Autism should not be treated as a single condition
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When I tell this to people they understand immediately that I am in fact on that "spectrum".
Oh but they do. the "spectrum" is by how socially acceptable someone's autism is.
I intuitively understand this but has it been clinically defined?
If people fit in well and didn’t have issues (either internal pain/suffering or society interaction pain/suffering), they are not applicable to the field.
Everyone experiences some obsession or compulsion. But only some experience it to the degree of a disorder.
Just like everyone has some “autistic” tendencies. But it is only a disorder in some.
In other words, the "spectrum" doesn't exist to capture the variation in the autistic person's own experience - if it did, it would look very different. It's a remnant of a time when autism was seen as just a "problem" for the people around you, and the spectrum measures how much of a problem you are and how weird you are seen by their measure; which does map onto a continuous line in the same way.
That does capture something useful, but only a small part of what autism actually comprises, and is much less useful at capturing the autistic person's own experience of it, and makes it a less useful tool to them than people might assume.
Alcoholism, for example - we don't define alcoholism as drinking ≥2 bottles of wine a week, or say that 1 glass of wine a week is part of an alcoholism spectrum.
Instead, we ask whether drinking often interferes with taking care of home and family; or leads to job/school troubles; or has lead to getting arrested.
How much of a problem an alcoholic is for others being roughly equal to how much of a problem alcoholism is for the alcoholic.
We don't ask just that, and the diagnosis doesn't hinge on those - in fact those account for only 3 (or 4 depending on how you count) of the 11 diagnostic criteria for alcohol use disorder. The others are about the person's own experience with alcohol, the difficulties and psychological problems caused by it to the person themself. And that's for alcohol use, an external behaviour-based problem with a specific narrow scope. Autism is a much wider construct with much more varied impact and experiences, and yet in practice people are placed somewhere on the spectrum based mainly on external interactions and troubles.
Historically this came about because people who were "low-functioning" caused more difficulties to others, whereas "high-functioning" folk didn't - even though they might have comparable amounts of difficulties and psychological anguish internally and in need of similar help too. This simplistic view is changing slowly within the field and with some therapists recognizing it better for what it is, but it's still not nearly as widely recognized as it needs to be.
I think it still is the current approach, and is not a bad thing per se:
People can have their own specific conditions, but if they are considered fully functional they will have no business getting clinically diagnosed. It will only be relevant when it reduces social functions, and becomes a problem, so that's the part that will be diagnosed.
To put another way, there is the biological/research part to understand how people work and how they think and behave, and the medical part to "fix" things. The variation of people's experience belongs in the former, the autism spectrum belongs to the latter.
Of course we do this for most conditions: for instance people's voice are all different, if yours is just "weird" but intelligible you won't go get a diagnostic, if half of the people can't understand what you say you might need one, whatever the biological cause is.
I am considered a "fully functional" adult from all outward appearances, even to friends and family. I'm lucky enough to be capable (with great internal effort) of typical "normal" things like participating in meaningless smalltalk, holding down a job, and doing all of life's chores just like "everyone else." However, unlike everyone else, I had to practice and endlessly rehearse things in my head to achieve the outcomes I desired. A charitable interpretation of your words would mean that "it's a problem", but who is it a problem for? The folks around me? Certainly not. This is invisible to others. It's akin to running monte carlo simulations of all permutations of outcomes before acting on decisions that others would consider trivial. For years I thought that was what everyone was doing. I eventually learned that "no one" did this, and I trained away all "problematic" characteristics of myself just to keep up the act.
So in lieu of your implications that 'passing' autistics "have no business getting diagnosed", I'd rather propose this instead: seek a diagnosis if your condition is debilitating in any way shape or form and would benefit from treatment, _regardless_ of whether or not your condition is externally visible or even apparent to others. A "fix" should be sought if you are suffering. There is no cure for autism, but there are many programs and medications that can help.
PS That said, it may be unwise to disclose your diagnosis to say your employer, unless you need specific accomodations for your set of symptoms at work. I speak from experience.
Still IMHO the bar to treat it as a medical condition is higher than that. To take another example, one can be hyper reactive to dust, and that has surprisingly wide impacts on everyday life. House maintenance becomes critical of course and interior furniture will reflect that (e.g. a long fur carpet and other hard to clean convoluted forms are out of question). It also bars the person from whole categories of shops ans places, old libraries is often a no go, some shops/restaurants using encent or heavier room flagrance will also trigger a reaction. There will be whole categories of jobs that are also not an option.
This kind of predicament will make everyday life a lot tougher and require significant effort, yet IME will not be categorized as a medical condition until something critical happens. Like an asthma crisis that ends at ER for instance.
It is not "fair" in the sense that successfuly dealing with the health/mental issue is kinda taken for granted, but I also understand why we draw a line between conditions the person can deal with alone, and other conditions that require external intervention.
> A. PERSISTENT DEFICITS IN SOCIAL COMMUNICATION AND SOCIAL INTERACTION ACROSS CONTEXTS, NOT ACCOUNTED FOR BY GENERAL DEVELOPMENTAL DELAYS
> B. RESTRICTED, REPETITIVE PATTERNS OF BEHAVIOR, INTERESTS, OR ACTIVITIES
For criteria A, severity is more or less measured by how much social impairment is observed --- that's a measure of social acceptability in some fashion.
For criteria B, the severity criteria is about "interference with functioning in contexts" as well as observed distress of the patient. Interference with functioning can be related to the patient resisting the desired function, but it can also be because the patient is socially excluded due to their behavior.
Although, I should point out clinical criteria in general and the DSM in specific are a formalization of arbitrary judgements that describe observable characteristics grouped into a diagnostic category; this can be useful, but it's not really an understanding of the underlying condition(s), it's a handbook of things to look for when a patient comes asking for help and what things to try to help them. If someone has the same underlying conditions but manages to pass as socially acceptable, they may not come in for help, and that's fine too. When multiple underlying conditions result in similar observable criteria, the DSM gets pretty confused; there's not much in the way of attaching traces and getting debug logs for mental processes though, especially out in the world, so this is the best society has, I guess.
[1] https://depts.washington.edu/dbpeds/Screening%20Tools/DSM-5(...
And even in milder cases, the "does not understand social rules" is sometimes or even frequently euphemism for what would be labeled as abusive or cruel or simply selfish behavior for non autistic person.
This usually happens when the person's needs have been repeatedly ignored, either because the person isn't aware of their needs, and thus isn't able to communicate them; or because the person has tried to communicate their needs but not been understood; or because the person has tried to communicate their needs and had their needs disregarded.
This isn't unique to people with neurodivergence.
> with yelling abusive things or even hitting things
Eventually communication fails and all that's left is violence. History (and the present day) is full of examples of this happening on an individual, national, and planetary scale.
This is not true. Low emotional control is one of symptoms and for many autistic this is just a default response. It is literally part of diagnosis. There is no space for needs or rights of others. This is response to someone putting a cut into drawer wrong way or disobeying one of thousands weird rules the autistic person have for themselves and the world.
This frequently happens as a first response to the situation, before any communication could possibly occur.
> Eventually communication fails and all that's left is violence.
Autistic person being violent is violence as any other. And there was no attempt at communication, because man autistic dont understand why the thing needs to be communicated in the first place. They dont understand other dont see the word the same way.
And even more importantly, it is an emotional meltdown having nothing to do with what went on with communication before or not.
Hmm, what are these 'colors' in your framing? I don't think anyone feels that ASD comprises totally distinct, 'disjoint' descriptions. It's true that there are multiple parameters along which one may vary, but that's true of any human syndromic disease, and probably true for any human disease, in general.
Here's a popular press article that talks about a very recent framing of autism that uses clinical and genetic data:
https://www.simonsfoundation.org/2025/07/09/new-study-reveal...
Likewise, when we talk about the "autism spectrum," we're not including every exhibition of traits associated with autism. You can have some traits associated with autism without being "on the spectrum."
Also, perhaps as importantly, "spectrum" isn't a term that generally applies only to color, or even electromagnetism.
"There's a spectrum between..." is not an uncommon way to describe something where there's a range of possible things.
I'm not so sure about this one. Whatever it is, you can point a camera at it and you'll get colors. That places it on the color spectrum, even if its color isn't the most important thing about it.
Sure, you'll get weird readings for transparent things, and you can't do this for "justice" or "pain", but everything that is remotely similar to something that has color, also has color.
In the example of the color spectrum, I don't mean that things necessarily don't (or do) have color. Take fundamental particles, as an extreme example. They don't themselves have any color at all, though they have 1ualities in common with color. And depending on what you do to them, they can exhibit qualities of color (or not).
But the fact that something has a color doesn't mean that thing itself is on the color spectrum — color is not a necessary quality of that thing, and can change depending on other factors — for energy that could be level of excitement, or for other things it might be the level and color of light in the room. Also, the physical things you point a camera at often do not themselves have color! They show up as being a color in the picture not because of their inherent qualities, but because of what wavelengths of light they do or do not absorb. And you can, by using different types of cameras or adjusting their settings, take in more of some wavelengths, less of others, or none of some, regardless of what things look like IRL (which is based in the wavelengths of light being reflected/not reflected from those things to your eyes, and which wavelengths the cones in your eyes can take in, and then how those are processed by your brain, etc).
> They show up as being a color in the picture not because of their inherent qualities, but because of what wavelengths of light they do or do not absorb.
The intrinsic/perceived duality that you're setting up here isn't related to what a spectrum is. What's fundamental for spectrums is that they're expansive: whatever the measured quality is, all such things map to somewhere on a single dimension which is the spectrum.
Color has been overused. Let's consider a mass spectrometer. It gives an electric charge to a sample, hurls it through a perpendicular magnetic field, and depending on the masses of the sample (or its components, supposing the ionization process broke it up), inertia causes spatial separation. Not-very-massive over here, and quite-massive over there. This is a spectrum because all masses have a place on it (nevermind that you might not actually be able to build a large enough spectrometer for some masses).
Or to use a mathematical example, if you exclude the interval [0,1] from the real number line, what you get is no longer a continuum, and mappings of things onto it are no longer a spectrum.
It may be a misconception that all political perspectives exist on a left/right axis, but when people talk about the political spectrum they're invoking a simplification under which all people do map to some point or another on that line.
