[HN Gopher] Metabolism of autism reveals developmental origins
       ___________________________________________________________________
        
       Metabolism of autism reveals developmental origins
        
       Author : wglb
       Score  : 93 points
       Date   : 2024-05-11 15:18 UTC (7 hours ago)
        
 (HTM) web link (medicalxpress.com)
 (TXT) w3m dump (medicalxpress.com)
        
       | faeriechangling wrote:
       | > The researchers discovered that a small number of biochemical
       | pathways are responsible for the majority of these changes, which
       | could help inform new early detection and prevention strategies
       | for autism.
       | 
       | It won't. Autism is a socioculturally bound diagnosis, not a
       | single disease that exists in biology. It's a label for those
       | perceived by others in a certain light, defined in such a way
       | that two with the same label can have remarkably little overlap
       | in terms of observed behaviour. You diagnose autism based on how
       | people act, not who they are. Any biological markers for autism
       | are politically suspect as it would imply those without those
       | markers are invalid, while also raising the spectre of eugenics
       | for those with the markers.
       | 
       | More likely and productivity it might eventually REPLACE autism
       | as a diagnosis with something scientifically valid and treatable,
       | as if somebody displays no autistic behaviours as a result of
       | treatment of a metabolic disorder, why diagnose them with autism?
        
         | furyofantares wrote:
         | > defined in such a way that two with the same label can have
         | remarkably little overlap in terms of observed behaviour
         | 
         | I believed this until my daughter was diagnosed and then I was
         | later diagnosed. My experience with (some) professionals was a
         | surprise to me; a much wider variety of "observed behaviors"
         | than I expected seem to stem from sensory issues for example.
         | And I think it makes sense that humans might adopt a wide
         | variety of ways to deal with for a much smaller variety of
         | processing issues.
         | 
         | (Unrelated to the professional experience) Have you looked into
         | monotropism? It's a fairly compact theory that ties a lot of
         | behaviors together that might look like they have no overlap
         | from the outside.
         | 
         | Also:
         | 
         | > It's a label for those perceived by others in a certain light
         | 
         | Lots of people self-diagnose.
        
           | faeriechangling wrote:
           | If you ask the majority of people if somebody who they do not
           | perceive as engaging in autisitic behaviours, and was not
           | diagnosed as autistic, but considers themselves autistic, is
           | autistic, they will say no. Scientifically (which how it's
           | defined in the OP), it's not defined by psychiatrist
           | appraisal and self-assessment plays no necessary role in the
           | process and alone holds no diagnostic validity. We can also
           | invert this: self-denial doesn't make one non-autistic if
           | they're seen as engaging in autistic behaviours and are
           | diagnosed as autistic by a professional.
           | 
           | I'll concede that a minority believe that autism is self-
           | definable though. I'd prefer things that way myself, but the
           | among other things it would make it impossible to gatekeep
           | services for the autistic if self-diagnosis were held in the
           | same esteem as physician diagnosis, so it won't catch on
           | anytime soon.
        
             | flatline wrote:
             | I'm not sure what point you are making with this reply. I'm
             | late/adult self-identifying autistic. I've done this with
             | some of the standard tests that psychiatrists use, attended
             | workgroups related to the topic, and studied extensively.
             | Self-diagnosis is highly accurate for autism, both for
             | positive and negative evaluations.
             | 
             | I am also pursuing a formal diagnosis because so many
             | people downplay it when I tell them I'm autistic. I don't
             | have the affect at first glance, but it does come out in my
             | behaviors if you get to know me a bit. I've also had the
             | luxury of therapy, eduction, etc.
             | 
             | I also agree that the categorization is overly broad and
             | your original post resonates. There are various non-
             | overlapping clusters of traits that fall under autism.
             | 
             | I do think, however, that at the core of it is a common
             | difference in information and sensory processing.
        
               | zeroonetwothree wrote:
               | Adults that get diagnosed later typically have developed
               | very good ability to mask so casual acquaintances
               | probably don't suspect they are autistic. So it's not
               | surprising they would downplay it.
        
               | faeriechangling wrote:
               | >Self-diagnosis is highly accurate for autism, both for
               | positive and negative evaluations.
               | 
               | I've also gone into autism communities before and
               | declared that I had self-undiagnosed myself with autism,
               | which is something I've desired recently, to re-diagnose
               | myself as not being autistic and either having nothing or
               | ADHD. This was totally rejected, and repeatedly brought
               | up was my admittance to a lengthy period of diagnosis,
               | overseen my multiple doctors, from a very young age,
               | which all were seen as evidence of the validity of my
               | diagnosis (conversely, I'd presume, they treat the
               | opposite as more less valid or invalid). Interestingly
               | the same people generally accepted diagnosis, but to
               | reject a diagnosis, well that was beyond the pale and
               | denialism. I brought up the same to a psychiatrist,
               | saying I wanted to be treated by a psychiatrist for ADHD
               | and NOT autism because I believe it will lead to superior
               | outcomes. They blew me off, exasperated, saying that any
               | psychiatrist would simply observe my symptoms and deem me
               | autistic and treat me that way no matter what I did,
               | denying that I even had the capability or possibility to
               | receive treatment which was not based on the premise that
               | I was autistic. Metabolic testing and self-diagnosis be
               | damned.
               | 
               | Just this moment I'm in the process of seeking
               | accommodations. I self reported autistic symptoms to my
               | employer. In the past, during interviews they have
               | accepted my diagnosis and pledged to "accommodate" me
               | accordingly, and I was ticked off as a diversity hire.
               | They asked me to verify such symptoms with a doctor. They
               | subsequently said they reserve the right to an
               | independent psychological assessment of myself or my
               | records. This is very pleasing to me, as either I shall
               | receive accommodations and an affirmation that I am
               | autistic, or my undiagnosis, which is truly a win-win.
               | 
               | If I was in family court, and it was argued that I was
               | unable to say take care of children because I'm autistic,
               | I could not successfully object on the grounds that "I'm
               | not autistic".
               | 
               | Yet my observation is what is considered the true measure
               | of somebodies autisticness, the validity of their
               | diagnosis and their symptoms, is independent
               | psychological assessments by an examiner not beholden to
               | your own self-assessment. I theorise this is both because
               | of a lack of faith in the competence of either of us to
               | assess an autism diagnosis, as well as a lack of faith in
               | our objectivity. I've met a number of self-diagnosed
               | people who are shy about disclosure or asking for
               | accommodation BECAUSE they are self-diagnosed, and while
               | obviously believing in the reality of their autism, are
               | either self-sceptical or believe in others scepticism to
               | a degree not commonly seen in those medically diagnosed.
               | 
               | I don't mean to be exclusionary or gatekeeping, just
               | descriptive of what I believe to be
               | social/political/legal/scientific reality. I don't like
               | that things are this way, I'm aware that hilariously I've
               | never seen ANY evidence that suggests physician diagnosis
               | is more accurate than self-diagnosis, I'm aware of the
               | many historical problems with physician diagnosis, I
               | merely believe that they ARE this way.
        
             | zeroonetwothree wrote:
             | I've never met anyone that self identifies as autistic that
             | didn't have some obvious behaviors (in the tech world there
             | are a lot). This seems like a strawman.
        
           | somenameforme wrote:
           | Here [1] is the DSM diagnostic criteria for autism. It's
           | broad to the point of absurdity. The reason many people think
           | autism is a faux disorder is because it includes everything
           | from an individual who simply sits in the corner endlessly
           | flapping his hands, completely unable to function as a human
           | being, to Bill Gates or Elon Musk. The weaker diagnoses,
           | which is an increasingly large chunk of all of them, often
           | seem like an effect to pathologize normal behavioral
           | differences within people. This is, IMO, one of those things
           | people are definitely going to look back at think 'wtf were
           | they even thinking?'
           | 
           | [1] - https://a4.org.au/dsm5-asd
        
             | whimsicalism wrote:
             | frankly, this will continue as long as performance-
             | enhancing drugs and accommodations are gated behind
             | diagnoses
        
               | pseudalopex wrote:
               | What performance enhancing drugs are prescribed for
               | autism?
        
             | mschuster91 wrote:
             | > It's broad to the point of absurdity.
             | 
             | It's called "autism spectrum" for a reason, partially
             | because a lot of the symptoms overlap with each other, and
             | can appear in every possible permutation.
             | 
             | > The reason many people think autism is a faux disorder is
             | because it includes everything from an individual who
             | simply sits in the corner endlessly flapping his hands,
             | completely unable to function as a human being, to Bill
             | Gates or Elon Musk.
             | 
             | At least for the latter, it's undeniable he's presenting
             | quite a few symptoms, and that even before he went off the
             | rocker in 2018 with the "pedo" comments. He's lucky to be
             | as rich and successful as he is.
        
             | ants_everywhere wrote:
             | > The reason many people think autism is a faux disorder is
             | because it includes everything from an individual who
             | simply sits in the corner endlessly flapping his hands,
             | completely unable to function as a human being, to Bill
             | Gates or Elon Musk.
             | 
             | Autism and intellectual disability are different things.
             | Successful people like Bill Gates can also be depressed, as
             | can somebody who sits in a corner. That doesn't say
             | anything interesting about depression, nor does it say
             | anything interesting about autism. Same with cancer or male
             | pattern baldness or really just about any condition you
             | care to think of.
        
             | aleph_minus_one wrote:
             | > The weaker diagnoses, which is an increasingly large
             | chunk of all of them, often seem like an effect to
             | pathologize normal behavioral differences within people.
             | 
             | This is a phenomenon which is known for a long time in the
             | hacker community. Relevant quote from the Jargon file
             | (http://catb.org/jargon/html/weaknesses.html):
             | 
             | "1994-95's fad behavioral disease was a syndrome called
             | Attention Deficit Disorder (ADD), supposedly characterized
             | by (among other things) a combination of short attention
             | span with an ability to 'hyperfocus' imaginatively on
             | interesting tasks. In 1998-1999 another syndrome that is
             | said to overlap with many hacker traits entered popular
             | awareness: Asperger's syndrome (AS). This disorder is also
             | sometimes called 'high-function autism', though researchers
             | are divided on whether AS is in fact a mild form of autism
             | or a distinct syndrome with a different etiology. AS
             | patients exhibit mild to severe deficits in interpreting
             | facial and body-language cues and in modeling or
             | empathizing with others' emotions. Though some AS patients
             | exhibit mild retardation, others compensate for their
             | deficits with high intelligence and analytical ability, and
             | frequently seek out technical fields where problem-solving
             | abilities are at a premium and people skills are relatively
             | unimportant. Both syndromes are thought to relate to
             | abnormalities in neurotransmitter chemistry, especially the
             | brain's processing of serotonin.
             | 
             | Many hackers have noticed that mainstream culture has shown
             | a tendency to pathologize and medicalize normal variations
             | in personality, especially those variations that make life
             | more complicated for authority figures and conformists.
             | Thus, hackers aware of the issue tend to be among those
             | questioning whether ADD and AS actually exist; and if so
             | whether they are really 'diseases' rather than extremes of
             | a normal genetic variation like having freckles or being
             | able to taste DPT. In either case, they have a sneaking
             | tendency to wonder if these syndromes are over-diagnosed
             | and over-treated. After all, people in authority will
             | always be inconvenienced by schoolchildren or workers or
             | citizens who are prickly, intelligent individualists --
             | thus, any social system that depends on authority
             | relationships will tend to helpfully ostracize and
             | therapize and drug such 'abnormal' people until they are
             | properly docile and stupid and 'well-socialized'.
             | 
             | So hackers tend to believe they have good reason for
             | skepticism about clinical explanations of the hacker
             | personality."
        
