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Comment by username90 | Hacker News Reader

I wonder how much this is autism and how much it is people with low trait agreeableness being diagnosed with autism for being "bad with people". Refusing to do rituals without a good explanation makes people think you are autistic, but it could just as well be that they are disagreeable by nature and don't do things just because people tell them to. And refusing to do things the way everyone else does them obviously helps you find new ways to do things.

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I have trait agreeableness in the bottom 1st percentile.

I'm also diagnosed with ADHD which is often co-morbid with ASD.

I very much refuse to go along with a looooot of things just for the sake it. Anything steeped in tradition without a whole lot of logic to it gets met with mostly flat rejection. This has steadily increased as I've gotten older.

My mum used to be a special needs teacher and she kind of suspected I might be on the spectrum when I was a teenager. I've met people diagnosed with ASD whom I share a bunch of lived experience in common with. My step brother has a son whose diagnosed with ASD and he sort of indicated I show some signs of it. So, there are hints that maybe I am somewhere possibly the invisible end of the spectrum? Or maybe it's just my personality?

I read through Asperger's The Complete Guide. There are a few puzzle pieces which fit like ding ding ding. But there just aren't enough of them. And I watch things like Love On The Spectrum etc and I have had my share of difficulties perhaps but nowhere near what those people experience.

I've kinda tossed up getting a professional opinion about it multiple times. I just mostly feel like this is me and it's who I enjoy being. Perhaps my 20s were just one big development of coping mechanisms? My social skills just haven't really troubled me until this year. Mostly it's either workmates, long term friends who share my interests, or special interest groups where I have stuff in common with people. This year I had to take my son to a school thing where there were other parents and the only shared context was our children. It was very anxiety inducing and I just felt like I had nothing. My son wanted to stay longer but I panicked and I said we had to go home.

So... At this point I don't really know.

Why not go then. It's good to know for self knowledge alone I would think, especially if you have a tech worker income and health insurance. And if you do, then a bunch of resources and books will be more applicable to you.

"I am acting like this because of my ASD" vs. "I am acting like this because I'm not very agreeable" I think is valuable self knowledge alone.

It's a spectrum and you already know you're somewhere on that spectrum or nearby. IMHO, you have all the information a professional could reasonably supply.

I tell my own ASD child, it's such a broad spectrum of otherwise loosely-associated characteristics that whatever diagnostic standards are deployed by professionals almost certainly will be reassessed as erroneous in my child's lifetime, which means all authoritative guidance you can receive now on the subject is 'wrong'. ASD is a bucket of 'different'. Those doing the judging can't even be consistent in expressing how ASDers are 'different'. That is all.

Spectrum diseases like schizophrenia and autism seem ripe for splitting. In particular, I'm holding out hope for improved diagnoses (and treatments) once we learn more about genetics and neuroscience.

The opposite happened with ASD. It was Autism and High Functioning Autism and Asperger's and it all got merged into ASD.

Autism is a spectrum disorder, defined by just a list of traits, one of which you describe. So it is, by definition, autism.

All of the traits of ASD also occur in people who don't have ASD – people with other disorders, people with broad autism phenotype (BAP), and just "neurotypical" people in general.

Kamp-Becker I, Albertowski K, Becker J, Ghahreman M, Langmann A, Mingebach T, Poustka L, Weber L, Schmidt H, Smidt J, Stehr T, Roessner V, Kucharczyk K, Wolff N, Stroth S. Diagnostic accuracy of the ADOS and ADOS-2 in clinical practice. Eur Child Adolesc Psychiatry. 2018 Sep;27(9):1193-1207. doi: 10.1007/s00787-018-1143-y. Epub 2018 Mar 20. PMID: 29560529:

> There is an obvious symptom overlap between ASD and emotional and anxiety disorders documented by several studies [24, 52–56]. Both disorders involve profound social interaction and communication defcits, problems in emotion recognition, insistence on sameness, infexible adherence to routines, or ritualized patterns or verbal/non-verbal behaviour. 30% of children with an anxiety disorder (but no known diagnosis of ASD) were above the cutof of the ADI-R in at least one domain [57]. Other disorders are likewise associated with “autistic traits” of profound amount, such as ADHD, conduct disorders, intellectual impairment, and language disorders (see above)

Since none of the traits of ASD is unique to ASD, none of those traits can be said to be "by definition, autism". One only should be diagnosed with ASD if one has enough of a broad enough cross-section of those traits, and those traits cause clinically significant dysfunction. (A person with a broad cross-section of those traits but without clinically significant dysfunction doesn't have ASD, they have BAP, but the boundary between ASD and BAP is unclear and varies from clinician to clinician.)

Autism diagnosis does not really focus on social interactions. Difficulties in social interaction are a side effect but it is not how they diagnose the condition.

Can you cite a reference to a diagnostic tool for autism which doesn't "focus on social interactions"? The DSM-5 certainly seems to indicate that social interactions are important diagnostically (excerpt below):

https://www.autismspeaks.org/autism-diagnosis-criteria-dsm-5

"""Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history...

Deficits in social-emotional reciprocity...

Deficits in nonverbal communicative behaviors used for social interaction...

Deficits in developing, maintaining, and understanding relationships... """

DSM-5 criteria for ASD have as criterion A "Persistent deficits in social communication and social interaction across multiple contexts". So if one doesn't have persistent deficits in social interaction, one doesn't meet the criteria for ASD. So this is a core part of the diagnosis of the condition, it is a mandatory requirement for diagnosis.

I have gone through the autism diagnosis process myself, it is very flexible so as long as you have the stereotypical problems with social situations they will give you a diagnosis if you want it. I didn't want it so they didn't give me a diagnosis. I guess if there were parents involved who wanted something to blame they would have pushed for the diagnosis though.

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