or commentator)]

Yeah.

[Guest 1 (possibly a co-host or commentator)]

All right. Where can people find you?

[Dr. Maya Gittleson]

They can go to my website or they can.

[Guest 1 (possibly a co-host or commentator)]

What's your website?

[Dr. Maya Gittleson]

It is doctormyagiddleson.com.

[Guest 1 (possibly a co-host or commentator)]

How do you spell Maya Gittleson?

[Dr. Maya Gittleson]

M Y, A H, G I, T T E L, S o, N. There we go.

[Guest 1 (possibly a co-host or commentator)]

And that's where they find you.

[Dr. Maya Gittleson]

Yes.

[Guest 1 (possibly a co-host or commentator)]

All right.

[Guest 2 (possibly a co-host or commentator)]

All right.

[Dr. Maya Gittleson]

Or I guess Elise and Jordan probably would say I should also plug Gittleson Psychology Services as well because we are growing from just my small one man show to having multiple therapist under. So I also incorporated to be Gittleson Psychology Services.

[Guest 2 (possibly a co-host or commentator)]

Congratulations. That's exciting.

[Guest 1 (possibly a co-host or commentator)]

That is a big.

[Guest 2 (possibly a co-host or commentator)]

Yeah.

[Guest 1 (possibly a co-host or commentator)]

She's been doing this forever, man. She's a big shot. And her dad. And her dad's like. Like the best psychiatrist that ever lived.

[Guest 2 (possibly a co-host or commentator)]

Awesome. Yeah. Well, it's a pleasure to meet you. Thank you so much.

[Dr. Maya Gittleson]

Nice to meet you, too, as well. Okay, see you next Tuesday.

[Guest 2 (possibly a co-host or commentator)]

He got you.