As far as I'm aware it's only the autism spectrum that doesn't work this way.
- Group together "rainman" type people (and people with even harder limitations) with "not overly social/minor social impairments"
- The current overmedicalization and diagnostication of everyday life wanting to label every minor difference between people
- Current "education was too hard, let's build accommodations" which is good but not when you can get any diagnosis by shopping for it
I get what you mean but I feel compelled to point out that colors are on a spectrum. A partition can be a quantized spectrum.
But many without autism don't have that need for precision so they get confused by mixing up later word use in different contexts like you did there.
UPDATE I have exceeded my grace with HN spam controls
The confusion arises from the direct import of a medical Latin term which means what it means in Latin, into the modern colloquial- this is important information
in this ASD model, a single person is like a light source, ASD traits are like frequencies, and ASD itself is like the EM spectrum
this is useful because our best understanding of ASD today is multidimensional
as you say, it is not supposed to be used as like "the spectrum" is a line from "normal" to "autistic"
unfortunately most people aren't familiar with spectroscopy, but I think it's a good metaphor
do you have a suggestion for a better word than spectrum, that could convey the same rich metaphor but be less easily misunderstood?
1. A linear continuum (like wavelength for light) from "no autism" to "really bad autism".
2. A collection of disjoint sets (like individual named colors like "cyan" and "puce") for cases like "really into trains autism", "freaks out at parties autism", "non-verbal autism", etc.
3. A continuous mixture of different properties (like rgb(.1, .2, .05)) for symptoms like "10% social dysfunction", "20% repetitive behavior", "5% sensory overstimulation".
When people describe autism as a spectrum disorder, they generally mean the third metaphor. It's a mixture of different symptoms and different autistic people have different amounts of those symptoms but all people diagnosed with autism have a significant amount of them and their symptoms will have some amount of overlap with other autistic people.
However, for the purpose of assessing social and family impact, it is rendered to (1). Both schools and state (US) programs use (1) to assess if a child qualifies for support. This is not always related to how to parent or educate the child.
Fortunately, the US school system with IEP (individualized educational plans) are developed along (3). (Source: two of my kids have ASD)
None of that necessarily helps in informal social contexts or in professional workplace settings. I think the American Disabilities Act covers reasonable accommodations for people with autism spectrum disorders, though I am not sure if it requires legal disabled status.
Lastly: I met a Native (Navajo) family with a child that seems to me, have some developmental disabilities — but I think they take a very different approach. For one, they don’t seem to have the usual social stigma associated with this, and are baffled why I would suggest getting state support for early childhood intervention. If anything, I would not be surprised if they thought I was, yet again, someone unthinkingly pushing a colonialist worldview.
My first thought was is (1) more of a projection of (3) from multiple dimensions to one, or more like the magnitude.
Also, it is known thing or are "trains" a euphemism now like "friend of Dorothy"?
I don't think it's quite the same as calling yourself or someone else a "friend of Dorothy". People who say they are into trains usually precisely mean they are into trains.
I meant it only as a reference that one of the common characteristic symptoms of autism is a deep focus on some topic of special interest. In boys with autism, trains, cars, or other machines are a common one.
Not an ounce of complaint to be clear. Honestly seeing them flip out and flap around and giggle excitedly is delightful. I'm glad they're having a good time and I'm also glad that all of these experiences have not involved some self-involved asshole leering, criticizing or yelling at them for being happy.
Metaphors often fail though, so it might just be best to say what we mean plainly.
It's a metaphor.
It helps people build an intuition. It doesn't need to be exact to do that.
I couldn't possibly disagree more.
No, it doesn't. Wavelength is unidimensional, but color can mix many wavelengths, and RGB is a 3d color system which doesn't cover all combinations of visible light but does approximate the way most human vision works, and is therefore useful as a description for human-perceived colors (and more accurate than picking a single point on the unidimensional wavelength spectrum for that purpose.)
This is the least helpful metaphor, when applied to anything with more than one dimension. "Really bad autism" can describe a multitude of unique symptoms.and is nearly information free, similar to describing someone as having "A really serious illness"
Let's not define autism in relation to what other people have to deal with. For years, autism has been discussed not in terms of what the autistic person experiences but what the people around them experience. That's kind of BS. Someone else being autistic isn't about you, it's about them.
You're welcome to talk about people with "high support needs", or people who have certain struggles in social situations, but discussing "really bad autism" just reinforces that negative stigma that autistic people shouldn't be thought of as people but rather as problems that "normal" people have to deal with.
Arguing relevant metaphors in HN?! A new low...
The top comment chain on the front page 'Plane crashed after 3D-printed part collapsed' is nothing more than arguing about metaphors. This happens all the time in just about every story.
We range from being blind to having exceptional eyesight, so we are all on a continuum.
But there are various subsets, such as color or light sensitivity, far/nearsighted, better tracking of motion or text - and these have their own subsets, such as the ability to scan text quickly (or dyslexia), read a room better or see things that require training (such as the details a race driver immediately sees that you wouldn't). Someone with an issue of vision usually finds himself in a cross of these sets, borrowing tools form one to compensate for another
The same can be said for hearing, for height and weight, and for any other physical, psychological or mental property we have.
(I've always felt it odd that "spectrum" usually refers only to Autism.)
It depends where the term is in use, when you get in to more medical like fields then people will use the ASD term to separate it from other spectrum disorders like OCD or different types of schizophrenia.
i.e. #3 here can be approximated as #2, and this can be helpful.
But the really interesting thing is, with neuroplasticity and skill training, you can make tiny adjustments to #3 which produce a change in the set of #2, i.e. real differences in quality and enjoyment of life.
On top of that, if you have ASD diagnosis, you definitely have other issues that describe your condition more, especially mental issues. Also, some of them are going to change - some can go away, because environment changes or simply because your understanding of issues have changed. A lot of the struggles are because diagnosed people even after diagnoses do not understand what exactly they have to deal with.
The issue is how these conditions are diagnosed - there are some similarities with LGBTQ+ that initially was labeled as a disease. And there is cautious fluidity in labeling because of that as well, because ASD is not completely understood, as we are really in the very beginning on mapping both of our brain functions and DNA - what those genes are responsible for. Also, the number increase of ASD might have other factors involved in the way how we as modern people are using our brains by dealing with all that information that humans previously did not need to do and most probably ASD is species wide change that we are causing as our behaviour has changed, especially when our unwritten beaviour rules are breaking down. When we have to compare this to how species are described, humans alone would be consisting of different species - the only difference why we are not different species is because of mixing.
Yes, but that's not what a spectrum technically is.
It's also not a very good idea descriptively, all the various properties people pile into this "spectrum" don't have nowhere equal weight with respect to relative importance to warrant the equal weight they get in such 'diagrams'.
It's a metaphor. A series of bytes within RAM interpreted as human text is not lterally a piece of string made out of some sort of wound fibrous material either, but we still call it a "string".
Also it is for autistic people. It grinds my gears when people say "everyone is on the spectrum", no, just no. Again it is only for autistic people and you need to have support needs to be diagnosed with autism. You don't get a diagnosis for being quirky and a little weird.
And no, just because someone is verbal and seems to be very articulate does not mean the person has low support needs or vice versa.
RGB(10,10,10) may be awfully dark but it's definitely not black. On the spectrum doesn't necessarily mean you have clinically relevant difficulties.
Having Autism is one cluster of values you can have. So is having ADHD. So is having Trauma. And many more things. And you can and often have multiple things at once and their symptoms overlap.
I understand that if a person has no support needs, they cannot be diagnosed with autism. But that person may still be neurodivergent, and therefore to me it seems to follow that you have folks who are autistic with high support needs, and folks who are autistic with low support needs. Then, you have neurodivergent folks with no support needs. But this seems to me like a difference in degree, rather than category, and which would mean that the “spectrum” analogy works quite well.
With a clear understanding that I am not trying to minimise the struggles autistic people face, a sincere desire to learn, and an open mind, would you mind trying to help me understand?
Support needs can change over time. You can need less help because you learn better coping strategies and have a stable environment or you can need more as you get older. It is not fixed.
Support needs are denoted in level because that is what system like schools and the like need. They don't really map to reality. Like for example a autistic person can have really bad sensory issues, being really sensitive to sounds, restricted diet and the like but decent social skill. Another autistic person might not have any sensory issues but really struggle with social stuff. Who needs more help? They need different kinds of help.
I’m still struggling to understand how this meshes with what you said above about only being autistic if you have support needs.
I don’t understand what implications that would have for someone who (for example) develops enough coping strategies that they no longer have any support needs. As far as I understand it, there’s no way to “cure” autism, so those folks would still be autistic but without support needs, which doesn’t seem to fit?
Yes, there is a bit of a contradiction in advocacy because on one hand we want to spread awareness about the natural diversity of how humans brains work and remove prejudices and celebrate that diversity but also we don't want to minimize that it is a disability and people do need help.
I was imprecise here. What I meant here was no longer having support needs that are above the diagnostic threshold.
Autism is not the only way your brain can be different from other people.
The problem is the people who actually have support needs are often not in a stable job with great insurance, and then they don't have access to the "get an official diagnosis" machinery. At which point you have to choose between respecting a self-diagnosis even if they're often wrong, or not respecting it even if they're often right.
It is still important to get a official diagnosis if one can but yeah the reality is that it can be a very long process and not in reach for some people.
Moreover, people have no idea how difficult this makes it to properly test anything related to it because control groups are so difficult. It’s why any type of study that claims something does or does not, definitively “cause autism” is highly unlikely.
You can identify potential contributors, but that’s about as good as it gets.
People in absolutes about this stuff can’t be taken seriously.
Wasn't Newton making the point that we normally perceive and treat colors as qualitatively different, but that they're in fact caused by a single underlying mechanism that can take on any of a continuous range of quantities?
Thus using the term "spectrum disorder" would be making precisely the same point, to describe a set of apparently qualitatively different disorders that are in fact caused by some underlying mechanism with a range of quantities? (To be clear, I don't know if any so-called spectrum disorders actually meet this criterion, and it's probably more complicated than that, but it seems to be the reason the term was chosen.)
As far as I can tell, everybody else is on some spectrum of "idiot".