               | AnthonyMouse wrote:
               | Which in turn becomes the dichotomy between wanting the
               | diagnosis and thinking the diagnosis is silly.
               | 
               | You start off with some institution that has a set of
               | rules on paper, which nobody actually follows or even
               | reads because they discover what they're expected to do
               | via social cues. Then someone with autism doesn't pick up
               | on the social cues, commits a faux pas, and the
               | administration flips through the rule book to find
               | whatever rule they can be found to have broken in order
               | to punish them.
               | 
               | The autistic individual is then told that they are bad
               | and need to learn to follow the rules, so they read the
               | rule book cover to cover and follow every rule to the
               | letter. But many of the rules are aggressively stupid and
               | impractical or even purposely designed to be violated by
               | ordinary behavior so the administration always has an
               | excuse to punish whoever they want. Strictly following
               | them is also a faux pas.
               | 
               | The question then is what to do about it. The autistic
               | individual wants some accommodations so they're not
               | constantly being punished for not picking up social cues.
               | The administration wants them to take some drug that
               | makes them stop being atypical, or to be rid of them.
               | These are, of course, two very different and incompatible
               | things.
        
             | gopher_space wrote:
             | Do you have the background and training to parse what
             | you're reading and apply it to individuals in the correct
             | context?
        
             | zeroonetwothree wrote:
             | Drug users can include people from a homeless addict who
             | can barely stay conscious to Elon Musk. Does that mean the
             | concept is absurd?
        
           | neom wrote:
           | I mean I was diagnosed with a salad of things. And then
           | different doctors tell me different things about how they're
           | all related or unrelated. It was honestly a very amusing
           | situation. The only sense I got out of the whole long ass
           | process was: neurological sensory difference "combo" in the
           | roll of the dice, some of it given hereditarily, some this
           | that and the other. I really see why this stuff is so
           | frustrating for people. I'm super lucky circumstances are
           | such for me that I can give less shits about the social
           | issues my autism causes, allowing me to explore it.I actually
           | just started a blog last week to share as I explore this
           | stuff, I'm a bit shy to share it as I've never blogged in
           | earnest before, so I have no sense of if this is good, bad,
           | silly, lame, boring, etc: https://b.h4x.zip/autism-thinking-
           | and-whiteboards/
        
             | ntxy wrote:
             | Please keep writing. I'm hooked!
        
         | ninininino wrote:
         | FTA:
         | 
         | "only 10-20% of children diagnosed before 5 years of age able
         | to live independently as adults"
         | 
         | ^ the article and the medical treatment is aimed at those so
         | severely impacted/compromised that they cannot live
         | independently.
        
           | Der_Einzige wrote:
           | People with high functioning autism make up a majority of the
           | "people who died at 25 and didn't know it until they were 80"
           | crowd.
        
             | giantg2 wrote:
             | I'm not sure I understand the quote.
        
               | normaler wrote:
               | There is an increased comorbidity with neuro divergence
               | and harmful behaviour.
        
               | IggleSniggle wrote:
               | I think they meant "people who _didnt_ die before 25. " I
               | don't know much about autism, but I had three friends who
               | died before 30 in accidents that were almost certainly
               | related to ADHD. Two of them were doing behavioral
               | therapy but didn't believe in pharmaceutical treatment.
               | One of them was generally medicated but wasn't taking
               | their medication on the day they died (due to medication
               | shortages for ADHD drugs).
               | 
               | That last one rear-ended a semi-truck at high speed.
               | Probably after getting lost in thought after reading a
               | "You shouldn't text and drive. If you text and drive, it
               | may be the last text you ever read. Remember, don't read
               | superfluous text; pay attention to the road, for your own
               | safety and the safety of those around you." Obviously I
               | don't know that last part; I am just bitter.
        
               | giantg2 wrote:
               | I knew someone in high school that had ADHD. He totaled
               | many cars when he wasn't on meds for things like game day
               | for sports (not sure if that's a performance or health
               | thing).
               | 
               | What baffles me, is how someone diagnosed with a
               | condition that affects driving is allowed to drive
               | without the condition being treated - especially if they
               | are under a prescription and just not taking it, and also
               | if they have multiple accidents attributed to the
               | condition. We already require this for people with
               | seizures, for people needing glasses to wear them, etc.
        
               | tgaj wrote:
               | I think it's because many important people still think
               | that ADHD is some kind of imaginary disease.
        
               | hirvi74 wrote:
               | ADHD doesn't affect everyone the same though.
               | 
               | For example, I have ADHD. I learned to drive at 15, got
               | my license at 16, and managed to get my first speeding
               | ticket at the age of 30, and my first car accident at 31
               | (of which I wasn't at fault). I wasn't
               | diagnosed/medicated until I was almost 23.I do not think
               | I am any better nor worse than the average driver either.
               | Perhaps I have been lucky, but who knows?
               | 
               | Also, just because one is medicated does not mean it
               | magically reduces all symptoms. IIRC, I think most adults
               | only get something like 50% reduction in symptoms at
               | best.
               | 
               | In my experiences, I find the efficacy of ADHD medication
               | to be _vastly overstated._ I think this is mainly due to
               | a strong honeymoon period the medication provides in the
               | beginning. What I mean is that, the medications are
               | extremely effective for a certain time period, but the
               | longer one is one the medications the greater the
               | diminishing returns become. There are only so many
               | options /formulations and dosages can only be increased
               | to an extent.
               | 
               | Also, euphoria is a very common side-effect when first
               | starting the medications. So, a lot of life-changing
               | anecdotes that people comment on the Internet in the
               | beginning of treatment should be taken with a grain of
               | salt. After a decade of treatment, most people cannot
               | tell if I am medicated or not anymore. As in, most people
               | think I am not medicated despite being so.
        
               | giantg2 wrote:
               | That's mostly the same for seizures - affects people
               | differently (and different effects), medications provide
               | various effectiveness, and individual evaluation is
               | needed.
        
               | ElFitz wrote:
               | It's a quote about how some people stop living their
               | lives long before their body dies.
               | 
               | https://quoteinvestigator.com/2021/11/03/not-buried/
        
               | hirvi74 wrote:
               | But what does the have to do with Autism? That quote
               | seems to be more about people not finding
               | fulfillment/confirming to social expectations/wasting
               | their lives vs. a neurodevelopmental disorder.
        
         | RobotToaster wrote:
         | IMO, it will probably end up like Ehlers Danlos, where you have
         | 20 or so subtypes defined by certain genes.
        
         | 2four2 wrote:
         | I think most people understand that disease nomenclature
         | changes rapidly. Even if the word "autism" is deprecated in the
         | future and replaced by a litany of other terms for conditions,
         | the research is still useful and interesting.
        
         | jncfhnb wrote:
         | Because it's fully possible and commonly understood that a
         | medical condition can arise from multiple different
         | circumstances
        
         | m00x wrote:
         | That's completely incorrect.
         | 
         | Autism has clear physiological differences in the brain. It's
         | not just a personality difference. People like to call
         | themselves autistic when it's just social awkwardness, and some
         | doctors might even improperly diagnose them, but these are
         | separate from the condition.
         | 
         | https://www.healthcentral.com/condition/autism/autism-brain-...
         | 
         | This could help us prevent autism completely.
        
           | faeriechangling wrote:
           | >People like to call themselves autistic when it's just
           | social awkwardness, and some doctors might even improperly
           | diagnose them, but these are separate from the condition.
           | 
           | What makes such a diagnosis incorrect when various forms of
           | social awkwardness satisfy criteria A and D of the diagnostic
           | criteria [1], and all of the criteria for social pragmatic
           | disorder[2]? In the DSM-V-TR era psychiatrists are instructed
           | to not just judge somebody to not be autistic if they do not
           | appear socially awkward, and to additionally ask if they find
           | social interactions distressing, and observe them for longer
           | in more naturalistic settings to find the deficit in social
           | functioning[3] as part of a thus far continuously lowering
           | diagnostic bar as to what is considered sufficient social
           | awkwardness to be diagnosable.
           | 
           | >Autism has clear physiological differences in the brain.
           | 
           | Which physiological changes in the brain make you autistic,
           | or put another way, which physiological changes in the brain
           | must you lack to NOT be autistic? I've heard of any autism
           | diagnosis's and self-diagnosis's and I've never heard of any
           | of them being based on a brain scan and yet people go around
           | calling others and themselves autistic. I've never heard of a
           | diagnosis being lost or gained due to a brain scan.
           | 
           | I've heard this insistence that we can infer the territory,
           | the neurological conditions of peoples brains, from the map,
           | the behaviourist diagnosis, and there may be a correlation
           | but it can't be said that any given person with an autism
           | diagnosis has any given specific neurological change. The
           | only thing we test for IS behaviour, and infer biology from
           | it.
           | 
           | [1] https://www.cdc.gov/ncbddd/autism/hcp-dsm.html [2] https:
           | //en.wikipedia.org/wiki/Social_(pragmatic)_communicati... [3]
           | https://www.reddit.com/r/aspergirls/comments/th9hku/dsm5tr_n.
           | ..
        
             | StressedDev wrote:
             | You cannot self-diagnose, and only a trained medical
             | professional can diagnose autism. By trained medical
             | professional, I mean an autism expert who is either a
             | therapist (PHD, PsyD, LMFT, etc.) or a psychiatrist.
             | 
             | Most people who use terms like autistic, bi-polar,
             | sociopath, narcist, etc. are using the terms incorrectly.
             | 
             | Also, I suspect you are correct that most ASD diagnoses do
             | not use brain scans and rely on a trained professional's
             | judgement and observations. That fact does not mean that
             | autism does not exist or that some autistic people may have
             | physical differences from neurotypical people.
        
               | zeroonetwothree wrote:
               | I'm not sure you think the word "cannot" means what most
               | people think it means.
        
             | m00x wrote:
             | Diagnosis for autism is complicated because some people act
             | the same as people with clear physiological changes, but
             | without those changes.
             | 
             | This puts medical boards in a sticky situation where they
             | have to be inclusive since there's not enough research to
             | say the latter group are definitely not autistic.
             | 
             | I'm in the camp that you shouldn't diagnose an issue
             | without clear physiological or chemistry differences, but
             | I'm not in control of the medical boards. I think we all
             | agree that you shouldn't self-diagnose.
        
