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Biography
Dr. Marschall has been a licensed psychologist since 2016, having completed her pre-doctoral internship through the National Psychology Training Consortium (Central Region) and her post-doctoral residency at Family Psychological Center, PA, in Harrison, Arkansas.
She currently owns a private practice, RMH-Therapy, where she provides therapy primarily to children and adolescents and psychological evaluations. Her clinical specializations include trauma-informed care, neurodiversity-affirming care, rural mental health, and Tele-mental health. She currently holds an active PSYPACT license, which allows her to see clients in 40+ states via Telehealth.
Dr. Marschall is a late-diagnosed autistic and ADHD individual and is passionate about providing affirming care for her patients.
Education
Doctoral degree in clinical psychology: University of Hartford, 2015
Certifications
Area of Expertise
I incorporate evidence-based interventions as well as a client-centered approach to therapy that empowers YOU to be in charge of your treatment. My practice is trauma-informed, which means that I recognize the prevalence of trauma in the general population and take steps to create a comfortable environment that feels safe and empowering for all clients.I believe each client is the expert on themselves.
As a psychologist, I can offer insight into symptoms and mental health diagnoses, but no one knows you and your experience better than you.In addition, my psychology practice emphasizes social justice, cultural competence, and LGBTQ+ affirming care.
Modalities
Affiliations
Research and Publications
Understanding 'High-Functioning' Autism: Traits and Misconceptions
As our understanding of the autism spectrum evolves, so does the language associated with autism spectrum disorder (ASD). And that language matters.
Right before my daughter was diagnosed with ASD, I felt like everyone around me was using the phrase “high-functioning autism” to describe her relatively moderate support needs. It also seemed to confirm why it took several years to receive an autism diagnosis at all. I soon learned, however, that describing someone with “high-functioning autism” was not only incorrect but harmful.
For starters, “high-functioning autism” isn’t even a clinical diagnosis, though the term is pervasive enough that some people may mistake it for one.
What the best-intentioned people usually mean when they say “high-functioning” is Level 1 or low support needs, which often refers to someone who needs circumstantial support with social communication and restricted or repetitive patterns of behavior and interests (RRB).
Specifically, that can mean help with managing the need for sameness, recognizing neurotypical social functioning and cues, and managing sensory sensitivities. Autistic people who are Level 1 may also engage in masking, which can make someone seem to have fewer support needs than what is actually sustainable.
Nasiyah Isra-Ul (they/she) is an autistic professional and disability advocate who believes that the once-prevalent “high-functioning autism” label prevented them from receiving the support they needed throughout their childhood and young adulthood. It could also explain why they received a late autism diagnosis as an adult.
If you’re curious about signs of high-functioning autism in adults, you’re in the right place! But we won’t be using that problematic term, and neither should you. In this article, we’ll explain why the term is outdated, what people actually mean by it, and what the most common autistic traits look like for adults with Level 1 autism support needs or who mask heavily.
Understanding Rejection Sensitive Dysphoria (RSD) in Autism and ADHD
It’s perfectly normal for breakups to hurt, criticism to sting, and being excluded to feel lousy. But for people with rejection sensitive dysphoria, or RSD, rejection or failure is distressing on another level. Whether the rejection is real or perceived, RSD can cause severe emotional and sometimes physical pain.
While this is something I’ve dealt with as long as I can remember, I didn’t have a name for it until I was diagnosed with ADHD in my 30s. Once I found out that neurodivergent people often experience RSD, the extreme emotional responses I was having suddenly made sense.
Rejection sensitive dysphoria was initially acknowledged in relation to ADHD, but it's now increasingly recognized as a common autistic experience too, says Dr. Kelly Whaling, a clinical psychologist and research lead at Prosper Health.
While people are quick to point out that no one likes rejection, RSD is something else completely. The shame, humiliation, anger, and sadness I felt when I thought I was being rejected in some capacity would easily ruin my day. But that was only the beginning. From there, I’d start mentally catastrophizing everything, assuming the worst possible scenario was inevitable.
If my boss gave me feedback on a project, I thought it meant I’d be fired the next day. If a friend didn’t respond to my text, I thought it meant that I had done something unforgivable and that they were mad at me. It’s a feeling I have to manage to this day, but finding out that I wasn’t the only person whose brain worked this way did help.
It’s important to note that RSD itself is not a formal diagnosis, but rather a pattern of experience recognized by clinicians and neurodivergent people alike. So, whether you’re neurodivergent, love someone who is, or have questions about RSD, here’s a clear, compassionate guide to understanding and management.
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Understanding Autism in Adult Women: Why It’s Often Missed and What It Really Looks Like
When I was a little girl in the early 2000s, autism was seen as a disorder that only boys had. My evaluators misdiagnosed my autism as ADHD, and mistreated my symptoms (my stims, masking, and social anxiety). Luckily, awareness around the rainbow of autistic presentations is growing, and things are starting to change. As an AFAB person who now identifies as non-binary, I was able to seek re-diagnosis and affirmation that I'm autistic—something I suspected for the majority of my life.
According to a recent study published in JAMA, autism diagnosis is increasing fastest among women between the ages of 26 and 34. And among those, women sought diagnosis a whopping 3 times more than men. This comes as no surprise, as autism is actually underdiagnosed in women because of biases in testing. The research behind these tests predominantly focused on the experiences of men and boys, so clinicians have trouble catching the varied autistic traits in women and AFAB folks.
This article will focus mainly on the experience of autistic adult women because the medical research is only just starting to catch up with AFAB experience. However, it’s worth noting the ways autism presents in nonbinary people.
Transgender and nonbinary people are around five times more likely to be autistic compared to cisgender people. The Autistic Women and Nonbinary Network’s website is a good place to start if you’d like to find autistic nonbinary people writing about their experiences.
Autism manifests in very specific ways in adult women that have been ignored until now. If you’re a woman or AFAB person wondering if you might be autistic, support is available. Read on to learn more.
