16 ms·

Autism severity can change substantially during early childhood, study suggests

175 points by EndXA 6y ago

SubiculumCode 6y ago
I am part of the research team that collects and analyses this dataset, although I am not an author on this particular analysis. Feel free to ask me any questions.
- vegetablepotpie 6y ago
  Thank you for coming on. This quote caught my attention: >The fact that more of the girls appear to have decreased in autism severity may be due to an increasing number of girls who have learned how to mask their symptoms. What hypothesis exist to explain this gender disparity?
  - SubiculumCode 6y ago
    The gender disparity in autism prevalence is one of the big mysteries of autism since genes associated with autism risk are not generally located on the XY sex chromosome. There are a number of hypotheses out there for the disparity of prevalence. One hypothesis is that the disparity is more apparent than real: That girls are better at masking/adapting to their symptoms, and thus more frequently escape diagnosis. The first step is to determine the extent to which this is true. If true, the underlying mechanism would need to be understood...some have suggested this could be related to greater inter-hemispheric connectivity in girls.
    - watwut 6y ago
      I think that question is, why are girls better at masking/adapting symptoms? Regardless of whether autism is more prevalent in girls, what it is about being girl that makes you mask better.
      - bondarchuk 6y ago
        I've always wondered about this one: symptoms of autism are closer to the expected behaviour of girls than that of boys.
        Jare 6y ago
        I touched on this in a nearby comment, but: I think that works, but only for the somewhat milder symptoms.
      - TeaDrunk 6y ago
        There is significant pressure on girls to behave in a manner that an adult might (quieter, more sociable, smiling, tolerant of situations) and significant pressure not to behave in an outwardly or rowdy manner (stimming, being hyperactive, responding in upset at being overstimulated, responding to sensory displeasure by rejection, etc).
        watwut 6y ago
        I thought that autistic cant be pressured away from symptoms?
        vulcan01 6y ago
        I think the parent comment is trying to say that the symptoms can be 'pressured away' by pressuring the child into masking their symptoms.
    - Jare 6y ago
      It would seem to me that masking works to a point (towards the "highly functioning" side of the spectrum), and once you get to the ways in which autism blocks ability to perform certain common behaviours and activities (e.g. non-verbal), the gender percentages should get closer again, because there's no masking to hide them or social expectations that they match. Is this the case?
      - nicoburns 6y ago
        I've seen research that suggests that estrogen could mitigate symptoms of autism, which could also explain a gender difference: - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193073/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193073/ - https://www.spectrumnews.org/news/estrogen-reverses-autism-like-features-in-mice/ https://www.spectrumnews.org/news/estrogen-reverses-autism-l...
      - SubiculumCode 6y ago
        It should be noted that this research sample, as opposed to many autism samples, includes autism with non-verbal, and severe intellectual disability phenotypes of autism, phenotypes not always captured in neuroimaging research of adults due to compliance issues (We collect neuroimaging data while participants sleep in the scanner).
    - fragmede 6y ago
      My hypothesis is that there's is a simpler, more-cultural answer, which is that girls with autism simply aren't diagnosed at the same rate that boys with autism are.
      - SubiculumCode 6y ago
        That is certainly one of the hypotheses in the mix. Personally, I think it accounts for some, but not all of the disparity.
- cmehdy 6y ago
  Out of curiosity, what is the basis for the idea that girls have an ability to camouflage or hide their symptoms better than boys? While trying to find information about this, I came across this meta-analytic review of gender differences in emotion expression in children[0], but without being in the field it's hard to make a link between emotion expression and ASD symptomatology. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597769/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597769/
  - SubiculumCode 6y ago
    Camouflage is just one of the potential hypotheses out there, and the one with which I am least familiar. There are ideas about increased social-cognitive abilities in girls, allowing more effective masking/adaption. But it can also be the case that it is not merely camouflaging symptoms, but actually neural adaption and compensation that reduce or even eliminate symptoms. It could be that girls receive more social support than boys, and the one thing we do know about autism during early childhood is that early behavioral interventions can improve quality of life outcomes.