           | throwaway2562 wrote:
           | Here's hoping. Autism is pure hell for some families. Unless
           | of course self-declared leaders of the 'neurodivergent
           | community' declare such efforts to be genocidal, modern
           | eugenics, and so on.
           | 
           | Relatedly, I was struck to see the recent breakthrough in
           | curing congenital deafness condemned by members of the 'deaf
           | community' on Twitter. So we unfortunately have good reason
           | to expect the same kinds of folly here.
        
             | jeroenhd wrote:
             | I've seen the same protests among certain deaf communities
             | and it baffles me that someone would oppose a cure to what
             | is obviously a medical condition.
             | 
             | In the same vein, I wouldn't oppose a cure for autism,
             | despite my own diagnosis. Why go through the pain and
             | suffering that comes with autism in a world of non-autists?
             | I've seen more than enough of the lives of people with non-
             | high functioning autism to realise the absolute living hell
             | a cure like this could prevent.
             | 
             | I'm wary of the "cures" people have tried, most of them
             | based on fake psychology or pseudoscience, but I have no
             | reason to expect the authors of this paper to be in it to
             | show how their kid is "normal", like most people looking
             | for "cures" seem to be. I expect this article to be quoted
             | many times in the terrible Facebook groups that will also
             | recommend things like bleach enemas to desperate parents,
             | but I also expect good developments from the real
             | scientists trying to understand and perhaps cure (the worst
             | cases of) autism.
        
               | filleduchaos wrote:
               | > it baffles me that someone would oppose a cure to what
               | is obviously a medical condition
               | 
               | Ultimately, not everybody seeks to be "normal", and there
               | is plenty of reason to fear the imposition of normalness
               | when simply being functional would have done just fine.
        
             | filleduchaos wrote:
             | Mmm, that sounds rather uncharitable. While obviously Deaf
             | people aren't a hivemind, I think people who are not Deaf
             | (and fully-abled people in particular) should listen when
             | they each speak for themselves instead of coming to broad
             | conclusions of "folly".
             | 
             | For me it began to click due to somewhat similar
             | discussions I've had about my sight (I'm moderately myopic
             | in both eyes and significantly astigmatic in one), where
             | I've explained that:
             | 
             | - yes I actually _like_ wearing glasses, and am not
             | interested in contact lenses at all
             | 
             | - yes I also _like_ my uncorrected vision: I like the
             | softness and the smoothing over of details, and the way
             | that lights scatter, and the fact that I can focus on
             | things that are right in front of my nose
             | 
             | - no it isn't anxiety that's stopping me from getting the
             | likes of LASIK; I actually _like_ having both corrected and
             | uncorrected vision
             | 
             | And it is astonishing how much people who are caught up in
             | _their_ own complexes about vision deficiencies try to
             | convince me that I 'm stupid or even lying because I don't
             | share _their_ aversion. It was rather off-putting, to be
             | honest.
             | 
             | So yeah, that was how I began to see how people whose
             | condition (for lack of a better term) is much more strongly
             | linked to their identity[0] would end up with their hackles
             | permanently raised against the idea of a cure for a life
             | experience that they find neutral and/or positive coupled
             | with the prevailing sentiment that they must be so grateful
             | and excited about its existence (and if they aren't then
             | they must be stupid or crazy). _Theoretically_ it 's good
             | that the capability exists because it gives the choice to
             | those who do want it, but when a person is part of a group
             | without much societal power to begin with, I don't think
             | it's irrational to fear that it would eventually end up as
             | an imposition rather than a choice (especially when we get
             | obstetric treatment).
             | 
             | 0. For example, sign languages are distinct linguistic
             | phenomena and not simply a cipher for spoken language. And
             | wherever there is distinct language, a distinct culture
             | soon follows. This is why "Deaf community" and "Deaf
             | culture" are real things in real life not just something
             | that someone on Twitter made up, contrary to many abled
             | people's assumptions.
        
             | faeriechangling wrote:
             | The history of Autistic Psychopathy/Aspergers specifically,
             | which has a direct throughline to the modern concept of
             | autism, is inexorably tied to the history of Austrian and
             | later Nazi eugenics. Sterilisation was supported especially
             | more by Nazi hardliners, although catholics tended to
             | support voluntary abstinence. Involuntary euthanasia was
             | practiced, not openly, against the autistics deemed to be
             | life unworthy of life - of no use to the Volk - who lacked
             | gemut (Soul, spirit, etc). Those deemed at one time
             | redeemable, but ruined by their parents were also purged.
             | Those deemed more useful, brilliant, geniuses in the
             | sciences, with good Nazi parents, but with lacking gemut
             | due to their hyper-masculine nature, were to be
             | rehabilitated and treated with patience and understanding,
             | but even there reproduction was to be AT LEAST discouraged.
             | The ideal Nazi autistic was either dead, or like a worker
             | bee, sterile and working tirelessly for the good of
             | National Socialism and the breeding stock Aryans. One of
             | the goals the child welfare system had was identifying
             | which category each child fell into as young as possible,
             | so as to treat them accordingly with haste.
             | 
             | We also have the western eugenics movements, and while
             | autism wasn't really conceived in their heyday, they had
             | much more of a family-centric take on eugenics, although it
             | was still at the time largely oriented around the good of
             | the welfare state.
             | 
             | For the autistic activist, nothing makes more sense than to
             | stymie such research, as autism's diagnostic prevalence
             | expands each year, seemingly driven largely by a loosening
             | definition of autism, so to delay the research which
             | enables eugenics, people are going to see Autistics as
             | having relatively high gemut and productivity compared to
             | the past, which should discourage eugenics. They plainly
             | value the right/value of the existence of
             | autistics/themselves, above the potential reduction of
             | suffering allowed by such research. Eugenics after all
             | never actually died and remain popular, it's just become
             | politically incorrect to openly admit to supporting or
             | doing it, and we're currently engaging in a quite
             | successful eugenics campaign against downs syndrome[1], oh,
             | and the ongoing eugenics against autistics [2]. Perhaps
             | these autistic activists would have more confidence in such
             | research if modern eugenics were not legal, accepted, and
             | practiced against them? Or perhaps they should just get
             | over their own egos and admit that this research is for the
             | good of the Volk, which is certainly a take I've heard from
             | autistics themselves.
             | 
             | That all being said - metabolic research is probably going
             | to be less controversial than say genetic research, since
             | it's unclear that you can use the former to facilitate
             | selective abortions or screen sperm donors. So I think in
             | this case, the self-declared neurodivergent leaders will
             | let this slide, as if such research can't be used for
             | eugenics but makes autistics more popular it should make
             | eugenics less likely, not more likely.
             | 
             | [1] https://www.psychologytoday.com/us/blog/fully-
             | human/202101/i... [2]. https://www.dailymail.co.uk/health/a
             | rticle-3377811/Britain-s...
        
         | mewpmewp2 wrote:
         | It's gross to hear that they want to prevent it.
        
         | ants_everywhere wrote:
         | > Autism is a socioculturally bound diagnosis
         | 
         | This is untrue and unsupported by evidence
         | 
         | > It's a label for those perceived by others in a certain light
         | 
         | This is untrue and unsupported by evidence
         | 
         | > defined in such a way that two with the same label can have
         | remarkably little overlap in terms of observed behaviour
         | 
         | This is untrue and unsupported by evidence
         | 
         | > You diagnose autism based on how people act, not who they are
         | 
         | You diagnose all disorders based on observable phenomena, not
         | some sort of metaphysical essence.
         | 
         | > Any biological markers for autism are politically suspect
         | 
         | What is this, Lysenkoism?
         | 
         | > as it would imply those without those markers are invalid
         | 
         | Are you saying that in your view biology has some ability to
         | mark people as valid or invalid? That's an extremist view and I
         | wonder how you arrived at it. If your ideology requires you
         | divide the world into "valid" and "invalid" people, then it's
         | probably a good time to rethink your approach.
        
           | zer00eyz wrote:
           | >> defined in such a way that two with the same label can
           | have remarkably little overlap in terms of observed behaviour
           | 
           | > This is untrue and unsupported by evidence
           | 
           | Here is the diagnostic criteria for ASD:
           | https://www.cdc.gov/ncbddd/autism/hcp-dsm.html ... It
           | literally lays out a path that can generate a non overlapping
           | diagnosis. It sort of has to because we lummped what were
           | previously two disorders together because people are
           | sensitive to nazi's having existed.
           | 
           | Now go to the UK where there is strong advocacy for a whole
           | other set of diagnostic criteria for women. The DSM begins to
           | look barbaric and/or sexist if not misinformed.
           | 
           | The moment there is a biological underpinning to something
           | like ASD it gets interesting because what do you do with all
           | the folks with a diagnosis who DONT fit that label. They have
           | something that looks the same but isnt... and the whole
           | psychiatry/psychology community looks like quacks. DO note
           | that im not opposed to these fields but they need to get
           | their shit together on reproducibility.
        
             | ants_everywhere wrote:
             | Thanks I'm thoroughly familiar with the DSM criteria, the
             | ICD criteria, and the research literature.
             | 
             | > It literally lays out a path that can generate a non
             | overlapping diagnosis.
             | 
             | It does not. If you believe there are exist two autistic
             | people who have no overlapping symptoms please present an
             | example.
             | 
             | > The moment there is a biological underpinning to
             | something like ASD it gets interesting because what do you
             | do with all the folks with a diagnosis who DONT fit that
             | label.
             | 
             | Compare this to, "The moment there is a biological
             | underpinning to something like cancer it gets interesting
             | because what do you do with all the folks with a diagnosis
             | who DONT fit that label." To which the answer is "that's a
             | red herring, the current understanding of cancer doesn't
             | require all cancers share the same biological origins, so
             | why should finding one marker call that into question?"
             | 
             | Or "The moment you locate the code line with a buffer
             | overflow it gets interesting because some programs that
             | seem like they have a buffer overflow don't have that line
             | of code."
        
           | mahatofu wrote:
           | Thanks for introducing me to quite a few different topics.
        