Like I mean maybe, but also he was a bored rich aristocrat before TV was invented, and sometimes there are no parties going on or everyone's hiding in their country estates because of a cholera outbreak or whatever, and "making shitloads of drawings and organizing them" was like 50% of scientific work at the time. So. Maybe he just had a lot of time to kill.
Going by randos posting online, "liking things" and "knowing stuff" and "caring about things" are all autistic traits when present in any but the tiniest of degrees. It's ridiculous.
I feel social media has conditioned people to think of you're anything other than bland and "normal" in your personality and have any degree of uniqueness about you then you're on the spectrum.
Sorties paradox. Everybody is on the spectrum, it's only called out when it's noticeable.
> well, were all on the spectrum, that's how spectra work: they're encompassing.
that I began to suspect that we weren't actually on the same page about spectra.
Actually, I'm allowed to be persnickety about language without it implying a diagnosis of any kind.
But I thought it was kind of funny to share it the way I did, so I made an exception.
It's always some anonymous "they". Those bad people. You know; not reasonable folk like you and me. "Them".
Typically no in the english language usage.
The partition I'm talking about is a set of sets of behaviors. I think the vector space you're talking about is a set of people (each person being a vector on the basis of the sets of behaviors).
So I think we're on the same page, just referring to different parts of the construction. I.e. everybody is somewhere on the verbal/nonverbal spectrum, and somewhere else on the sensitive/tolerant stimulus spectrum and so on for each dimension.
It's always going to be a metaphor, but that's the way that I best understand it.
1. We've seen them long before we could really investigate them.
2. We've already grouped them up based on seeing them in a similar direction.
3. ... But it might turn out they are actually very far away from one-another, or have important differences we weren't able to see before.
I might've recommended "palette" if asked before spectrum got traction.
Or maybe we don't need a better word at all, maybe we should try grouping the characteristics differently such that they're no longer all together under the same heading. (I'm not qualified to say, just a hunch).
In terms of advocacy, there is strength in numbers, and arguably having such a large autism community has been good for both research and support. Potentially breaking that up into several smaller communities might lead to an overall decrease in impact.
On the other hand, pretty much everyone with autism, or families who have children with autism, will tell you that there is wide variation in both severity and presentation. And I think most would welcome better definition of subtypes.
It also leaves room to start distinguishing/separating out more subtle variants of what we currently umbrella as “autism,” perhaps making it better defined in the future. And I kind of suspect doing this with “less profound” neurodivergencies could help folks with “more profound” (and rarer) cases.
To look at a historical case: Gay Rights didn’t make a lot of headway. But adding lesbians, trans folks, etc. ultimately did a lot of good for that community in the US.
Your colleague is full of shit. Generally, neurodivergence is for everyone who regularly experiences that the way their brain works causes them trouble.
Self diagnosis is surprisingly accurate but people also tend to under estimate the severity of their symptoms.
Even the "no empathy" sociopaths can spend decades thinking that they're perfectly normal, everyone is like them, and people just pretend to be sad and grieving at the funerals because that's some kind of established convention and breaking it would be very rude.
What I'm saying is: maybe you just think you don't show any signs of autism - because you think your experience is "normal", and you think that everyone has the same struggles as you do, even when it isn't true.
Or maybe you genuinely aren't autistic at all! It's just very, very hard to say at a glance.
Symptoms of mental disorders can be normal human traits taken to the point it affects person so severely it's an impairment.
This means anything normal can be pointed to as evidence of a disorder.
I am a proponent of finding neurobiological bases for subgrouping autism into different clinically meaningful etiologies so that the debate can move forward productively. Its one reason that more and more I'd rather forgo acquiring non-autistic controls in my studies, but just look within the autism sample for how to parse the heterogeneity into homogeneous subsets
You think a parent without any autism is more qualified to speak than someone who has autism but a different cluster of symptoms? Because being a parent makes you an expert on what exactly?
The is a video of the spokesperson of autism speaks. Her autistic child is in the room and can hear everything. She talks about how bad it is for her to have an autistic child. How she wanted to kill herself by driving down a cliff. Again, while her autistic child is in the room. She is acting like her child is not even a person.
Autism Speaks is a hate group of abusive parents.
Those advocates with low support needs are the ones that are actually making an attempt to give those high support needs a voice. Not by speaking for them but by taking down barriers so that they can advocate for themselves. Because guess what? High Support needs autistic people are still people.
Just because someone is non-verbal does not mean they can not communicate in other forms. They can advocate for themselves if given the tools.
Support needs are multi dimensional, one person might have sensory issues, another no sensory issues at all but more social issues. Who has more support needs? They are different. And they can change. You can learn better coping skills, you can need more or less support as you age.
> Those advocates with low support needs are the ones that are actually making an attempt to give those high support needs a voice.
Having low-support-needs autism is neither necessary nor sufficient for being a good voice for others. In fact, it can be a very bad thing, if they imply that the problems they face are similar to problems faced by high-support-needs folks. The focus in the media on low-support-needs individuals gives people the wrong impression of the autism spectrum's individual experience and broader societal impact.
I think a better form of advocacy is the YouTube channel "Special Books by Special Kids," which doesn't make a point of the channel's author having a disability (no clue whether he does), but rather just introduces viewers to a broad variety of people.
It's an indicator of the current state of affairs in the social media autism space that the only organization focusing on reducing the suffering of individuals with higher levels of dysfunction (i.e. requires lifelong support for basic needs) is demonized to this degree. Though it also makes sense as the most disabled autistic individuals do not post online.
That’s kinda the whole argument behind more subgroups. Mild autists don’t need a cure. A subgrouping would help explain this.
There are plenty of conditions which are just “part of who you are” that still probably should be cured if possible, if for no other reason than to improve their quality of life.
Meanwhile autism speaks spends money for anti-scientific research to find out whether vaccines cause autism and how to find a "cure" for autism. Such a cure can not exist. Autism is something you are born with and that is part of you.
If you knew anything about autism then you would know that we speak about levels of care needs, not "low/high functioning". So either you are ignorant or did choose to use hurtful language.
Signs of autism generally show up in early childhood, but it has not been proven that it is something a person is born with. Vaccines have been studied enough to rule them out, but there are still a zillion other things that babies today are exposed to that could be a factor, from antibiotics to endocrine disrupting chemicals to microplastics to viruses or even something we're not even considering medically today.
Also, tons of birth defects and inborn diseases can be cured. We cure cleft palates and spina bifida routinely. We manage diabetes and Phenylketonuria effectively enough that patients can live regular lives. Here's a paper published in the prestigious Cell journal covering 700 different genetic disorders which can be treated today: https://www.cell.com/ajhg/fulltext/S0002-9297(25)00110-7
It's possible that in the future autism will have a cure, a preventative measure or a highly effective treatment.
Unfortunately, but the main issue is that people, that are trying to take control of talking space are acting like humans do and in autistic circles they are most efficient at taking over... also, the obsession levels in activity is quite high, as that is topic that they are interested in.
1) I see autism as non-verbal, no concept that other people or conscious minds exist. That's what -actual- autism is to me. And there are plenty of people like that.
2) In light of the above definition, I see the concept of "autism is on a spectrum" as extremely disrespectful to both autists and non-autists. For example, if I have a deformed pinky toe I'm not now on the "paraplegic spectrum disorder". If my IQ is 99 I'm not on the "braindead spectrum disorder" and so on. Such a system applies a negative label to people with the most extreme form, and simultaneous everyone else gets a taste of that label too.
3) the above smooshiness of definition has caused autism to be embraced by people - people who have legitimate mental disorders - just not autism. Moreso the cluster B family of disorders i.e. the manipulative and dramatic family. They are "neurodivergent" vs "neurotypical" and now they have just conjured manipulative leverage from thin air.
Seeing it as one single conditions is established scientific consensus not some advocacy thing.
The diagnosis "Asperger's" was invented by Hans Asperger, a Nazi scientist that was responsible for the murder of many autistic children. It was never about science. It was invented because he thought that some autistic children might have a potential to become scientist and the like and therefore useful to Nazi Germany and some might not.
Hans Asperger decided which autistic children should be murdered and which one to be spared purely based on ideology.
Autism is something you are born with but support needs can change over your life depending on many factors like you environment, if you are diagnosed early and so on. They are not fixed.
No, it wasn't. The diagnosis of “autistic psychopathy”, which loosely corresponds to much of the range of the modern diagnosis of autism spectrum disorder was invented by Hans Asperger (Asperger does not seem to be the first to have described the condition, though he invented that name; a Societ doctor seems to have recognized a similar condition a couple decades earlier.) The distinct separate diagnoses of “Asperger’s syndrome” was invented later (the term seems to have first been used in 1976), and roughly corresponded to the “higher-functioning” individuals within his diagnosis of “autistic psychopathy” that Asperger described as potentially socially useful.
My dad was highly successful; a leader in his industry and did a great job supporting us. His life was relatively easy (as easy as life can be in general) and he was a contributing member of society.
We love my friends kids to death and they do have many positive things going for them, but they will likely never be able to live on their own. Even if they do, they are in for a very hard life. They will likely always need to be supported by family and will likely never be contributing members of society.
To lump both those together is insane. It drives me crazy when people who are functional members of society run around laughing about how they are "autistic". I can't think of anything more disrespectful to those who can never have a "normal" life.
With that being said, I do recognize that medically there is a spectrum. I, as someone with ADHD am likely on that spectrum somewhere as well, from how the science is sounding these days. We need to make this spectrum obvious and respectful though. Why can't we classify a level or something? For example "Autistic level 1" for Asperger's, "Autistic level 2" for barely verbal, "Autistic level 3" for non-verbel... Something like that, so we can unite the cause, but still differentiate the effects and potential outcomes.
The DSM-5 introduced three ASD levels of severity: level 1 (“requiring support”), level 2 (“requiring substantial support”), and level 3 (“requiring very substantial support”).
https://www.autismspeaks.org/levels-of-autism has a good complete overview.
A lot of us low-support-needs autistic people are functional members of society right up until we aren't (i.e., until we've been masking for too long while dealing with sensory stressors and One More Little Thing pushes us into the "screeching meltdown" or renders us temporarily nonverbal). And a lot of us have "normal" lives only in as much as you only see the normal parts.