- lionheart 6y ago
  Were there any correlations in this study between changes in severity of symptoms and therapies such as ABA?
  - SubiculumCode 6y ago
    This dataset did not include a controlled therapy intervention. Community therapy of a multitude of varieties probably occurred.
- gwern 6y ago
  I have a question: how do their analyses account for regression to the mean? The headline sex and IQ differences look exactly like regression to the mean to me: https://www.reddit.com/r/science/comments/gtvoan/around_30_percent_of_young_children_with_autism/fsfm3pu/ https://www.reddit.com/r/science/comments/gtvoan/around_30_p...
  - SubiculumCode 6y ago
    Generally, in longitudinal analysis, three data points are the minimum required to fit a line while guarding against reversions to the mean. The lead author is currently assessing data with a third longitudinal timepoint of the ADOS severity measure. That said, the research article tried to guard against this problem by defining the minimum amount of change to be considered a reliable change i.e. a Reliable Change Index statistic (RCI; Jacobson and Truax 1991), which is, in Latex: RCI_{{Z\,SCORE}} = \frac{{({\text{ADOS}}\,{\text{CSS}}{\mkern 1mu} {\text{Time}}{\mkern 1mu} 3 - {\text{ADOS}}\,{\text{CSS}}{\mkern 1mu} {\text{Time}}{\mkern 1mu} 1)}}{{\sqrt {2\left( {SD\sqrt {1 - r_{{xy}} } } \right)^{2} } }} which takes into account test-retest reliability correlations. Roughly speaking, this meant the the change groups ended up changing dX>+2 or dX<-2 on a 0-10 ADOS severity scale (4 is usually the clinical threshold for ASD diagnosis), while the no change group was defined roughly as between -2<dX<+2. Furthermore, in data I did help analyze which is currently included in a journal submission, the change groups defined here exhibited altered longitudinal trajectories of white matter fractional anistropy and diffusivity, suggesting biological relevance one might not expect with a statistical reversion to the mean.
    - gwern 6y ago
      I see. > suggesting biological relevance one might not expect with a statistical reversion to the mean. Just going to note here that regression to the mean is not 'just' statistical. It happens any time two variables are not perfectly correlated. The imperfect correlation could be due just as easily to 'biological relevance' as it could be to some sort of more purely statistical random error like rater error, so pointing out biology is no evidence. (As in the classic example of the flu patient going to the doctor and recovering afterwards; they really were biologically sick and really did biologically recover.)
kstenerud 6y ago
> The study also found that IQ had a significant relationship with change in symptom severity. Children with higher IQs were more likely to show a reduction in ASD symptoms. This is important information. People of higher intelligence would be more likely to learn things, such as how to mask effectively. I learned to mask so well that most people are shocked to learn that I'm autistic. It takes about 6 months of constant exposure for someone to get creeped out and dislike me, to the point that I wonder if I've done myself a disservice with my masking habit.
- scandox 6y ago
  Presumably they're creeped out because they believe your emotional responses are simulated and that your engagement in phatic discourse is inauthentic? But how they can they tell the difference? And even if they can how do they know that this isn't also true of everybody else, only that others are superior fakers? How can they even know that their own responses are authentic? I ask because I'm really not sure about this in my own mind.
  - krageon 6y ago
    Being "creeped out" is mostly a function of instinct. It's something you feel in your gut (or wherever instinct lives for you). This means that if you do not have it, it's hard to explain. The questions you are asking sort of miss the point, there's plenty of ways people can explain their instinct but at the end of the day it's not really a conscious process. If you don't have the same instincts as some people have, I suppose it would be natural to end up with the questions you do. What's important to remember is that they don't have the answers either. If you really want an explanation that may or may not be true, in my personal experience I can tell that things are simulated or inauthentic unless (as you say) they're being simulated by an extremely competent actor (in the sense that they are acting). Even with people who act very competently, there are always (at least, I've never met an exception) small indicators over time that feel a little