           | faeriechangling wrote:
           | Responding to all the "This is untrue and unsupported by
           | evidence" statements. In the context of this thread, which is
           | addressing a scientific article.
           | 
           | > Autism is a socioculturally bound diagnosis
           | 
           | I'm making a normative claim here, so your criticism is
           | correct, as this is not a scientifically testable claim at
           | all. I'm loosely an adherent of the social model of
           | disability[1].
           | 
           | > It's a label for those perceived by others in a certain
           | light
           | 
           | First, you later agreed with this statement later when you
           | said "You diagnose all disorders based on observable
           | phenomena" so this criticism is incoherent and I'm not
           | convinced you even disagree with me so much as misunderstand
           | me. Scientifically I'd point out the DSM-V-TR defines autism
           | observationally[2] and the CDC's research on autism uses said
           | definitions[9]. That is evidence supporting what I say.
           | 
           | > _defined_ in such a way that two with the same label _can_
           | have _remarkably little_ overlap in terms of observed
           | behaviour
           | 
           | I'll again point to the DSM-V-TR[1] where two individuals can
           | satisfy section B of the criteria with no overlap whatsoever.
           | The only necessary behavioural commonality are various social
           | deficits. I'll also point out there are three categories of
           | autistics depending on support needs.
           | 
           | More blithely and common-sense like, I'll just point out most
           | people do not see all that much common in the behaviour of
           | Elon Musk and some autistic in a full time care home who
           | cannot dress or bathe themselves. The Autistic Spectrum also
           | literally used to be split into 3 separate diagnosis's
           | diagnosed based partially on behaviour, and how was that ever
           | even possible or contemplated if people never believed there
           | was a significant difference in autistic's behaviours?
           | 
           | ---
           | 
           | >Any biological markers for autism are politically suspect -
           | What is this lysenkoism
           | 
           | I have not scientifically researched this specific point, but
           | some historical background: Autism genetics research projects
           | have been cancelled by patient backlash [3] where autism
           | genetics projects were scuttled upon popular backlash.
           | "Autistic psychopaths" in the past were subject to
           | Euthanasia, forced sterilisation, and encouraged to
           | voluntarily sterilised themselves by the Nazi regime[4] which
           | raises obvious questions as to the utility of biological
           | testing to enable a future eugenics regime which may also
           | include new technologies like pre-natal testing. While not
           | biological testing, we can see that there is political
           | backlash against cognitive testing[5] to determine social
           | supports for autism. We have also seen the rise of self-
           | diagnosis[6] with it defended as being more accessible than
           | physician diagnosis and based on the lack of evidence that
           | it's LESS accurate than physician diagnosis which
           | historically has been subjected to multiple definitional
           | changes[7] and bias in terms of access to diagnosis
           | itself[8]. Ergo, unless this serves as a method of diagnosis
           | more accurate than physician diagnosis, it will be subject to
           | the same criticism.
           | 
           | > as it would imply those without those markers are invalid -
           | Are you saying that in your view biology has some ability to
           | mark people as valid or invalid?
           | 
           | I'm making a claim about _others_ belief if biology _should_
           | be used to establish the _validity or invalidity_ of autism.
           | It 's my belief that the recognition of biological markers of
           | autism would be vigorously protested by patients and advocacy
           | groups because of what I just brought up.
           | 
           | [1] https://en.wikipedia.org/wiki/Social_model_of_disability
           | [2] (please forgive the source - DSM-V-TR is under copyright)
           | https://www.reddit.com/r/aspergirls/comments/th9hku/dsm5tr_n.
           | .. [3] https://www.scientificamerican.com/article/high-
           | profile-auti... [4]
           | https://www.goodreads.com/book/show/36236157-asperger-s-
           | chil... [5] https://www.cbc.ca/news/canada/nova-
           | scotia/direct-family-sup... [6]
           | https://www.psychologytoday.com/us/blog/neurodiverse-
           | age/201... [7]
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365987/ [8]
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924013/ [9]
           | https://www.cdc.gov/ncbddd/autism/data.html
        
         | ModernMech wrote:
         | > the same label can have remarkably little overlap in terms of
         | observed behaviour.... You diagnose autism based on how people
         | act, not who they are.
         | 
         | I'm able to mask until I'm alone. My meltdowns look exactly
         | like the observed behavior you see in other people, I just hide
         | it better.
         | 
         | I'm also verbal mostly, until I'm not and I'm dissociating.
         | Then I look a lot what you're used to seeing, except i don't
         | let you see that. I don't let you see me rocking and stimming.
         | 
         | I can talk for an hour in front of 100 people about my special
         | interests at any depth, but I can't complete simple tasks that
         | others can do every day like going to the grocery store and
         | restaurants without extreme difficulty.
         | 
         | Some people are "high functioning" autists, meaning that they
         | are able to suppress their negative autistic expressions for
         | the benefit and comfort of people around them. This doesn't
         | make them "not autistic" -- they still are even if you
         | personally can't tell. It just means they're putting on an act
         | for you, to make you happy, so that you don't respond in the
         | negative way they are used to being received. You are
         | witnessing a performance.
         | 
         | That suppression is not a constant, and it can't go on forever.
         | Someone doing this long enough will go into autistic burnout,
         | which is like an extended depression and comes with skill loss
         | and an inability to function in society. If you were to see
         | this person at that point, you'd "see" the autism then.
         | 
         | Is this all there is to being autistic though? No! Being
         | autistic comes with a great capacity for curiosity, creativity,
         | artistic expression, innovation, and excellence associated with
         | committing fully (as in actually 100%, eschewing loved ones and
         | society) to an endeavor.
         | 
         | These are things we don't want to "cure". Most of the problems
         | I face related to my autism have to do with interfacing with
         | society, and not understanding people or not being able to do
         | things everyone else seems to be able to, without any
         | compassion for my inability to do so.
         | 
         | As far as I can tell they come from being dysregulated, and
         | being dysregulated comes from extreme sensory overload. If we
         | can fix the sensory overload a lot of other things are fixed.
         | But that doesn't mean we should be "curing" or "preventing"
         | autism, and it doesn't mean people who aren't melting down and
         | who can live by themselves aren't autistic -- they're just well
         | regulated.,
        
           | faeriechangling wrote:
           | From the DSM-V-TR:
           | 
           | "Symptoms must be present in the early developmental period
           | (but may not become fully manifest until social demands
           | exceed limited capacities, or may be masked by learned
           | strategies in later life)."
           | 
           | "Core diagnostic features are evident in the developmental
           | period, but intervention, compensation, and current supports
           | may mask difficulties in at least some contexts."
           | 
           | "Individuals who have developed compensation strategies for
           | some social challenges still struggle in novel or unsupported
           | situations and suffer from the effort and anxiety of
           | consciously calculating what is socially intuitive for most
           | individuals. This behavior may contribute to lower
           | ascertainment of autism spectrum disorder in these
           | individuals, perhaps especially in adult women. Thus, longer
           | assessments, observation in naturalistic settings, and
           | inquiring about any tolls of social interaction may be
           | needed(Cage and Troxell-Whitman 2019; Hull et al. 2017). If
           | asked about the costs of social interaction, for example,
           | these individuals might respond that social interactions are
           | exhausting for them, that they are unable to concentrate
           | because of the mental effort in monitoring social
           | conventions, that their self-esteem is adversely affected by
           | being unable to be themselves, and so forth."
           | 
           | Observation is STILL actually essential to a diagnosis, you
           | can't merely just claim to be masking, but it's not
           | technically considered disqualifying for symptoms to only
           | appear in certain contexts.
           | 
           | >Some people are "high functioning" autists, meaning that
           | they are able to suppress their negative autistic expressions
           | for the benefit and comfort of people around them. This
           | doesn't make them "not autistic" -- they still are even if
           | you personally can't tell. It just means they're putting on
           | an act for you, to make you happy, so that you don't respond
           | in the negative way they are used to being received. You are
           | witnessing a performance.
           | 
           | The research I've seen on the cat-q shows that [1]:
           | 
           | - Neurotypicals men mask a statistically insignificant amount
           | more than autistic men
           | 
           | - Autistic women mask a statistically insignificant more than
           | neurotypical women
           | 
           | - Autistic women mask a statistically significant amount more
           | than autistic men
           | 
           | - Autistics "Compensate" more, copy others behaviour, copy
           | behaviour they learned from movies
           | 
           | - Autistics "Assimilate" more, they will force themselves
           | unwillingly more than others to be social or not be social.
           | 
           | We should also get over what gets somebody defined as having
           | "high functioning" or "level 1" autism. It's a lack of
           | severity of social impairments AND restricted & repetitive
           | behaviours. With autistic men specifically, the evidence
           | points to the "high functioning" as simply naturally
           | exhibiting less autistic social interactions and behaviours
           | than the "low functioning" without any exceptional effort
           | beyond what the everyday non-disabled person does. Some of
           | them may be tortured actors, but said people are no more
           | prevalent than they are in the general population. It's
           | things like imitation, and being in unwanted social
           | situations, which is more characteristic of autism.
           | 
           | >Being autistic comes with a great capacity for curiosity,
           | creativity, artistic expression, innovation, and excellence
           | associated with committing fully (as in actually 100%,
           | eschewing loved ones and society) to an endeavor.
           | 
           | Those may correlate with autism, but aren't definitional of
           | it. The DSM-V-TR's 1891 word diagnostic criteria briefly
           | mentions "Special interests may be a source of pleasure and
           | motivation and provide avenues for education and employment
           | later in life" as the sole positive trait of autistics.
           | 
           | I don't mean to be a dick here - more activist. If these are
           | qualities of autistics, they should either be part of the
           | criteria for "Autism spectrum disorder" or autism should be
           | conceptualised as being distinct from disorder similar to how
           | we distinguish between being transgender and having gender
           | dysphoria. Otherwise, one can say that all they wish, but
           | they'll face negative stigmatisation from those who see
           | autism as a definitionally negative mental disorder with no
           | upside other than employability. "Autism" is quite the
           | stigmatised word today and I blame psychiatry and The DSM for
           | that more than anything else as they treat negatives
           | associated with autism as definitional but not positives.
           | 
           | [1] ctrl-f "What it tests" "Average Scores" https://embrace-
           | autism.com/cat-q/
        
       | squigz wrote:
       | Actual paper: https://www.nature.com/articles/s42003-024-06102-y
        
         | m00x wrote:
         | ^^^^
         | 
         | Better to read the paper instead of the pop journals. Most
         | writers don't understand the issues fully and make mistakes, or
         | sensationalize the discovery.
        