It's kind of fair to divide things up by support level, but you then also have to understand that there are a lot of different support needs people have and they can look very different at the same "level".
Congratulations, the DSM-5 must have heard you talking :) It does have levels for autism, and classifies the levels in terms of support required:
- Level 1: Requiring support - Level 2: Requiring substantial support - Level 3: Requiring very substantial support
> To lump both those together is insane.
I'm diagnosed with ADHD and also clearly on the spectrum. This life has been decades of confusion and--finally--answers & discovery. My time with my son--diagnosed as Level 1 autistic--and my time observing people in Level 2 and level 3 makes me realize that what you say about lumping everything together is spot on. I always feel like our diagnoses make life oh so difficult, but then I see what parents and guardians of Level 3 autistic people go through and have nothing but endless empathy.
They even eliminated "Asperger" and then just folded that into the spectrum as well.
I sometimes think about two women sitting on down on a bench. Once says a bit uneasily "my son, well he is on the spectrum" The other responds with "Oh I know what you are going through my daughter is also on the spectrum"
At this point neither has any idea whatsoever about what the others experience is like.
One may be highly functional, socially awkward and doesn't think like normal people and processes sight and sounds the same. I find myself moderately down this path.
The other may be non verbal and violent.
This is true for anything else and no argument against the current diagnosis.
There are people with Covid that ended up in the hospital and people with Covid who barely had any symptoms. Both have Covid.
Autism doesn't work from "little autism" to "a lot of autism". One person can have strong sensory issues but decent social skills. Another bad social skills but not sensory issues at all. And care needs can change over your life, they are not fixed.
It might turn out like if we treated the cold, COVID, tuberculosis and lung cancer as the same thing because they all involve coughing.
Furthermore we employ differential diagnostic and check whether your symptoms could be better explained by another condition. You don't just diagnose people with autism because they have a few symptoms.
Furthermore autistic people can generally relate to each other. Even if two autistic people show very different symptoms there is often a feeling of belonging together.
It is always possible that we will learn more in the future and maybe we will have other diagnosis criteria or discover some people currently diagnosed under autistism would fit better under something else.
However the current diagnostic criteria for ASD is the current state of our scientific knowledge. A lot of clinical research is baked into it.
Well there are 200 different viruses that cause the common cold. We lump them together because they all involve coughing.
Basically all cancers are unique, even for the same type of cancer. Again, these are lumped due to shared symptoms.
Tuberculosis is caused by 9 different species of bacteria, but these are at least related species.
Covid is basically exactly the same disease as SARS, just caused by a particular strain of coronavirus, though that strain divereged into multiple ones that now produce quite different symptoms. In addition to SARS, other coronaviruses are among those 200 that cause the common cold.
Diseases are historical groupings that someone at some point thought would be useful, nothing more.
We usually use the term "neurotypical". Autistic people aren't abnormal, the are different.
If "we" are autistic people, then I am part of "we" then "we" is in error since I don't use term "neurotypical"
Perhaps you should say "I usually use the term "neurotypical"
If you are specifically distinguishing autistic and not-autistic, "allistic" is more specific than "neurotypical" (one can be neurodivergent and not autistic) and also avoids any implication than one side is normal and the other is not. (Unfortunately, there is no very good direct replacement for "neurotypical"/"neurodivergent", but one can minimize the impact of that problem by not using them when the real concern is about presence or absence of a particular trait that is within the broad array deemed "neurodivergent".)
The presence of too many/particular ones of them is notably disabling for certain tasks, or makes perceiving some things difficult (and other things easier). But I think the presence of some is preferable to having none, and implies “can think abstractly for/about oneself.”
(And yes, a lot of the “problems” that arise with folks on the spectrum happen because, well, being aware of yourself as a cog/workmeat creates friction… It’s important to keep in mind how much of our history of psychological medicine that created the label “autism” is ultimately oriented towards “fixing the cog/workmeat.”)
Setting asside the very clear science of neurodevelopmental causes, in practice your description is very helpful way to describe it.
(Ive often myself described it as a standard deviation beyond 2 sigma in a normal distribution with 500 dimensions.)
The traits associated with autism are naturally present in the population in healthy and useful ways.
Matching a large fraction of the definition may pose no problem for alot of people. But another smaller deviation in another sub permutation may be detrimental to live a normal life.
So it's really difficult to draw a line between "condition" that need assistance and just outlier human that like trains.
I mildly match a significant fraction of the diagnostic criteria myself, but have had a rather easy time. I don't need special resources, and feel wierd to count under a medical term.
But recognising the traits of ASD had allowed me to find quite a lot of good practical advice that improve my life significantly. So the broad definition has been helpful.
I think the "spectrum" analogy has reduced stigma overall, especially toward people with poor social skills. But it isn't always helpful.
The people without intellectual disability are more convenient to recruit for studies. As a result, across a wide variety of studies on autism, only 6% of autistic participants had intellectual disability.
I feel that the word "autism" is now meaningless. I must know 50 of his cohorts and even though they're all "autistic" they can be quite different.
I also agree that his needs are underrepresented and drowned out by those mildly-affected who have the mental capacity to speak out for themselves.
To compare: Three profiles of people with diagnosed Autism.
Blindboy Boatclub: An Irish satirist who wears a plastic bag on his head in public appearances. Formerly of a band called The Rubberbandits. Today he is known for his podcast and has authored three books of short stories. He comes across as eccentric, but he's quite capable of managing in society otherwise.
Side note, one of the other members of The Rubberbandits went by the moniker of Mr Chrome, but is better known to people as Bobby Fingers today.
My stepson: Just a teenager navigating one of the more emotionally turbulent times while being noticeably different. He has fine motor issues and some social deficiencies. The best I could describe it is that he's emotionally a few years behind where other kids his age would be. He has few accommodations, mostly extra time and the ability to leave a situation that is overstimulating him. He's odd, probably always be a bit odd. May never be able to tie his shoes, but with work, he should be able to navigate society as a functioning adult one day.
Wife's student: My wife is a special education teacher and she has a student who is completely non-verbal. However, he is noticeably intelligent and can form complex thoughts and can attempt to express them. Managed to use his visual communication device to insult one of his teachers based on her appearance. He will likely have issues for his entire life and will likely need constant therapy.
Now, what one thing can we do for these three very different autistic people?
There's a reason people say "When you've met one person with autism, you've met one person with autism". While there are some commonalities and typical comorbidities, what we regard as autism presents in so many different ways, it's incredibly difficult to construct a single program to address it.
And I can see why we'd want to break it up. But that gets difficult as well. My stepson started low-verbal. Didn't speak for a while. Spoke rarely for a while longer. And now he speaks a lot. And he's learning when it is appropriate to speak and to handle people speaking around him but not to him. So he was non-verbal. But then became verbal. But not all autistic children cross that border.
All that to say: I dunno. Shit's complicated, yo.
As someone with some similar issues, a) my motor skills are fine, b) the focus on tieing shoes is so frustrating; velcro shoes are everywhere, you can even get Dr. Martens high boots with zippers so you don't have to tie them... like sure, try laces and if it works great... but just provide the accommodation and move on. :P
On the plus side, everyone said playing video games would help my fine motor skills, so I got an out to play a lot of video games, which I enjoyed. :D And my atrocious penmanship hasn't been an issue in adult life, because nobody writes anything anymore (and have you seen the penmanship for kids that were in 2-4th grade during covid ... it's worse than mine!)
"Stomach ache" is not a spectrum disorder, even though is comes in many severities. It's a symptom of dozens of different medical conditions.
I suspect "autism" is similar.
A stomach ache is a single manifestation of something happening. A stomach ache can have varying degrees and reasons behind it. The stomach ache is the signal. The disorder that causes it could be psychological (GAD) or external (someone punched you, and the flesh is bruised) or internal (someone fed you a weeks old egg salad sandwich).
In autism the 'symptom' could be model train enthusiasm or being nonverbal. There are a lot of symptoms the fit under the umbrella of the disorder.
As for different medical conditions - imagine, that previously mentioned Aspie in different environment can have stomach pain, because it is caused by environment and not by stomach pain. Yes - there are some medical conditions, that also comes from genetical conditions and those just happen to be in neighbourhood to autism for no other reason than just general damage to DNA. And the issue here is that we actually do not fully know how DNA functions - only some of the bits.
When we have a cluster of symptoms that travel together we can see there's an underlying issue without knowing what that underlying issue is. And we normally use the word "syndrome" for that. For example, AIDS or IBS. And society tends to dismiss it for as long as possible because to face it is to admit there's a problem with no answer. For an example that's still in the denial phase, look at long Covid. There's clearly something there, like AIDS it's a slew of apparently unrelated issues. Which says that, like AIDS, there's probably some underlying issue that is itself very hard to see and we are only seeing the secondary effects.
https://en.wikipedia.org/wiki/Archive.today
> archiveiya74codqgiixo33q62qlrqtkgmcitqx5u2oeqnmn5bpcbiyd.onion
via this post on their blog:
https://blog.archive.today/post/711271973835227136/did-somet...
Stop posting paywalled shit on HN please.
People get abortions because it’s financially inconvenient or a bad time or something else trivial constantly. Surely a lifelong affliction isn’t that hard to understand the motivations behind.
I am forgetting how serious ASD people can be without having able to make any jokes. Relax, dude - by the time when government will be able to provide such services, all the humans will have autistic genes - there clearly are some natural advantages to people, that are multiplying with those genes and spreading them around. And unfortunately to say this, but natural selection is the only thing that will weed out those so called "heavy autistic cases" and they will cease to be a problem in time.
However, I don't think the random nature of evolution will have a meaningful effect on humanity going forward. We will soon reach the point of selecting for more desirable genes. Done badly it would be Gattaca.
If you are not, why are you trying to force others to go through it?
I'd note that RFK Jr.'s very own aunt was lobotomized then hidden away for something that sounds a lot like autism if diagnosed today. https://en.wikipedia.org/wiki/Rosemary_Kennedy
https://en.wikipedia.org/wiki/John_Bentinck,_5th_Duke_of_Por...
> The tunnels under the estate were reputed to have totalled 15 mi (24 km), connecting various underground chambers and above-ground buildings. They included a 1,000 yd (910 m) long tunnel between the house and the riding house, wide enough for several people to walk side by side. A more roughly constructed tunnel ran parallel to this for the use of his workmen.
