[HN Gopher] Autism should not be treated as a single condition
       ___________________________________________________________________
        
       Autism should not be treated as a single condition
        
       https://archive.md/zOQv5
        
       Author : bookofjoe
       Score  : 162 points
       Date   : 2025-12-04 16:25 UTC (6 hours ago)
        
 (HTM) web link (www.economist.com)
 (TXT) w3m dump (www.economist.com)
        
       | bookofjoe wrote:
       | https://archive.ph/zOQv5
        
         | ilvez wrote:
         | What's with these archive links these days. I just get locked
         | behind "Are you a human" clicking and random captchas.
        
       | ceejayoz wrote:
       | > Robert F. Kennedy junior, America's health secretary, thinks
       | that autism has become an "epidemic" in his country. His concern
       | stems from figures from the Centres for Disease Control and
       | Prevention, which shows that the condition now affects 32 per
       | 1,000 eight-year-old children in America (see chart). That is in
       | contrast, he says, with the near-absence of the condition in his
       | childhood. Mr Kennedy was born in the 1950s, and studies estimate
       | a prevalence of autism to around two to four per 10,000 in the
       | 1960s.
       | 
       | I'd note that RFK Jr.'s very own aunt was lobotomized then
       | _hidden away_ for something that sounds a lot like autism if
       | diagnosed today. https://en.wikipedia.org/wiki/Rosemary_Kennedy
        
         | bluGill wrote:
         | Read any old book (like from the 1800s), or look into anyone's
         | family history. There is always some version of "Larry never
         | leaves the farm". Nobody every diagnosed "Larry" so we don't
         | know what he had and often we only have a small fraction of the
         | symptoms recorded, but what we have sounds suspiciously like
         | Autism (and one of a dozen other things we now have names for)
        
           | ceejayoz wrote:
           | Yup. Or if they were rich, "eccentric".
           | 
           | https://en.wikipedia.org/wiki/John_Bentinck,_5th_Duke_of_Por.
           | ..
           | 
           | > The tunnels under the estate were reputed to have totalled
           | 15 mi (24 km), connecting various underground chambers and
           | above-ground buildings. They included a 1,000 yd (910 m) long
           | tunnel between the house and the riding house, wide enough
           | for several people to walk side by side. A more roughly
           | constructed tunnel ran parallel to this for the use of his
           | workmen.
           | 
           | > The duke was highly introverted and well known for his
           | eccentricity; he did not want to meet people and never
           | invited anyone to his home. He employed hundreds through his
           | various construction projects, and though well paid, the
           | employees were not allowed to speak to him or acknowledge
           | him.
           | 
           | > He ventured outside mainly by night, when he was preceded
           | by a lady servant carrying a lantern 40 yards (37 m) ahead of
           | him. If he did walk out by day, the duke wore two overcoats,
           | an extremely tall hat, an extremely high collar, and carried
           | a very large umbrella behind which he tried to hide if
           | someone addressed him.
           | 
           | > He insisted on a chicken roasting at all hours of the day
           | and the servants brought him his food on heated trucks that
           | ran on rails through the tunnels.
        
             | DaveZale wrote:
             | Pugsley's tunnels! The Adams Family old black and white tv
             | show...
        
           | SoftTalker wrote:
           | I think this explains at least some of it. In my childhood
           | (1970s) as best I recall, these kids were hidden away. They
           | went to separate special education schools or a separate
           | classroom in the main school and didn't really mix with the
           | rest of the kids. Today the attempt is made, for better or
           | worse, to mainstream everyone as much as possible.
           | 
           | It still feels like there is more autism today compared to
           | then though. I would guess that it's some combination of more
           | people waiting to have kids until they are older,
           | environmental factors, mania about cleanliness and sanitizing
           | everything, maybe social factors such as putting more kids in
           | daycare at a very young age, IDK. I'd say the same thing
           | about asthma and food allergies too, seems that half the kids
           | today are allergic to something, need inhalers, etc. It was
           | unusual among my friends as a kid, at least I don't remember
           | it being common.
        
             | ceejayoz wrote:
             | > I'd say the same thing about asthma and food allergies
             | too, seems that half the kids today are allergic to
             | something, need inhalers, etc.
             | 
             | I mean, if you were deathly allergic to eggs in the 1800s,
             | you _died_. Very early.
             | 
             | If smoke sent you into respiratory distress, you _died_.
             | Very early.
             | 
             | Or see the "left-handedness epidemic". It is probably not
             | massively more prevalent now than it was in 1900s, even if
             | that's what the stats say.
             | https://www.researchgate.net/figure/The-overall-rate-of-
             | left...
        
               | SoftTalker wrote:
               | No real argument, but I'm not talking about that long
               | ago. When I was a kid, lots of parents smoked, in the
               | house, in the car, everywhere. My father did. Yet I don't
               | remember any of my friends having asthma or using
               | inhalers. Peanut allergy is very common today, among my
               | kids friends, several of them had it. Was almost unheard
               | of when I was a kid, schools served peanut butter often
               | at lunch. Nobody was ever asked what food allergies they
               | had.
               | 
               | It's possible my anecdotes are not representative, but
               | this is just what I have observed.
        
               | ceejayoz wrote:
               | https://commons.wikimedia.org/wiki/File:Asthma_prevalence
               | .pn... looks relatively steady over the last ~50 years or
               | so.
               | 
               | > Asthma was recognized in ancient Egypt and was treated
               | by drinking an incense mixture known as kyphi. It was
               | officially named as a specific respiratory problem by
               | Hippocrates circa 450 BC, with the Greek word for
               | "panting" forming the basis of our modern name. In 200
               | BC, it was believed to be at least partly related to the
               | emotions.
               | 
               | Theodore Roosevelt had asthma.
        
               | hexedpackets wrote:
               | I think the argument still applies on a shorter
               | timescale. The child mortality rate in the US fell from
               | 26 per thousand in 1970 to 7 in 2020 [1]. It seems
               | reasonable that some portion of kids that now have
               | treatable but persistent illnesses such as
               | allergies/asthma would have died just a few decades ago.
               | 
               | [1] https://www.statista.com/statistics/1041693/united-
               | states-al...
        
               | squigz wrote:
               | You don't notice nearly as much as a kid as you do as an
               | adult; nor do you get a representative picture of your
               | friends.
               | 
               | Beyond that, there's a question of, while maybe they
               | didn't have an inhaler, how many _needed_ one but didn 't
               | get one due to awareness or whatnot? Or how many people
               | had allergic reactions, because we didn't ask about their
               | allergies?
        
               | scythe wrote:
               | Peanut allergies might be caused by poor advice in some
               | cases. There was a period where people believed that
               | babies should be protected from any food allergens, in
               | case they were allergic. Later research suggested that
               | early exposure to allergens might actually prevent
               | allergies.
        
             | mrguyorama wrote:
             | In the 1970s it was still easy to just abandon the school
             | system. Kids who didn't obviously thrive were usually
             | treated as family burdens, and still mostly removed from
             | society.
             | 
             | They also usually died young.
             | 
             | People with ADHD for example, are more prone to abusing
             | drugs and alcohol. How many people died from alcoholism who
             | were untreated ADHD cases?
             | 
             | >It still feels like there is more autism today compared to
             | then though.
             | 
             | This is objectively true, do you know why? We changed the
             | name of really poorly functioning people in some cases from
             | "Mentally retarded" to "Autistic".
             | 
             | That's it.
             | 
             | Look at a graph of generic "mental retardation" diagnosis
             | and it's fall coincides with the "rise" of autism
             | diagnosis. Those people were always actually autistic, but
             | we did not have the institutional knowledge and tools to
             | know that, because _the science of psychiatry and
             | psychology is still in its infancy_ and struggled with
             | rampant a-scientific thought even into today. Jordan
             | Peterson for example is a  "Jungian" trained psychologist
             | even though that's not science, and he was fired when his
             | college discovered he was leaning more on that unscientific
             | worldview than actual hard science in his college courses.
             | 
             | >I'd say the same thing about asthma and food allergies
             | too, seems that half the kids today are allergic to
             | something, need inhalers, etc.
             | 
             | The food allergies is real because a bunch of doctors were
             | "nervous" about babies with peanut butter allergies, and
             | _without any scientific study or consideration_ , spent
             | over a decade recommending parents not expose kids to
             | peanuts.
             | 
             | Now that we have _actually done the science_ , we know that
             | was dead wrong, completely irresponsible, _unscientific_ ,
             | and directly responsible for something like 8 million fully
             | preventable peanut allergies. That's what happens when you
             | let _even medical professionals_ use their  "intuition"
             | rather than hard data. This is why medical studies blind
             | those professionals. Doctors are not usually scientists.
             | 
             | There is no education that removes human biases and
             | cognitive missteps, and it is impossible to cure yourself
             | of the standard human fallacies. Statisticians can still
             | become gambling addicts, and can still suffer from gambling
             | fallacies when not being rigorous.
             | 
             | >I would guess that it's some combination of more people
             | waiting to have kids until they are older, environmental
             | factors, mania about cleanliness and sanitizing everything,
             | maybe social factors such as putting more kids in daycare
             | at a very young age, IDK.
             | 
             | The only one of these with any real evidence is that
             | Geriatric Pregnancy is a known risk factor for autism.
             | Everything else is nonsense.
             | 
             | Don't feed into the _rampant_ misinformation and
             | _malicious_ refusal to learn what is _already known_ by
             | throwing out baseless guesses and letting them carry any
             | weight. How often has one of your customers correctly
             | guessed what caused a bug without understanding, access,
             | and rigor? You are doing the same.
        
             | bluGill wrote:
             | (read the other replies first, they make good points)
             | 
             | I knew plenty of kids in the 1970s that were "a little off"
             | (probably including me), but they were not so bad that we
             | would remove them from society which was the only option
             | back then so we called them normal. Now that we have
             | treatment we give it not only to those so autistic that
             | they can't function in society at all, but also those who
             | could function but not well and treat them.
        
         | alaithea wrote:
         | It could be, but the Wikipedia article notes that she may have
         | also suffered a birth injury from hypoxia.
         | 
         | Rosemary's story is so tragic and heartbreaking. Her life was
         | filled with what would today be considered multiple instances
         | of medical malpractice, and heartless, unethical behavior on
         | the part of the Kennedy family. Her father didn't even tell her
         | mother about the lobotomy until after it was done.
         | 
         | Incredible that she lived to the age of 86. The nuns taking
         | care of her might have actually cared, which could hardly be
         | said of the Kennedy family.
        
           | o11c wrote:
           | Those are not unrelated. Both from my family and from looking
           | at the research, there's a strong correlation between
           | long/difficult births (sometimes explicitly hypoxia) and
           | autism.
        
             | marklar423 wrote:
             | Would you mind pointing me at the research you found? I've
             | been looking for studies that correlated hypoxia and autism
             | (and related interventions that might help) but I haven't
             | been successful.
        
         | neilv wrote:
         | The Rosemary Kennedy story is tragic.
         | 
         | JFK was great in some ways, but that political dynasty had
         | serious problems even before RFK Jr.
         | 
         | The Wikipedia article paints this as partly driven by the
         | political aspirations of the patriarch. I suspect this is yet
         | another example of we'd be in much better shape if the US
         | didn't have quasi-royalty, nor families aspiring to that.
        
           | psunavy03 wrote:
           | The only reason JFK was JFK is because his older brother was
           | killed in an aircraft mishap in WWII. Joe Kennedy, Jr. would
           | have gotten the big political push if he'd lived.
        
       | nerdjon wrote:
       | I will admit that I stopped reading the article because I think
       | the article is completely mixing things up and honestly just did
       | not feel like reading anymore of it.
       | 
       | I think very few people actually consider it a single condition.
       | To the point that most people that I know, including myself, say
       | that we are "somewhere on the spectrum" or some variant of that.
       | 
       | This isn't a post diagnoses understanding either, it is well
       | understood by anyone I have talked to about this in the last
       | 10ish years? (maybe less, I cant really pinpoint that).
       | 
       | While I feel like there is value for professionals to be more
       | specific about it, from an everyday person prospective I feel
       | like "Autism" is well enough understood to be not just a single
       | thing. Enough so that some phrasing along the lines of "my tism
       | is..." is somewhat commonplace.
       | 
       | The real problem is anti-science people joining the conversation,
       | but splitting up Autism is not going to change that.
       | 
       | Edit: To be very clear here I am not trying to say that most
       | people in general are saying "I am somewhere on the spectrum". I
       | am saying that most people _I_ know which a larger portion of the
       | people I regularly talk to are also diagnosed.
        
         | jklinger410 wrote:
         | > I think very few people actually consider it a single
         | condition. To the point that most people that I know, including
         | myself, say that we are "somewhere on the spectrum" or some
         | variant of that.
         | 
         | Couldn't disagree more. The "autism is my super power" movement
         | is borderline offensive to people dealing with severe or low
         | functioning autism.
         | 
         | Dismissive, uninformed comment.
        
           | nerdjon wrote:
           | I have never in my life used "autism is my super power" so
           | please don't put words in my mouth. I will agree that it is
           | offensive but that is very different from saying "somewhere
           | on the spectrum" when I don't feel like having a more in dept
           | conversation.
           | 
           | And again my point is that contrary to what the article seems
           | to be trying to make, no one really considers Autism a single
           | thing.
        
             | nxor wrote:
             | The article is about ASD.
        
             | dpark wrote:
             | You obviously did not claim autism as a superpower.
             | 
             | Still this "everyone is a bit autistic" stuff is kind of
             | absurd. It diminishes the condition.
             | 
             | > most people that I know, including myself, say that we
             | are "somewhere on the spectrum"
             | 
             | No one says "everyone I know is a bit paraplegic", because
             | that would be insane. Yet people glibly call themselves
             | autistic as if having geeky hobbies or a job in software is
             | the same as being diagnosable as having an autism spectrum
             | disorder.
        