         | quodestabsurdum wrote:
         | The paper is a super fascinating read, and lines up with
         | several key features I've noticed in both of my professionally
         | diagnosed autistic children (good luck getting access to a
         | competent diagnostician who understands how the ASD criteria
         | manifest in passing adults). It's really enlightening to see
         | the association between Xanthine, one of the end-stage products
         | of eATP metabolization, and the anxiety that is so prevalent
         | within my own family.
         | 
         | From the Discussion[1] section of the paper:
         | 
         | > These self-calming connections in metabolism failed to
         | develop in ASD. The natural consequence of the loss of these
         | metabolic safeguards to overexcitation is for children with ASD
         | to seek sameness to avoid the anxiety produced by change91, and
         | to be more sensitive to environmental changes across many
         | sensory domains.
         | 
         | And a bit further on:
         | 
         | > In the current study, xanthine was the purine that gained the
         | most stimulatory (+r) correlations in 5-year-olds with ASD.
         | Xanthine is one of the end-products of eATP metabolism97.
         | Xanthine is known to trigger a cascade of events that leads to
         | mitochondrial network fragmentation, reactive oxygen species
         | and reactive nitrogen species (ROS and RNS), eicosanoid (e.g.,
         | leukotriene, HETE, and prostaglandin) signaling, immune
         | activation, anxiety-associated behaviors, and consolidates
         | long-term aversive memories that make the animal hypersensitive
         | to future environmental changes that warn of environmental
         | danger, cause fear, and trigger anxiety in mice, and is
         | elevated in the blood of adults with anxiety disorders98.
         | Anxiety is a common but under-recognized problem in autism99.
         | 
         | Another really important observation:
         | 
         | > A major result of this research was that the developmental
         | differences observed in ASD were not the result of an increase
         | or decrease of one causal metabolite, or an isolated change in
         | the gut-brain axis, or neuroendocrine, autonomic, cytokine, or
         | immunologic circuits. Instead, it was the interconnectedness
         | and developmental state of the metabolic network that underlies
         | all these systems that was fundamentally changed.
         | 
         | In the last year, the All Brains Belong VT organization has
         | been working on a collection of information they call "All The
         | Things" [2], which lines up with the paper's observation that
         | there is an underlying metabolic network at play. As a side
         | note, All Brains Belong VT is a fantastic organization that
         | focuses heavily on validation and support in a healthcare
         | industry which often feels incredibly invalidating for
         | individuals who have been reporting symptoms across a wide
         | variety of siloed physician specialties.
         | 
         | [1]: https://www.nature.com/articles/s42003-024-06102-y#Sec25
         | 
         | [2]: https://allbrainsbelong.org/all-the-things/
        
         | huijzer wrote:
         | So there is a clear result found and then post hoc there is an
         | explanation made for why this makes sense. That's a bit of a
         | red flag since you preferably hypothesize first, but let's look
         | at the analysis. If I'm not mistaken, then these are the most
         | important parts:
         | 
         | - 467 measured metabolites (features)
         | 
         | - 136 males and 69 females = 205 (data points)
         | 
         | - "To minimize overfitting, only correlations with q values <
         | 0.05 were tallied."
         | 
         | Then the predictive performance in Fig. 3 looks very promising
         | with a 0.88 AUC score. However, according to the methods:
         | "Classifiers of 4-7 metabolites were selected and tested for
         | diagnostic accuracy using area under the receiver operator
         | characteristic curve and random forest analysis."
         | 
         | Then, those AUC scores do not provide so much value since they
         | first used the data to select the best features and then used
         | the same data to fit the model on the best features.
         | 
         | It also looks a bit like the authors have thrown the kitchen
         | sink at these 200 samples since I see R, GraphPad Prism,
         | Python, CIRCOS, Cytoscape, and MetaboAnalyst being used.
         | 
         | And the statement "Fifty (50) random samples at each subsample
         | size were taken to estimate the population statistics based on
         | the central limit theorem." is a bit weird because the central
         | limit theorem shows up throughout many analyses including
         | confidence intervals.
         | 
         | So all in all I'm not 100% sure, but I am skeptical. Anyone
         | here who knows more about "Metabolic network and hub-and-spoke
         | analysis" or "network growth" analysis? Or why it is reasonable
         | to use so many metrics instead of being more selective?
        
           | elcritch wrote:
           | > So there is a clear result found and then post hoc there is
           | an explanation made for why this makes sense. That's a bit of
           | a red flag since you preferably hypothesize first, but let's
           | look at the analysis.
           | 
           | Eh, this doesn't look to be a P-hacking attempt. Scientific
           | exploration doesn't always hit the hypothesis first model.
           | Ideally this paper should be a source of future specific
           | hypothesis and experiments. Though, IMHO, their implicit
           | hypothesis is that metabolism is a core feature of ASD.
           | 
           | The points about the predictive power in fig 3 are
           | interesting.
        
       | AnEro wrote:
       | I feel like this is going to be used by pseudo-science
       | influencers to push trendy diets to prevent autism when this
       | study is observations stage at best.
        
         | asdfman123 wrote:
         | For stuff like this, overfitting is a given.
        
         | drewcon wrote:
         | My only and immediate reaction as well.
        
         | throwup238 wrote:
         | Those people often link to papers that directly contradict the
         | claims they make, assuming no one is going to check them. This
         | won't make a difference.
        
           | AnEro wrote:
           | yea example now there are guys in this comment section
           | claiming keto has cured their adhd/autism. Helped reduce
           | symptoms, sure, but cure? (I've got both of them been on
           | keto, like crazy strict ensuring i was in ketosis every two
           | days type, and it only reduced brain fog personally)
        
             | ryandrake wrote:
             | Whenever you get an HN story that even remotely brushes up
             | against health, fitness, or nutrition, you inevitably get
             | all the wacky exercise, supplements, and diet commenters
             | coming out of the woodwork to tell you all about "what
             | worked for me". It's a constant that you can 100% count on
             | every time.
        
         | 0xcde4c3db wrote:
         | Probably, but it's hardly a requirement. There have been some
         | doing it for decades, partly fueled by Wakefield's "autistic
         | enterocolitis" pseudoscience and partly the usual
         | organic/vegan/raw/paleo/keto bullshit.
        
         | dylan604 wrote:
         | Does this mean that they'll start getting their kids
         | vaccinated?
        
           | AnEro wrote:
           | I fear it will be both that crowd and the anti-covid vaccine
           | blind trust of joe rogan guest crowd
        
       | whimsicalism wrote:
       | Reveals developmental origins or merely an observational study of
       | metabolites in children?
        
       | Der_Einzige wrote:
       | I know of at least one book written by and for autistic people
       | who advocates for a gluten free diet. They claim in the book that
       | this significantly reduces their symptoms.
       | 
       | I don't know if I believe it or not, but the notion of gut-brain
       | axis seems to imply that a good diet should help a bit, right?
        
         | jl6 wrote:
         | A gluten free diet may or may not help but it's not synonymous
         | with "a good diet".
        
           | Der_Einzige wrote:
           | That's what I thought too. It seems that the only general
           | lesson we have in dieting which js reliable is "refined sugar
           | bad" and that intermittent fasting works for getting blood
           | sugar under control.
        
           | 0xcde4c3db wrote:
           | And it might also help for reasons that have nothing to do
           | with gluten. Almost any major dietary restriction tends to
           | cause broader changes in diet than just the thing that is
           | restricted.
        
           | dkga wrote:
           | Indeed. ASD or not, everyone would surely benefit from
           | following a nutritionist-set diet based on the person's own
           | requirements.
        
         | dkga wrote:
         | Asperger here, who doesn't eat gluten at all for almost 3 years
         | now (due to allergy). I cant say it improved symptoms of autism
         | but my life is divided between before/after stopping gluten
         | consumption. I feel like I just started living for real.
        
           | switch007 wrote:
           | Interesting. Could you expand?
        
           | m00x wrote:
           | Celiac is an awful disease. My ex has it and it wrecked her
           | life for years until she found out.
        
         | RobotToaster wrote:
         | Gut issues are a common comorbidity with autism, it could just
         | be he had some kind of gluten sensitivity and treating it
         | allowed more energy to compensate for autism.
        
           | Waterluvian wrote:
           | When "comorbidity" is used in this context, are we actually
           | referring to people dying because of it? Or does it just mean
           | "are found together when discussing this disease?"
        
             | quodestabsurdum wrote:
             | Comorbidity is a commonly used term to denote that a
             | condition occurs with another condition. In this case you
             | can think of it more like "co-occurs".
        
             | RobotToaster wrote:
             | > Or does it just mean "are found together when discussing
             | this disease?"
             | 
             | this.
             | 
             | "morbid" is from the Latin root "morbus", meaning sickness.
        
               | Waterluvian wrote:
               | Ahhh okay. My mind had catalogued it to mean death.
        
               | selimthegrim wrote:
               | Hence's the CDC's "Morbidity and Mortality Weekly Report"
        
               | toasterlovin wrote:
               | In common use ("don't be morbid", "that's morbid") I
               | agree that 'morbid' has a connotation of death, so I
               | don't think your understanding is wrong. In this case, a
               | 'co-morbidity' is a term of art in the medical literature
               | with the specific meaning of "occurring with".
        
             | zeroonetwothree wrote:
             | Morbidity doesn't mean dying...
        
             | discretion22 wrote:
             | The Latin morbus is disease and mortis is [of] death but my
             | experience - and perhaps yours too - is that when
             | discussions of morbidity (i.e. using the word
             | morbid/morbidity) arise, they are often in the context
             | where someone is near death or has died so it is a natural
             | linguistic connection to make.
             | 
             | Remarkably often I find my partner has a different
             | understanding of English words from me - she was schooled
             | in French and can communicate in Italian and Spanish, but
             | is also fluent in English (though spoken with French
             | mannerisms which seem odd to me as a native English
             | speaker). We often find we descend into discussions of the
             | most correct meaning of a word in English which has a Latin
             | root. The dictionary agrees with her mostly but I have an
             | occasional win.
        
         | anon84873628 wrote:
         | Well as the article says:
         | 
         | "Metabolism is the language that the brain, gut and immune
         | system use to communicate, and autism occurs when the
         | communication between these systems is changed"
         | 
         | So it's not unreasonable that for _some_ people, dietary
         | interventions can have _some_ effect on this interplay between
         | systems. Mostly a just a random  "YMMV" shot in the dark at
         | this point. But hopefully as this research advances, more
         | targeted and predictable treatments will emerge.
        
         | r3trohack3r wrote:
         | Anecdotal, but we grow a heritage strain of wheat here in PHX
         | (Sonoran White).
         | 
         | Its appearance gives me pause. Common commercial wheat is very
         | short in comparison.
         | 
         | I have a friend who can't eat "common" wheat products from the
         | grocery store, having been diagnosed with severe gluten
         | intolerance, but can eat Sonoran White without symptoms.
         | 
         | You can follow the same exact recipe but substitute Sonoran
         | White flour for standard flower, and they can eat the final
         | product.
         | 
         | I have absolutely no research to support my stance here. But
         | given gluten intolerance is, from my understanding, a
         | microbiome disorder. And Sonoran White grows tall and requires
         | less pesticide/herbicide/fungicide, while common commercial
         | wheat grows low to the ground and the head of wheat sits
         | stewing in a bath of herbicide/pesticide/fungicide - I suspect
         | the difference between the two strains' impact on the
         | microbiome is less genetic and more environmental.
         | 
         | ADHD research is showing similar early correlation between a
         | mothers' diet and the rate of ADHD (particularly caffeine
         | consumption). I have a similar belief here that ADHD correlates
         | with caffeine consumption because caffeine is often consumed in
         | liquids containing additives that disrupt the mother's
         | microbiome.
         | 
         | I strongly suspect that, over the next 100 years, we are going
         | to find that we've been waging war on the human biome through
         | food preservatives and environmental contaminants. And that
         | many common chronic disorders/illnesses (including ADHD,
         | Autism, weight gain, etc) in our generation are actually
         | attributable to a disfunctioning microbiome.
        