> The duke was highly introverted and well known for his eccentricity; he did not want to meet people and never invited anyone to his home. He employed hundreds through his various construction projects, and though well paid, the employees were not allowed to speak to him or acknowledge him.
> He ventured outside mainly by night, when he was preceded by a lady servant carrying a lantern 40 yards (37 m) ahead of him. If he did walk out by day, the duke wore two overcoats, an extremely tall hat, an extremely high collar, and carried a very large umbrella behind which he tried to hide if someone addressed him.
> He insisted on a chicken roasting at all hours of the day and the servants brought him his food on heated trucks that ran on rails through the tunnels.
Yeah, nobody wants to speak with me anyway - they just scurry away, so no problem with that...
It still feels like there is more autism today compared to then though. I would guess that it's some combination of more people waiting to have kids until they are older, environmental factors, mania about cleanliness and sanitizing everything, maybe social factors such as putting more kids in daycare at a very young age, IDK. I'd say the same thing about asthma and food allergies too, seems that half the kids today are allergic to something, need inhalers, etc. It was unusual among my friends as a kid, at least I don't remember it being common.
I mean, if you were deathly allergic to eggs in the 1800s, you died. Very early.
If smoke sent you into respiratory distress, you died. Very early.
Or see the "left-handedness epidemic". It is probably not massively more prevalent now than it was in 1900s, even if that's what the stats say. https://www.researchgate.net/figure/The-overall-rate-of-left...
It's possible my anecdotes are not representative, but this is just what I have observed.
> Asthma was recognized in ancient Egypt and was treated by drinking an incense mixture known as kyphi. It was officially named as a specific respiratory problem by Hippocrates circa 450 BC, with the Greek word for "panting" forming the basis of our modern name. In 200 BC, it was believed to be at least partly related to the emotions.
Theodore Roosevelt had asthma.
[1] https://www.statista.com/statistics/1041693/united-states-al...
Beyond that, there's a question of, while maybe they didn't have an inhaler, how many needed one but didn't get one due to awareness or whatnot? Or how many people had allergic reactions, because we didn't ask about their allergies?
They also usually died young.
People with ADHD for example, are more prone to abusing drugs and alcohol. How many people died from alcoholism who were untreated ADHD cases?
>It still feels like there is more autism today compared to then though.
This is objectively true, do you know why? We changed the name of really poorly functioning people in some cases from "Mentally retarded" to "Autistic".
That's it.
Look at a graph of generic "mental retardation" diagnosis and it's fall coincides with the "rise" of autism diagnosis. Those people were always actually autistic, but we did not have the institutional knowledge and tools to know that, because the science of psychiatry and psychology is still in its infancy and struggled with rampant a-scientific thought even into today. Jordan Peterson for example is a "Jungian" trained psychologist even though that's not science, and he was fired when his college discovered he was leaning more on that unscientific worldview than actual hard science in his college courses.
>I'd say the same thing about asthma and food allergies too, seems that half the kids today are allergic to something, need inhalers, etc.
The food allergies is real because a bunch of doctors were "nervous" about babies with peanut butter allergies, and without any scientific study or consideration, spent over a decade recommending parents not expose kids to peanuts.
Now that we have actually done the science, we know that was dead wrong, completely irresponsible, unscientific, and directly responsible for something like 8 million fully preventable peanut allergies. That's what happens when you let even medical professionals use their "intuition" rather than hard data. This is why medical studies blind those professionals. Doctors are not usually scientists.
There is no education that removes human biases and cognitive missteps, and it is impossible to cure yourself of the standard human fallacies. Statisticians can still become gambling addicts, and can still suffer from gambling fallacies when not being rigorous.
>I would guess that it's some combination of more people waiting to have kids until they are older, environmental factors, mania about cleanliness and sanitizing everything, maybe social factors such as putting more kids in daycare at a very young age, IDK.
The only one of these with any real evidence is that Geriatric Pregnancy is a known risk factor for autism. Everything else is nonsense.
Don't feed into the rampant misinformation and malicious refusal to learn what is already known by throwing out baseless guesses and letting them carry any weight. How often has one of your customers correctly guessed what caused a bug without understanding, access, and rigor? You are doing the same.
> They also usually died young.
> People with ADHD for example, are more prone to abusing drugs and alcohol. How many people died from alcoholism who were untreated ADHD cases?
Or suicide. Look at the suicide rate amongst those with autism even now. And when people take themselves out of society with drugs or alcohol we don't put much into figuring out why they chose that path. I recall a bit in a book by an ER doctor--one of the frequent fliers, brought in because they were found unconscious. When asked if he knew what brought him to the ER, responded alcohol. And one time he admitted why: he had been a sniper in the Serbian war and it was the only way he could keep from killing himself.
I believe that to a large degree the "drug" problem is a manifestation of other issues.
> This is objectively true, do you know why? We changed the name of really poorly functioning people in some cases from "Mentally retarded" to "Autistic".
> That's it.
> Look at a graph of generic "mental retardation" diagnosis and it's fall coincides with the "rise" of autism diagnosis. Those people were always actually autistic,
Exactly. There is no epidemic of autism, there is an "epidemic" of better diagnoses.
I knew plenty of kids in the 1970s that were "a little off" (probably including me), but they were not so bad that we would remove them from society which was the only option back then so we called them normal. Now that we have treatment we give it not only to those so autistic that they can't function in society at all, but also those who could function but not well and treat them.
Depends. My childhood was in the 70s. Autistic kids with low support needs were labeled "gifted" and sent to the "gifted program" classroom one day a week. Autistic kids with high support needs were labeled "retarded" and kept in the special ed classroom all week.
Rosemary's story is so tragic and heartbreaking. Her life was filled with what would today be considered multiple instances of medical malpractice, and heartless, unethical behavior on the part of the Kennedy family. Her father didn't even tell her mother about the lobotomy until after it was done.
Incredible that she lived to the age of 86. The nuns taking care of her might have actually cared, which could hardly be said of the Kennedy family.
JFK was great in some ways, but that political dynasty had serious problems even before RFK Jr.
The Wikipedia article paints this as partly driven by the political aspirations of the patriarch. I suspect this is yet another example of we'd be in much better shape if the US didn't have quasi-royalty, nor families aspiring to that.
Babies are born with many more neural connections than most adults have. The learning process appears to include a "winnowing" process. OTOH, autistic individuals appear to have a larger number of neural connections, which suggests that they did in fact "not converge" (or not weed out excessive connections that distract from more productive decision-making).
There's a reason Asperger Syndrome was abandoned as a separate condition and folded into ASD (in DSM-5) -- until then, anyone who wanted the diagnosis could get it, by displaying symptoms popularly associated with the condition. So we had clinical indicators, but no objective biological tests -- still true for most DSM-listed conditions. This led to widespread abuse and uncertainty.
The single label "autism" has many drawbacks, but one important advantage -- it reveals what we know in a scientific sense, which is next to nothing. Eventually neuroscience will change this and identify biological causes for many "mental" conditions. This will end diagnoses based on clinical interviews and replace them with objective biological tests.
I imagine this scene in a future neuroscience clinic:
Patient: "Let me tell you what I think is wrong with me."
Clinician: "Don't bother, we have objective biological tests now -- your narrative would only confuse the process. Remember psychology?"
One such profile is pathological demand avoidance (PDA). Another is Asperger Syndrome, which has been reclassified as an ASD profile. They all exhibit the diagnostic criteria for ASD in one or more ways.
Also, I want to point out that calling ASD a "mental condition" doesn't have a scientific basis; it is classified as a developmental disability. These terms matter, whether or not you consider this to be some kind of abuse.
The criteria are based on effects, not causes. They lack depth.
Let me put it this way -- if a trained actor can acquire a diagnosis, then it's not based on causes, only effects. This would be like gathering rocks from a field and classifying them based on their color or shape, but without a science of geology to inform the classifications.
A trained actor can't pretend to have cancer, because we know what causes it, and we have meaningful clinical tests that categorically exclude anything but a specific biological source. Psychology doesn't have this property, and it may never have it.
When Thomas Insel resigned as director of the NIMH, he frankly said that the agency hadn't "moved the needle" in terms of knowledge or treatment, in spite of 13 years of effort and a 20 billion dollar outlay (reference: http://blog.stevenreidbordmd.com/?p=1615). I greatly respect Insel's candor and willingness to report facts in a field seemingly driven by illusion.
> Also, I want to point out that calling ASD a "mental condition" doesn't have a scientific basis
Sorry, but since the entire field has no scientific basis, it's unfair to single out a specific example without acknowledging this fact -- the elephant in the room.
> ... it is classified as a developmental disability.
That also has no scientific basis, it's a response to a fad, a transitory response to fashion (as were all the classifications that went before it). In point of fact, ASD has a biological cause, but we have no idea what it is.
> These terms matter ...
No. They don't. This is proven by the fact that they keep changing, but without any change in evidence or science.
Neuroscience will change all this, but not any time soon.
The overlap also makes it difficult to diagnose ADHD when both are present.
Disorder by definition means that we do not consider it to have a single cause or issue, and we acknowledge that we don't understand it well enough to give it a single name, cause, or objective diagnostic criteria.
When we know what causes something, or how to strictly and objectively identify it, then we usually call it a disease.
This is well understood by medical professionals, and a normal part of their job, and not confusing for the vast majority of people diagnosed with some disorder or other.
This article is utter trash. As per the usual for the economist
I suggest a change of the autism term to something like "idiopathic apsychia" (loss of soul, empathy disorder etc) which demonstrates a common causal base and can focus the attention to more meaningful academic research and public acknowledgement.
Litman et. al (2025): Decomposition of phenotypic heterogeneity in autism reveals underlying genetic programs
https://pmc.ncbi.nlm.nih.gov/articles/PMC12283356/
The code is available at https://github.com/FunctionLab/asd-pheno-classes .
It looks like this article is talking about that exact preprint, but a quick skim didn't reveal any sort of link.
Ever since I first read it, I've been training myself to identify the subtypes. I don't have good names for them, nor do I know how they correspond to the names in the preprint, but I can usually tell them apart. I have indeed seen exactly four.