               | nerdjon wrote:
               | > Still this "everyone is a bit autistic" stuff is kind
               | of absurd. It diminishes the condition.
               | 
               | Again nowhere am I saying that.
               | 
               | Maybe I could have worded it much better but I never
               | meant to imply, it happens that like myself a larger
               | portion of the people I hang out with are diagnosed which
               | for me works with just saying "most people" but I can see
               | why that was not clear.
        
               | dpark wrote:
               | Fine. You said most people you know.
        
             | jklinger410 wrote:
             | I'm not putting words in your mouth. What I'm saying is, if
             | we had different names for different types of autism,
             | saying "autism is my super power" wouldn't be such an
             | issue.
             | 
             | And if "no one considers autism a single thing" THEN WHAT
             | IS EACH THING? lol
        
               | ceejayoz wrote:
               | > And if "no one considers autism a single thing" THEN
               | WHAT IS EACH THING? lol
               | 
               | We don't have a name for every color on the light
               | spectrum, nor can the average person tell you what's
               | different about #FF0000 vs #FE0000. They still exist!
        
               | jklinger410 wrote:
               | Autism should not be treated as a single condition
        
               | ceejayoz wrote:
               | No one is disagreeing with that.
               | 
               | People are trying to point out that the "spectrum" thing
               | is the medical field doing precisely what you're asking
               | for.
        
               | nerdjon wrote:
               | Please point me to anywhere that it is treated as a
               | single thing that isn't the people using Autism to push
               | an anti-science agenda.
               | 
               | It is an Umbrella term that is well understood to be a
               | "spectrum" and well understood to not be the same for 2
               | different people.
               | 
               | My question though, what is the point of separating it.
               | What do we actually gain from doing so? I guarantee you
               | these attacks will still exist.
               | 
               | I don't have a degree in this but I have to imagine there
               | was a good reason that Aspergers is no longer its own
               | diagnosis.
        
           | squigz wrote:
           | ???
           | 
           | In what way is GP being dismissive, or taking the "autism is
           | my super power" position with that comment?
        
           | mystraline wrote:
           | > Couldn't disagree more. The "autism is my super power"
           | movement is borderline offensive to people dealing with
           | severe or low functioning autism.
           | 
           | I doubt those types are saying much of anything. Its more
           | likely their caregivers.
           | 
           | Again the old name for those of us who think its more a super
           | power used to be called Aspergers syndrome.
           | https://en.wikipedia.org/wiki/Asperger_syndrome . And we got
           | folded in to Autism Spectrum Disorder, as did a whole host of
           | other diagnostics.
           | 
           | And we have been found to be more truthful, better at
           | focusing, can hyperfocus, notice more details than NT's, and
           | plenty more. We're only a disease cause we're the minority.
        
             | kube-system wrote:
             | Many with Aspergers take advantage of their strengths (as
             | anyone does) but it is not without its difficulties
        
             | some_random wrote:
             | >And we have been found to be more truthful, better at
             | focusing, can hyperfocus, notice more details than NT's,
             | and plenty more. We're only a disease cause we're the
             | minority.
             | 
             | Yeah and this is why Autism shouldn't be treated as a
             | single condition, even if the cause is the same the outcome
             | is meaningfully different than someone who cannot function.
        
             | alphager wrote:
             | It's not a disease, it's a disability.
             | 
             | As someone with a diagnosis, I would add several sensory
             | issues (for me it's noises, multiple conversations at the
             | same time, stickiness, physical contact, whole categories
             | of food and several others) and several social issues to
             | your list of superpowers.
             | 
             | Seeing it purely as a positive is insultingly reductive.
             | 
             | To be clear: I would not take a cure if it somehow got
             | invented, but it /is/ limiting in a multitude of ways even
             | in the best cases.
        
               | mystraline wrote:
               | I only have so many comments before idiotic rate
               | limiting. But I'll comment here.
               | 
               | So for dis-ease or dis-ability, it doesnt interfere with
               | ease of life. Nor does it materially affect my ability.
               | 
               | > I would add several sensory issues (for me it's noises,
               | multiple conversations at the same time, stickiness,
               | physical contact, whole categories of food and several
               | others) and several social issues to your list of
               | superpowers.
               | 
               | And too true. I have some as you listed as well. However,
               | I also figured out what causes them in me, and how to
               | reduce their effects to nil. In a way, its self-treatment
               | with n=1.
               | 
               | Noise: I dont have a problem with noise per se. However,
               | when multiple people are talking or music with lyrics are
               | on in the background, its incredibly hard for me to
               | process what's spoken along with it.
               | 
               | Weirdly though, when I was principal clarinettist in a
               | symphony, I could easily pick out any instrument by
               | simple concentration. All I know is the noise issue with
               | me is something with vocal processing of over-talking
               | voices.
               | 
               | stickiness: for me, its dirt on my hands. Or
               | chicken/turkey/beef/pork/lamb/goat blood. I do a lot of
               | cooking. I hate those feelings on my skin. But I find
               | that as long as I wash my hands before and after with a
               | good degreasing soap (Dawn), the icky goes away. I can
               | still do the task at speed.
               | 
               | I dont have the physical contact issues for people I'm
               | close with. So, thats not an issue.
               | 
               | Food: theres only a few foods I can't eat, due to
               | vomiting reasons. Tapioca based products are the big one.
               | Aside from that, I eat everything from blue cheese, to
               | cow tongue, offal from beef and birds,ghost peppers, pork
               | brains, hakarl. I like the tastes and sensations that
               | foods have. In a way, I'm wondering if this is also
               | relayed to the supersensitive reject-foods type.
               | Definitely not a disability.
               | 
               | And of course, theres the huge downsides with
               | interpersonal interactions. Took me decades to really
               | piece together and emulate and identify emotional state
               | in others. But the psychologists dont know how to fix
               | this either. Most of them are NTs who it comes naturally.
               | But they want their indefinite sessions to do basically
               | nothing but pay $200/hr.
               | 
               | > Seeing it purely as a positive is insultingly
               | reductive.
               | 
               | Again, there are up and downsides to NT's and ND's.
               | 
               | Neurotypicals are more known for deception and lying. Or
               | they use the term "little white lies". These things
               | slowly stack up in NT conversations until they become
               | huge problems. Sitcoms are based on this. But ND's, well,
               | we are the weird ones. When someone asks "do I look good
               | in this?" And you say "no, it clashes with your skin
               | tone" - you were supposed to know they wanted a yes.
               | 
               | I feel sad that NTs can't properly hyperfocus, and can
               | easily drop out of hyperfocus with low sensory input.
               | 
               | NTs memory is foggy and badly reorders things. Or they
               | misremember and blame others for ill-perceived issues.
               | 
               | There are good and bad. I'm glad I'm ND, likely Aspergers
               | (hence autistic). Most of these problems are ones that
               | can be solved, at least for Aspergers side of things.
        
             | jklinger410 wrote:
             | > I doubt those types are saying much of anything. Its more
             | likely their caregivers.
             | 
             | It doesn't really matter whose saying it. The point is that
             | autism is not cool or fun for many people. We need a way to
             | distinguish the difference, besides saying high or low
             | functioning.
             | 
             | > We're only a disease cause we're the minority.
             | 
             | WHICH WE ARE WE TALKING ABOUT THEN? IS IT NOT A DISEASE
             | WHEN SOMEONE IS NON-VERBAL? Holy shit. Point, meet case.
        
               | mystraline wrote:
               | I immediately started with 'Aspergers was folded into
               | autism spectrum disorder'.
               | 
               | I dont think they ever should have did that.
               | 
               | If the doctors say that "someone is nonverbal, pisses
               | their pants, and needs spoonfed at 17yr old" is somehow
               | the same as "someone who is a professional engineer who
               | can hyperfocus but misses social cues and says weird
               | stuff" - the doctors are completely wrong.
               | 
               | Those are demonstrably NOT the same thing.
               | 
               | And yes, my Aspergers is a super power. Those abilities
               | (many positive, some negative) have gotten me far.
        
               | staticman2 wrote:
               | The diagnostic criteria for "Aspergers" never required
               | above average, or even average intelligence.
               | 
               | If you had visited the Aspergers and autism website
               | support forum "wrong planet" 20 years ago you'd have seen
               | many lower functioning than you people with "aspergers"
               | complaining about aspects of their lives.
               | 
               | So I don't see how "aspergers" is a superpower.
        
               | jklinger410 wrote:
               | Then we agree that autism should be comprised of several
               | named and distinct "disorders."
        
         | bluGill wrote:
         | The reason we say "somewhere on the spectrum" is there are a
         | lot of high functioning people who have a few autism like
         | symptoms that benefit from some autism treatments. You can
         | change the name/diagnosis what you want, but in the end we need
         | to get people the treatment they need.
        
           | cogman10 wrote:
           | That's the benefit of a broad diagnosis. Narrow diagnoses
           | make it hard to get specific treatments for problems.
           | 
           | That's my main concern about trying to split up autism. It's
           | all well and good for study purposes, but for "can I get my
           | insurance to pay for my kid's occupational therapy" purposes
           | I'm really skittish about such a breakup. All the sudden my
           | kid might have "omegaism" or whatever and boom, it's uncommon
           | for them to need OT so insurance won't cover it.
        
             | phito wrote:
             | That's exactly my issue with "autism" because it feels like
             | lumping a bunch of things together just for the sake of
             | simplifying health care. Meanwhile you have a bunch of
             | people that have completely different symptoms, experiences
             | and causes with the same diagnostic.
        
               | cogman10 wrote:
               | The vast amount of treatment for autism is therapies.
               | 
               | It really doesn't matter if the underlying cause is very
               | different in terms of treatment because a speech
               | therapist works the same with a kid with autism as they
               | do with a kid with down syndrome.
               | 
               | If there were more pharmaceutical interventions then I
               | might care a bit more. But there's just not.
               | 
               | In terms of the research, the researchers already have
               | tools to sort and filter individuals based on their
               | specific set of symptoms. Just because 2 people share an
               | autism diagnosis doesn't really impact the research.
               | 
               | What objection do you have other than not liking that
               | it's not a "pure" diagnosis?
        
               | mrguyorama wrote:
               | It's lumping a bunch of things together because _they are
               | empirically linked together_
               | 
               | People with sensory issues _often_ also have more
               | cognitive rigidity for example.
               | 
               | Autism, and many other psychological disorders, are quite
               | literally just a lump of symptoms and presentations,
               | _because we do not have better options_.
               | 
               | Sure, it makes navigating american health insurance
               | easier if you can just say "Autism" and get various
               | treatments paid for, but very similar diagnostic criteria
               | and definitions are used in countries with fully
               | socialized medicine.
               | 
               | Those people with those linked issues tend to benefit
               | from similar treatment, and that's _the entire point of a
               | diagnostic criteria_.
               | 
               | All the complaints come from people who seem to just not
               | like the vibe of that?
               | 
               | Deal with it. Go fund more research into the heritability
               | of neurodivergent pathologies if you want a blood test.
               | 
               | Some day we WILL be able to separate "Autism" into very
               | specific diseases with specific causes, and some of those
               | causes will have a genetic test. Unless we kill the
               | concept of medical research because we elected morons who
               | tear apart our institutions.
               | 
               | I have "Impaired vision", and I share that with people
               | who are profoundly (but not totally) blind, and it does
               | not matter that I can drive with glasses and they can't,
               | and the name of that condition is not the important part.
               | 
               | All this handwringing about "but but but my mildly
               | autistic son is mostly functional and I'm sad that he has
               | the same name of condition as someone who cannot be
               | educated past a 3rd grade level" is _stupid_. It does not
               | benefit anyone struggling with autism to complain about
               | it.
               | 
               | Are you aware that we have multiple medical conditions
               | called "Palsy"s, and that they have drastically different
               | causes and effects, such that my sister's Palsy which was
               | caused by medical malpractice and prevented her from
               | using her dominant hand in some cases is very different
               | from my schoolmate's Palsy which left her wheelchair
               | bound and requiring professional help day to day? They
               | are both palsy because they are (partially) movement
               | disorders stemming from nerve damage or dysfunction.
               | 
               | The horror!
        
               | cogman10 wrote:
               | I honestly can't help but feel like the main point of
               | people whinging at autism being a broad diagnosis is
               | because they don't like that it makes getting treatment
               | easy (especially coming from "the economist").
               | 
               | Maybe I'm not being charitable. But that really does feel
               | like the only real outcome of trying to piecemeal the
               | diagnosis.
               | 
               | I don't believe research or treatment is negatively
               | impacted in anyway by the diagnosis being broad. If
               | anything, that opens doors so that research isn't
               | accidentally too narrowly focused.
        
           | nerdjon wrote:
           | So... you agree with what I am saying?
           | 
           | My point is, if it is commonplace to refer to Autism as a
           | spectrum we are already acknowledging that it is not a single
           | thing.
           | 
           | Which seems to be the entire basis of this article while also
           | mixing in the rambling of someone anti-science that frankly
           | won't change even if it was split up.
        
             | bluGill wrote:
             | I don't know enough above the subject (and what I could
             | make of the article isn't helpful) to know if I agree or
             | not. We should split Autism if we can conclusively separate
             | people into the different diagnoses and then give them the
             | correct treatment (which would be wrong for the other).
             | However if we still give the same treatments in the end
             | there isn't any point even if we can find different
             | symptoms to result in a different diagnosis.
             | 
             | As science learns more (or I learn more) I reserve the
             | right to change my position.
        
           | SoftTalker wrote:
           | If a person can take care of himself, hold a job, and
           | generally not burden anyone else why does he need treatment?
           | To try to make him into whatever we consider "more normal?"
           | Just let him be who he is.
        
             | bluGill wrote:
             | Is that person happy? Would/could they be more happy?
        
             | cogman10 wrote:
             | The entire point of diagnosis is because a person needs
             | help.
             | 
             | The point of treatment isn't to "fix" or "make normal"
             | someone. It's to give them the tools needed to participate.
             | 
             | For example, someone with autism might be more prone to
             | having a meltdown. What therapy does is give them the tools
             | to both identify that they are on the verge of such a
             | meltdown and to de-escalate themselves.
             | 
             | The point of treatment is to help someone take care of
             | themselves, hold a job, and generally not burden anyone.
             | It's also to help a person feel better about themselves.
        