           | mandmandam wrote:
           | > I strongly suspect that, over the next 100 years, we are
           | going to find that we've been waging war on the human biome
           | through food preservatives and environmental contaminants.
           | And that many common chronic disorders/illnesses (including
           | ADHD, Autism, weight gain, etc) in our generation are
           | actually attributable to a disfunctioning microbiome.
           | 
           | I suspect you're very right, and I further suspect that
           | there's already research proving this that has been shelved
           | and hidden behind NDAs by the people profiting from this,
           | just as with big tobacco and big oil and big agri etc.
        
             | kridsdale3 wrote:
             | I fully intend to get my new kid on Kimchi once he moves to
             | solid food-eating.
        
           | aitchnyu wrote:
           | What is referred to cuisine today is partly preserving food
           | in bacteria killing chemicals. Do you mean to hypothesize
           | people ingesting more (traditonal) bactericide are sicker?
        
           | squigz wrote:
           | > And that many common chronic disorders/illnesses (including
           | ADHD, Autism, weight gain, etc) in our generation are
           | actually attributable to a disfunctioning microbiome
           | 
           | All of those things have existed for ... ever
        
             | r3trohack3r wrote:
             | They have.
             | 
             | But I do not believe they were as common prior to the 1960s
             | as they are in the 2020s.
        
         | zamalek wrote:
         | Gluten-free only makes a difference for those with an
         | intolerance. Source: I am HF-ASD, my wife is gluten intolerant
         | so my gluten intake is sporadic but bingey, gluten does nothing
         | at all to me.
         | 
         | The only food that is objectively bad for every single human is
         | processed food. Gluten tends to be processed, so people who
         | needlessly go gluten-free may be incorrectly attributing
         | improvements to that.
         | 
         | Also: if you're not actually intolerant, there is a high chance
         | you're eating gluten without knowing it. Treat yourself to fast
         | food fries? How sure are you that gluten (crumbed chicken)
         | wasn't fried in the oil?
        
         | faeriechangling wrote:
         | I'll incidentally mention that gluten-free diets tend to
         | incidentally be lower in FODMAPs which are another gut
         | intervention, and autism has LONG correlated to digestive and
         | dietary issues. Ketogenic/low-carb is also popular.
         | 
         | The gut-brain link I'm aware of three major theories. Gut
         | issues could be causing a disorder of the brain. A disorder of
         | the brain could be causing disordered lifestyle habits (Diet,
         | exercise) causing digestive issues. A disorder of the brain
         | could directly impacting digestive function.
         | 
         | I will however say, I would treat claims about the gut-brain
         | axis and autism with the utmost scepticism as disgraced doctor
         | Andrew Wakefield, who popularised the link between the MMR
         | vaccine and autism to personally financially benefit from an
         | undisclosed patent on a measles vaccine using fraudulent
         | research, was a gastroenterologist and later anti-vax
         | influencer who ended up popularising the gut-brain link of
         | autism particularly among those who distrust scientific
         | institutions. He notably influenced Jenny McCarthy who became a
         | noted alt-medicine momfluencer in the '00s/'10s pushing gluten-
         | free and anti-vax. Which is to say, research on the gut-brain
         | link is done quite a lot by legitimate scientific researchers,
         | quacks, and frauds alike so you have to be discriminating.
         | 
         | Additionally there have been various scientific reviews of
         | dietary interventions, gluten-free being one of the most
         | researched, and the evidence hasn't been shown ANY dietary
         | intervention or gut intervention like fecal transplants is a
         | silver bullet.
         | 
         | This isn't to say that there isn't anything to the idea that
         | some people we've diagnosed as autistic or believe they're
         | autistic, cannot be helped by dietary interventions. I would
         | dare speculate, that a significant portion of those called
         | "autistic" could make autistic symptoms fall into the sub-
         | clinical range through gut interventions (diet AND exercise),
         | and that such people may even be clinically distinct from other
         | people considered autistic other than through their similar
         | behaviour.
        
       | ModernMech wrote:
       | "Prevention strategies"
       | 
       | As an autistic person, no thanks. Let people be autistic.
        
         | 2four2 wrote:
         | Autistic as an identity and autism as a disease are different
         | things that are difficult to uncouple. Similarly to obesity,
         | it's difficult to talk about the health aspect without people
         | being sensitive about the identity aspect. I find it's useful
         | when reading about research to empathize with the authors and
         | realize their work is an attempt to be constructive instead of
         | providing social commentary.
        
           | mewpmewp2 wrote:
           | Autism is not a disease. It's a diverging feature.
        
             | munchler wrote:
             | Some people are severely disabled by autism. Are you
             | suggesting that we should just let them suffer?
        
             | anon84873628 wrote:
             | Saying this doesn't make you hip, woke, or cool.
             | 
             | Autism is clearly a "spectrum" disorder that is not fully
             | understood or categorized yet, which is exactly why we need
             | this type of research to reach a conclusive, testable
             | biological basis.
             | 
             | To portray severely afflicted people as simply
             | "neurodiverse" and dismiss treatment options for them, is
             | far more bigoted than the reverse.
        
             | dukeyukey wrote:
             | How do you square that with the severe cases of autism? The
             | people who will never be able to live independently?
        
               | Tijdreiziger wrote:
               | There are also non-autistic people who aren't able to
               | live independently.
        
               | dukeyukey wrote:
               | Absolutely, but nobody tries to dissuade people from
               | finding a cure to most conditions that stop independent
               | living.
        
           | ModernMech wrote:
           | I'm being productive by pushing back and saying that when
           | people say that autism needs to be cured and prevented, that
           | they shouldn't say that, because autism doesn't need to be
           | cured and prevented.
           | 
           | It's not a disease, but in this society it is a disability,
           | and there's a stigma and lack of understanding around autism
           | in general.
           | 
           | What we can do today to make life better for autistic people
           | everywhere is to spread awareness and acceptance of autism.
           | Not talk about curing and preventing it. That's stigmatizing.
        
             | anon84873628 wrote:
             | Of course society should become more accepting and
             | accommodating of differently-abled people of all types. But
             | can you really look at the extreme end of the Autism
             | spectrum and say that isn't a disease or disorder?
             | 
             | One reason we need this fundamental research is to
             | disentangle the different types of afflictions and give
             | them different names.
        
               | MajimasEyepatch wrote:
               | You don't even have to go to the extreme end. Ask people
               | with milder presentations, and they'll be able to tell
               | you about all sorts of confusing interactions and
               | frustrating situations they've experienced that wouldn't
               | have happened if they were neurotypical. Hard to say that
               | doesn't impact their quality of life.
        
               | pseudalopex wrote:
               | Those experiences wouldn't have happened if the autistic
               | people were medicated to neurotypical or neurotypical
               | people were more accepting of autistic people. And many
               | autistic people would reject being medicated to
               | neurotypical despite those experiences.
        
             | Scarblac wrote:
             | This is about people diagnosed before the age of 5, they're
             | almost all cases of severe autism. That's very different
             | from the kind of autism you're talking about.
             | 
             | People who are permanently unable to live independently
             | have a condition that should be prevented if possible.
        
               | ModernMech wrote:
               | As a spectrum, autism presents in many ways, but it's all
               | considered "autism" at this point. There are not
               | different "kinds".
               | 
               | Sometimes "severe" autism at an early age calms down as a
               | person grows.
               | 
               | Sometimes "mild" autism gets worse as someone becomes
               | dysregulated and overstimulated.
               | 
               | Many times autism is missed in women and POC because they
               | mask more readily than boys. Sometimes it's missed in
               | boys because it's explained as "boys being boys".
               | 
               | Either way, why don't you ask autistic people if they
               | want to be "cured" or "accommodated"? I think you'll find
               | the answer is "accommodation". It seems like, to me at
               | least, it's only not autistic people who talk about
               | "curing" autism, as if they'd be doing the world a favor
               | if there were no more autistic people.
        
               | selimthegrim wrote:
               | I don't see why POC would mask this easier
        
               | spondylosaurus wrote:
               | IIRC it's not really masking, more that children of color
               | are more likely to get labeled "disruptive" or "defiant"
               | than diagnosed as autistic, at least compared to their
               | white peers. Two kids could exhibit the same behavior,
               | but one is correctly recognized as having a meltdown and
               | the other is written off as a troublemaker.
        
               | zwaps wrote:
               | Why not ask autistic people
               | 
               | Have you ever even seen someone with severe autism?
        
               | robocat wrote:
               | Strongly yes as per other comment:
               | https://news.ycombinator.com/item?id=40329772
        
               | Scarblac wrote:
               | I have autism myself and so do both my kids, I would
               | _love it_ if there was some way to lessen it. It 's a
               | great hindrance for me, all the time I want to do things
               | that I feel I should be able to do, but then run into
               | various walls.
               | 
               | My children (15 and 10) are learning about themselves but
               | they haven't found an advantage of their autism yet.
               | 
               | But, we function well enough, I can hold down jobs and so
               | will they, it's a set of things we're not good at but we
               | can deal.
               | 
               | The severe cases I know, I have never heard them utter a
               | word, or leave the house on their own. They live in a
               | world inside their heads. I really can't see what they
               | have as the same as what I have.
        
               | pseudalopex wrote:
               | -
        
               | Scarblac wrote:
               | No, 10% - 20%.
               | 
               | The article says:
               | 
               | > For the majority of people with ASD, the condition is a
               | significant disability, with only 10-20% of children
               | diagnosed before 5 years of age able to live
               | independently as adults.
        
         | shipman05 wrote:
         | I understand the sentiment, but there's a reason it's called
         | the autism spectrum.
         | 
         | I work with several software engineers with autism who are as
         | capable as their peers. Sure they may have behavioral quirks,
         | but not significantly more so than the normal variation in
         | human behavior. Their brains don't seem to work in an inferior
         | or problematic way, just different.
         | 
         | On the other hand, I have a close relative with more severe
         | autism who could never read and understand this article, could
         | never type a comment such as yours. She's incapable of holding
         | a job or living on her own without assistance. Her mother
         | passed away young, and her older sister, just 19 at the time,
         | had to take on the responsibility of being her sole caregiver,
         | and she will have that burden for the rest of their lives.
         | 
         | For some it may be a different variation of the human
         | experience, but for cases as severe as my relative's, I find it
         | hard to believe that a cure or prevention for autism wouldn't
         | be a massive quality of life improvement for all involved.
        