wrong. You can't act 24/7, so the longer people interact with you (if you are acting) the more likely it is they'll see you slip up. This isn't really a problem, as the experience of getting to know someone naturally tends to lead to you seeing them in an entirely different light. The trick is figuring out when to show some authentic drive of yourself and when to present a socially desirable composite. That trick is something you learn by making a lot of mistakes (or if there's some rule to it, I have no idea what it is). If you don't consciously stop acting at some point and people see through it on their own, then it becomes creepy. The ideal is to head that off and figure out together if you are compatible personality types.
EndXA 6y ago
Study abstract: > Autism symptom severity change was evaluated during early childhood in 125 children diagnosed with autism spectrum disorder (ASD). Children were assessed at approximately 3 and 6 years of age for autism symptom severity, IQ and adaptive functioning. Each child was assigned a change score, representing the difference between ADOS Calibrated Severity Scores (CSS) at the two ages. A Decreased Severity Group (28.8%) decreased by 2 or more points; a Stable Severity Group (54.4%) changed by 1 point or less; and an Increased Severity Group (16.8%) increased by 2 or more points. Girls tended to decrease in severity more than boys and increase in severity less than boys. There was no clear relationship between intervention history and membership in the groups. The study can be found at: https://link.springer.com/article/10.1007/s10803-020-04526-z https://link.springer.com/article/10.1007/s10803-020-04526-z
DyslexicAtheist 6y ago
my son had a couple of very annoying years between 4-7 where he would seem behind compared to other kids on certain things such as motor skills and physical (hand/leg) coordination. he was also huge for his age, like trapped in a larger child's body. when it was time to send him to school our neighbors who knew him (because he hung out with their kid) suggested to send him to an IQ test because they figured he might be highly intelligent ("same as their kid"). they believed that their own son was very bright too but I thought it's only because both parents were closer to 50 than to 20. their child also had no real children friends and mixed mostly with adults - hence also talked like an adult (and seemed smarter than average for that reason alone - he was total sh1t with being a kid though but he knew how to recite grown up books and read/write long before school ...) anyway - bear with me, I promise to connect these things eventually we sent our son to do an IQ test and it came back inconclusive. we were told to test him again in a years time. (he was a mixed kids growing up with 3 languages which might also have altered how he performed on the test). Long story short he had a difficult first year in school with the teachers telling us that either a) he is too smart and should be moved forward a class, or b) he needs to go to a special school because he is dumb, or c) he should probably be tested for both autism and ADD. We decided to do none of the above and give it another 2 years to see how it play out. Eventually he settled into his surrounding and turned out one of the best students in class. another case: my best friend's kid is diagnosed with autism ("somewhere on the spectrum" they say). He is incredibly active for his age and more than other kids. His parents who are both very ill (ALS and MS) are used to seeing a doctor every few weeks to get injections, ... they have more exposure to doctors than to any other grown ups in their life, and meanwhile their friends are also all people who have "sick" kids. Whenever I play with the kid I think he is pretty normal, except for that he is a lot smarter than anyone else. Like a smart boy stuck in a smaller childs body. Another example: my gf is a nurse and occupational therapist. she literally works with disabled kids who are on the spectrum, have down-syndrome, cerebral palsy (to name the most common problems). She says if somebody has autism you can sure as hell tell. There is no "maybe", or "somewhere on the spectrum"- yes some cases are milder but she thinks that some doctors just diagnose and presribe solutions for things they don't fully understand themselves. could it be that a lot of these kids simply go through stages in their childhood at different speeds? like not every kid fits into our "systems-thinking" model and maybe totally grows out of it a year later? The horrid thing here is that the moment way start treating their behavior as a disease it has good potential to actually become one, ... which brings me to the last example. I worked with a US company remote. we were all on Jitsi every day even we weren't meeting so the mgmt could keep tabs (this was the rule for