             | abigail95 wrote:
             | The diagnostic criteria would exclude someone from an
             | autism diagnosis unless they had persistent deficits across
             | time and context.
             | 
             | Your example person may function well within a narrow band
             | of capability - the purpose of treatment/support is to
             | expand that band and help maintain it. I'm not advocating
             | forcing support on someone that doesn't want it, but I am
             | for improving someones quality of life by expanding their
             | choice of occupation and social environment.
             | 
             | Without any external support I would wake up, work, sleep,
             | repeat. Eating? Cleaning? annoyances that just interrupt
             | work.
             | 
             | I've made a lot of money doing that but it's unfulfilling
             | and at times, disgusting.
             | 
             | If you want to live in a society that leaves me be - I
             | won't starve to death but I'm never going to have a partner
             | or a family without external services like psychology,
             | occupational therapy, social events.
             | 
             | Whether I pay for these services or someone else does it
             | doesn't matter. I want them to be available for people like
             | me to understand that we are not alone, there's a reason we
             | can only exist comfortably in our narrow slice of the
             | world, and if we want to leave our bubble there is support
             | available.
        
             | Lendal wrote:
             | It's a personal decision. I haven't gotten a diagnosis
             | because I've been able to hold a job for many years, and
             | I'm married, so I'm mostly fine. But I have spent my life
             | avoiding most human contact, precisely because I know I'm
             | incompatible with them, and people often want to know why I
             | never leave the house.
             | 
             | I don't think there is any treatment. I think it's just a
             | set of skills that you learn in case you want to try to
             | pursue activities that most neurotypicals take for granted.
             | It seems like a lot of work to me, and maybe it would be
             | easier to just let things be, as you're saying.
             | 
             | I know what my limitations are and I can observe others
             | doing the things that I can't do, including my own wife,
             | and I imagine what life would be like if I could do those
             | things too. But it mainly boils down to having FOMO, and
             | thinking about how much work you want to go through in
             | order to be able to do some of the things that you're
             | having FOMO about.
        
           | staticman2 wrote:
           | The diagnostic criteria isn't based on whether the condition
           | is treatable.
           | 
           | For example, nobody who is diagnosed with autism is
           | proclaimed "not autistic" if they find therapy to be
           | unhelpful.
        
             | bluGill wrote:
             | Yes, but the whole point of diagnosis is we have treatments
             | for those things that usually [sometimes] work and so we
             | need to diagnosis people because that is the first step in
             | getting them treatment.
        
         | stuffn wrote:
         | > Enough so that some phrasing along the lines of "my tism
         | is..." is somewhat commonplace.
         | 
         | In the 1990s we drugged kids (especially young boys) who
         | weren't able to sit still with ADHD medication. Every parent's
         | kid suddenly had ADHD, people would talk about their quirky
         | behavior as "oh its my ADHD".
         | 
         | This generation it's autism, and it's likely over-diagnosed
         | just as much as ADHD. You do it in your own post, attributing a
         | defined, binary, thing as "I am somewhere on the spectrum". If
         | anything, your own post demonstrates the anti-scientific (pop-
         | sci) instagramification of mental illness. You either have some
         | quantity of illness or you don't. You can't just ascribe some
         | quirky, possibly somewhat anti-social, behavior as being on the
         | spectrum. Sadly, this is often used like ADHD self-diagnoses to
         | gain sympathy or social leeway. Much to the disservice of
         | people suffering from the condition.
         | 
         | It comes as no surprise that psychiatry, and medicine in
         | general, is suffering from a massive reproducibility crisis.
         | It's not anti-science to call into question the amount of bunk,
         | p-hacked, corporate funded garbage coming out of even the
         | highest tier of medical grade journals.
        
           | flatline wrote:
           | I both agree and disagree with the over-diagnosis claim. Yes,
           | everyone is suddenly autistic, which lessens the meaning or
           | impact of the term. Also, the DSM 5 reclassifies a good
           | portion of human behavior under the umbrella of ASD, so this
           | is in part driven by the diagnostic model itself. We continue
           | to see rising rates of severe autism in children, which are
           | likely attributable to this reclassification as well as
           | better common understanding of the diagnostic criteria.
           | Presumably, just as many adults either qualify now or would
           | have qualified as children.
           | 
           | At the same time, there's the neurodiversity movement that
           | seeks to destigmatize and depathologize these diagnoses for
           | both high functioning and more profoundly disabled
           | individuals. Just because you don't conform to the norm - and
           | ASD is heavily defined in relation to deviation from an
           | underspecified norm - does not make you "mentally ill." So we
           | have autism as an identity additional to a diagnosis, which I
           | think can be really empowering for people, and also cause
           | confusion and frustration for others. It's a reclaiming of
           | "disability" from the paternalistic and abusive medical and
           | pseudoscientific practitioners that have been harming
           | autistic people for decades.
           | 
           | I also wish you were not being downvoted. You express some
           | common sentiments and I think your comment adds to the
           | conversation.
        
             | squigz wrote:
             | There's a lot of stuff to unpack in such a discussion, but
             | I only want to add that I see the prevalence of things like
             | autism as a sort of "over correction" to practically all of
             | history. Sure, some kids might relate to it and incorporate
             | it as part of their personality, but 1) I don't think
             | that's as widespread a problem as some people claim, 2)
             | kids do this all the time with various things, and have
             | done forever, and 3) I think that's a small price to pay
             | for society learning about these things and destigmatizing
             | them
             | 
             | > I also wish you were not being downvoted. You express
             | some common sentiments and I think your comment adds to the
             | conversation.
             | 
             | Common or reasonable sentiments or not, the whole "kids
             | these days" overtone is tiring and annoying, and most
             | people - online and in person - don't want to engage with
             | that, because it does not imply a position of good faith.
        
           | mrguyorama wrote:
           | >In the 1990s we drugged kids (especially young boys) who
           | weren't able to sit still with ADHD medication
           | 
           | This never happened. We did not overprescribe Ritalin.
           | 
           | What actually happened, is uninformed people like you with no
           | actual evidence spread FUD about how giving kids well
           | understood medicine was "bad" and the direct result of that
           | was people like me, my sister, and my brother who all had
           | stereotypical ADHD symptoms that we inherited from our
           | stereotypically ADHD parents were tested and _rejected_ an
           | ADHD diagnosis by untrained school guidance counselors
           | terrified of something that _wasn 't happening_.
           | 
           | Each of us spent the next 30 years utterly failing to thrive
           | due to struggling with these symptoms, and experienced
           | immense suffering from normal life things. We all have
           | finally gotten real diagnosis, and some of us are getting
           | real treatment, and we are so much better off now and able to
           | function, and we are even able to pass those learnings back
           | up the chain to our parents.
           | 
           | A huge part of the "ADHD Epidemic" right now is the fact that
           | a couple million people with clear ADHD symptoms were _passed
           | over_ by people who were supposed to be helping them due to
           | the exact FUD you are spreading now.
           | 
           | >This generation it's autism, and it's likely over-diagnosed
           | just as much as ADHD.
           | 
           | ADHD is not overdiagnosed. Autism is not overdiagnosed.
           | Provide any evidence _at all_ to support your shit claims.
           | 
           | If someone with just a whiff of autism struggle gets
           | diagnosed as autism, that's fine, and they will be explained
           | how they might not even need significant support, and they
           | don't really get any treatment at all. For people with gentle
           | autism like that, it's mostly just about understanding _why_
           | you are the way you are.  "Oh, that's why I <X>". And you
           | suddenly have a framework and vocabulary to better explain
           | the struggles you have and the problems you experience, and a
           | way to bond with people who have similar difficulties, and a
           | way to think about your own brain that can help you lessen
           | the negative impact of being different.
           | 
           | >It comes as no surprise that psychiatry, and medicine in
           | general, is suffering from a massive reproducibility crisis.
           | 
           | There is ZERO reproducibility crisis in ADHD science, and
           | amphetamine based ADHD medications are some of the most well
           | supported, scientifically, medicine we have _full stop_. You
           | can literally measure _physiological_ brain differences of
           | people with ADHD, and if you give a kid with ADHD a stimulant
           | medication for their life, _those measurable differences go
           | away_
           | 
           | If you give ADHD people stimulants, _all cause mortality
           | decreases_. They become statistically better drivers, which
           | is something that ADHD people are statistically worse than
           | average at. You lower all forms of addiction and substance
           | abuse, because ADHD people struggle with self medicating and
           | abusing substances as a rule. Notably, all the good Ritalin
           | does for people who struggle with ADHD is _not_ duplicated in
           | people who do not have ADHD. People who take unprescribed
           | Ritalin as a  "study drug" have worse outcomes than people
           | who take it for actual ADHD.
           | 
           | Giving kids with ADHD stimulants _reduces bone fractures and
           | STDs!_
           | 
           | >You either have some quantity of illness or you don't.
           | 
           | This is stupid. Some people with bad eyesight need glasses to
           | do normal day to day things while others don't, or only need
           | glasses for reading, but _both are diagnosed nearsighted_
           | 
           | >Much to the disservice of people suffering from the
           | condition.
           | 
           | Stop talking for me, you are doing an atrocious job of it.
           | 
           | >It's not anti-science to call into question the amount of
           | bunk, p-hacked, corporate funded garbage coming out of even
           | the highest tier of medical grade journals.
           | 
           | It is _entirely_ antiscience to demonstrably have no clue
           | what you are talking about and yet claim the experts are
           | wrong. That is literally antiscience. There 's no p-hacking
           | in ADHD science. There's no corporate funded garbage for
           | ADHD. Ritalin is old and cheap and no longer patent
           | protected.
           | 
           | >If anything, your own post demonstrates the anti-scientific
           | (pop-sci) instagramification of mental illness.
           | 
           | How dare you thumb your nose at kids self diagnosing on
           | tiktok (not instagram, pay attention) as "pop-sci" when you
           | yourself know only reactionary FUD. Shame on you. Educate
           | yourself.
        
             | flatline wrote:
             | I think your point could be better made with less vitriolic
             | language, and I also think you get a few things wrong: a
             | bunch of my peers were _over_ -medicated to the point of
             | being senseless during the late 80s and early 90s. These
             | drugs were pushed on kids by many well meaning but
             | exasperated parents whose children - mostly boys - could
             | not sit still and behave in the way demanded of them by
             | school and society. So it's a mixed bag with regard to the
             | intent behind medication, and the effectiveness with which
             | it was applied. Nowadays, if anything it's harder than ever
             | to get amphetamines because of US drug scheduling policies
             | and our patchwork, piecemeal healthcare system.
        
             | nerdjon wrote:
             | > This never happened. We did not overprescribe Ritalin.
             | 
             | I think it is important to stress a difference between
             | "over medicated", "over prescribed", and "over dosed"
             | (often also called over medicated, something I have been
             | guilty of).
             | 
             | An example being my partner, apparently when he was a kid
             | and diagnosed with ADHD he was put on a very high (I am
             | only relaying what I was told) dose that he hated being on.
             | That has caused him now as an adult to be very cautious to
             | go back on the medication.
             | 
             | Where as for myself I was not diagnosed until an adult, was
             | able to actually advocate for myself and I started on the
             | lowest dose possible for all of my medications (also
             | treating Anxiety and Depression). While I do take several
             | medications I would not consider myself over medicated
             | because we have identified that at this point in time all
             | of these medications are actually helpful, but I am very
             | cautious of being on too high of a dose for each of these.
             | 
             | I do think there are likely people that were put on too
             | high of a dose too quickly to expedite treatment, but being
             | on the medication in the first place was not the issue. It
             | doesn't mean that the diagnoses was wrong though.
        
             | mtlmtlmtlmtl wrote:
             | I just want to say, I wish I could give 100 upvotes, but
             | I'll have to settle for one.
             | 
             | It's definitely the case that there is undue paranoia about
             | stimulants.
             | 
             | One case you only briefly touch on, addiction. Let me
             | elaborate. I have struggled with severe ADHD(largely
             | untreated during childhood, mainting severity into
             | adulthood as a result) for all my life. I've struggled with
             | drug addiction for most of my adult life(mainly cannabis).
             | The amount of hoops addicts are made to jump through to get
             | access to amphetamines is insane. Generally the
             | requirements in my country(Norway) are to deliver weekly
             | clean drug tests for 3 months. In the case of heavy
             | cannabis use, it takes up to 3 months from going cold
             | turkey until tests are negative. So, a 6 month commitment
             | before treatment can even begin. Now, the relationship
             | between ADHD and cannabis is interesting. I know some
             | ADHDers who swear by it as a treatment. These tend to be of
             | the predominantly hyperactive/impulsive type.
             | 
             | For me, it can't really be called a treatment. It actively
             | worsens my condition in terms of executive dysfunction.
             | Although it does improve some of the aspects like
             | hyperactivity and emotional lability and helps make things
             | bearable.
             | 
             | By the time I'm a year into a binge, my life is such a mess
             | that getting myself out of it without meds is completely
             | hopeless. Here I'm talking my apartment being such a mess
             | I'm generally expecting to be woken up by people in
             | biohazard suits any day now, and wondering how the hell I
             | haven't contracted some kinda crazy bacterial disease by
             | now. Cleaning it up is weeks if not months of work even
             | with meds. Without it's inherently impossible. And the
             | cannabis at least numbs me to the horror of it all.
             | 
             | So for 6 months I have to abandon that small comfort and
             | just exist in this hellish life until I can even begin to
             | improve things. Try to imagine how hard that makes going
             | cold turkey in the first place. Not to mention the fact
             | that meds significantly help me manage the addiction in the
             | first place. I've successfully made it through this 6 month
             | purgatory 3 separate times in the last 13 years. I've made
             | more failed attempts than I can count. Wasted most of my
             | 20s hiding from the purgatory inside a bong. I often wonder
             | ehat my life would've been like if the rules weren't so
             | strict. There's no evidence supported medical justification
             | for waiting any longer than about 4 weeks. Out of the
             | bajillion or so failed attempts, I reckon maybe 3/4 made it
             | that far. Go figure.
             | 
             | I'm currently, close to 2 years semi-sober(doing a new
             | moderation based approach to my addiction, very
             | successfully, smoking exactly once every 4 weeks. Bit
             | unrelated to the stimulant thing, it's more about relapse
             | avoidance. But it's worked wonders so far.) and doing
             | better than ever, but I still have a long way to go. And I
             | will fight anyone who sows FUD about amphetamine or
             | methylphenidate. These are wonder drugs. If you want to
             | freak out about psych meds, go read up on neuroleptics. Now
             | there's something truly horrifying. But of course, that
             | only happens to crazy people hidden away in mental wards,
             | so no one cares about them. I've been to those mental wards
             | and I have seen some shit I will never forget. People whose
             | lives were destroyed, reduced to an unbearable living hell
             | for the remainder, by a supposed "treatment". These people
             | are treated like animals. Go talk about that. Shut the fuck
             | up about stimulants and SSRIs already, jesus. And go touch
             | some grass.
        