           | ModernMech wrote:
           | Indeed, my ex wife was incapable of living on her own or
           | holding a job. I have a whole social circle of autistic
           | friends of different abilities. Some still live with their
           | parents. Men in their 40s living with their parents. Women
           | who left home for the first time at 30 only to have to move
           | back within months. My one friend is a sex worker because she
           | can't hold down a real job. She sells her meds and her body
           | to get by.
           | 
           | I lived with my parents last year, at 36, but I moved out and
           | got a 1 bedroom. It was touch and go for a while, I still
           | can't cook for myself, but at least I can take care of my
           | cats.
           | 
           | I'm never going to have children. I'm never going to have a
           | house. A family like my parents had. My sister as well, well
           | she just got a boy friend so maybe not.
           | 
           | The through line problem here is not autism. Despite the
           | range of (dis)ability, the thing that makes it a problem is
           | how autistic needs are unmet by a society that expects us to
           | be worker bees.
           | 
           | My ability to type this message and read is not a constant.
           | There are times when I am non verbal. There are times when I
           | cannot read because the letters are all jumbled in my head.
           | When I'm able to read and write and speak, society values me.
           | When I'm not, society devalues me. You want to take autism
           | out of the equation so that I can be valuable to society.
           | 
           | What I'm saying is that society needs to be reoriented so
           | that autistic people are valued whether or not they can read
           | or write or speak.
           | 
           | Although I have to say I'm unsettled by you speaking for
           | someone who can't speak, and deciding unilaterally that
           | "curing" them would be a massive quality of life improvement
           | for "all involved". Did you ask them?
        
             | MajimasEyepatch wrote:
             | > My ability to type this message and read is not a
             | constant. There are times when I am non verbal. There are
             | times when I cannot read because the letters are all
             | jumbled in my head. When I'm able to read and write and
             | speak, society values me. When I'm not, society devalues
             | me. You want to take autism out of the equation so that I
             | can be valuable to society.
             | 
             | > What I'm saying is that society needs to be reoriented so
             | that autistic people are valued whether or not they can
             | read or write or speak.
             | 
             | People like to say stuff like this on social media, but I
             | can never quite figure out what they actually mean. Society
             | emerges from interactions between people. If someone can't
             | communicate, how exactly are they supposed to participate
             | fully in society? All people deserve love and support and
             | dignity regardless of their ability to contribute
             | economically, but I'm curious what this "reorientation"
             | would actually mean in practice.
        
           | somenameforme wrote:
           | Then people should stop conflating the two. This whole
           | "spectrum" nonsense is nonsense. Your coworkers are not
           | autistic - they are weird or whatever other more PC term you
           | might want to use, and that's great - many, if not most,
           | great engineers are!. There is no need to pathologize
           | differences in people. Your relative, by contrast, is. If you
           | have a habit of feeling sleepy at work, it's not like we say
           | you're on the narcolepsy spectrum. It's just a completely
           | dumb concept.
           | 
           | People like your relative, or the kid who sits around
           | flapping his hand and starts freaking out if anybody
           | interacts with him - those people are obviously not just
           | 'weird'. They clearly have severe mental disorders, and if we
           | want to call whatever it is that they have autism - fine. But
           | if we do, then we need to stop calling people like your
           | coworkers, Bill Gates, or whoever else also autistic.
        
             | cubefox wrote:
             | > Autism is known as a "spectrum" disorder because there is
             | wide variation in the type and severity of symptoms people
             | experience.
             | 
             | https://www.nimh.nih.gov/health/topics/autism-spectrum-
             | disor...
        
             | rjmunro wrote:
             | There is a continuous range of people in between. Where do
             | you draw the line?
        
               | somenameforme wrote:
               | This is like asking where to draw the line when somebody
               | is bald. Are you bald if you have 1 hair? Yes. 2? 3? 137?
               | There's of course reasonable room for discretion in
               | saying what is or isn't bald. But it isn't reasonable to
               | say somebody with a full-on afro is on the spectrum of
               | being bald.
               | 
               | Literally some of the most high functioning and
               | successful individuals are being diagnosed as "on the
               | spectrum" of what is, in its "real" form, a completely
               | crippling and disabling condition that yields individuals
               | who would have simply been classified as mentally
               | retarded in the past. This is just completely
               | nonsensical.
        
               | cubefox wrote:
               | What you call "real" form is just a strong form, and
               | there is no clear line to draw between real and not real
               | autism, or between "completely crippling" and "not
               | completely crippling", etc.
        
               | pseudalopex wrote:
               | Many people are on the balding spectrum.
        
               | shermantanktop wrote:
               | You could say that we all lose our hair eventually. Some
               | of us are just temporarily hirsute.
        
             | Tijdreiziger wrote:
             | I got my autism diagnosis in my early 20s (from a licensed
             | psychologist, before you ask).
             | 
             | It was a life-changing experience for me. Suddenly I was
             | able to understand and validate my experiences and
             | shortcomings, and to improve myself based on that
             | understanding, instead of resigning myself to the fact that
             | I'll always just be a 'weird' human with 'weird' opinions,
             | feelings and experiences.
             | 
             | I suppose though that since a random guy on HN said so,
             | this is actually impossible, and I should just go back to
             | having the entirety of my lived experience dismissed as
             | 'weird'.
             | 
             | Gee, I'm sure glad we cleared that up.
        
             | MajimasEyepatch wrote:
             | There's this thing people online tend to do where they'll
             | take a well-defined word or phrase like autism spectrum
             | disorder and just decide that it actually should mean
             | something else and get mad when everyone else uses the word
             | in the "wrong" way. It consistently derails conversations,
             | and it almost never brings anyone around to a place of
             | greater understanding.
        
         | oblio wrote:
         | This is just ridiculous, just like some deaf people wanting
         | their kids to be deaf to be part of the deaf community.
         | 
         | We were born with ears for a reason, same thing, our brains are
         | to a huge percentage built for social skills for a reason.
         | 
         | We can call them however we want but all these are basically
         | diseases of various forms.
         | 
         | People can choose their hair color, to grow their nails long,
         | their clothes or the myriad other things that allow us to
         | express our uniqueness, without making life stupidly difficult
         | for no reason when it's already super hard.
        
         | squigz wrote:
         | If you don't mind being on the spectrum, that's great for you.
         | Some of us are looking forward to more research like this. Many
         | of us don't want to go through this struggle forever, or make
         | another generation go through it, all while waiting for society
         | to get its shit together and completely reorient itself to be
         | neurodivergent-friendly? No thanks.
        
       | softfalcon wrote:
       | Is anyone else reading this and seeing the worrying, "we can just
       | medicate away the autism"?
       | 
       | They're talking about a possible pharmaceutical "fix" for autism
       | in children under 5.
       | 
       | Seems a bit premature for just recently finding a metabolic
       | difference in a cohort of children.
        
         | m00x wrote:
         | That's not what the article suggests at all. It's during the
         | developmental stage, which is by nature temporary.
        
           | somenameforme wrote:
           | Yes it is. It's exactly what the article suggests:
           | 
           | ---
           | 
           | ... Naviaux and his team completed early clinical testing for
           | suramin. ... Now, the researchers hope that by revealing the
           | specific ATP-related pathways that are altered in autism,
           | their work will help scientists develop more drugs that
           | target these pathways to manage the symptoms of ASD.
           | 
           | "Suramin is just one drug that targets the cell danger
           | response," he said. "Now that we're closely interrogating how
           | metabolism changes in ASD, we could be at the beginning of a
           | drug renaissance that will create new options for treatment
           | that never existed before."
           | 
           | ---
           | 
           | This study [literally] brought to you by Pannex Therapeutics,
           | Yuva Biosciences, Kuzani, and Paxmedica, MaraBio Systems, Inc
           | and undoubtedly numerous other big pharma interests that were
           | able to keep the study at arm's length enough to avoid
           | disclosure requirements. [1]
           | 
           | [1] -
           | https://www.nature.com/articles/s42003-024-06102-y#Sec36
        
             | softfalcon wrote:
             | Thanks, appreciate you backing up my thoughts on this.
             | 
             | I've already received several down votes from folks who
             | seem to disagree with my concern.
        
       | ldjkfkdsjnv wrote:
       | Used to have a mix of what could be considered ADHD/light
       | asperbergers. I dont eat carbs and mostly stick to a keto diet,
       | it resolved many symptoms. Our food is poison
        
         | 2four2 wrote:
         | Lots of carbs make me fall asleep and kill my motivation. My
         | lunches at work are light and carb-free for that reason.
        
         | manmal wrote:
         | Do you have microbiome dysbiosis? A keto diet might improve
         | things (eg lower LPS production), but long term can diminish
         | microbial diversity. I'm not saying keto is bad at all - it's
         | just that microbial diversity is an important predictor in GI
         | health and one should keep an eye on that too.
        
           | ldjkfkdsjnv wrote:
           | Yeah i mean i know that keto isnt great, but it has changed
           | my life to some degree. When in ketosis, i feel like i have
           | "agency", otherwise i am this foggy headed, sloth
        
             | hailruda wrote:
             | I can relate to this. Could you point me to any resources
             | about keto diets?
        
         | electrondood wrote:
         | I'm Broad Autism Phenotype (BAP) and prefer low carb because I
         | feel better, but it doesn't change my personality traits or
         | cognitive tendencies one iota.
        
           | ldjkfkdsjnv wrote:
           | I have a noticable ability to react quicker in social
           | situations, im more "normal". Otherwise my brain is sluggish
           | and i struggle to maintain conversation/things go over my
           | head
        
         | ffjffsfr wrote:
         | > what could be considered ADHD/light asperbergers
         | 
         | could be considered, or did you get a diagnosis from a
         | specialist? Self diagnosis is not reliable. If you don't have
         | an official diagnosis you can't be certain you really have
         | ADHD. There may be several differe tfactors relevant for YOU
         | that make keto diet work for you. Same diet can be harmful for
         | similar people who have ADHD.
        
           | ldjkfkdsjnv wrote:
           | I have a diagnosis, i just dont trust doctors. please stop
           | gaslighting me
        
           | throwaway092323 wrote:
           | > Self diagnosis is not reliable
           | 
           | Professional diagnosis is not reliable either. ADHD and
           | autism are often misdiagnosed as one-another, especially in
           | girls.
           | 
           | > If you don't have an official diagnosis you can't be
           | certain you really have ADHD
           | 
           | A lot of the time, the mental health professional making the
           | determination doesn't have specialty in ADHD/Autism. All
           | they're doing is looking at symptoms and making their best
           | guess. Which is exactly what people are doing when they make
           | a self-determination. In many cases, people with high-
           | functioning autism know more about autism than the people who
           | are supposed to know. And it's not like the diagnoses can be
           | validated when we're still figuring out what autism even is.
        
           | bluecalm wrote:
           | If you knew anything about how "diagnosis from specialist"
           | works in practice you wouldn't dismiss self dismiss diagnosis
           | so easily. "The specialist" usually spend a few hours at most
           | on the diagnosis (if even that) while people who self
           | diagnose live with the symptoms their whole life.
           | 
           | It would be such an easy world of you could go to a doctor
           | and get answers but it's not the world we live in unless it's
           | common cold (and even then a lot of doctors can't be bothered
           | and prescribe antibiotics just in case).
        
       | b800h wrote:
       | "with only 10-20% of children diagnosed before 5 years of age
       | able to live independently as adults"
       | 
       | > Well this is nonsense for starters - circular logic. Doctors
       | won't diagnose autism in most cases before the age of eight. For
       | the diagnosis to have happened before the age of five would imply
       | that the case is profound in the first place.
        