some reason). The assistant to the CEO a mid 30ies lady insisted that her child had autism. She constants forgot to switch her mic to mute and I could see how she talked to that child. He would get regular slaps in the face and get screamed at - then he would be told to take his meds. Also I think they might have been on some deal where they get benefits because their kids was "disabled". idk what to make of this but the whole medical profession seems like a racket to me. especially in the US (where this disease seems more of a fashion than anything) ... I hope these kids don't wake up one day and realize the crimes that have been committed against them. I'm glad I put my foot down and not put my child on pills (just to put money in some idiotic Dr. med. pocket). I would have destroyed my child! (and I see what it's like whenever I look at my best friends kid!
JacksonGariety 6y ago
I have high-functioning autism. Does anyone have some suggestions for making and keeping friends? When I meet a friend, things seem to go really well at first, and then my friend seems to slowly get bored of the interactions we have, and after a couple months I just don't hear from them again. Not sure what I'm doing wrong. Is there a scientific way to find out?
- forgotmypw17 6y ago
  Every day, try to think of something you can share with them, and then do it. Some ideas: Tell them about what made you smile that day. Neat moments that you appreciated, but they weren't there to share it with you. Food and drink. Whatever you're eating and enjoying, share it with that friend. Either invite them out or bring/send it to them. Text, pictures, and video. Funny and positive, no drama, politics, etc. Experiences. Think of something you like to do that can be shared, and invite them out to do it. Share your time and effort. Offer your help, once, maybe twice. Don't be pushy with it. If they accept, help them like a servant, doing exactly what they ask you. The basic idea is to consistently repeat the combination of "spending time together with you" and "day is improved". If you do one of these daily with five people for a month, I can almost guarantee you will end up with at least one friend. After that, you can focus on that one person more for a month to deepen your friendship. After that, add a few more people, but maintain friendship with the one person.
- kstenerud 6y ago
  I'm not sure if this helps, but after 45 years as a stranger in a strange land, the only friends I've managed to keep longer than a year have been autistic themselves. My wife is also autistic, and we both marvel over how, for the first time ever in our lives, our home is our sanctuary where we can just relax and be completely ourselves with all the weirdness that entails. All previous romantic relationships were stressful and ended badly because it felt like I was walking on eggshells, and couldn't understand why my SO kept getting upset. My wife had similar experiences in past relationships.
  - bsder 6y ago
pgt 6y ago
What if all children start off as autistic and gradually develop situational and emotional awareness? Some never do.
- wozer 6y ago
  If that is true, it must happen very early. Some two year olds are already extremely non-autistic.
  - Lammy 6y ago
    Two years old is well past "very early" development stages.
    - hanniabu 6y ago
      What constitutes very early? 6 months? 2 months?
      - Lammy 6y ago
        https://www.cdc.gov/ncbddd/actearly/milestones/index.html https://www.cdc.gov/ncbddd/actearly/milestones/index.html
  - pbhjpbhj 6y ago
    Parents in the UK will some times describe a child as "flirty", it has nothing to do with sexuality - to head that one off. They have learnt, by only a few months old, to attract attention of adults by using facial expressions, coos, and such. They certainly seem to be the other end of the spectrum wrt commanding social interaction. But I'd suspect it's more that most children have the capacity but a few just happen upon the formula early. Like we mostly have capacity to walk but some take 14 months then just get up and walk, whilst others are walking at 8 months when they can barely raise their heads; and others are crawling backwards, or shuffling on their bums because walking didn't click quite so quickly.
    - 6y ago
conistonwater 6y ago
How do studies like this take regression to the mean into account? Seems like a hard problem.
stretchwithme 6y ago
I've read recently that supplementing zinc and sulforaphane can help autism. Is there any truth to that? Anyone have personal experience trying either?
- chownie 6y ago
  n=1 obviously I take a multivitamin with 15mg zinc in it, as far as I can tell none of the autism specific symptoms are affected. The biggest difference is that I feel sleepy in the afternoons when I take zinc, when I don't take it I feel more awake but less rested.