           | standardly wrote:
           | "You do it in your own post, attributing a defined, binary,
           | thing as "I am somewhere on the spectrum"
           | 
           | "You either have some quantity of illness or you don't."
           | 
           | I'm not sure what kind of argument you are making for (or
           | against?) "binary" symptoms. The DSM-5 clearly lays out the
           | spectrum. There is a conglomerate of effects caused by
           | autism, and where you are on "the spectrum" is determined by
           | how many of the symptoms you have, and their severity.
           | 
           | There is nothing wrong with someone claiming "I'm on the
           | spectrum" if you don't know how or what they were diagnosed
           | with. That language is consistent with the DSM. Unless they
           | admitted to self-diagnosing, it seems wrong to assume someone
           | is lying about their own experience.
           | 
           | "You can't just ascribe some quirky, possibly somewhat anti-
           | social, behavior as being on the spectrum"
           | 
           | Quriky, somewhat anti-social behaviour (in your words)
           | essentially _is_ one of the dialogistic criteria. But nobody
           | would be diagnosed with autism for that alone. Just like how
           | autistic folks usually avoid eye contact. That doesn 't mean
           | they ALL avoid eye contact, and it also doesn't mean anyone
           | who avoids eye contact is autistic. It's a wholistic
           | diagnosis. One would need to be experiencing SEVERAL of the
           | symptoms to receive an autism diagnosis. IME, the majority on
           | the spectrum are indeed level 1, and high functioning, even
           | to the point others might question if they are really
           | autistic.
           | 
           | If you take issue with people self-diagnosing, I don't think
           | anyone would disagree. But your combativeness in just
           | discussing the topic kind of looks similar to people who
           | refuse to accept that autism is really a thing ("there were
           | no autisms back in my day" kind of thing).
        
           | grokgrok wrote:
           | Agreed; in short: any monolithic system will have individuals
           | with natural dispositions transverse to that order, those
           | individuals provide resiliance and novelty but also risk
           | driving decoherence and defection. Yay pluralism.
        
           | pessimizer wrote:
           | > It comes as no surprise that psychiatry, and medicine in
           | general, is suffering from a massive reproducibility crisis.
           | 
           | Psychiatry still hasn't coped with the fact that it spent
           | most of the 20th century taking Freud seriously. More
           | recently, it still hasn't figured out a way to repudiate the
           | Satanic Ritual Abuse panic in the 80s. The people who were
           | involved are literally still working, and have moved on to
           | Facilitated Communication in severe autism, Gender Identity,
           | and are still pushing around the fraud of Multiple
           | Personality Disorder. Literally the same people involved in
           | all of them, and now their children. [edit: forgot about one
           | of the most important, Recovered Memory Syndrome]
           | 
           | There's just no scientific method in most of psychology, it's
           | simply guru-led systemic theories delivered mostly (but often
           | entirely) by a single person who is licensing practitioners.
           | What comes along with that is a complete inability for any of
           | these theories to die. They just eventually become unpopular
           | and unprofitable, and people jump onto the next thing.
           | 
           | The psychopharmacological revolution has complicated this
           | even more, because now there are billions of dollars wrapped
           | up in it. The only advantage to SSRIs and the new generation
           | of knockoffs was that they didn't cause tardive dyskinesia,
           | there was never any statistical evidence that they performed
           | any better than the previous drugs. And in the case of the
           | previous drugs, they weren't ever shown to have much of an
           | effect other than quieting down patients. They were all based
           | on the wackjob theory that people having epileptic seizures
           | suddenly became sane, and were one of the ways of inducing a
           | seizure-like state, along with freezing baths, saline
           | injections, electrocution, etc. All of the pioneers were also
           | _enthusiastic_ lobotomists.
           | 
           | How can we say that these new tactics are medicine or science
           | when the statistics on mental illness keep getting _worse_?
        
         | tokai wrote:
         | Understanding autism as a spectrum does not at all imply that
         | its multiple conditions. Just one with varying severity.
        
           | phito wrote:
           | It's not a one dimensional spectrum with just severity as
           | variable. It's a multi dimensional spectrum, you could
           | potentially assign a "condition" to each dimension
           | (hypersensitivity, OCD, rigid thinking, non-verbality, ...)
        
           | Matticus_Rex wrote:
           | But virtually everyone in the field _does_ believe there are
           | many different mechanisms behind autism, some of which have
           | little-to-no overlap either in the mechanisms themselves or
           | necessarily even in the presentation.
           | 
           | Many scientists believe that one day we will likely be able
           | to split off at least some of the undifferentiated mass of
           | ASD into potentially completely unrelated disorders that may
           | share a lot of aspects of presentation.
           | 
           | For example, we may find out that one set of genes combined
           | with cytokine storms in utero cause dysfunction in synaptic
           | pruning, while another set of genes combined with gut
           | dysbiosis may affect brain plasticity in the critical period
           | of early childhood. Those would be two completely unrelated
           | conditions, with overlapping symptoms for some (but not all)
           | who have them.
        
         | some_random wrote:
         | I disagree completely, the discourse around RFK and "anti-
         | science people" makes it extraordinarily clear that when most
         | people hear "Autism Spectrum Disorder" they think exclusively
         | of common, mild cases where the person has no serious issues
         | existing in society and frequently benefits from their
         | "disorder". They consider discussion of "curing" autism
         | insulting, and challenge the idea that it's a read detriment at
         | all. They do not for a moment think about the more severe cases
         | that require people to have full time caretakers because they
         | are unable to feed themselves.
         | 
         | I can't read the article because of the paywall, but I assume
         | that it is referring the fact that these two extremes need to
         | be treated completely differently and even discussing ASD is
         | made remarkably difficult because these extremes are the same
         | diagnosis.
        
           | squigz wrote:
           | I don't think it's safe to draw conclusions about what "most
           | people" think based on the discourse around RFK and his
           | nonsense.
        
             | some_random wrote:
             | Yeah, that's why I'm drawing conclusions based on what how
             | it's being discussed in real life, social media, this
             | thread, etc.
        
           | mrguyorama wrote:
           | > common, mild cases where the person has no serious issues
           | existing in society and frequently benefits from their
           | "disorder"
           | 
           | This is not at all a thing. People with some mild
           | neurodivergence _sometimes_ being good _at very specific
           | tasks_ is not even in the same ballpark as  "Benefits"
           | 
           | There's no benefit to a brain that struggles in modern
           | society.
           | 
           | >but I assume that it is referring the fact that these two
           | extremes need to be treated completely differently
           | 
           | Except they don't. What is different is the _intensity_ of
           | the treatment. My girlfriend needs patience and a little
           | therapy. Her sister needs _intense forever therapy_ and
           | _infinite patience_ and a system that will allow her to live
           | despite never being able to be a productive member of
           | society.
           | 
           | >They do not for a moment think about the more severe cases
           | that require people to have full time caretakers because they
           | are unable to feed themselves.
           | 
           | They are regularly _the parents of exactly those people_ and
           | are sick and tired of you speaking for them and making their
           | life harder. Those people who need fulltime caretakers can
           | only pay for them through social security benefits, and guess
           | who is trying to change that?
           | 
           | >even discussing ASD is made remarkably difficult because
           | these extremes are the same diagnosis.
           | 
           | The reams of neurodivergent people I have interacted with in
           | my life have never found issues with this, and have regularly
           | been very willing to engage with the nuance of _a poorly
           | understood disorder which by definition has no single cause
           | and might be several similar looking diseases because that 's
           | what the word disorder means in medical science_
           | 
           | The discourse around RFK is that morons with no experience,
           | training, or even ability to read introductory material
           | apparently should _shut the fuck up_ , and let the adults
           | work.
        
         | squigz wrote:
         | > To the point that most people that I know, including myself,
         | say that we are "somewhere on the spectrum" or some variant of
         | that.
         | 
         | I'm not entirely sure why this comment is apparently so
         | controversial, but I think people are confused by this. My
         | reading of it was that you meant "most autistic people you
         | know", and you yourself are. Maybe I'm wrong?
        
           | nerdjon wrote:
           | That is exactly what I meant to say which is why I added an
           | edit. I for sure could have phrased that a lot better.
           | 
           | Now yes there are people who are undiagnosed for whatever
           | reason (including some people I know that don't see the point
           | after being diagnosed with ADHD, I know personally I had to
           | have this conversation with my psychologist to determine if
           | there was a point to actually do it at that point) that use
           | that phrase and it gets a bit tricky.
           | 
           | But nowhere am I trying to imply that *everyone* is saying
           | this.
        
       | Cypher wrote:
       | Who was?
        
       | dboreham wrote:
       | What's going on with the brain of any particular person is a
       | point in a very high dimension space. What doctors call
       | conditions are regions in that space. The definition of those
       | regions has something to do with understanding and helping the
       | humans and their families, but also something to do with the
       | doctors making money. In the US Healthcare system nothing can be
       | paid for unless it is in service of treating a "condition".
       | Slightly odd that an article in The Economist doesn't mention
       | this.
        
         | o11c wrote:
         | Related: doctors will refuse to test you to see if what you're
         | suffering from is a particular condition unless that condition
         | actually has a known treatment.
        
           | ceejayoz wrote:
           | We test for plenty of incurable diseases.
        
       | __MatrixMan__ wrote:
       | It has always bothered me that by "spectrum" they mean not the
       | sort of continuous thing that spectra actually are, but instead
       | some disjoint set of "colors" any one of which might describe a
       | person. That's called a partition, and its in an entirely
       | separate thing.
       | 
       | When I tell this to people they understand immediately that I am
       | in fact on that "spectrum".
        
         | 4ndr3vv wrote:
         | > It has always bothered me that by "spectrum" they mean not
         | the sort of continuous thing
         | 
         | Oh but they do. the "spectrum" is by how socially acceptable
         | someone's autism is.
        
           | rusk wrote:
           | > how socially acceptable someone
           | 
           | I intuitively understand this but has it been clinically
           | defined?
        
             | mikestorrent wrote:
             | Has social acceptability in any context ever been defined,
             | beyond say, rules of etiquette? It's a free market and
             | everyone is arguably entitled to test to see what it will
             | bear.
        
             | lazide wrote:
             | The entire nature of the field of psychology and mental
             | health treatment is relative to pain and dysfunction.
             | 
             | If people fit in well and didn't have issues (either
             | internal pain/suffering or society interaction
             | pain/suffering), they are not applicable to the field.
        
               | prepend wrote:
               | This is key and what makes something a disorder.
               | 
               | Everyone experiences some obsession or compulsion. But
               | only some experience it to the degree of a disorder.
               | 
               | Just like everyone has some "autistic" tendencies. But it
               | is only a disorder in some.
        
             | JohnMakin wrote:
             | ASD is defined by the level of support the individual
             | needs. It says nothing about "fitting in" or by pain or
             | anything else like that
        
               | fragmede wrote:
               | having friends is a level of support though
        
             | sundarurfriend wrote:
             | I suspect part of your parent comment's point is that this
             | is an implicit bias in the way the spectrum is defined and
             | thought of, so it _wouldn 't_ be clinically defined in
             | those terms explicitly.
             | 
             | In other words, the "spectrum" doesn't exist to capture the
             | variation in the autistic person's own experience - if it
             | did, it would look very different. It's a remnant of a time
             | when autism was seen as just a "problem" for the people
             | around you, and the spectrum measures how much of a problem
             | you are and how weird you are seen by their measure; which
             | does map onto a continuous line in the same way.
             | 
             | That does capture something useful, but only a small part
             | of what autism actually comprises, and is much less useful
             | at capturing the autistic person's own experience of it,
             | and makes it a less useful tool to them than people might
             | assume.
        
               | michaelt wrote:
               | It's not unusual for diagnostic criteria to hinge on the
               | _impact_ the thing is having on your work /family/school
               | life.
               | 
               | Alcoholism, for example - we don't define alcoholism as
               | drinking >=2 bottles of wine a week, or say that 1 glass
               | of wine a week is part of an alcoholism spectrum.
               | 
               | Instead, we ask whether drinking often interferes with
               | taking care of home and family; or leads to job/school
               | troubles; or has lead to getting arrested.
               | 
               | How much of a problem an alcoholic is for others being
               | roughly equal to how much of a problem alcoholism is for
               | the alcoholic.
        
               | sundarurfriend wrote:
               | > Instead, we ask whether drinking often interferes with
               | taking care of home and family; or leads to job/school
               | troubles; or has lead to getting arrested.
               | 
               | We don't ask _just_ that, and the diagnosis doesn 't
               | hinge on those - in fact those account for only 3 (or 4
               | depending on how you count) of the 11 diagnostic criteria
               | for alcohol use disorder. The others are about the
               | person's own experience with alcohol, the difficulties
               | and psychological problems caused by it to the person
               | themself. And that's for alcohol use, an external
               | behaviour-based problem with a specific narrow scope.
               | Autism is a much wider construct with much more varied
               | impact and experiences, and yet in practice people are
               | placed somewhere on the spectrum based mainly on external
               | interactions and troubles.
               | 
               | Historically this came about because people who were
               | "low-functioning" caused more difficulties to _others_ ,
               | whereas "high-functioning" folk didn't - even though they
               | might have comparable amounts of difficulties and
               | psychological anguish internally and in need of similar
               | help too. This simplistic view is changing slowly within
               | the field and with some therapists recognizing it better
               | for what it is, but it's still not nearly as widely
               | recognized as it needs to be.
        
