Dr. Suzanne Goh

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Dr. Suzanne Goh

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Dr. Suzanne Goh is a board-certified pediatric behavioral neurologist, a neuroscience researcher, and author.

She has dedicated her career to researching and developing therapies for neurological conditions that impact childhood brain development.

09/25/2026

Even if you're working with a great clinician, diagnosing autism in girls is genuinely harder. Here's why.

The same effortful performance she uses at school can show up during an evaluation itself, so a clinician meeting her for an hour may see the mask, not what's underneath it. Diagnosis leans heavily on what gets reported, by her, a parent, or a teacher, which can make it harder to get to the full truth.

Trust your instincts. Don't let "she seems fine socially" end the conversation. Getting the right diagnosis may take more than one appointment, and that's not a failure, it reflects how much careful listening an accurate picture requires.

For more, comment "GIRLS" and I'll send you the links to listen to Episode 18 of the Magnificent Minds podcast.

09/22/2026

You've probably heard bits and pieces about toxins and wondered what's actually real. Here's the science, without the fear mongering.

Children breathe more air, eat more food, and drink more water relative to their size than adults do, and their systems for clearing chemicals aren't fully mature yet.

The biggest places to focus: air quality, water filtration, organic produce for the "Dirty Dozen," fragrance-free household products, and regular dust control. Pick one category, make one change this month, and let it become routine before adding another. Progress over perfection.

This isn't about fear. Reducing harmful exposures supports every child's brain, including children with autism.

For the full guide, comment "CLEAN" and I'll send you the links to listen to Episode 4 of the Magnificent Minds podcast.

09/17/2026

Brain-based ABA adds one letter to a framework you already know, and it changes everything.

Traditional ABA looks at Antecedent, Behavior, Consequence. It's powerful, but it can miss what's happening inside your child's brain. Brain-based ABA keeps that framework and adds one piece in the middle: the brain.

Instead of asking "How do we stop this tantrum?" it asks what's overwhelming your child's sensory system or motor planning, and how to support the brain toward a new response.

Good ABA assesses sensory antecedents, uses declarative language over commands, distinguishes tantrums from meltdowns, and teaches skills in real, natural settings.

For the rest of the 10 steps, comment "ABA10" and I'll send you the links to listen to Episode 6 of the Magnificent Minds podcast.

08/28/2026

Your daughter holds it together all day. Then she gets home and falls apart. This isn't a behavior problem. This is masking.

Masking is the effortful, learned performance of neurotypical behavior: rehearsing responses, scripting conversations, studying how others move through the world so you seem natural in the moment. It is an enormous amount of cognitive and emotional work happening below the surface, every single day.

The research is striking: 3 in 4 autistic women reported that masking directly impacted their ability to receive a diagnosis, compared to 1 in 4 men. Masking doesn't just cost energy. It costs years of recognition.

When it goes unrecognized long enough, the result is autistic burnout. Not ordinary tiredness. A system-level collapse that can look like depression, anxiety, or chronic fatigue, and often gets treated as exactly that.

The girl described as "doing fine" at school may be spending every available unit of energy maintaining that performance. Home is where the mask comes off. The meltdown after school, the shutdown on the couch. That's not bad behavior. That's the cost of the performance.

When autistic girls are finally seen for who they are, they can stop asking "what is wrong with me?" and start asking "what do I need?" The earlier we find her, the less of that road she has to walk alone.

For more, comment "GIRLS" and I'll send you the links to listen to Episode 18 of the Magnificent Minds podcast.

08/24/2026

Autism in girls often looks nothing like what most people expect. Here's what to actually look for.

Difference #1: She wants connection deeply, but it costs her enormously. Autistic girls often want connection just as much as their peers. But wanting it and navigating it smoothly are two very different things. They're also significantly more likely to be hurt by the subtler cruelties between girls: being left out, the group quietly shifting against them, not knowing what they did wrong. That reaction isn't drama. It's the loss of something she was working very hard to maintain.

Difference #2: Her special interests look "normal," so no one notices the intensity. Autistic girls tend to develop deep interests in subjects that aren't flagged as unusual: animals, fictional characters, celebrities, fantasy worlds. The intensity is just as high, the knowledge just as encyclopedic, the distress when she can't engage just as real. But it receives praise, not understanding.

Difference #3: She has learned to perform neurotypicality. Carefully. Exhaustingly. Researchers call this masking: rehearsing responses, scripting conversations, studying how others move through the world so she seems natural in the moment. Most people around her never see the work it takes.

Difference #4: Before she receives an autism diagnosis, she'll likely receive several others. Anxiety, depression, OCD, eating disorders. These aren't false diagnoses, but they are frequently incomplete. When they're treated in isolation, the treatment misses the mark.

Trust your instincts. Don't let "she seems fine socially" be the end of the conversation. The earlier we find her, the less of that road she has to walk alone.

For more on autism in girls, comment "GIRLS" and I'll send you the links to listen to Episode 18 of the Magnificent Minds podcast.

08/17/2026

Autism Biological Subtype #4: Single Gene.

When one identifiable gene is doing something differently, and that change shapes everything.

In this subtype, one gene produces a recognizable pattern that often has its own name. That pattern may include characteristics beyond autism itself: certain physical features, or differences in how other body systems function like the heart, GI tract, bones, or hormones.

