Since when was autism classified as a disease?
Pretty much every medical body would list it under its classification of illnesses.
e.g. NHS: https://www.nhsinform.scot/illnesses-and-conditions/brain-ne...
The problem here is that most people think that those who suffer from autism are the quirky guy at work who’s good at math while in reality most of them would be in diapers trough adulthood.
In reality it is a terrible debilitating disease that enacts a huge toll on both those who suffer from it and their families. I really hope no one would have to live through the fear that they can’t die because no one would be there to provide the life long support their child might need, not to mention having to live with that responsibility for the rest of their natural life.
The lower you go on the spectrum the higher the chances for comorbidity for a lot of other conditions, mitochondrial and metabolic syndrome, fragile x chromosome, gastrointestinal diseases and many many more horrific things.
For example the reason why many people who suffer from autism would require diapers after being potty trained isn't because of MR or any other intellectual disability but because they are more likely to suffer from encopresis which leads to fecal leakage.
It also doesn't help that the image of autism was changed from kids that would require tremendous support for the rest of their life to SV engineers making 500K a year that can't seem to be able to not be a jerk or are too introverted.
As an anecdotal evidence I managed to get myself diagnosed on the spectrum in the UK I went to an official diagnosis center and had sessions with an "occupational therapist", at no point have I ever seen a doctor not to mention a neurologist. As morbid as it sound I have that framed just by my ordained minister license which I got despite being Jewish.
If ASD has a single or a subset of related underlying genetic causes then it's a single disease, and if these causes are present both in high functioning and low functioning autistic individual then it is truly a single condition, however it is still a disease just like relapsing MS is a disease even if it never fully flares out.
That said however I have a strong feeling that the more we understand the epidemiology of ASD the more likely we'll find out that it's much more likely a group of distinct diseases with different causes. And some might not even be classified as a condition anymore.
Or the greater the likelihood that the autism symptoms are caused by one of these conditions as opposed to it being a primary condition. Fragile-x in particular is a genetic condition known for its physical and mental effects, much like like prader-willi syndrome or down syndrome. It's just as likely that effects from these conditions are being misdiagnosed as autism.
Your post seems confused more generally, though. What clinicians are diagnosing with ASD is a cluster of symptoms, not a specific syndrome. Symptoms can have multiple etiologies and that would still be useful clinically. A cold is treated similarly regardless of the exact viral strain causing the infection.
That a particular person doesn't have to deal with anal leakage is not an argument that they don't have a different condition.
"As an anecdotal evidence I managed to get myself diagnosed on the spectrum in the UK I went to an official diagnosis center and had sessions with an "occupational therapist", at no point have I ever seen a doctor not to mention a neurologist. As morbid as it sound I have that framed just by my ordained minister license which I got despite being Jewish."
If I was willing to lie to a therapist, I could probably get diagnosed with depression, anxiety, bipolar disorder, or any of a large number of disorders, but the presence of malingering creeps doesn't disprove the existence of those conditions.
It is really dangerous to claim that autism can't be a serious condition unless it is alongside low IQ or physiological symptoms. It is also entirely unnecessary to stigmatise autism by calling it a disease, when it is so often inextricably linked to a persons personality.
Those with autism absolutely can be high functioning in the sense that they don't have the kind of co-occurring conditions that you describe. This does not always mean they do not need what most would see as drastic interventions and care.
People with autism often have a high ability to function on some social axis but are dangerously unaware of social conventions in others. Those with autism that lack the proper support can hurt themselves, they can hurt others, they can cause massive social disruption and they can end up with serious mental health problems. A diagnosis of autism can help society to provide much needed support.
We owe it to everyone in society to think about how we can help people without considering their states of existence defective.
Seen so many health professionals because of my family, not one has ever referred to it as a disease.
Just to elaborate further.
Child 1 - ASD/ADHD Child 2 - ASD/SPD possibly PDA Partner - ASD/SPD
They're all different and display different characteristics,have differing needs and have different mental health issues. Child 1 is about 2 years behind their peers educationally and socially, Child 2 is on par.
What most seem to agree on is that “Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders [1].”
Is a disorder a disease? While the terms are often used interchangeably by us laymen, the DSM-5 distinguishes the two [2].
[0] https://www.psychologytoday.com/us/blog/abcs-child-psychiatr...
[1] https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat...
[2] http://www2.hawaii.edu/~heiby/overheads_classification.html
It still contained ego-dystonic homosexuality (TL;DR: "I don't want to be gay") - which was opposed by the APA in 1987 [3] - until 1988, with the publication of the DSM-III-R.
[1]: https://www.nytimes.com/1973/12/16/archives/psychiatrists-in...