             | toast0 wrote:
             | DSM-V [1] describes criteria / symptoms in two groups (caps
             | from document, sorry):
             | 
             | > A. PERSISTENT DEFICITS IN SOCIAL COMMUNICATION AND SOCIAL
             | INTERACTION ACROSS CONTEXTS, NOT ACCOUNTED FOR BY GENERAL
             | DEVELOPMENTAL DELAYS
             | 
             | > B. RESTRICTED, REPETITIVE PATTERNS OF BEHAVIOR,
             | INTERESTS, OR ACTIVITIES
             | 
             | For criteria A, severity is more or less measured by how
             | much social impairment is observed --- that's a measure of
             | social acceptability in some fashion.
             | 
             | For criteria B, the severity criteria is about
             | "interference with functioning in contexts" as well as
             | observed distress of the patient. Interference with
             | functioning can be related to the patient resisting the
             | desired function, but it can also be because the patient is
             | socially excluded due to their behavior.
             | 
             | Although, I should point out clinical criteria in general
             | and the DSM in specific are a formalization of arbitrary
             | judgements that describe observable characteristics grouped
             | into a diagnostic category; this can be useful, but it's
             | not really an understanding of the underlying condition(s),
             | it's a handbook of things to look for when a patient comes
             | asking for help and what things to try to help them. If
             | someone has the same underlying conditions but manages to
             | pass as socially acceptable, they may not come in for help,
             | and that's fine too. When multiple underlying conditions
             | result in similar observable criteria, the DSM gets pretty
             | confused; there's not much in the way of attaching traces
             | and getting debug logs for mental processes though,
             | especially out in the world, so this is the best society
             | has, I guess.
             | 
             | [1] https://depts.washington.edu/dbpeds/Screening%20Tools/D
             | SM-5(...
        
               | kube-system wrote:
               | "Society's acceptance of a person who has a condition",
               | and "a condition that inhibits social interactions" are
               | two entirely different things.
        
               | notarobot123 wrote:
               | If I persistently ask awkward questions, that might
               | "inhibit social interactions". If my community was
               | tolerant and even accepting of this behavior it might not
               | inhibit social interactions quite as much. They are
               | different things for some behaviors but extremely closely
               | related for others.
        
               | watwut wrote:
               | It is not just about societal tolerance. It is also about
               | autistic person having complete emotional meltdown with
               | yelling abusive things or even hitting things because
               | something was not exactly to his/her liking. You can
               | "tolerate" that, but then you are just allowing someone
               | else to be abused.
               | 
               | And even in milder cases, the "does not understand social
               | rules" is sometimes or even frequently euphemism for what
               | would be labeled as abusive or cruel or simply selfish
               | behavior for non autistic person.
        
         | bonsai_spool wrote:
         | > It has always bothered me that by "spectrum" they mean not
         | the sort of continuous thing that spectra actually are, but
         | instead some disjoint set of "colors" any one of which might
         | describe a person. That's called a partition, and its in an
         | entirely separate thing.
         | 
         | Hmm, what are these 'colors' in your framing? I don't think
         | anyone feels that ASD comprises totally distinct, 'disjoint'
         | descriptions. It's true that there are multiple parameters
         | along which one may vary, but that's true of any human
         | syndromic disease, and probably true for any human disease, in
         | general.
         | 
         | Here's a popular press article that talks about a very recent
         | framing of autism that uses clinical and genetic data:
         | 
         | https://www.simonsfoundation.org/2025/07/09/new-study-reveal...
        
         | Hard_Space wrote:
         | It seems a poor analogy, since it's impossible not to be on the
         | spectrum somewhere, even if it's #000000.
        
           | Matticus_Rex wrote:
           | This is a misconception I see pop up frequently online. In
           | terms of the color spectrum, there are plenty of things--even
           | things that have qualities in common with color--that aren't
           | on the color spectrum. And while there are colors outside of
           | what humans can see, we generally use it not to refer to the
           | entire electromagnetic spectrum, but only to the subset that
           | makes up light visible to human eyes.
           | 
           | Likewise, when we talk about the "autism spectrum," we're not
           | including every exhibition of traits associated with autism.
           | You can have some traits associated with autism without being
           | "on the spectrum."
           | 
           | Also, perhaps as importantly, "spectrum" isn't a term that
           | generally applies only to color, or even electromagnetism.
        
         | sfpotter wrote:
         | Fun fact: some spectra are discrete, not continuous! And some
         | have both parts. Depends on the operator...
        
           | delichon wrote:
           | Autism researchers talks in terms of "graded membership" in
           | "fuzzy clusters" within trait space.
        
         | jckahn wrote:
         | This is the most delightfully autistic response to the article.
        
         | raverbashing wrote:
         | The current shitshow was the result of several misshaps and
         | naive thinking
         | 
         | - Group together "rainman" type people (and people with even
         | harder limitations) with "not overly social/minor social
         | impairments"
         | 
         | - The current overmedicalization and diagnostication of
         | everyday life wanting to label every minor difference between
         | people
         | 
         | - Current "education was too hard, let's build accommodations"
         | which is good but not when you can get any diagnosis by
         | shopping for it
        
         | maxbond wrote:
         | > It has always bothered me that by "spectrum" they mean not
         | the sort of continuous thing that spectra actually are, but
         | instead some disjoint set of "colors"...
         | 
         | I get what you mean but I feel compelled to point out that
         | colors are on a spectrum. A partition can be a quantized
         | spectrum.
        
           | rusk wrote:
           | GP's concern is that the quantisation scale is not
           | representative of linear severity. It's more like
           | classification of disjoint characteristics tagged with colour
        
             | maxbond wrote:
             | I won't offer an opinion of my own but I don't disagree
             | with that take.
        
         | dooglius wrote:
         | I think the former is what they are trying to imply?
        
         | renewiltord wrote:
         | Actually, the original word has nothing to do with continuity.
         | That's a later adoption of it from Latin to English. So to be
         | precise, you don't need continuity. It's just a re-adoption of
         | the same word form the original Latin.
         | 
         | But many without autism don't have that need for precision so
         | they get confused by mixing up later word use in different
         | contexts like you did there.
        
           | rusk wrote:
           | The present day meaning describes a continuum. The term could
           | indeed be defined in the anachronistic terms you describe so
           | it is anachronistic, which is a reasonable complaint when
           | something enters common usage. We see terms redefined all the
           | time thusly
           | 
           | UPDATE I have exceeded my grace with HN spam controls
           | 
           | The confusion arises from the direct import of a medical
           | Latin term which means what it means in Latin, into the
           | modern colloquial- this is important information
        
             | renewiltord wrote:
             | Well, if one is being pedantic about a loanword one must
             | admit the possibility of the word being loaned twice with
             | different meanings. If one doesn't want to be pedantic, all
             | manner of things are admissible, of course.
        
         | kube-system wrote:
         | And yet, colors themselves are arbitrarily chosen partitions of
         | a spectrum.
        
           | bluGill wrote:
           | Not exactly - there are very clear areas where everyone
           | agrees the dividing line exists when you look a full spectrum
           | map. Even most colorblind will agree with the areas in
           | general (there are lots of specific color blind types but
           | most will agree what area of the map is which colors even if
           | you don't put any scale indications on the map)
        
             | QuercusMax wrote:
             | Within a particular culture that may be true, but for
             | example the Japanese concept of blue/green is decidedly
             | different from most Western concepts which consider blue
             | and green separate colors.
        
             | watwut wrote:
             | I argued over a color names with a guy who later admitted
             | he is color blind. So, no, we don't agree on zones. I mean,
             | it was rather clear he is off. Basically, he has seen
             | different color.
        
         | spongebobstoes wrote:
         | spectrum is a good word because of spectroscopy, where for
         | example a single beam of light is broken down into constituent
         | parts
         | 
         | in this ASD model, a single person is like a light source, ASD
         | traits are like frequencies, and ASD itself is like the EM
         | spectrum
         | 
         | this is useful because our best understanding of ASD today is
         | multidimensional
         | 
         | as you say, it is not supposed to be used as like "the
         | spectrum" is a line from "normal" to "autistic"
         | 
         | unfortunately most people aren't familiar with spectroscopy,
         | but I think it's a good metaphor
         | 
         | do you have a suggestion for a better word than spectrum, that
         | could convey the same rich metaphor but be less easily
         | misunderstood?
        
           | jermaustin1 wrote:
           | That metaphor actually fits well with how it is interpreted
           | in my head. Even the "visual" of a spectroscope's graph, just
           | turned 90o in my mind.
        
         | munificent wrote:
         | Here are three separate metaphors:
         | 
         | 1. A linear continuum (like wavelength for light) from "no
         | autism" to "really bad autism".
         | 
         | 2. A collection of disjoint sets (like individual named colors
         | like "cyan" and "puce") for cases like "really into trains
         | autism", "freaks out at parties autism", "non-verbal autism",
         | etc.
         | 
         | 3. A continuous mixture of different properties (like rgb(.1,
         | .2, .05)) for symptoms like "10% social dysfunction", "20%
         | repetitive behavior", "5% sensory overstimulation".
         | 
         | When people describe autism as a spectrum disorder, they
         | generally mean the third metaphor. It's a mixture of different
         | symptoms and different autistic people have different amounts
         | of those symptoms but all people diagnosed with autism have a
         | significant amount of them and their symptoms will have some
         | amount of overlap with other autistic people.
        
           | hosh wrote:
           | Number (3) has better explanatory powers than (1).
           | 
           | However, for the purpose of assessing social and family
           | impact, it is rendered to (1). Both schools and state (US)
           | programs use (1) to assess if a child qualifies for support.
           | This is not always related to how to parent or educate the
           | child.
           | 
           | Fortunately, the US school system with IEP (individualized
           | educational plans) are developed along (3). (Source: two of
           | my kids have ASD)
           | 
           | None of that necessarily helps in informal social contexts or
           | in professional workplace settings. I think the American
           | Disabilities Act covers reasonable accommodations for people
           | with autism spectrum disorders, though I am not sure if it
           | requires legal disabled status.
           | 
           | Lastly: I met a Native (Navajo) family with a child that
           | seems to me, have some developmental disabilities -- but I
           | think they take a very different approach. For one, they
           | don't seem to have the usual social stigma associated with
           | this, and are baffled why I would suggest getting state
           | support for early childhood intervention. If anything, I
           | would not be surprised if they thought I was, yet again,
           | someone unthinkingly pushing a colonialist worldview.
        
             | Pet_Ant wrote:
             | > Number (3) has better explanatory powers than (1).
             | However, for the purpose of assessing social and family
             | impact, it is rendered to (1).
             | 
             | My first thought was is (1) more of a projection of (3)
             | from multiple dimensions to one, or more like the
             | magnitude.
             | 
             | Also, it is known thing or are "trains" a euphemism now
             | like "friend of Dorothy"?
        
               | dfxm12 wrote:
               | It's the punchline to a meme. This is one example:
               | https://encrypted-
               | tbn0.gstatic.com/images?q=tbn:ANd9GcRgeiEh...
               | 
               | I don't think it's quite the same as calling yourself or
               | someone else a "friend of Dorothy". People who say they
               | are into trains usually precisely mean they are into
               | trains.
        
               | tbrownaw wrote:
               | While that word does get used to refer to people
               | sometimes, it's afaik always hostile (slur rather than
               | euphemism).
        
               | munificent wrote:
               | _> Also, it is known thing or are  "trains" a euphemism
               | now like "friend of Dorothy"?_
               | 
               | I meant it only as a reference that one of the common
               | characteristic symptoms of autism is a deep focus on some
               | topic of special interest. In boys with autism, trains,
               | cars, or other machines are a common one.
        
               | estimator7292 wrote:
               | Within the community it's a bit of an in-joke. It's not a
               | coded message or anything, just an acknowledgement that
               | autistic people are disproportionately into trains.
        
               | fragmede wrote:
               | But they're just so cool! How is everyone not into trains
               | this much?
        
               | ToucanLoucan wrote:
               | Strictly my anecdotal observation but, as someone who
               | attends train shows regularly, they definitely,
               | absolutely are.
               | 
               | Not an ounce of complaint to be clear. Honestly seeing
               | them flip out and flap around and giggle excitedly is
               | delightful. I'm glad they're having a good time and I'm
               | also glad that all of these experiences have not involved
               | some self-involved asshole leering, criticizing or
               | yelling at them for being happy.
        
           | dfxm12 wrote:
           | I don't think the 3rd metaphor fits. rgb values still points
           | to a single color, which maps back to a single value on a 0
           | -> 1 or red -> violet continuum. It's more apt to describe it
           | like a multi channel audio mixer. Many different channels
           | ("really into a specific topic", "freaks out at parties"),
           | each with their own value (10%, 20%).
           | 
           | Metaphors often fail though, so it might just be best to say
           | what we mean plainly.
        
             | darzu wrote:
             | RGB doesn't map to a single line, you're thinking just
             | about the hue. RGB is a proper vector that addresses a
             | whole 3D color space.
        
             | delecti wrote:
             | _An_ RGB value points to a single color, but if R is
             | "really into trains" and B is "repetitive behavior" and G
             | is "susceptibility to sensory overload", then it's
             | basically the same metaphor as a multi channel audio mixer,
             | except understandable to a different (and likely bigger)
             | pool of people.
        
               | dfxm12 wrote:
               | That line of reasoning doesn't follow as RGB implies
               | there are exactly three measures, which isn't the case.
        
               | jfindper wrote:
               | > _RGB implies there are exactly three measures_
               | 
               | It's a metaphor.
               | 
               | It helps people build an intuition. It doesn't need to be
               | exact to do that.
        