I would love for there to be more research into the intricacies of each subtype, because I feel that care and accommodation could get a lot more personalized and helpful if there were less of "anything goes / anything could happen" and more specialization to what's most likely to be effective for each particular subtype. As it is, a lot of care programs or individuals supporting them may be specialized to an unknown degree to particular subtypes and not really understand how to become less specialized or even specialize further.
On top of that, I greatly want to understand better the subtypes other than my own, not least because a couple of them I can find very difficult to communicate with because my knowledge and arguments are formatted differently than how they learn. I want to learn how to format my knowledge in a way that's easier for them to understand and more convincing for them.
I'm just very curious and interested and I really hope the idea of autistic subtypes takes off because it absolutely agrees with what I've seen in practice.
Particularly when it comes to the brain. It's a reflection of how little we know about it.
I think very few people actually consider it a single condition. To the point that most people that I know, including myself, say that we are "somewhere on the spectrum" or some variant of that.
This isn't a post diagnoses understanding either, it is well understood by anyone I have talked to about this in the last 10ish years? (maybe less, I cant really pinpoint that).
While I feel like there is value for professionals to be more specific about it, from an everyday person prospective I feel like "Autism" is well enough understood to be not just a single thing. Enough so that some phrasing along the lines of "my tism is..." is somewhat commonplace.
The real problem is anti-science people joining the conversation, but splitting up Autism is not going to change that.
Edit: To be very clear here I am not trying to say that most people in general are saying "I am somewhere on the spectrum". I am saying that most people I know which a larger portion of the people I regularly talk to are also diagnosed.
Couldn't disagree more. The "autism is my super power" movement is borderline offensive to people dealing with severe or low functioning autism.
Dismissive, uninformed comment.
And again my point is that contrary to what the article seems to be trying to make, no one really considers Autism a single thing.
Still this “everyone is a bit autistic” stuff is kind of absurd. It diminishes the condition.
> most people that I know, including myself, say that we are "somewhere on the spectrum"
No one says “everyone I know is a bit paraplegic”, because that would be insane. Yet people glibly call themselves autistic as if having geeky hobbies or a job in software is the same as being diagnosable as having an autism spectrum disorder.
Again nowhere am I saying that.
Maybe I could have worded it much better but I never meant to imply, it happens that like myself a larger portion of the people I hang out with are diagnosed which for me works with just saying "most people" but I can see why that was not clear.
And if "no one considers autism a single thing" THEN WHAT IS EACH THING? lol
We don't have a name for every color on the light spectrum, nor can the average person tell you what's different about #FF0000 vs #FE0000. They still exist!
People are trying to point out that the "spectrum" thing is the medical field doing precisely what you're asking for.
It is an Umbrella term that is well understood to be a "spectrum" and well understood to not be the same for 2 different people.
My question though, what is the point of separating it. What do we actually gain from doing so? I guarantee you these attacks will still exist.
I don't have a degree in this but I have to imagine there was a good reason that Aspergers is no longer its own diagnosis.
In what way is GP being dismissive, or taking the "autism is my super power" position with that comment?
I doubt those types are saying much of anything. Its more likely their caregivers.
Again the old name for those of us who think its more a super power used to be called Aspergers syndrome. https://en.wikipedia.org/wiki/Asperger_syndrome . And we got folded in to Autism Spectrum Disorder, as did a whole host of other diagnostics.
And we have been found to be more truthful, better at focusing, can hyperfocus, notice more details than NT's, and plenty more. We're only a disease cause we're the minority.
Yeah and this is why Autism shouldn't be treated as a single condition, even if the cause is the same the outcome is meaningfully different than someone who cannot function.
As someone with a diagnosis, I would add several sensory issues (for me it's noises, multiple conversations at the same time, stickiness, physical contact, whole categories of food and several others) and several social issues to your list of superpowers.
Seeing it purely as a positive is insultingly reductive.
To be clear: I would not take a cure if it somehow got invented, but it /is/ limiting in a multitude of ways even in the best cases.
So for dis-ease or dis-ability, it doesnt interfere with ease of life. Nor does it materially affect my ability.
> I would add several sensory issues (for me it's noises, multiple conversations at the same time, stickiness, physical contact, whole categories of food and several others) and several social issues to your list of superpowers.
And too true. I have some as you listed as well. However, I also figured out what causes them in me, and how to reduce their effects to nil. In a way, its self-treatment with n=1.
Noise: I dont have a problem with noise per se. However, when multiple people are talking or music with lyrics are on in the background, its incredibly hard for me to process what's spoken along with it.
Weirdly though, when I was principal clarinettist in a symphony, I could easily pick out any instrument by simple concentration. All I know is the noise issue with me is something with vocal processing of over-talking voices.
stickiness: for me, its dirt on my hands. Or chicken/turkey/beef/pork/lamb/goat blood. I do a lot of cooking. I hate those feelings on my skin. But I find that as long as I wash my hands before and after with a good degreasing soap (Dawn), the icky goes away. I can still do the task at speed.
I dont have the physical contact issues for people I'm close with. So, thats not an issue.
Food: theres only a few foods I can't eat, due to vomiting reasons. Tapioca based products are the big one. Aside from that, I eat everything from blue cheese, to cow tongue, offal from beef and birds,ghost peppers, pork brains, hakarl. I like the tastes and sensations that foods have. In a way, I'm wondering if this is also relayed to the supersensitive reject-foods type. Definitely not a disability.
And of course, theres the huge downsides with interpersonal interactions. Took me decades to really piece together and emulate and identify emotional state in others. But the psychologists dont know how to fix this either. Most of them are NTs who it comes naturally. But they want their indefinite sessions to do basically nothing but pay $200/hr.
> Seeing it purely as a positive is insultingly reductive.
Again, there are up and downsides to NT's and ND's.
Neurotypicals are more known for deception and lying. Or they use the term "little white lies". These things slowly stack up in NT conversations until they become huge problems. Sitcoms are based on this. But ND's, well, we are the weird ones. When someone asks "do I look good in this?" And you say "no, it clashes with your skin tone" - you were supposed to know they wanted a yes.
I feel sad that NTs can't properly hyperfocus, and can easily drop out of hyperfocus with low sensory input.
NTs memory is foggy and badly reorders things. Or they misremember and blame others for ill-perceived issues.
There are good and bad. I'm glad I'm ND, likely Aspergers (hence autistic). Most of these problems are ones that can be solved, at least for Aspergers side of things.
It doesn't really matter whose saying it. The point is that autism is not cool or fun for many people. We need a way to distinguish the difference, besides saying high or low functioning.
> We're only a disease cause we're the minority.
WHICH WE ARE WE TALKING ABOUT THEN? IS IT NOT A DISEASE WHEN SOMEONE IS NON-VERBAL? Holy shit. Point, meet case.
I dont think they ever should have did that.
If the doctors say that "someone is nonverbal, pisses their pants, and needs spoonfed at 17yr old" is somehow the same as "someone who is a professional engineer who can hyperfocus but misses social cues and says weird stuff" - the doctors are completely wrong.
Those are demonstrably NOT the same thing.
And yes, my Aspergers is a super power. Those abilities (many positive, some negative) have gotten me far.
If you had visited the Aspergers and autism website support forum "wrong planet" 20 years ago you'd have seen many lower functioning than you people with "aspergers" complaining about aspects of their lives.
So I don't see how "aspergers" is a superpower.
That's my main concern about trying to split up autism. It's all well and good for study purposes, but for "can I get my insurance to pay for my kid's occupational therapy" purposes I'm really skittish about such a breakup. All the sudden my kid might have "omegaism" or whatever and boom, it's uncommon for them to need OT so insurance won't cover it.
It really doesn't matter if the underlying cause is very different in terms of treatment because a speech therapist works the same with a kid with autism as they do with a kid with down syndrome.
If there were more pharmaceutical interventions then I might care a bit more. But there's just not.
In terms of the research, the researchers already have tools to sort and filter individuals based on their specific set of symptoms. Just because 2 people share an autism diagnosis doesn't really impact the research.
What objection do you have other than not liking that it's not a "pure" diagnosis?
People with sensory issues often also have more cognitive rigidity for example.
Autism, and many other psychological disorders, are quite literally just a lump of symptoms and presentations, because we do not have better options.
Sure, it makes navigating american health insurance easier if you can just say "Autism" and get various treatments paid for, but very similar diagnostic criteria and definitions are used in countries with fully socialized medicine.
Those people with those linked issues tend to benefit from similar treatment, and that's the entire point of a diagnostic criteria.
All the complaints come from people who seem to just not like the vibe of that?
Deal with it. Go fund more research into the heritability of neurodivergent pathologies if you want a blood test.
Some day we WILL be able to separate "Autism" into very specific diseases with specific causes, and some of those causes will have a genetic test. Unless we kill the concept of medical research because we elected morons who tear apart our institutions.
I have "Impaired vision", and I share that with people who are profoundly (but not totally) blind, and it does not matter that I can drive with glasses and they can't, and the name of that condition is not the important part.
All this handwringing about "but but but my mildly autistic son is mostly functional and I'm sad that he has the same name of condition as someone who cannot be educated past a 3rd grade level" is stupid. It does not benefit anyone struggling with autism to complain about it.
Are you aware that we have multiple medical conditions called "Palsy"s, and that they have drastically different causes and effects, such that my sister's Palsy which was caused by medical malpractice and prevented her from using her dominant hand in some cases is very different from my schoolmate's Palsy which left her wheelchair bound and requiring professional help day to day? They are both palsy because they are (partially) movement disorders stemming from nerve damage or dysfunction.
The horror!
Maybe I'm not being charitable. But that really does feel like the only real outcome of trying to piecemeal the diagnosis.
I don't believe research or treatment is negatively impacted in anyway by the diagnosis being broad. If anything, that opens doors so that research isn't accidentally too narrowly focused.
I'm rather dismayed by the recent outpouring of articles about splitting the diagnosis up by people who don't even have a horse in this race but have somehow become qualified to weigh in on psychiatric diagnosis.