         | piker wrote:
         | The stat seems accurate on that basis. True, it may be read to
         | imply more.
        
         | willsmith72 wrote:
         | That's the whole point.
         | 
         | It's not like they took the age 5 at random, it's literally
         | what was used in the study
        
         | ffjffsfr wrote:
         | there are other factors here. Children diagnosed with autism at
         | the age of 5 must be adults now to determine if they can live
         | alone. So they were diagnosed at minimum 13 years ago, with
         | many diagnosed much earlier. Autism diagnostics is much more
         | common now than it used to be, especially in families with
         | higher economic status. Diagnostics tools evolved, more kids
         | are tested and tests capture more kids. So I think this number
         | will be completely different in 10-20 years from now. In my
         | experience as a parent of ASD kid, many kids now considered ASD
         | would not be considered ASD 20 or 30 years ago.
        
       | grumpy-de-sre wrote:
       | On the topic of metabolic disturbances in Autism, huge fan of the
       | work Dr. Randy Blakely is doing on the links between Serotonin
       | metabolism and Autism. One of the most surprising, and strongest
       | (25-30% of patients), biomarkers for Autism is actually Platelet
       | Hyperserotonemia (high levels of bound Serotonin in the blood).
       | 
       | For decades it's been without explanation but recently Dr Blakely
       | has described a bunch of cases where it was narrowed down to SERT
       | transporter polymorphisms and inflammation.
       | 
       | Worth a watch for those interested in the weeds of this stuff:
       | https://www.youtube.com/watch?v=cpDtuKV5CJs
       | 
       | I've got a pet hypothesis that differences in Serotonin
       | metabolism (and receptor hypersensitivity) might play a role in
       | why SSRIs aren't generally considered a first line treatment for
       | ASD symptoms,
       | https://www.pnas.org/doi/abs/10.1073/pnas.1112345109
        
       | john01dav wrote:
       | Pathologizing autistic behaviors is not the right approach here.
       | Most autistic behaviors are harmless except insofar as allistic
       | (non-autistic) people provide unnecessary consequences for it and
       | through incompatibilities. We don't say that a Linux workstation
       | in a network of Windows computers is broken or needs to be fixed
       | (or visa-versa), but rather we recognize that the problems are
       | due to the differences. As such, attempts to "cure" or "prevent"
       | autism are actually an eugenic attempt to remove harmless
       | variation that many people irrationally deem to be objectionable.
       | 
       | For example, it is commonly stated that autistic people have
       | communication deficits, but this is just a communication
       | difference. We can see this because if a communication task is
       | given to a group of only autistic people they perform comparably
       | to when the same task is given to a group of allistic people.
       | Problems only take place when the group is mixed with both
       | autistic and allistic people being present. The keyword "double
       | empathy problem" can be used to find more information about this.
       | (https://doi.org/10.1177/1362361320919286)
       | 
       | As another example, allistic people tend to _very_ harshly judge
       | autistic people for extremely subtle cues that they are
       | different. When allistic people are shown recordings of autistic
       | people communicating and of allistic people doing similiar tasks
       | they, within less than a second, judge the autistic people very
       | harshly. This effect persists when controlling for the content of
       | the communication. (https://doi.org/10.1038/srep40700) Of course,
       | doing anything that actually warrants such a judgement in a
       | context like that is impossible so this is a bias against
       | autistic people. I think that this can be compared to implicit
       | racial bias: it is something that most people need to learn to
       | consciously identify and then not perpetuate and is not due to
       | any faults with the victim.
       | 
       | Good resource on this: https://www.youtube.com/watch?v=A1AUdaH-
       | EPM
       | 
       | There are higher support needs autistic people who need help with
       | activities of daily living. In my opinion, though, in many cases
       | this is not autism but rather autism with an accompanying
       | intellectual disability and the intellectual disability is the
       | reason for higher supports needs. In some cases this could also
       | be caregivers unnecessarily pathologizing behavior and then
       | convincing someone that they need more support than they really
       | do, which I have seen in real life.
        
         | anon84873628 wrote:
         | There is a big difference between "neurodiverse" people and
         | severely autistic people facing huge challenges in their life.
         | Are you seriously dismissing the idea of helping treat that
         | latter group?
         | 
         | " this is not autism but rather autism with an accompanying
         | intellectual disability and the intellectual disability is the
         | reason for higher supports needs. "
         | 
         | This is a self-contradictory statement. But what do you think
         | people are researching if not those intellectual disabilities
         | -- why they occur and how they can be prevented.
        
           | john01dav wrote:
           | > There is a big difference between "neurodiverse" people and
           | severely autistic people facing huge challenges in their
           | life. Are you seriously dismissing the idea of helping treat
           | that latter group?
           | 
           | The people who you are referring to as neurodiverse also face
           | huge challenges. When everyone hates you just for being
           | yourself and not hurting anyone, that _is_ a huge challenge.
           | This can threaten peoples ability to make a living. This can
           | result in people having to live in abusive situations due to
           | lack of financial -- not practical -- ability to live on
           | their own. When you need to do stimming to feel internally at
           | piece but most other people will perceive this as a threat,
           | that is a challenge. When you need protection (e.g.,
           | headphones) from sensory input in the outside world, but the
           | world does not allow this in some cases (for example a job
           | may deem it to be  "unprofessional") that is also a threat.
           | Supports are needed in this case, and these supports are for
           | the world to lighten up about allowing these things.
           | 
           | Also, there are, perhaps more challenging, problems that what
           | you call "severely autistic" people face. We should _also_
           | support these people. For these people, the supports could be
           | similar as above (the world lightening up, perhaps about the
           | requirement that everyone be productively employed) or they
           | could be different (a medical treatment that increases
           | intelligence). Such a medical treatment needs to be performed
           | ONLY with the informed consent of the patient, to the degree
           | that that is possible with the communication difficulties.
           | 
           | > This is a self-contradictory statement. But what do you
           | think people are researching if not those intellectual
           | disabilities -- why they occur and how they can be prevented.
           | 
           | I think that this type of research is unnecessarily lumping
           | intellectual disabilities with the traits in what you call
           | neurodiverse people. I am much more open to helping people
           | with intellectual disabilities, to the extent that these
           | people want that help, than I am to treatments that attempt
           | to normalize neurodiverse people. The word "autism" refers to
           | both groups, so research that is about "curing autism" is at
           | least in part about normalizing neurodiverse people.
        
             | anon84873628 wrote:
             | Thanks for you comment. I was only splitting the spectrum
             | into the two broadest categories for rhetorical simplicity.
             | 
             | Of course I also agree that society needs to become more
             | accepting and supportive of all types of people. To put it
             | simply, we should not become a bioengineered dystopia. We
             | can do two things at once though.
             | 
             | >I think that this type of research is unnecessarily
             | lumping intellectual disabilities with the traits in what
             | you call neurodiverse people.
             | 
             | This is an unfair and unsubstantiated view that you are
             | projecting onto the researchers. _I_ give benefit of the
             | doubt that these professionals have a far better
             | understanding of the science, sociology, and ethics of the
             | topic than any of us. We need better understanding and
             | improvement in _all_ the areas right now.
        
               | john01dav wrote:
               | The medical system has a history of mistreating
               | marginalized groups (of which neurodiverse people are
               | definitely an example), and there are a huge number of
               | people who fund and perform research aimed solely at
               | eradicating all forms of autism. Autism Speaks is one
               | such group (which is an ironic name since the views of
               | the organization differ greatly from those of most
               | autistic people), and they are quite active in autism
               | research and well-funded. As such, I do not think that
               | giving the benefit of the doubt is reasonable.
               | Furthermore, even if the researchers have an excellent
               | and completely ethical view of autism, many people
               | reading about the research will not so giving such a
               | perspective remains valuable.
               | 
               | If can be easy to say that we should simply explore all
               | avenues of research, and in an ideal world this would be
               | true, but we do not live in an ideal world. There are two
               | concerns with this type of research:
               | 
               | - it has an opportunity cost of research that might be
               | more effective (for example medical treatments that could
               | help with sensory hypersensitivity under an informed
               | consent model could be a good result, or research that
               | helps us understand what, exactly, leads allistic people
               | to hate autistic people so much so that we can improve
               | communication in both directions)
               | 
               | - it creates new abilities for those who would do
               | eugenicist harm, even if they are well-meaning
        
         | shutupnerd0000 wrote:
         | > In my opinion, though, in many cases this is not autism but
         | rather autism with an accompanying intellectual disability
         | 
         | That's just like, your opinion, man.
         | 
         | If autism warrants needing help with daily living then it's a
         | disorder by definition.
        
           | john01dav wrote:
           | There are two ways that something can lead to needing help
           | with daily living:
           | 
           | - society rejects the trait without good reason, so then
           | someone needs help to deal with this rejection
           | 
           | - the trait leads to an inability to do something that the
           | person wants to do, irrespective of any societal concerns
           | 
           | I am okay with calling the latter a disorder, but not the
           | former. The traits that are recognized as part of autism
           | (social incompatibilities, stimming, special interests, hyper
           | or hyposensitivity -- these are the DSM traits for autism
           | rephrased more politely) are clearly in the former case.
           | Traits that lead to being unable to function (such as an
           | inability to feed one's self) are not on this list, but
           | rather are characterized by intellectual disability.
        
             | shutupnerd0000 wrote:
             | Do you always reply with definitions you invented on the
             | spot to justify your view of reality?
        
         | jprete wrote:
         | I think you're engaging in the no-true-Scotsman fallacy with
         | the claim that highly autistic people with a lot of special
         | needs are really "autistic with intellectual disabilities". I
         | disagree. They're simply more autistic and more impacted than
         | either of us.
        
           | john01dav wrote:
           | See here for why I think that it is different:
           | https://news.ycombinator.com/item?id=40329752
        
           | pseudalopex wrote:
           | They did not say no true autistic person are intellectually
           | disabled. They said they are overlapping groups. Like
           | Scotsmen and people who put sugar in porridge.
        
       | tsoukase wrote:
       | Autism is rooted during fetal brain development. Behavioural and
       | metabolic changes show up later. There is no an egg and chicken
       | problem. The primary disease starts in the CNS and everything
       | else follows
        
         | computerphage wrote:
         | How do you know that?
        
           | tsoukase wrote:
           | Schizophrenia, Alzheimer's, Parkinson's have links with the
           | gut too. But I "know" they start from the brain. No advanced
           | or complicated hypothesis
        
             | kelseyfrog wrote:
             | How would you prove or disprove this theory?
        
         | MajimasEyepatch wrote:
         | There's so much brain development that happens in the first few
         | years after birth that there's absolutely no way you can say
         | that with confidence.
        
           | tsoukase wrote:
           | No developmental anomaly can start after birth. It must
           | preexist but is not detected. Proof: heavy cases of autism
           | are diagnosed at birth, so the beginning lies sometime in
           | uterus. The same holds for the lighter cases too.
        
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