               | dfxm12 wrote:
               | It doesn't have to be exact, but it's counter productive
               | when it is clearly and meaningfully incorrect though.
               | That's the problem with the two dimensional [0,1] scale
               | as well.
        
               | jfindper wrote:
               | > _so obviously incorrect though_
               | 
               | I couldn't possibly disagree more.
        
               | delecti wrote:
               | That's just the limits of it being a metaphor. Audio
               | mixers also only have a finite number of channels, but
               | are also much less familiar to most people.
        
               | Aardwolf wrote:
               | "spectrum" encompasses any hue, not just those 3, any
               | wavelength of light can have a different amplitude
        
             | dragonwriter wrote:
             | > rgb values still points to a single color, which maps
             | back to a single value on a 0 -> 1 or red -> violet
             | continuum.
             | 
             | No, it doesn't. Wavelength is unidimensional, but color can
             | mix many wavelengths, and RGB is a 3d color system which
             | doesn't cover all combinations of visible light but does
             | approximate the way most human vision works, and is
             | therefore useful as a description for human-perceived
             | colors (and more accurate than picking a single point on
             | the unidimensional wavelength spectrum for that purpose.)
        
           | overfeed wrote:
           | > 1. A linear continuum (like wavelength for light) from "no
           | autism" to "really bad autism"
           | 
           | This is the least helpful metaphor, when applied to anything
           | with more than one dimension. "Really bad autism" can
           | describe a multitude of unique symptoms.and is nearly
           | information free, similar to describing someone as having "A
           | really serious illness"
        
             | brudgers wrote:
             | _For reasons_ I am compelled to comment that "really bad
             | autism" is not a medical description.
        
           | frereubu wrote:
           | To take the rbg metaphor further, it should really be a
           | "gamut" rather than a "spectrum".
        
             | giardini wrote:
             | Perhaps "big ball of mud"? "mess"? "cluster f*k"?
             | 
             | Arguing relevant metaphors in HN?! A new low...
        
               | echelon_musk wrote:
               | If this is a new low, that's news to me.
               | 
               | The top comment chain on the front page 'Plane crashed
               | after 3D-printed part collapsed' is nothing more than
               | arguing about metaphors. This happens _all_ the time in
               | just about every story.
        
             | munificent wrote:
             | "Spectrum" works too in that if you take white light and
             | split it in a prism, it is spread out into its separate but
             | overlapping components of light at different wavelengths.
        
           | sam_goody wrote:
           | Humans range across such spectrum that actually match all 3.
           | 
           | We range from being blind to having exceptional eyesight, so
           | we are all on a continuum.
           | 
           | But there are various subsets, such as color or light
           | sensitivity, far/nearsighted, better tracking of motion or
           | text - and these have their own subsets, such as the ability
           | to scan text quickly (or dyslexia), read a room better or see
           | things that require training (such as the details a race
           | driver immediately sees that you wouldn't). Someone with an
           | issue of vision usually finds himself in a cross of these
           | sets, borrowing tools form one to compensate for another
           | 
           | The same can be said for hearing, for height and weight, and
           | for any other physical, psychological or mental property we
           | have.
           | 
           | (I've always felt it odd that "spectrum" usually refers only
           | to Autism.)
        
           | andai wrote:
           | A small difference in quantity can become a radical
           | difference in quality. (Look at what happens if you cool or
           | heat water! Or the effect that small amounts of lag have on
           | UX, it goes from interactive to not.)
           | 
           | i.e. #3 here can be approximated as #2, and this can be
           | helpful.
           | 
           | But the really interesting thing is, with neuroplasticity and
           | skill training, you can make tiny adjustments to #3 which
           | produce a change in the set of #2, i.e. real differences in
           | quality and enjoyment of life.
        
           | fragmede wrote:
           | yeah my thoughts on this is to present it as a kivat diagram.
           | 
           | https://blog.onepatchdown.net/autism/2023/01/13/autism/
        
         | cardanome wrote:
         | The more correct way is to think about it as a prisms. It is
         | multi dimensional.
         | 
         | Also it is for autistic people. It grinds my gears when people
         | say "everyone is on the spectrum", no, just no. Again it is
         | only for autistic people and you need to have support needs to
         | be diagnosed with autism. You don't get a diagnosis for being
         | quirky and a little weird.
         | 
         | And no, just because someone is verbal and seems to be very
         | articulate does not mean the person has low support needs or
         | vice versa.
        
           | QuercusMax wrote:
           | I guess it depends on whether you consider RGB(0,0,0) to be
           | on the same spectrum as RGB(100,0, 100) or RGB(100, 150,
           | 100).
           | 
           | RGB(10,10,10) may be awfully dark but it's definitely not
           | black. On the spectrum doesn't necessarily mean you have
           | clinically relevant difficulties.
        
             | cardanome wrote:
             | The more helpful way to think about is that the
             | neurotypical brain is like RGB(63.32, 12.3, 73.02) but with
             | thousands or maybe millions of variables. If certain values
             | are significantly lower or bigger it might cause you
             | trouble.
             | 
             | Having Autism is one cluster of values you can have. So is
             | having ADHD. So is having Trauma. And many more things. And
             | you can and often have multiple things at once and their
             | symptoms overlap.
        
           | d1sxeyes wrote:
           | I find this take quite challenging, although I know it is one
           | shared by a lot of autistic people.
           | 
           | I understand that if a person has no support needs, they
           | cannot be diagnosed with autism. But that person may still be
           | neurodivergent, and therefore to me it seems to follow that
           | you have folks who are autistic with high support needs, and
           | folks who are autistic with low support needs. Then, you have
           | neurodivergent folks with no support needs. But this seems to
           | me like a difference in degree, rather than category, and
           | which would mean that the "spectrum" analogy works quite
           | well.
           | 
           | With a clear understanding that I am not trying to minimise
           | the struggles autistic people face, a sincere desire to
           | learn, and an open mind, would you mind trying to help me
           | understand?
        
             | cardanome wrote:
             | Autism is something you are born with. It is simply who you
             | are.
             | 
             | Support needs can change over time. You can need less help
             | because you learn better coping strategies and have a
             | stable environment or you can need more as you get older.
             | It is not fixed.
             | 
             | Support needs are denoted in level because that is what
             | system like schools and the like need. They don't really
             | map to reality. Like for example a autistic person can have
             | really bad sensory issues, being really sensitive to
             | sounds, restricted diet and the like but decent social
             | skill. Another autistic person might not have any sensory
             | issues but really struggle with social stuff. Who needs
             | more help? They need different kinds of help.
        
           | prepend wrote:
           | Everyone is on the spectrum, but only some are diagnosed with
           | autism spectrum disorder. So there's a tipping point or
           | dividing frequency in the spectrum that moves people into
           | disorder.
        
             | cardanome wrote:
             | Having Covid is a spectrum from having nearly no or even no
             | symptoms to having really bad symptoms. Just because
             | everyone experiences having a running nose from time to
             | time, does not mean everyone has Covid.
             | 
             | Autism is not the only way your brain can be different from
             | other people.
        
           | AnthonyMouse wrote:
           | > you need to have support needs to be diagnosed with autism.
           | You don't get a diagnosis for being quirky and a little
           | weird.
           | 
           | The problem is the people who actually have support needs are
           | often not in a stable job with great insurance, and then they
           | don't have access to the "get an official diagnosis"
           | machinery. At which point you have to choose between
           | respecting a self-diagnosis even if they're often wrong, or
           | not respecting it even if they're often right.
        
             | cardanome wrote:
             | Oh yes, absolutely. Self-diagnosis is valid.
             | 
             | It is still important to get a official diagnosis if one
             | can but yeah the reality is that it can be a very long
             | process and not in reach for some people.
        
         | brightball wrote:
         | Numerous people don't realize this or that there's not some
         | simple consistent blood test to say "yep, he's got autism."
         | 
         | Moreover, people have no idea how difficult this makes it to
         | properly test anything related to it because control groups are
         | so difficult. It's why any type of study that claims something
         | does or does not, definitively "cause autism" is highly
         | unlikely.
         | 
         | You can identify potential contributors, but that's about as
         | good as it gets.
         | 
         | People in absolutes about this stuff can't be taken seriously.
        
         | MichaelDickens wrote:
         | Isn't this a retcon? As I understand, autism was considered by
         | many to be a spectrum in the literal sense, and the "colors"
         | thing came later.
        
         | tshaddox wrote:
         | > It has always bothered me that by "spectrum" they mean not
         | the sort of continuous thing that spectra actually are, but
         | instead some disjoint set of "colors" any one of which might
         | describe a person.
         | 
         | Wasn't Newton making the point that we normally perceive and
         | treat colors as qualitatively different, but that they're in
         | fact caused by a single underlying mechanism that can take on
         | any of a continuous range of quantities?
         | 
         | Thus using the term "spectrum disorder" would be making
         | precisely the same point, to describe a set of apparently
         | qualitatively different disorders that are in fact caused by
         | some underlying mechanism with a range of quantities? (To be
         | clear, I don't know if any so-called spectrum disorders
         | actually meet this criterion, and it's probably more
         | complicated than that, but it seems to be the reason the term
         | was chosen.)
        
         | yunnpp wrote:
         | Why are you "on the spectrum" for pointing out the correct use
         | of the term?
         | 
         | As far as I can tell, everybody else is on some spectrum of
         | "idiot".
        
           | phantasmish wrote:
           | There's a whole genre of viral social media posts that amount
           | to lumping anyone who appears to have cared quite a bit about
           | something that's not obviously exciting (to most other
           | people) into the autism spectrum. Especially historical
           | figures. "This guy made tons of detailed beetle drawings and
           | cataloged them in books! See, there have always been autistic
           | folks, because he definitely was!"
           | 
           | Like I mean maybe, but also he was a bored rich aristocrat
           | before TV was invented, and sometimes there are no parties
           | going on or everyone's hiding in their country estates
           | because of a cholera outbreak or whatever, and "making
           | shitloads of drawings and organizing them" was like 50% of
           | scientific work at the time. So. Maybe he just had a lot of
           | time to kill.
           | 
           | Going by randos posting online, "liking things" and "knowing
           | stuff" and "caring about things" are all autistic traits when
           | present in any but the _tiniest_ of degrees. It 's
           | ridiculous.
        
           | bluerooibos wrote:
           | It's getting a tad out of hand. A friend "jokes" that I'm on
           | the spectrum fairly often any time I speak with any sort of
           | passion on topics in interested in or care about.
           | 
           | I feel social media has conditioned people to think of you're
           | anything other than bland and "normal" in your personality
           | and have any degree of uniqueness about you then you're on
           | the spectrum.
        
             | pixl97 wrote:
             | >then you're on the spectrum.
             | 
             | Sorties paradox. Everybody is on the spectrum, it's only
             | called out when it's noticeable.
        
         | ryandvm wrote:
         | It should just be called the "well actually spectrum".
        
         | IAmBroom wrote:
         | > "...they mean..."
         | 
         | It's always some anonymous "they". Those bad people. You know;
         | not reasonable folk like you and me. "Them".
        
         | humanfromearth9 wrote:
         | Isn't a spectrum limited to a single dimension? If yes, that
         | doesn't sound like Autism disorders (Asperger's, ADHD, verbal,
         | non-verbal, violence, exacerbated sensitivity, social
         | abilities...). They all suggest that there are multiple more or
         | less independent/orthogonal. dimensions. And everyone scores
         | differently on the combination of these dimensions. Which puts
         | us on different coordinates in a vector space. Is this still a
         | partition?
        
           | pixl97 wrote:
           | >Isn't a spectrum limited to a single dimension?
           | 
           | Typically no in the english language usage.
        
         | narrator wrote:
         | What you are witnessing is the process of "mystification" where
         | it requires an "expert" annointed by some organization to
         | interpret arbitrary criteria to make a politically or
         | economically important determination that can't really be
         | challenged on any objective basis. Since you are not an
         | "expert", you are not permitted to do your own research and
         | therefore by rule are incapable of being able to access the
         | special mystified knowledge that only the "expert" has access
         | to.
        
           | pixl97 wrote:
           | That, or it keeps non-expert snake oil sales people from
           | 'flat making shit up'.
        
       | photochemsyn wrote:
       | The Economist should not be treated as reliable source of
       | information on medical issues.
       | 
       | [edit] To be more specific, this is a lazy take and is about as
       | insightful as saying 'cancer should not be treated as a single
       | condition' which for HN is about as meaningful as saying 'the CPU
       | and the GPU may both contain chips, but they should not be
       | programmed the same.'
        
         | zzzeek wrote:
         | and times a hundred, Robert F Kennedy Jr., an absolute con
         | artist with no qualifications of any kind
        
       | mrguyorama wrote:
       | It is called "Autism spectrum disorder"
       | 
       | Disorder _by definition_ means that we do not consider it to have
       | a single cause or issue, and we acknowledge that we don 't
       | understand it well enough to give it a single name, cause, or
       | objective diagnostic criteria.
       | 
       | When we know what _causes_ something, or how to strictly and
       | objectively identify it, then we usually call it a _disease_.
       | 
       | This is well understood by medical professionals, and a normal
       | part of their job, and not confusing for the vast majority of
       | people diagnosed with some disorder or other.
       | 
       | This article is utter trash. As per the usual for the economist
        
         | Lendal wrote:
         | Thanks for that insight. I previously had only a vague notion
         | of why disorder is used. One of the main reasons I don't want
         | to have an official diagnosis is because the word disorder has
         | such a negative connotation. I really don't want any disorders,
         | so if I just ignore it, try not to think about it, maybe it
         | will go away, and then I won't have a disorder.
        
       | ilaksh wrote:
       | We don't have any geniuses or stupid people anymore -- just
       | autistic and ADHD.
       | 
       | Are you shy, slightly socially awkward and very intelligent? You
       | must be "on the spectrum".
       | 
       | The most intelligent, knowledgeable, socially tuned and socially
       | integrated people I see online claim to be autistic. I swear it
       | is absolute nonsense.
        
