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Comment by ksm1717 | Hacker News Reader

The first sentence rubs me the wrong way. The claim that you wouldn’t expect autism to be coupled with invention because it is a disability only makes sense because of the semantics of labeling autism necessarily a disability. Not to mention the slight to disabilities as a whole

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One of my sons has Asperger syndrome. He's brilliant, happy, and has one of the sharpest senses of humor I've encountered. I'm not sure if his Asperger syndrome is a net positive or negative in his life, but it's certainly not a straight-up disability.

Perhaps the author was thinking about a strong form of Autism that pretty unequivocally makes life difficult?

Yep.

I was diagnosed with Asperger's later in life. I received this diagnosis after I already had a successful career, happy marriage, and house full of kids. Not much of a hindrance, right?

On the other hand, my brother suffers a much more severe form of autism. He does hold a profession job in finance. But he otherwise requires a full-time caretaker, tons of medication and understanding, etc. No friends. He's not self-sufficient.

It's a huge spectrum.

I too received a probable-diagnosis later in life. (It was part of neuro-psych testing to look for ADD, so they didn't run the specific test battery used for Asperger.)

In many ways my life has been just fine: steady well-paying employment, wonderful wife and kids, etc. So as with you, being (probably) somewhere on the spectrum isn't correlated with a crappy life.

But...

I've also had some unusual personality traits for my whole life, and I've really beaten myself up regarding them. Once I had a probably Asperger diagnosis, I felt like a tremendous weight was lifted. I no longer felt like I was uniquely messed up in those way. And maybe the subconscious logic is that if I'm part of a cluster of people with these idiosynchronies, maybe there's an underlying physiological cause that's somewhat out of my control, and therefore I'm less morally culpable for my atypical social failures.

can you go into a little more detail about what results allowed them to conclude you were probably aspergers, and what the personality traits that you previously felt guilty for were?

ADHD and mild ASD can sometimes look like one or the other. TBH a good neuropsych will do both if they have any suspicion of ASD if they are also doing ADHD testing.

interesting. i was diagnosed with adhd in my freshman year of high school, but i distinctly remember about a year later my therapist conducted a cognitive performance test that showed i did worse on the meds, which i remember he was surprised and embarrassed about. so, i wonder... i have always had a faint suspicion, but i know im absolutely not qualified or objective enough to make an inferrence

There are several forms of ADD, some of which don't respond to stimulants. Check Daniel Amen's work, there is a video on youtube "healing add - see and heal the 7 types".

There can be overlap and comorbidity too.

As part of my BPD the psychiatrist gave me an ADHD test, 25% of people with BPD also have ADHD.

would love to hear more if you'd be willing.

Not sure what more to say. Was there something specific?

I think they were talking about your atypical social tendencies in specific.

Good point. The author of that article, Baron-Cohen, has previously written (debated?) about whether HFA/AS is a disability OR a difference. Speaking for myself, and many who identify as having Asperger's -- and your son, from what it sounds like (who sounds really cool!) -- it is indeed a difference, and by no means a disability.

I should be clear in stating that my life hasn't been a bowl of cherries. Asperger's is at the core of a looooong list of problems I've had with interpersonal relationships, whether it's family, friends, co-workers, roommates, etc. I'm sort of intolerant of being treated unjustly or being taken advantage of, and I react rather nastily to those who cross me. (And before you judge me, know that people with Asperger's have a knack for finding these situations. Exploited by coworkers? It really happens. Undesirable roommates who've physically threatened me? Been there more than once. Physical altercations as a kid, refusing to back down from bullies? Too many times to count. Screwed up relatives? I have many.)

But I don't care to use the word disabled in describing myself. Being unable to keep my mouth shut in the face of something I don't agree with doesn't qualify as a disability. My sensory issues aren't anything I ask for accommodations for. That I prefer to spend more time away from people than the average bear is not a disability. And in the context of autism, it's hard to use the word disabled and not have people place limitations on what one can/can't do. So, I don't use the word. And just consider myself different.

I recognize that there are people deeply offended by people like me, who are at the higher-functioning end of the spectrum and refuse to consider themselves disabled. (They see us as impostors.) There are also many people who take offense to the term lower/lesser functioning, and resent the use of terms like "severe autism". They consider this language to be demeaning. Autistic twitter is quite the landmine for semantic wars of this sort.

Disabled against the context of "normality".

You can function obviously, but not as society expects you to or even in way they can understand. For that reason, you receive the label of "has a disability".

The term "disability" is unfortunately as much a reflection of societal norms as it is genuine medical diagnosis.

Exactly. Luckily society seems to be slowly becoming more accommodating and understanding, but there is a long was to go before society truly understands how to value the contribution of people who are different. Seeing 'disability' in this way, it can even apply to traits like introversion (depending on the culture you live in).

> There are also many people who take offense to the term lower/lesser functioning

As I understand it, the problem with using the expressions "lower / higher functioning" is that it evokes the idea that problems of people with "lower functioning" are a strict superset of problems of people with "higher functioning".

In reality, it's more like there is a set of symptoms, and some people have a larger random selection, and some people have a smaller random selection, so it is possible to be "higher functioning" but fail at X, or be "lower functioning" and fail at everything but X. So the "higher/lower" is more about how much your specific set of symptoms disrupts your life, but it doesn't imply which symptoms are present or absent.

But people who see the "lower / higher functioning" as two sets of symptoms will judge you by presence or absence of one specific symptom.

(Also, with some symptoms, how much they disrupt your life depends on what environment you live in.)

> Autistic twitter is quite the landmine for semantic wars of this sort.

