Comment by dogma1138 | Hacker News Reader

Comment by dogma1138 | Hacker News Reader

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I'm perfectly aware that it's a spectrum but at the end there's a limit to how much you can throw at it before it becomes a jackson pollock painting.

Look at autism today vs even 10 years ago, look at how many perfectly adjusted individuals are diagnosed with it something just doesn't seem right to me.

When I've started school we have had 2 kids with ADHD during my entire primary school class, by the end of high school half the class had some sort of form of learning disability which many of them got to get extra time on tests or other type of exemptions (verbal testing for example). I've seen this happen in front of me within a decade and it seems to happen now again with other so called disorder. Don't get me wrong I have the utmost respect to children with developmental disorders I've volunteered with a special care group for 2 summers during high school and I've seen what the ends of both the disfunctioning and functioning spectrum looked like then and the very clear similarities you could tie between them in many activities.

But now? not really I've met some people that were diagnosed with Autism late in their life mostly with AAS (usually after a fairly short diagnosis session) all of them are to me perfectly functional adults yes each and everyone of them had their issues but I've seen in none of them the actual "signs" that I've seen in actual children that were professionally and clinically diagnosed with what back then was while quite polar but fairly narrow spectrum.

Okay but have you considered that people who seem like fully functional adults can also have autism and that they are fully functional by finding coping mechanisms to work with their autism? That is a thing that happens. To assume you know better than someone about their own mental scape because they 'seem fully functional' to you seems like a position without actually believing or listening to other people's experiences.

Well, part of it is that they increased the size of the "spectrum" by adding more conditions and that doctors now check early in case intervention may be required are why the numbers are not so high.

Take for example my daughter. She was able to walk by herself when she was 8 months old. She got very independent quickly. She was about to recite entire alphabet and count to 20 by 15 months. The concerning fact that doctors had was that she did not point at things of interest and had poor eye contact. By her 2nd birthday, she started receiving speech and occupational therapies from a local early intervention program. It definitely helped her along with putting her into daycare/early preschool environment. She is very good at memorizing songs and objects. We're a bilingual family and she understands both Polish and English languages. Recently, she started learning some bits of Spanish at preschool. She can draw pretty well and can write her own name.

Her biggest weakness that we're working on now is her speech / communication. She is currently at 27% for her age.

> She is currently at 27% for her age.

That sounds precise... Is that based on the size of her vocabulary?

Various states, comprehension, engagement, expression, and quite a few other factors. It's not the most accurate assessment but child development disorders including autism are very well measured and quantized compared to any adult syndrome.

I questioned that part but could not get a concrete answer how they established that. I just mentioned it because that's what the report states. However, the location and setup did not look very kid friendly and my little one didn't like it one bit so she refused to cooperate with the folks doing the evaluation.

I think part of the problem was the main entrance had a big swimming pool right past the main doors, and all my little one wanted to do was to go swimming.

Again I'm not talking about every case of autism, early development disorders are very well documented as well as backed by physiological evidence and can be measured quantized and worked through.

My issue with that lately allot of various neurotic behaviors especially in adults has been classified as autism.

Allot of studies shown that autism especially in teenagers and beyond has more to do with where you were diagnosed than your actual condition in the US there were multiple very specific spots in which there were very abnormal numbers of positive diagnosis which did not held through secondary evaluation.

The APA has officially started to clean up the autism spectrum for 2-3 (DSM5) years now throwing out very wide net and non-diagnosable conditions like Aspergers and mandated that existing cases should be reevaluated.

>Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.

In some countries there was a huge resistance to this from purely non-medical associations, in the UK you can now get a referral for diagnosis from a nurse (previously it was only GP) and the diagnosis it self can be taken in one of the privately operated centers operating in the country like the ones which are operated by the national autism society (which while it does wonders for children) isn't part of the NHS and is responsible for over 50% of the cases diagnosed since 2011, a vast majority of which were adults.

The diagnosis it self isn't done by doctors but by "professionals" like "speech therapists" and "developmental therapists" which while are certified to some extent (although for the most part are self regulated as there is no government sponsored certification process for them) are not medical doctors.

This is why I looks to me like ADHD2.0 as in another case when non doctors and non clinical professionals got the power to diagnose a disorder which was almost tailored for pushing pills to children despite substantial resistance from actual medical professionals mainly from child and development psychiatrists and clinical psychologists.

> The APA has officially started to clean up the autism spectrum for 2-3 (DSM5) years now throwing out very wide net and non-diagnosable conditions like Aspergers and mandated that existing cases should be reevaluated.

"Reevaluated", okay, but the first sentence you've quoted here makes clear that the intent is not to discard previous Asperger diagnoses across the board:

> > Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.

The relevant section of the DSM can be read at [0]. One analysis of the changes is at [1]. It seems to me (IANAMentalHealthProfessional) that the changes were motivated at least as much by a desire to bring Asperger and autism under the same umbrella as by a desire to discourage borderline diagnoses of Asperger.

> This is why I looks to me like ADHD2.0 as in another case when non doctors and non clinical professionals got the power to diagnose a disorder which was almost tailored for pushing pills to children

Are pills being pushed to children who are diagnosed with Asperger or mild autism?

I think I understand your concern; diagnostic fads are always problematic, and if it's really true that untrained people are making these diagnoses, and pushing pills on children, then yes, I think you're right to object.

At the same time, this is personal for me -- my wife has been diagnosed with Asperger, and as in the articles we're discussing, she found it a relief and a great help in understanding herself. In some ways, she's like the women in these articles; it sounds like you would want to challenge her diagnosis. While I would agree that some care needs to be exercised in applying this label, I would defend its use in her case.

[0] https://www.autismspeaks.org/what-autism/diagnosis/dsm-5-dia...

[1] https://vcuautismcenter.org/resources/factsheets/printView.c...

I understand that it's personal the problem with AAA is that it ignores quite a few of the childhood symptoms of what was Asperger assuming that we would grow out of, the test cast very wide net and even have some contradictory evaluation criteria within them (e.g. DSM-4 referenced that people with Asperger have an aversion for fiction and have difficulty relating to non fictional works, however it also says that the exact opposite might be true and that people with Asperger find science fiction and or fantasy very attractive and are fascinated by it. And that's hardly the only internal contradiction in them pretty much most criteria have either internal loopholes or catch anything that strafes to close to one of the poles).

And while this is utterly not a medical opinion Asperger in adult women i now quite commonly falsely diagnosed in place of borderline emotional personality disorder which predominantly affects women (80% of patients) and is has quite common late onset triggers. This is especially common on early cases of BPD or due to short observation period where mood swings and various other tenancies that are not only not indicative or Asperger but outright rule it out cannot be properly observed. Beyond that BPD and Asperger can have quite similar symptoms in terms of case book diagnosis (which often the only thing that most mental health professionals have to go by unless they have been treating the patient for chronically) as BPD often can exhibit similar emotional shortcomings (lack of empathy, being unable to recognize or reflect emotion) and irregular thinking as well as distractedness (which may also be interpreted as inability to properly communicate/hold conversation) and forgetfulness which often again can be attributed to several AAS criteria.

ASD/AAS while I'm sure are unpleasant (not trying to be patronizing just don't have a better word for it) are not life threatening BDP however can be so while it's quite unlikely you'll take an advice from some internet smartass I would definitely get a second and even a third opinion in your case.

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