         | dontwannahearit wrote:
         | I think a lot of it is peverse incentives.
         | 
         | There are social (cut me some slack, I'm autistic) and in
         | socialized medicine systems, financial benefits to an autism
         | diagnosis. So yeah, why wouldn't you claim to be autistic,
         | what's the downside?
         | 
         | Add to that Gen-Z, socially awkward, isolated and poisoned by
         | their obessive phone addictions frantically searching the
         | internet "Why do I feel socially awkward?" and a million "Take
         | out autism test!" links later get their answer. Yes indeed,
         | they have autism, the test proved it.
        
           | JohnMakin wrote:
           | Autism is much more than social awkwardness, and I'm sure
           | you're not intending to be, but this post is extremely
           | dehumanizing and insulting to people dealing with the issues
           | that an ASD diagnosis typically presents with. and, by the
           | way, many high functioning individuals have to fight for
           | their entire lives to even get a diagnosis, so I'm not sure
           | where you're getting your information from that these are
           | being "handed out like candy" or whatever. I can point you to
           | a variety of sources online if you're interested in learning
           | what this actually is.
        
             | dontwannahearit wrote:
             | With respect, I am not insulting people dealing with the
             | issues of ASD diagnosis. Autism is real and can be
             | debilitating.
             | 
             | The comment I replied to said "...claim to be autistic" and
             | that is what I am refering to.
             | 
             | I am calling out self-diagnosing over vague feelings of
             | "feeling different" and on the basis of online tests.
             | 
             | Everyone who needs an autism diagnosis should get one. Not
             | everyone who wants one.
        
           | skippyboxedhero wrote:
           | Unfortunate you have been downvoted because this is
           | definitely the case. I am not actually sure that anyone
           | disagrees with this, UK governments on both the left and
           | right have identified this.
           | 
           | Ten years ago in the UK getting disability money for autism
           | meant being non-verbal, requires extensive in-home care,
           | unable to live independently, etc. Whatever you think about
           | the definitions, it is very clearly not the same now and
           | refers exclusively to some kind of social disorder. Rates of
           | the former haven't changed significantly, rates of the latter
           | are exploding.
           | 
           | When I say this, I don't think people understand the scale
           | here: in some regions of the UK as much 40% of primary-school
           | age children are disabled. Spending in this area is projected
           | to bankrupt many local governments...to be clear, these are
           | economic units with multi-billion pound budgets and
           | responsibility for basic societal functions. It is difficult
           | to understate the extent to which this is an issue.
           | 
           | I don't necessarily think people who engage in the over-
           | diagnosis are ill-meaning: individuals are being given money
           | to do this, psychologists are raking it in hand over fist,
           | and the UK is now a place with a very effective disability
           | lobby with lots of incentives to keep it all going. But it
           | remains true despite all of this that it cannot continue.
           | 
           | Just imo, the damage done already is close to irretrievable.
           | The situation in UK schools is dire: teachers are frequently
           | attacked physically (in some regions in the UK, this is so
           | frequent and so little support is provided because of the
           | inability to exclude "disabled" children that there are
           | frequent staff walkouts), typical classes have 5-6 ASD
           | assistants at all times, behaviour is so poor that other
           | children are unable to learn, parenting of these children is
           | non-existent because parents gain financially and the
           | incentives to blame a medical condition rather than poor
           | parenting are clear, etc. If you consider other trends, it is
           | dire...we are talking about most of the workforce entrants
           | coming out: many unable to speak English, can't perform basic
           | tasks without support, zero impulse control, usually claiming
           | benefits straight out of secondary...it is so bleak.
        
         | Dilettante_ wrote:
         | What's your thesis here? I'm getting "shy, slightly socially
         | awkward and very intelligent is _not_ what autism is, " _and_
         | "people who are intelligent, knowledgeable, socially tuned and
         | socially integrated claiming to be autistic must obviously be
         | lying, autistics could not possibly be those things."
         | 
         | These seem to contradict each other?
        
         | stronglikedan wrote:
         | > We don't have any geniuses or stupid people anymore
         | 
         | What planet are you talking about, because that does not align
         | with my daily experiences on Earth?
        
         | furyofantares wrote:
         | I am an autist in a family filled with autists - some of whom I
         | think you would CLEARLY recognize as autistic, but some of whom
         | you'd have this "absolute nonsense" reaction to. I say that
         | because that is the reaction I had myself, I was very skeptical
         | of this whole thing until I came to learn a lot about it after
         | my daughter was diagnosed.
         | 
         | I don't think it's mainstream science, but monotropism is a
         | theory of attention which has been theorized as the central
         | underlying feature of autism and you might be interested in
         | looking it up. It makes a lot of sense to me. I think the more
         | mainstream way of talking about it is bottom up processing
         | (details, the trees rather than the forest) vs top down
         | processing (holistic, the forest rather than the trees).
         | 
         | Either way - you can get a very diverse set of results
         | depending on how which sorts of things the individual's
         | attention gets commandeered by, and by how much. Some people
         | can't stop paying attention to individual sounds or individual
         | tactile sensations or any other individual sensation, some
         | people have difficulty putting sentences together despite
         | having an excellent grasp of each word, some get stuck trying
         | to process specific individual facial expressions and fail to
         | grasp the actual social dynamics going on around them - it goes
         | on and on.
         | 
         | Some have special interests (deep attention to a specific
         | topic) that are extremely economically profitable (programming)
         | or simply socially mainstream (music or movies) which give them
         | social cachet. Some have special interests that mark them as
         | weird and socially outcast (collecting bugs, memorizing bus
         | routes). Some are very intelligent and are able to make up for
         | a lot of difficulties with effort. Some have a great focus on
         | social dynamics and come off quite charming. All of this can
         | add up to very different experiences though life, very
         | different sets of difficulties, and that of course can
         | compound.
         | 
         | I think you should expect there to be a very wide variety of
         | autistic people, if there is an underlying similarity in
         | processing things. There is a very wide variety of non-autistic
         | people, too. Heck, I think there's a wide variety of people
         | with only one hand, just because Jim Abbott was a major league
         | baseball pitcher doesn't mean he actually had two hands, and
         | just because Muggsy Bogues was a great NBA player doesn't mean
         | he wasn't short.
        
         | driverdan wrote:
         | Just because you don't understand something doesn't mean it's
         | real. Spend a few hours to read about these topics and educate
         | yourself.
        
       | bolangi wrote:
       | Reacting to the headline, I understand the basic concept of
       | medicine is you treat a patient who presents with a condition,
       | not a condition in isolation like some kind of abstract math
       | problem. I think it's a mistake when doctors say to each other,
       | even as a shorthand, I have a gallbladder to deal with, when it's
       | a real person, and the best results come from considering the
       | whole person when pondering how to care for them and which
       | treatments to administer, with the medicine being only a part.
        
         | rusk wrote:
         | You are speaking commendably from the point of view of
         | diagnostics but from the point of view of physical operation
         | you absolutely need that specialisation.
        
       | jawns wrote:
       | The main argument in favor of treating it as a single condition
       | tends to come from the advocacy side, rather than from the
       | diagnostic side.
       | 
       | In terms of advocacy, there is strength in numbers, and arguably
       | having such a large autism community has been good for both
       | research and support. Potentially breaking that up into several
       | smaller communities might lead to an overall decrease in impact.
       | 
       | On the other hand, pretty much everyone with autism, or families
       | who have children with autism, will tell you that there is wide
       | variation in both severity and presentation. And I think most
       | would welcome better definition of subtypes.
        
         | pseudocomposer wrote:
         | I think "neurodivergence" is a better label if the goal is
         | gaining strength in numbers. It fully encompasses autism and
         | autism spectrum related conditions, plus ADHD and others. A lot
         | of people don't want the label "autistic," but share
         | experiences with people who do, and would love to offer
         | solidarity as an "inside" rather than "outside" member of the
         | community. We now have "AuDHD spectrum" as a thing, but really,
         | I think optimum numbers might come from including folks who
         | identify as "broadly neurodivergent."
         | 
         | It also leaves room to start distinguishing/separating out more
         | subtle variants of what we currently umbrella as "autism,"
         | perhaps making it better defined in the future. And I kind of
         | suspect doing this with "less profound" neurodivergencies could
         | help folks with "more profound" (and rarer) cases.
         | 
         | To look at a historical case: Gay Rights didn't make a lot of
         | headway. But adding lesbians, trans folks, etc. ultimately did
         | a lot of good for that community in the US.
        
           | reedf1 wrote:
           | I was recently labelled neurodivergent by a colleague at
           | work, as far as I can tell this is simply because I am good
           | with numbers and don't like parties. I'm not sure how I feel
           | about this, I wouldn't say I am Autistic or show any
           | representative characteristics.
        
             | cardanome wrote:
             | Autism or well any form of neurodivergence are about how
             | you work on the inside. It is not possible to observe how a
             | person behaves and just diagnose someone. That is why
             | getting a diagnosis is a whole process involving a trained
             | professional.
             | 
             | Your colleague is full of shit. Generally, neurodivergence
             | is for everyone who regularly experiences that the way
             | their brain works causes them trouble.
             | 
             | Self diagnosis is surprisingly accurate but people also
             | tend to under estimate the severity of their symptoms.
        
             | ACCount37 wrote:
             | Or so you think. Humans aren't any good at that whole
             | "self-awareness" thing.
             | 
             | Even the "no empathy" sociopaths can spend decades thinking
             | that they're perfectly normal, everyone is like them, and
             | people just pretend to be sad and grieving at the funerals
             | because that's some kind of established convention and
             | breaking it would be very rude.
             | 
             | What I'm saying is: maybe you just _think_ you don 't show
             | any signs of autism - because you think your experience is
             | "normal", and you think that everyone has the same
             | struggles as you do, even when it isn't true.
             | 
             | Or maybe you genuinely aren't autistic at all! It's just
             | very, very hard to say at a glance.
        
         | SubiculumCode wrote:
         | I have serious doubts that an autistic advocate with low
         | support needs, as opposed to 'neurotypicals' or impacted
         | parents, are meaningfully more qualified to represent the needs
         | of autistics with high support needs (e.g. severe intellectual
         | disability, nonverbal, severe self injurious behaviors). Those
         | autism are very very different with very very different lived
         | experiences....and yet, well-meaning autistic advocates often
         | bristle at that idea, almost as if it is an attempt to divide
         | and and destroy autistic advocacy. The neurodiversity vs
         | profound autism battle for hearts and minds continues to rage,
         | and even threatens how and what autism research gets
         | conducted...sometimes with good consequences, sometimes with
         | poor consequences.
         | 
         | I am a proponent of finding neurobiological bases for
         | subgrouping autism into different clinically meaningful
         | etiologies so that the debate can move forward productively.
         | Its one reason that more and more I'd rather forgo acquiring
         | non-autistic controls in my studies, but just look within the
         | autism sample for how to parse the heterogeneity into
         | homogeneous subsets
        
           | cardanome wrote:
           | > I have serious doubts that an autistic advocate with low
           | support needs, as opposed to 'neurotypicals' or impacted
           | parents, are meaningfully more qualified to represent the
           | needs of autistics with high support needs
           | 
           | You think a parent without any autism is more qualified to
           | speak than someone who has autism but a different cluster of
           | symptoms? Because being a parent makes you an expert on what
           | exactly?
           | 
           | The is a video of the spokesperson of autism speaks. Her
           | autistic child is in the room and can hear everything. She
           | talks about how bad it is for her to have an autistic child.
           | How she wanted to kill herself by driving down a cliff.
           | Again, while her autistic child is in the room. She is acting
           | like her child is not even a person.
           | 
           | Autism Speaks is a hate group of abusive parents.
           | 
           | Those advocates with low support needs are the ones that are
           | actually making an attempt to give those high support needs a
           | voice. Not by speaking for them but by taking down barriers
           | so that they can advocate for themselves. Because guess what?
           | High Support needs autistic people are still people.
           | 
           | Just because someone is non-verbal does not mean they can not
           | communicate in other forms. They can advocate for themselves
           | if given the tools.
           | 
           | Support needs are multi dimensional, one person might have
           | sensory issues, another no sensory issues at all but more
           | social issues. Who has more support needs? They are
           | different. And they can change. You can learn better coping
           | skills, you can need more or less support as you age.
        
             | anematode wrote:
             | The parents you talk about just seem like assholes.
             | 
             | > Those advocates with low support needs are the ones that
             | are actually making an attempt to give those high support
             | needs a voice.
             | 
             | Having low-support-needs autism is neither necessary nor
             | sufficient for being a good voice for others. In fact, it
             | can be a very bad thing, if they imply that the problems
             | they face are similar to problems faced by high-support-
             | needs folks. The focus in the media on low-support-needs
             | individuals gives people the wrong impression of the autism
             | spectrum's individual experience and broader societal
             | impact.
             | 
             | I think a better form of advocacy is the YouTube channel
             | "Special Books by Special Kids," which doesn't make a point
             | of the channel's author having a disability (no clue
             | whether he does), but rather just introduces viewers to a
             | broad variety of people.
        
             | GoatInGrey wrote:
             | > Autism Speaks is a hate group of abusive parents.
             | 
             | It's an indicator of the current state of affairs in the
             | social media autism space that the only organization
             | focusing on reducing the suffering of individuals with
             | higher levels of dysfunction (i.e. requires lifelong
             | support for basic needs) is demonized to this degree.
             | Though it also makes sense as the most disabled autistic
             | individuals do not post online.
        
         | cardanome wrote:
         | > The main argument in favor of treating it as a single
         | condition tends to come from the advocacy side, rather than
         | from the diagnostic side.
         | 
         | Seeing it as one single conditions is established scientific
         | consensus not some advocacy thing.
         | 
         | The diagnosis "Asperger's" was invented by Hans Asperger, a
         | Nazi scientist that was responsible for the murder of many
         | autistic children. It was never about science. It was invented
         | because he thought that some autistic children might have a
         | potential to become scientist and the like and therefore useful
         | to Nazi Germany and some might not.
         | 
         | Hans Asperger decided which autistic children should be
         | murdered and which one to be spared purely based on ideology.
         | 
         | Autism is something you are born with but support needs can
         | change over your life depending on many factors like you
         | environment, if you are diagnosed early and so on. They are not
         | fixed.
        