Or, consider TPA. It is an extremely dangerous drug (used correctly it still has greater than a 1% chance of killing the patient), if you administer it to "stroke" patients you almost certainly do more harm than good. The reality is that if you use it on a bleed type stroke it can (and likely will) only make things worse. Use it on a clot type stroke and you might save them. We of course know this and only use it when a CAT has confirmed it's a clot--but what would happen if we didn't distinguish the two cases?
> The vast amount of treatment for autism is therapies.
> It really doesn't matter if the underlying cause is very different in terms of treatment because a speech therapist works the same with a kid with autism as they do with a kid with down syndrome.
> If there were more pharmaceutical interventions then I might care a bit more. But there's just not.
There are a limited set of drugs involved in autism therapies, but they are general drugs that would be applied regardless the diagnosis (for example, antidepressants.)
In fact, it's much like depression in that sense in that it's a very broad definition with a number of causes. Some antidepressants even work better or worse for people.
My point is, if it is commonplace to refer to Autism as a spectrum we are already acknowledging that it is not a single thing.
Which seems to be the entire basis of this article while also mixing in the rambling of someone anti-science that frankly won't change even if it was split up.
As science learns more (or I learn more) I reserve the right to change my position.
The point of treatment isn't to "fix" or "make normal" someone. It's to give them the tools needed to participate.
For example, someone with autism might be more prone to having a meltdown. What therapy does is give them the tools to both identify that they are on the verge of such a meltdown and to de-escalate themselves.
The point of treatment is to help someone take care of themselves, hold a job, and generally not burden anyone. It's also to help a person feel better about themselves.
Your example person may function well within a narrow band of capability - the purpose of treatment/support is to expand that band and help maintain it. I'm not advocating forcing support on someone that doesn't want it, but I am for improving someones quality of life by expanding their choice of occupation and social environment.
Without any external support I would wake up, work, sleep, repeat. Eating? Cleaning? annoyances that just interrupt work.
I've made a lot of money doing that but it's unfulfilling and at times, disgusting.
If you want to live in a society that leaves me be - I won't starve to death but I'm never going to have a partner or a family without external services like psychology, occupational therapy, social events.
Whether I pay for these services or someone else does it doesn't matter. I want them to be available for people like me to understand that we are not alone, there's a reason we can only exist comfortably in our narrow slice of the world, and if we want to leave our bubble there is support available.
I don't think there is any treatment. I think it's just a set of skills that you learn in case you want to try to pursue activities that most neurotypicals take for granted. It seems like a lot of work to me, and maybe it would be easier to just let things be, as you're saying.
I know what my limitations are and I can observe others doing the things that I can't do, including my own wife, and I imagine what life would be like if I could do those things too. But it mainly boils down to having FOMO, and thinking about how much work you want to go through in order to be able to do some of the things that you're having FOMO about.
Look at the percent of those with autism that commit suicide. (And how many slow suicides of drugs or alcohol?? I don't think we even have a ballpark for this.)
It's not just whether they can take care of themselves.
For example, nobody who is diagnosed with autism is proclaimed "not autistic" if they find therapy to be unhelpful.
In the 1990s we drugged kids (especially young boys) who weren't able to sit still with ADHD medication. Every parent's kid suddenly had ADHD, people would talk about their quirky behavior as "oh its my ADHD".
This generation it's autism, and it's likely over-diagnosed just as much as ADHD. You do it in your own post, attributing a defined, binary, thing as "I am somewhere on the spectrum". If anything, your own post demonstrates the anti-scientific (pop-sci) instagramification of mental illness. You either have some quantity of illness or you don't. You can't just ascribe some quirky, possibly somewhat anti-social, behavior as being on the spectrum. Sadly, this is often used like ADHD self-diagnoses to gain sympathy or social leeway. Much to the disservice of people suffering from the condition.
It comes as no surprise that psychiatry, and medicine in general, is suffering from a massive reproducibility crisis. It's not anti-science to call into question the amount of bunk, p-hacked, corporate funded garbage coming out of even the highest tier of medical grade journals.
At the same time, there’s the neurodiversity movement that seeks to destigmatize and depathologize these diagnoses for both high functioning and more profoundly disabled individuals. Just because you don’t conform to the norm - and ASD is heavily defined in relation to deviation from an underspecified norm - does not make you “mentally ill.” So we have autism as an identity additional to a diagnosis, which I think can be really empowering for people, and also cause confusion and frustration for others. It’s a reclaiming of “disability” from the paternalistic and abusive medical and pseudoscientific practitioners that have been harming autistic people for decades.
I also wish you were not being downvoted. You express some common sentiments and I think your comment adds to the conversation.
> I also wish you were not being downvoted. You express some common sentiments and I think your comment adds to the conversation.
Common or reasonable sentiments or not, the whole "kids these days" overtone is tiring and annoying, and most people - online and in person - don't want to engage with that, because it does not imply a position of good faith.
I think it is important to stress a difference between "over medicated", "over prescribed", and "over dosed" (often also called over medicated, something I have been guilty of).
An example being my partner, apparently when he was a kid and diagnosed with ADHD he was put on a very high (I am only relaying what I was told) dose that he hated being on. That has caused him now as an adult to be very cautious to go back on the medication.
Where as for myself I was not diagnosed until an adult, was able to actually advocate for myself and I started on the lowest dose possible for all of my medications (also treating Anxiety and Depression). While I do take several medications I would not consider myself over medicated because we have identified that at this point in time all of these medications are actually helpful, but I am very cautious of being on too high of a dose for each of these.
I do think there are likely people that were put on too high of a dose too quickly to expedite treatment, but being on the medication in the first place was not the issue. It doesn't mean that the diagnoses was wrong though.
It's definitely the case that there is undue paranoia about stimulants.
One case you only briefly touch on, addiction. Let me elaborate. I have struggled with severe ADHD(largely untreated during childhood, mainting severity into adulthood as a result) for all my life. I've struggled with drug addiction for most of my adult life(mainly cannabis). The amount of hoops addicts are made to jump through to get access to amphetamines is insane. Generally the requirements in my country(Norway) are to deliver weekly clean drug tests for 3 months. In the case of heavy cannabis use, it takes up to 3 months from going cold turkey until tests are negative. So, a 6 month commitment before treatment can even begin. Now, the relationship between ADHD and cannabis is interesting. I know some ADHDers who swear by it as a treatment. These tend to be of the predominantly hyperactive/impulsive type.
For me, it can't really be called a treatment. It actively worsens my condition in terms of executive dysfunction. Although it does improve some of the aspects like hyperactivity and emotional lability and helps make things bearable.
By the time I'm a year into a binge, my life is such a mess that getting myself out of it without meds is completely hopeless. Here I'm talking my apartment being such a mess I'm generally expecting to be woken up by people in biohazard suits any day now, and wondering how the hell I haven't contracted some kinda crazy bacterial disease by now. Cleaning it up is weeks if not months of work even with meds. Without it's inherently impossible. And the cannabis at least numbs me to the horror of it all.
So for 6 months I have to abandon that small comfort and just exist in this hellish life until I can even begin to improve things. Try to imagine how hard that makes going cold turkey in the first place. Not to mention the fact that meds significantly help me manage the addiction in the first place. I've successfully made it through this 6 month purgatory 3 separate times in the last 13 years. I've made more failed attempts than I can count. Wasted most of my 20s hiding from the purgatory inside a bong. I often wonder ehat my life would've been like if the rules weren't so strict. There's no evidence supported medical justification for waiting any longer than about 4 weeks. Out of the bajillion or so failed attempts, I reckon maybe 3/4 made it that far. Go figure.
I'm currently, close to 2 years semi-sober(doing a new moderation based approach to my addiction, very successfully, smoking exactly once every 4 weeks. Bit unrelated to the stimulant thing, it's more about relapse avoidance. But it's worked wonders so far.) and doing better than ever, but I still have a long way to go. And I will fight anyone who sows FUD about amphetamine or methylphenidate. These are wonder drugs. If you want to freak out about psych meds, go read up on neuroleptics. Now there's something truly horrifying. But of course, that only happens to crazy people hidden away in mental wards, so no one cares about them. I've been to those mental wards and I have seen some shit I will never forget. People whose lives were destroyed, reduced to an unbearable living hell for the remainder, by a supposed "treatment". These people are treated like animals. Go talk about that. Shut the fuck up about stimulants and SSRIs already, jesus. And go touch some grass.
"You either have some quantity of illness or you don't."
I'm not sure what kind of argument you are making for (or against?) "binary" symptoms. The DSM-5 clearly lays out the spectrum. There is a conglomerate of effects caused by autism, and where you are on "the spectrum" is determined by how many of the symptoms you have, and their severity.
There is nothing wrong with someone claiming "I'm on the spectrum" if you don't know how or what they were diagnosed with. That language is consistent with the DSM. Unless they admitted to self-diagnosing, it seems wrong to assume someone is lying about their own experience.
"You can't just ascribe some quirky, possibly somewhat anti-social, behavior as being on the spectrum"
Quriky, somewhat anti-social behaviour (in your words) essentially is one of the dialogistic criteria. But nobody would be diagnosed with autism for that alone. Just like how autistic folks usually avoid eye contact. That doesn't mean they ALL avoid eye contact, and it also doesn't mean anyone who avoids eye contact is autistic. It's a wholistic diagnosis. One would need to be experiencing SEVERAL of the symptoms to receive an autism diagnosis. IME, the majority on the spectrum are indeed level 1, and high functioning, even to the point others might question if they are really autistic.
If you take issue with people self-diagnosing, I don't think anyone would disagree. But your combativeness in just discussing the topic kind of looks similar to people who refuse to accept that autism is really a thing ("there were no autisms back in my day" kind of thing).
My OCD would not let me ignore this typo. (Just kidding - I self-diagnosed OCD)
Psychiatry still hasn't coped with the fact that it spent most of the 20th century taking Freud seriously. More recently, it still hasn't figured out a way to repudiate the Satanic Ritual Abuse panic in the 80s. The people who were involved are literally still working, and have moved on to Facilitated Communication in severe autism, Gender Identity, and are still pushing around the fraud of Multiple Personality Disorder. Literally the same people involved in all of them, and now their children. [edit: forgot about one of the most important, Recovered Memory Syndrome]
There's just no scientific method in most of psychology, it's simply guru-led systemic theories delivered mostly (but often entirely) by a single person who is licensing practitioners. What comes along with that is a complete inability for any of these theories to die. They just eventually become unpopular and unprofitable, and people jump onto the next thing.