You may have heard of some of these: Fragile X syndrome, Rett syndrome, Phelan-McDermid syndrome, Tuberous sclerosis complex (TSC), and PTEN-related conditions, among many others. Each involves a specific genetic variant with its own developmental profile and medical considerations.

Why this category matters so much right now: when you can point to a single gene, researchers can look at exactly what it does and why it matters for your child specifically. There are already specific medical therapies for some of these conditions, and this is one of the fastest-moving areas in autism science.

One important thing to remember: having one biological subtype doesn't mean others aren't present. These four categories aren't a checklist. They're a biological map, a direction to investigate, so your child's care can be built around their actual biology.

For the full series on biological subtypes, comment "BIOLOGY" and I'll send you the links to listen to Episode 19 of the Magnificent Minds podcast.

08/13/2026

Autism Biological Subtype #3: Cortical Patterning.

How your child's brain was physically built before they were even born.

During pregnancy, billions of neurons are being born, traveling to their designated locations, and organizing themselves into precise layers and regions. The outer layer of the brain, called the cortex, is where most of this complex organization happens and where higher-level thinking, sensory processing, and communication take place throughout life.

A study in the New England Journal of Medicine found patches in the brains of autistic children where the cortex wasn't organized into its expected layers, suggesting a disruption during prenatal development. Think of it like a city where some neighborhoods get built according to plan and others don't. It functions differently.

One visible sign of this subtype is something measured at every well-child visit: head circumference. A subset of autistic children have a period of unusually rapid brain growth in the first years of life. This isn't harmful in itself, but it is a marker that something in the early brain-building process was different.

This subtype often goes unrecognized unless you're working with a doctor who knows to look for it, through brain imaging or a very detailed medical history.

Every autistic child deserves to be understood in full. Not just their behavior, but the whole biological context they're living in.

For more, comment "BIOLOGY" and I'll send you the links to listen to Episode 19 of the Magnificent Minds podcast.

08/10/2026

Autism Biological Subtype #2: Immune.

Your child's brain and immune system are in constant conversation. When one is dysregulated, the other often feels it too.

The brain has its own immune cells called microglia, whose job is to monitor the brain environment and respond to potential threats. When the immune system is over-activated or dysregulated, it can affect how the brain develops and functions.

This can start before birth. Significant immune activation during pregnancy can send inflammatory signals across the placenta that affect how the fetal brain is developing during critical windows of growth. This is not about anything a mother did wrong--often there is no way to know this is happening. Ongoing low-level neuroinflammation can shape how the brain processes the world every day.

What this can look like: sensory sensitivities may be particularly intense. Behavior or regulation may shift noticeably when your child is sick. They may have recurring immune-related health challenges alongside their autism profile.

One more thing: immune differences in autism often run in families. Knowing your family health history matters more than many families realize.

A care team that isn't asking about your child's biological profile is working with an incomplete picture.

For more, comment "BIOLOGY" and I'll send you the links to listen to Episode 19 of the Magnificent Minds podcast.

08/04/2026

Autism Biological Subtype #1: Metabolic.

Think of every cell in your child's body as a tiny factory. When part of that system isn't running smoothly, we can often see and measure exactly where it's getting stuck.

The most common disruption is mitochondrial. Potentially more than 1 in 4 autistic children show biomarker evidence of mitochondrial dysfunction that affects how their cells produce energy. In my own 2014 research at Columbia, markers of inefficient energy production were found in the brains of autistic children at 13%, compared to 1% in non-autistic individuals.

Nutrients also fall here. 30-40% of autistic children have insufficient vitamin D or iron levels regardless of their eating habits, and vitamin B12 deficiency is more common in autism too. Some autistic children also have difficulty converting folate to its active form in the body, or have low folate levels in the brain itself. This is where leucovorin can play an important role.

Behavioral support and biological understanding are not separate tracks. They belong together.

For more, comment "BIOLOGY" and I'll send you the links to listen to Episode 19 of the Magnificent Minds podcast.

07/28/2026

4 questions to ask about your child's ABA program. Beyond "how many hours," here's what is worth asking.

Question 1: Where will the hours be delivered? A child spending all their time in a center is having a very different experience than a child whose hours are spread across the center, the home, and the community. Home-based therapy is where caregiver coaching happens, where skills get practiced in real contexts, and where your family becomes equipped to support learning every hour of the day, not just when a therapist is present.

Question 2: What's the ratio of individual to group sessions? Some skills genuinely need one-on-one work and others need group interaction.

Question 3: Is there room left in the week for my child to just be a child? A week cannot be wall-to-wall therapy. There has to be room for family, for play that your child leads, for siblings, grandparents, neighbors, and friends. A schedule so packed with intervention that there's no time left for living simply isn't in your child's best interest.

Question 4: Is anyone treating co-occurring needs as part of this plan? Sleep problems, GI issues, sensory needs, anxiety: these aren't edge cases in autism. They're the rule, and they shape every moment of therapy. A program is only as strong as its understanding of your child's whole self, not just their behavior.

A child who is exhausted, dysregulated, or in physical discomfort cannot learn well, no matter how many hours of therapy they receive. The goal was never the most hours. It's the right care, delivered in the right way, for your specific child.

You are allowed to ask these questions. A good program will welcome them.

For the full conversation on ABA hours and whole-child care, comment "ABA" and I'll send you the links to listen to Episode 17 of the Magnificent Minds podcast.

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+18582517901

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