[2]: https://www.apa.org/about/policy/discrimination
[3]: https://www.apa.org/about/policy/diagnoses-homosexuality-arc...
How about we work on understanding and acknowledging that having a disease or mental illness or physical disfigurement or disability is ok, no matter what it is?
Maybe I am reading too much into this question. I am sorry if I am. It's a pretty sore subject for me. I'm not trying to offend anyone.
Most people on the spectrum will require help to go to the bathroom or complete other basic tasks so them making medical decisions is unlikely.
There is now a pretty big concern about the over-diagnosing of ASD especially amongst functioning adults.
In many countries you can be diagnosed in a commercial center without even seeing a doctor, it has become almost a business similar to the ADHD “epidemic” of the early 2000’s.
It's difderent to the ADHD "epidemic", because it generally doesn't involve medication. Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing.
I agree that those with more debilitating forms might want treatment.
Those are the majority.
>So I'd consider myself one of these people.
I got myself positively diagnosed also, not autistic in any way, the behaviour therapists that can diagnose anyone in the UK should be thrown out, any diagnosis especially in adulthood that does not involve multiple doctors including neurologists and psychiatrists is not something I take too seriously.
>And I think it's really important that people like myself are grouped with those with more severe forms of autism.
Why? there is no clinical significance to this. I'm being honest here, from your perspective what is the clinical significance of your diagnosis in general not to mention of being grouped with people who will suffer from fecal leakage all their life?
If your diagnosis is not used to treat or manage your condition it is not clinically significant.
>Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction.
Considering that you are highly unlikely to suffer from any of syndromes that are comorbid to low functioning autistic individuals I would strongly disagree, and I have a strong feeling that once we understand the genetics of this disease better especially in relation to FXS and mitochondrial syndromes I will be right.
>It's difderent to the ADHD "epidemic", because it generally doesn't involve medication.
The epidemic is about just how many diagnosis centers are popping up targeting adults as a business with little to no oversight. This is really terrifying that we've watered down the diagnosis of autism to a behaviour therapist who had a 6 week course that can diagnose you in a single session.
>Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing.
No it doesn't in fact it detracts severely from those who actually need help the most, those without a six figure salary. Just look at where the funding and attention goes these days vs 10 or 20 years ago.
Some people just like systemizing for its own sake :)
Asperger's is still on the DSM but might also be moved to its own category since it's the only "distinct" classification in the ASD where there isn't clear ~4:1 ratio (or higher) of males to females. The extreme dimorphism of autism and it's comorbidity with other x chromosome related syndromes including FXS is quite distinctive and Asperger's does not usually exhibits this.
I'm the opposite, I have never gotten myself diagnosed. As you say, there doesn't seem to be much point to this.
> Why? there is no clinical significance to this.
I'm not really looking at this from a clinical perspective, but from a research perspective. From the perspective of finding out more about why this condition exists and what causes it, I think it is pretty significant there are large number of people who seem to be affected in similar ways, but for whom the condition is not so problematic.
What's your source for this claim? Is this the majority of all people diagnosed with ASD, or just the majority of people diagnosed with ASD that you believe should have been diagnosed?
https://www.ncbi.nlm.nih.gov/pubmed/20431403 https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm https://www.ncbi.nlm.nih.gov/pubmed/19268036
Overall this varies based on how many things you tack into the ASD, with PDD-NOS being thrown out of the DSM in 2013 it would take probably another decade if the needle moved.
Also, all three of these studies were conducted either before or shortly after the release of the DSM V, and explicitly use the DSM VI diagnostic criteria for autism.:
"Although new diagnostic criteria became available in 2013, the children under surveillance in 2014 would have grown up primarily under the DSM-IV-TR definitions for ASD, which are prioritized in this report."
You seem to be arguing that the relaxed criteria of the DSM V is invalid because the studies on people diagnosed with the stricter methods suggest a more severe condition. This is circular reasoning.
14% of the population have an IQ below 85. It's low, but not to the point of being a disability.
> 83% would have a other developmental, neurologic, chromosomal, and genetic conditions
What qualifies as a "condition" for the purpose of that statistic? What's the percentage for the general population? Frankly, if you actually include all genetic conditions, I'd be surprised if much less than 100% of the general population have one.
For some people it's debilitating, but for others it's not.
Logical thinking is really easy for me. Also abstracting, pattern matching, "out-of-the-box" thinking.. Loyalty, honesty and helpfulness are also positive traits common among autistic people.
Having a unique worldview certainly is helpful in some situations. However it also makes other situations, especially pertaining to social interactions with strangers, rather challenging at times..
Because forced treatments rarely work for anything as patient compliance is a massive factor for actual treatment success.