Twitter seems to evoke the worst in people in general. The explanation I wrote here would almost certainly be also considered highly offensive by someone.

Low end ASD can make dating really hard for men, and their often inflexible nature makes them hard people to live with at times. I think from that perspective alone it's a disability.

For a large part of my life I was somewhat jealous of my brother, who had Asperger's, for his natural wit, and his incredible creativity (in art, in music, in writing). So I can't possibly see it as a disability. It certainly makes some aspects of life more difficult for him, but my experience is that he generally figures things out in the end, even if it's many years later than his peers. On the other hand, some things 'normal' people struggle with come very easily to him. Really, I think 'difference' is the best way to put it. Some 'good', some 'bad', but I think they play a very important role in society.

As an aside, I'm really disappointed it's all under the umbrella term of ASD now. People are generally more aware of the differences now but no thanks to that.

I'm not quite sure if your brothers ASD [0] is responsible for his IQ and his artistic ability. I knew a kid in high school who had aspergers and he tried to be a witty comedian, but it was just bad and grating. He had a hard time dating, a hunchback, bad hygiene and from my impression, average academics and below average physical ability, I really felt sorry for him. ASD does not give you an IQ boost, maybe at most an obsessiveness which can help you have the will to practice more.

0. I like ASD better because aspergers sounds like ass-burgers TBH and once explained it makes people understand immediately that you have various degrees of it.

Asperger's does not give one a natural wit, usually it's very much the opposite.

I respect and agree with what you are saying. Even on the "higher-end", my relationships with the opposite sex were often unorthodox, shallow, or outright dysfunctional. And most of them were before my diagnosis.

I'm probably guilty of not viewing this as disabling because I'm treating the term too concretely, as if a disability has to be something "physical" that might require special accommodations. But yeah, I suppose my challenges in understanding the game of love are disabling.

By low-end ASD I mean mild ASD. I think strong ASD is pretty well recognized to be definitely disabling.

Conversely, that is also true of ugly or inconsiderate people regardless. When the problems are caused entirely by incompatibility with other people, I think its reasonable to say that maybe you aren't working with a disability.

So many of the traits that are bundled into the label autistic are on par with lactose intolerance.

Lactose intolerance in adults is something that the majority of our species lives with. It's only the Indo-European minority that can keep drinking cow's milk after puberty.

So, for example: Eye contact aversion. Prevalent among autistics. But only a disability in cultures that equate it with dishonesty.

  Inability to tolerate fluorescent lighting. Those damned things did not exist until what, 60 years ago? How is it a pathology to  be averse to them.

I understand that sentiment, but I reckon it's better overall to emphasise the disadvantages, because that puts the focus on "things to improve", so to speak. Otherwise, if the focus lies 'too much' with the advantages (such as the ability to focus, which is not present in all individuals) it can be overlooked that autism has real (sometimes quite debilitating) disadvantages.

I think their intention was to capture the attention of their target audience. Their target audience typically thinks of autism as something that mostly hinders someone, rather than elevate / enable them.

The idea that it's a disability is as stupid as the idea that being 7 foot tall is a disability.

Not to nit-pick, but exceptionally tall people often have spine issues, and in sports, career-ending foot injuries are common in basketball.

https://en.wikipedia.org/wiki/Yao_Ming

Also disable sound and search for "Kevin Durant injury: A look at the NBA's history with foot injuries"

As well, some of the "tall genes" are associated with connective tissue and other health problems:

https://en.wikipedia.org/wiki/Marfan_syndrome

I'm average height for the West, but when I'm in Asia, I often hit my head on gates, taxi doorways, etc. I imagine that would also happen for 7 footers in the West.

Yes, that was the point I was making. It seems that it flew over peoples heads.

Being on the spectrum without learning how to work around neurotypicals is the issue, the same way that being 7 foot tall without the physical modifications needed to support that body is also an issue.

I am very much on the spectrum but have developed a large number of coping strategies [0]. Had I been diagnosed and treated as a child I would have never had the ability to become anywhere near as successful and fulfilled as I am today. Instead I would have been drugged into being an office drone and probably been looking at suicide about now.

[0] One of the odder ones that no one neurotypical understands is an algebra of social relations I use to model office politics. It lets me evaluate the social graph analytically several jumps further than any person can keep in their head.

Most (like 90% or more) autistic people are low functioning. But they are completely invisible to people like you. When you hear the word you think of the border line cases that fall under the label "high functioning autism". But the author is not limiting himself to just these borderline cases.

Do you have any data for this distribution? This is the first time I've heard someone suggest any particular shape to this distribution, much less that it's shaped as you suggest.

I published this paper recently (1) in Biological Psychiatry. I bring it up only because unlike most neuroimaging research, we are able to image children at all levels of disability (since we image them while asleep). We argue that the idea that there is early brain overgrowth in autism followed by a period of regression or normalization of brain volume does not appear to be true, and the apparent differences in cross-sectional research are due to biases in most studies against including harder to image individuals with autism. In any case, intellectual disability is not 90% but it is quite substantial.

1. https://news.ycombinator.com/item?id=25462145

I don't know about these precise numbers, but ~57% of autistic people have an <85 IQ (cf. 16% in general population), and somewhere between 25% to 50% are nonverbal. So 90% may be too high, but it seems very likely that a solid majority has profound difficulties in life.

edit: my source is the CDC(https://www.cdc.gov/ncbddd/autism/data.html) for IQ and this paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727194/ for proportion of nonverbal autism.

Note that these numbers are for autism diagnoses, not autism cases. Someone with profound difficulties in life is far more likely to wind up with an autism diagnosis than higher-functioning autistics that are more likely to figure out successful adaptations.

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