           | dragonwriter wrote:
           | > The diagnosis "Asperger's" was invented by Hans Asperger
           | 
           | No, it wasn't. The diagnosis of "autistic psychopathy", which
           | loosely corresponds to much of the range of the modern
           | diagnosis of autism spectrum disorder was invented by Hans
           | Asperger (Asperger does not seem to be the first to have
           | described the condition, though he invented that name; a
           | Societ doctor seems to have recognized a similar condition a
           | couple decades earlier.) The distinct separate diagnoses of
           | "Asperger's syndrome" was invented later (the term seems to
           | have first been used in 1976), and roughly corresponded to
           | the "higher-functioning" individuals within his diagnosis of
           | "autistic psychopathy" that Asperger described as potentially
           | socially useful.
        
       | bena wrote:
       | It's difficult because the variance is so wide.
       | 
       | To compare: Three profiles of people with diagnosed Autism.
       | 
       | Blindboy Boatclub: An Irish satirist who wears a plastic bag on
       | his head in public appearances. Formerly of a band called The
       | Rubberbandits. Today he is known for his podcast and has authored
       | three books of short stories. He comes across as eccentric, but
       | he's quite capable of managing in society otherwise.
       | 
       | Side note, one of the other members of The Rubberbandits went by
       | the moniker of Mr Chrome, but is better known to people as Bobby
       | Fingers today.
       | 
       | My stepson: Just a teenager navigating one of the more
       | emotionally turbulent times while being noticeably different. He
       | has fine motor issues and some social deficiencies. The best I
       | could describe it is that he's emotionally a few years behind
       | where other kids his age would be. He has few accommodations,
       | mostly extra time and the ability to leave a situation that is
       | overstimulating him. He's odd, probably always be a bit odd. May
       | never be able to tie his shoes, but with work, he should be able
       | to navigate society as a functioning adult one day.
       | 
       | Wife's student: My wife is a special education teacher and she
       | has a student who is completely non-verbal. However, he is
       | noticeably intelligent and can form complex thoughts and can
       | attempt to express them. Managed to use his visual communication
       | device to insult one of his teachers based on her appearance. He
       | will likely have issues for his entire life and will likely need
       | constant therapy.
       | 
       | Now, what one thing can we do for these three very different
       | autistic people?
       | 
       | There's a reason people say "When you've met one person with
       | autism, you've met one person with autism". While there are some
       | commonalities and typical comorbidities, what we regard as autism
       | presents in so many different ways, it's incredibly difficult to
       | construct a single program to address it.
       | 
       | And I can see why we'd want to break it up. But that gets
       | difficult as well. My stepson started low-verbal. Didn't speak
       | for a while. Spoke rarely for a while longer. And now he speaks a
       | lot. And he's learning when it is appropriate to speak and to
       | handle people speaking around him but not _to_ him. So he was
       | non-verbal. But then became verbal. But not all autistic children
       | cross that border.
       | 
       | All that to say: I dunno. Shit's complicated, yo.
        
         | toast0 wrote:
         | > My stepson: Just a teenager navigating one of the more
         | emotionally turbulent times while being noticeably different.
         | He has fine motor issues and some social deficiencies. The best
         | I could describe it is that he's emotionally a few years behind
         | where other kids his age would be. He has few accommodations,
         | mostly extra time and the ability to leave a situation that is
         | overstimulating him. He's odd, probably always be a bit odd.
         | May never be able to tie his shoes, but with work, he should be
         | able to navigate society as a functioning adult one day.
         | 
         | As someone with some similar issues, a) my motor skills _are
         | fine_ , b) the focus on tieing shoes is so frustrating; velcro
         | shoes are everywhere, you can even get Dr. Martens high boots
         | with zippers so you don't have to tie them... like sure, try
         | laces and if it works great... but just provide the
         | accommodation and move on. :P
         | 
         | On the plus side, everyone said playing video games would help
         | my fine motor skills, so I got an out to play a lot of video
         | games, which I enjoyed. :D And my atrocious penmanship hasn't
         | been an issue in adult life, because nobody writes anything
         | anymore (and have you seen the penmanship for kids that were in
         | 2-4th grade during covid ... it's worse than mine!)
        
       | BurningFrog wrote:
       | Autism seems more like a symptom than a condition.
       | 
       | "Stomach ache" is not a spectrum disorder, even though is comes
       | in many severities. It's a _symptom_ of dozens of different
       | medical conditions.
       | 
       | I suspect "autism" is similar.
        
         | jermaustin1 wrote:
         | Autism isn't a symptom because Autism Spectrum Disorder isn't a
         | singular "thing" it is a combination of features that manifest
         | in various "symptoms" - eye contact avoidance (or the
         | opposite), sensory processing (over- or under-stimulating),
         | restrictive interests (singular focus), etc.
         | 
         | A stomach ache is a single manifestation of something
         | happening. A stomach ache can have varying degrees and reasons
         | behind it. The stomach ache is the signal. The disorder that
         | causes it could be psychological (GAD) or external (someone
         | punched you, and the flesh is bruised) or internal (someone fed
         | you a weeks old egg salad sandwich).
         | 
         | In autism the 'symptom' could be model train enthusiasm or
         | being nonverbal. There are a lot of symptoms the fit under the
         | umbrella of the disorder.
        
       | pseudocomposer wrote:
       | I've long thought that autism is basically a few thousand very
       | normal, small neurodivergencies (which may each be compounded
       | with social effects). The absence of any of them is "perfect
       | functioning human cog/prime chunk of workmeat."
       | 
       | The presence of too many/particular ones of them is notably
       | disabling for certain tasks, or makes perceiving some things
       | difficult (and other things easier). But I think the presence of
       | _some_ is preferable to having none, and implies "can think
       | abstractly for /about oneself."
       | 
       | (And yes, a lot of the "problems" that arise with folks on the
       | spectrum happen because, well, being aware of yourself as a
       | cog/workmeat creates friction... It's important to keep in mind
       | how much of our history of psychological medicine that created
       | the label "autism" is ultimately oriented towards "fixing the
       | cog/workmeat.")
        
       | ThinkBeat wrote:
       | This is highly accurate. Presently its a whole set of entirely
       | different diagnosis make up "the spectrum".
       | 
       | They even eliminated "Asperger" and then just folded that into
       | the spectrum as well.
       | 
       | I sometimes think about two women sitting on down on a bench.
       | Once says a bit uneasily "my son, well he is on the spectrum" The
       | other responds with "Oh I know what you are going through my
       | daughter is also on the spectrum"
       | 
       | At this point neither has any idea whatsoever about what the
       | others experience is like.
       | 
       | One may be highly functional, socially awkward and doesn't think
       | like normal people and processes sight and sounds the same. I
       | find myself moderately down this path.
       | 
       | The other may be non verbal and violent.
        
         | cardanome wrote:
         | If you have met one person with autism you have met one person
         | with autism.
         | 
         | This is true for anything else and no argument against the
         | current diagnosis.
         | 
         | There are people with Covid that ended up in the hospital and
         | people with Covid who barely had any symptoms. Both have Covid.
         | 
         | Autism doesn't work from "little autism" to "a lot of autism".
         | One person can have strong sensory issues but decent social
         | skills. Another bad social skills but not sensory issues at
         | all. And care needs can change over your life, they are not
         | fixed.
        
           | suddenlybananas wrote:
           | The crucial difference is that we know the etiology of COVID
           | and so are justified in treating those two people as having
           | the same disease. Autism is much more complicated because we
           | don't have a thing to define it other than a bunch of
           | disparate symptoms.
           | 
           | It might turn out like if we treated the cold, COVID,
           | tuberculosis and lung cancer as the same thing because they
           | all involve coughing.
        
       | ChrisArchitect wrote:
       | Previously: https://news.ycombinator.com/item?id=45451103
        
       | dr_dshiv wrote:
       | Autism was split into autism and Asperger's.
       | 
       | But calling people with social challenges "Assburgers," I mean,
       | wow. Just wow.
        
         | lcnPylGDnU4H9OF wrote:
         | > Asperger's
         | 
         | This term has a complicated history so people use "high-
         | functioning" now. Many refer to Hans Asperger as a Nazi
         | eugenicist. Reasonably, I'd say.
         | 
         | https://en.wikipedia.org/wiki/Hans_Asperger#Children_sent_to...
         | 
         | https://en.wikipedia.org/wiki/Am_Spiegelgrund_clinic#Experim...
         | 
         | > Just as the physician must often make painful incisions
         | during the treatment of individuals, we must also make
         | incisions in the national body, out of a sense of
         | responsibility: we must make sure that those patients who would
         | pass on their diseases to distant generations, to the detriment
         | of the individual and of the Volk, are prevented from passing
         | on their diseased hereditary material
        
       | wslh wrote:
       | https://archive.is/zOQv5
        
       | prepend wrote:
       | I've been using "autism that I care about" because a large number
       | of people I encounter are on the spectrum / neurodivergent
       | (hobbies and work I suppose) that require very different
       | interventions and accommodations that people with whatever you
       | call significantly affected people with autism are called (eg,
       | Rain Man, etc).
       | 
       | Not that people low on the spectrum aren't important, they are,
       | but that just using standard interaction tactics that I would
       | with non-spectrum people works well enough.
       | 
       | So trying to save time that someone doesn't need to interrupt the
       | conversation to say they are on the spectrum and can only eat
       | smooth foods or whatever.
        
       | austin-cheney wrote:
       | The article does not mention Pathological Demand Avoidance as a
       | form of autism. Everybody avoids chores they don't like, but
       | people with PDA take it an extreme. For somebody to have PDA
       | enough that it becomes a shade of autism the world exists only in
       | the form of _I want_ and _I don 't Want_ so much so that it
       | limits the imagination and perceptions of the world.
       | 
       | For example somebody with PDA autism cannot interpret the
       | nonverbal communications of other people because they have
       | already made the immediate decision that they want to be liked by
       | others, so therefore they are. They cannot try new foods because
       | they may not like it if they do try, so therefore they don't like
       | it already. They would rather suffer hours of punishment grounded
       | in their room than accomplish a 2 minute chore, because they
       | already know in advance they would prefer to not do the chore
       | given a choice to not do it.
       | 
       | People with PDA autism often appear to be sociopaths and
       | pathological liars. They are not either of those things, due only
       | to a minor difference in motivation. Sociopaths don't care if
       | somebody else gets hurt so long as they get what they want, while
       | harm to others does impact somebody with PDA in a very normal
       | way. Since they have no capacity for empathy and color every past
       | observance to fit their world definition of saving face it takes
       | a lot of time with a PDA person to see the distinctions between
       | them and a sociopath.
        
       | nathias wrote:
       | I think we will slowly come to understand that we all start
       | neurodivergent and only some people converge.
        
         | IAmBroom wrote:
         | Ironically very accurate for an _en vogue_ theory of how autism
         | occurs.
         | 
         | Babies are born with many more neural connections than most
         | adults have. The learning process appears to include a
         | "winnowing" process. OTOH, autistic individuals appear to have
         | a larger number of neural connections, which suggests that they
         | did in fact "not converge" (or not weed out excessive
         | connections that distract from more productive decision-
         | making).
        
       | creatonez wrote:
       | This is an idiotic media talking point not actually reflected in
       | the clinical evidence. Unifying autism diagnosis under the ASD
       | label was not a mistake, for a lot of reasons.
        
       | squidsoup wrote:
       | I'm concerned that the identification of genetic subtypes of ASD,
       | as mentioned in the article, will lead to more terminations of
       | pregnancy. We need people that see the world differently.
        
         | scythe wrote:
         | The most easily identified "autism genes" (eg "fragile X") tend
         | to lead to severe variants of the condition, which probably
         | don't benefit anyone. We may eventually have a "Gattaca
         | problem" but this isn't that, at least not yet.
        
       | carlCarlCarlCar wrote:
       | Autism emerges from higher intelligence:
       | https://pmc.ncbi.nlm.nih.gov/articles/PMC4927579/
       | 
       | If anyone must be branded atypical (not saying anyone should but
       | am willing to pushback on those who do) and in need of special
       | attention it should be the historical story-mode dependent who
       | cannot move on from childhood allegory.
        
       | ianberdin wrote:
       | I have some sort of it and I built an AI tool to help myself to
       | get emotional intelligence.
       | 
       | https://getpartner.ai
        
       | tiberriver256 wrote:
       | YES PLEASE.
       | 
       | This actively harms diagnostics and encourages cure-all peddlers.
       | 
       | Definitely has been good for financial benefits and such but...
       | Once someone gets the "autistic" diagnosis all further research
       | stops.
        
       | LoganDark wrote:
       | This preprint inspired me greatly:
       | https://www.thetransmitter.org/spectrum/untangling-biologica...
       | 
       | It looks like this article is talking about that exact preprint,
       | but a quick skim didn't reveal any sort of link.
       | 
       | Ever since I first read it, I've been training myself to identify
       | the subtypes. I don't have good names for them, nor do I know how
       | they correspond to the names in the preprint, but I can usually
       | tell them apart. I have indeed seen exactly four.
       | 
       | I would love for there to be more research into the intricacies
       | of each subtype, because I feel that care and accommodation could
       | get a lot more personalized and helpful if there were less of
       | "anything goes / anything could happen" and more specialization
       | to what's most likely to be effective for each particular
       | subtype. As it is, a lot of care programs or individuals
       | supporting them may be specialized to an unknown degree to
       | particular subtypes and not really understand how to become less
       | specialized or even specialize further.
       | 
       | On top of that, I greatly want to understand better the subtypes
       | other than my own, not least because a couple of them I can find
       | very difficult to communicate with because my knowledge and
       | arguments are formatted differently than how they learn. I want
       | to learn how to format my knowledge in a way that's easier for
       | them to understand and more convincing for them.
       | 
       | I'm just very curious and interested and I really hope the idea
       | of autistic subtypes takes off because it absolutely agrees with
       | what I've seen in practice.
        
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