175 points by EndXA 6y ago

I am part of the research team that collects and analyses this dataset, although I am not an author on this particular analysis. Feel free to ask me any questions.

vegetablepotpie 6y ago
Thank you for coming on. This quote caught my attention: >The fact that more of the girls appear to have decreased in autism severity may be due to an increasing number of girls who have learned how to mask their symptoms. What hypothesis exist to explain this gender disparity?
- SubiculumCode 6y ago
  The gender disparity in autism prevalence is one of the big mysteries of autism since genes associated with autism risk are not generally located on the XY sex chromosome. There are a number of hypotheses out there for the disparity of prevalence. One hypothesis is that the disparity is more apparent than real: That girls are better at masking/adapting to their symptoms, and thus more frequently escape diagnosis. The first step is to determine the extent to which this is true. If true, the underlying mechanism would need to be understood...some have suggested this could be related to greater inter-hemispheric connectivity in girls.
  - watwut 6y ago
    I think that question is, why are girls better at masking/adapting symptoms? Regardless of whether autism is more prevalent in girls, what it is about being girl that makes you mask better.
    - bondarchuk 6y ago
      I've always wondered about this one: symptoms of autism are closer to the expected behaviour of girls than that of boys.
      - Jare 6y ago
        I touched on this in a nearby comment, but: I think that works, but only for the somewhat milder symptoms.
    - TeaDrunk 6y ago
      There is significant pressure on girls to behave in a manner that an adult might (quieter, more sociable, smiling, tolerant of situations) and significant pressure not to behave in an outwardly or rowdy manner (stimming, being hyperactive, responding in upset at being overstimulated, responding to sensory displeasure by rejection, etc).
      - watwut 6y ago
        I thought that autistic cant be pressured away from symptoms?
        vulcan01 6y ago
        I think the parent comment is trying to say that the symptoms can be 'pressured away' by pressuring the child into masking their symptoms.
  - Jare 6y ago
    It would seem to me that masking works to a point (towards the "highly functioning" side of the spectrum), and once you get to the ways in which autism blocks ability to perform certain common behaviours and activities (e.g. non-verbal), the gender percentages should get closer again, because there's no masking to hide them or social expectations that they match. Is this the case?
    - nicoburns 6y ago
      I've seen research that suggests that estrogen could mitigate symptoms of autism, which could also explain a gender difference: - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193073/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193073/ - https://www.spectrumnews.org/news/estrogen-reverses-autism-like-features-in-mice/ https://www.spectrumnews.org/news/estrogen-reverses-autism-l...
    - SubiculumCode 6y ago
      It should be noted that this research sample, as opposed to many autism samples, includes autism with non-verbal, and severe intellectual disability phenotypes of autism, phenotypes not always captured in neuroimaging research of adults due to compliance issues (We collect neuroimaging data while participants sleep in the scanner).
  - fragmede 6y ago
    My hypothesis is that there's is a simpler, more-cultural answer, which is that girls with autism simply aren't diagnosed at the same rate that boys with autism are.
    - SubiculumCode 6y ago
      That is certainly one of the hypotheses in the mix. Personally, I think it accounts for some, but not all of the disparity.
cmehdy 6y ago
Out of curiosity, what is the basis for the idea that girls have an ability to camouflage or hide their symptoms better than boys? While trying to find information about this, I came across this meta-analytic review of gender differences in emotion expression in children[0], but without being in the field it's hard to make a link between emotion expression and ASD symptomatology. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597769/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597769/
- SubiculumCode 6y ago
  Camouflage is just one of the potential hypotheses out there, and the one with which I am least familiar. There are ideas about increased social-cognitive abilities in girls, allowing more effective masking/adaption. But it can also be the case that it is not merely camouflaging symptoms, but actually neural adaption and compensation that reduce or even eliminate symptoms. It could be that girls receive more social support than boys, and the one thing we do know about autism during early childhood is that early behavioral interventions can improve quality of life outcomes.
lionheart 6y ago
Were there any correlations in this study between changes in severity of symptoms and therapies such as ABA?
- SubiculumCode 6y ago
  This dataset did not include a controlled therapy intervention. Community therapy of a multitude of varieties probably occurred.
gwern 6y ago
I have a question: how do their analyses account for regression to the mean? The headline sex and IQ differences look exactly like regression to the mean to me: https://www.reddit.com/r/science/comments/gtvoan/around_30_percent_of_young_children_with_autism/fsfm3pu/ https://www.reddit.com/r/science/comments/gtvoan/around_30_p...
- SubiculumCode 6y ago
  Generally, in longitudinal analysis, three data points are the minimum required to fit a line while guarding against reversions to the mean. The lead author is currently assessing data with a third longitudinal timepoint of the ADOS severity measure. That said, the research article tried to guard against this problem by defining the minimum amount of change to be considered a reliable change i.e. a Reliable Change Index statistic (RCI; Jacobson and Truax 1991), which is, in Latex: RCI_{{Z\,SCORE}} = \frac{{({\text{ADOS}}\,{\text{CSS}}{\mkern 1mu} {\text{Time}}{\mkern 1mu} 3 - {\text{ADOS}}\,{\text{CSS}}{\mkern 1mu} {\text{Time}}{\mkern 1mu} 1)}}{{\sqrt {2\left( {SD\sqrt {1 - r_{{xy}} } } \right)^{2} } }} which takes into account test-retest reliability correlations. Roughly speaking, this meant the the change groups ended up changing dX>+2 or dX<-2 on a 0-10 ADOS severity scale (4 is usually the clinical threshold for ASD diagnosis), while the no change group was defined roughly as between -2<dX<+2. Furthermore, in data I did help analyze which is currently included in a journal submission, the change groups defined here exhibited altered longitudinal trajectories of white matter fractional anistropy and diffusivity, suggesting biological relevance one might not expect with a statistical reversion to the mean.
  - gwern 6y ago
    I see. > suggesting biological relevance one might not expect with a statistical reversion to the mean. Just going to note here that regression to the mean is not 'just' statistical. It happens any time two variables are not perfectly correlated. The imperfect correlation could be due just as easily to 'biological relevance' as it could be to some sort of more purely statistical random error like rater error, so pointing out biology is no evidence. (As in the classic example of the flu patient going to the doctor and recovering afterwards; they really were biologically sick and really did biologically recover.)