The psychopharmacological revolution has complicated this even more, because now there are billions of dollars wrapped up in it. The only advantage to SSRIs and the new generation of knockoffs was that they didn't cause tardive dyskinesia, there was never any statistical evidence that they performed any better than the previous drugs. And in the case of the previous drugs, they weren't ever shown to have much of an effect other than quieting down patients. They were all based on the wackjob theory that people having epileptic seizures suddenly became sane, and were one of the ways of inducing a seizure-like state, along with freezing baths, saline injections, electrocution, etc. All of the pioneers were also enthusiastic lobotomists.
How can we say that these new tactics are medicine or science when the statistics on mental illness keep getting worse?
Is that really your position?
Your other words seem fine, but that is a standout sentence!
Many scientists believe that one day we will likely be able to split off at least some of the undifferentiated mass of ASD into potentially completely unrelated disorders that may share a lot of aspects of presentation.
For example, we may find out that one set of genes combined with cytokine storms in utero cause dysfunction in synaptic pruning, while another set of genes combined with gut dysbiosis may affect brain plasticity in the critical period of early childhood. Those would be two completely unrelated conditions, with overlapping symptoms for some (but not all) who have them.
I can't read the article because of the paywall, but I assume that it is referring the fact that these two extremes need to be treated completely differently and even discussing ASD is made remarkably difficult because these extremes are the same diagnosis.
This is not at all a thing. People with some mild neurodivergence sometimes being good at very specific tasks is not even in the same ballpark as "Benefits"
There's no benefit to a brain that struggles in modern society.
>but I assume that it is referring the fact that these two extremes need to be treated completely differently
Except they don't. What is different is the intensity of the treatment. My girlfriend needs patience and a little therapy. Her sister needs intense forever therapy and infinite patience and a system that will allow her to live despite never being able to be a productive member of society.
>They do not for a moment think about the more severe cases that require people to have full time caretakers because they are unable to feed themselves.
They are regularly the parents of exactly those people and are sick and tired of you speaking for them and making their life harder. Those people who need fulltime caretakers can only pay for them through social security benefits, and guess who is trying to change that?
>even discussing ASD is made remarkably difficult because these extremes are the same diagnosis.
The reams of neurodivergent people I have interacted with in my life have never found issues with this, and have regularly been very willing to engage with the nuance of a poorly understood disorder which by definition has no single cause and might be several similar looking diseases because that's what the word disorder means in medical science
The discourse around RFK is that morons with no experience, training, or even ability to read introductory material apparently should shut the fuck up, and let the adults work.
Would you say there’s no benefit to the genes associated with sickle cell anemia? How about homosexuality? Schizophrenia?
The reality is that we cannot reliably predict how genes interact with the environment in the long term. Modern society is more malleable than ever.
The fact that this topic is relevant on a site disproportionately frequented by computing professionals suggests a strictly negative characterization is incomplete even in today’s society.
I'm not entirely sure why this comment is apparently so controversial, but I think people are confused by this. My reading of it was that you meant "most autistic people you know", and you yourself are. Maybe I'm wrong?
Now yes there are people who are undiagnosed for whatever reason (including some people I know that don't see the point after being diagnosed with ADHD, I know personally I had to have this conversation with my psychologist to determine if there was a point to actually do it at that point) that use that phrase and it gets a bit tricky.
But nowhere am I trying to imply that *everyone* is saying this.
[edit] To be more specific, this is a lazy take and is about as insightful as saying 'cancer should not be treated as a single condition' which for HN is about as meaningful as saying 'the CPU and the GPU may both contain chips, but they should not be programmed the same.'
This actively harms diagnostics and encourages cure-all peddlers.
Definitely has been good for financial benefits and such but... Once someone gets the "autistic" diagnosis all further research stops.
For example somebody with PDA autism cannot interpret the nonverbal communications of other people because they have already made the immediate decision that they want to be liked by others, so therefore they are. They cannot try new foods because they may not like it if they do try, so therefore they don't like it already. They would rather suffer hours of punishment grounded in their room than accomplish a 2 minute chore, because they already know in advance they would prefer to not do the chore given a choice to not do it.
People with PDA autism often appear to be sociopaths and pathological liars. They are not either of those things, due only to a minor difference in motivation. Sociopaths don't care if somebody else gets hurt so long as they get what they want, while harm to others does impact somebody with PDA in a very normal way. Since they have no capacity for empathy and color every past observance to fit their world definition of saving face it takes a lot of time with a PDA person to see the distinctions between them and a sociopath.
90% of the "conversation" around autism today is a bunch of handwavey bullshit. There's no incentive for people to be intellectually honest. It's now a moral hazard because so many people are "attached" to the label and get accommodations out of it. You can pay phony therapists online to just go straight to a diagnosis so you can get accommodations. There are financial and political incentives in diagnosing more people.
People can't have an honest conversation around it either because it's such a charged issue. We either get one side that wants to expand the scope of autism to infinity or the RFK vaccine bullshit
So people who have problems get lumped together because these systems are all stripped for parts because of capitalism and religiousity.
It'd be great to have a functional science based medical care but that won't help the children stuck in a hellhole of anti science, antisocial and pathological liars.
If anyone must be branded atypical (not saying anyone should but am willing to pushback on those who do) and in need of special attention it should be the historical story-mode dependent who cannot move on from childhood allegory.
But calling people with social challenges “Assburgers,” I mean, wow. Just wow.
This term has a complicated history so people use "high-functioning" now. Many refer to Hans Asperger as a Nazi eugenicist. Reasonably, I'd say.
https://en.wikipedia.org/wiki/Hans_Asperger#Children_sent_to...
https://en.wikipedia.org/wiki/Am_Spiegelgrund_clinic#Experim...
> Just as the physician must often make painful incisions during the treatment of individuals, we must also make incisions in the national body, out of a sense of responsibility: we must make sure that those patients who would pass on their diseases to distant generations, to the detriment of the individual and of the Volk, are prevented from passing on their diseased hereditary material
The same folks who cause all the Mandela effects did this cus they thought it’s funny. We are all job in his biblical story.
Are you shy, slightly socially awkward and very intelligent? You must be "on the spectrum".
The most intelligent, knowledgeable, socially tuned and socially integrated people I see online claim to be autistic. I swear it is absolute nonsense.
There are social (cut me some slack, I'm autistic) and in socialized medicine systems, financial benefits to an autism diagnosis. So yeah, why wouldn't you claim to be autistic, what's the downside?
Add to that Gen-Z, socially awkward, isolated and poisoned by their obessive phone addictions frantically searching the internet "Why do I feel socially awkward?" and a million "Take out autism test!" links later get their answer. Yes indeed, they have autism, the test proved it.
The comment I replied to said "...claim to be autistic" and that is what I am refering to.
I am calling out self-diagnosing over vague feelings of "feeling different" and on the basis of online tests.
Everyone who needs an autism diagnosis should get one. Not everyone who wants one.
Ten years ago in the UK getting disability money for autism meant being non-verbal, requires extensive in-home care, unable to live independently, etc. Whatever you think about the definitions, it is very clearly not the same now and refers exclusively to some kind of social disorder. Rates of the former haven't changed significantly, rates of the latter are exploding.
When I say this, I don't think people understand the scale here: in some regions of the UK as much 40% of primary-school age children are disabled. Spending in this area is projected to bankrupt many local governments...to be clear, these are economic units with multi-billion pound budgets and responsibility for basic societal functions. It is difficult to understate the extent to which this is an issue.
I don't necessarily think people who engage in the over-diagnosis are ill-meaning: individuals are being given money to do this, psychologists are raking it in hand over fist, and the UK is now a place with a very effective disability lobby with lots of incentives to keep it all going. But it remains true despite all of this that it cannot continue.
Just imo, the damage done already is close to irretrievable. The situation in UK schools is dire: teachers are frequently attacked physically (in some regions in the UK, this is so frequent and so little support is provided because of the inability to exclude "disabled" children that there are frequent staff walkouts), typical classes have 5-6 ASD assistants at all times, behaviour is so poor that other children are unable to learn, parenting of these children is non-existent because parents gain financially and the incentives to blame a medical condition rather than poor parenting are clear, etc. If you consider other trends, it is dire...we are talking about most of the workforce entrants coming out: many unable to speak English, can't perform basic tasks without support, zero impulse control, usually claiming benefits straight out of secondary...it is so bleak.
These seem to contradict each other?
What planet are you talking about, because that does not align with my daily experiences on Earth?
I don't think it's mainstream science, but monotropism is a theory of attention which has been theorized as the central underlying feature of autism and you might be interested in looking it up. It makes a lot of sense to me. I think the more mainstream way of talking about it is bottom up processing (details, the trees rather than the forest) vs top down processing (holistic, the forest rather than the trees).
Either way - you can get a very diverse set of results depending on how which sorts of things the individual's attention gets commandeered by, and by how much. Some people can't stop paying attention to individual sounds or individual tactile sensations or any other individual sensation, some people have difficulty putting sentences together despite having an excellent grasp of each word, some get stuck trying to process specific individual facial expressions and fail to grasp the actual social dynamics going on around them - it goes on and on.
Some have special interests (deep attention to a specific topic) that are extremely economically profitable (programming) or simply socially mainstream (music or movies) which give them social cachet. Some have special interests that mark them as weird and socially outcast (collecting bugs, memorizing bus routes). Some are very intelligent and are able to make up for a lot of difficulties with effort. Some have a great focus on social dynamics and come off quite charming. All of this can add up to very different experiences though life, very different sets of difficulties, and that of course can compound.
I think you should expect there to be a very wide variety of autistic people, if there is an underlying similarity in processing things. There is a very wide variety of non-autistic people, too. Heck, I think there's a wide variety of people with only one hand, just because Jim Abbott was a major league baseball pitcher doesn't mean he actually had two hands, and just because Muggsy Bogues was a great NBA player doesn't mean he wasn't short.
Not that people low on the spectrum aren’t important, they are, but that just using standard interaction tactics that I would with non-spectrum people works well enough.
So trying to save time that someone doesn’t need to interrupt the conversation to say they are on the spectrum and can only eat smooth foods or whatever.