kstenerud 6y ago

> The study also found that IQ had a significant relationship with change in symptom severity. Children with higher IQs were more likely to show a reduction in ASD symptoms. This is important information. People of higher intelligence would be more likely to learn things, such as how to mask effectively. I learned to mask so well that most people are shocked to learn that I'm autistic. It takes about 6 months of constant exposure for someone to get creeped out and dislike me, to the point that I wonder if I've done myself a disservice with my masking habit.

scandox 6y ago
Presumably they're creeped out because they believe your emotional responses are simulated and that your engagement in phatic discourse is inauthentic? But how they can they tell the difference? And even if they can how do they know that this isn't also true of everybody else, only that others are superior fakers? How can they even know that their own responses are authentic? I ask because I'm really not sure about this in my own mind.
- krageon 6y ago
  Being "creeped out" is mostly a function of instinct. It's something you feel in your gut (or wherever instinct lives for you). This means that if you do not have it, it's hard to explain. The questions you are asking sort of miss the point, there's plenty of ways people can explain their instinct but at the end of the day it's not really a conscious process. If you don't have the same instincts as some people have, I suppose it would be natural to end up with the questions you do. What's important to remember is that they don't have the answers either. If you really want an explanation that may or may not be true, in my personal experience I can tell that things are simulated or inauthentic unless (as you say) they're being simulated by an extremely competent actor (in the sense that they are acting). Even with people who act very competently, there are always (at least, I've never met an exception) small indicators over time that feel a little wrong. You can't act 24/7, so the longer people interact with you (if you are acting) the more likely it is they'll see you slip up. This isn't really a problem, as the experience of getting to know someone naturally tends to lead to you seeing them in an entirely different light. The trick is figuring out when to show some authentic drive of yourself and when to present a socially desirable composite. That trick is something you learn by making a lot of mistakes (or if there's some rule to it, I have no idea what it is). If you don't consciously stop acting at some point and people see through it on their own, then it becomes creepy. The ideal is to head that off and figure out together if you are compatible personality types.

EndXA 6y ago

Study abstract: > Autism symptom severity change was evaluated during early childhood in 125 children diagnosed with autism spectrum disorder (ASD). Children were assessed at approximately 3 and 6 years of age for autism symptom severity, IQ and adaptive functioning. Each child was assigned a change score, representing the difference between ADOS Calibrated Severity Scores (CSS) at the two ages. A Decreased Severity Group (28.8%) decreased by 2 or more points; a Stable Severity Group (54.4%) changed by 1 point or less; and an Increased Severity Group (16.8%) increased by 2 or more points. Girls tended to decrease in severity more than boys and increase in severity less than boys. There was no clear relationship between intervention history and membership in the groups. The study can be found at: https://link.springer.com/article/10.1007/s10803-020-04526-z https://link.springer.com/article/10.1007/s10803-020-04526-z

DyslexicAtheist 6y ago

my son had a couple of very annoying years between 4-7 where he would seem behind compared to other kids on certain things such as motor skills and physical (hand/leg) coordination. he was also huge for his age, like trapped in a larger child's body. when it was time to send him to school our neighbors who knew him (because he hung out with their kid) suggested to send him to an IQ test because they figured he might be highly intelligent ("same as their kid"). they believed that their own son was very bright too but I thought it's only because both parents were closer to 50 than to 20. their child also had no real children friends and mixed mostly with adults - hence also talked like an adult (and seemed smarter than average for that reason alone - he was total sh1t with being a kid though but he knew how to recite grown up books and read/write long before school ...) anyway - bear with me, I promise to connect these things eventually we sent our son to do an IQ test and it came back inconclusive. we were told to test him again in a years time. (he was a mixed kids growing up with 3 languages which might also have altered how he performed on the test). Long story short he had a difficult first year in school with the teachers telling us that either a) he is too smart and should be moved forward a class, or b) he needs to go to a special school because he is dumb, or c) he should probably be tested for both autism and ADD. We decided to do none of the above and give it another 2 years to see how it play out. Eventually he settled into his surrounding and turned out one of the best students in class. another case: my best friend's kid is diagnosed with autism ("somewhere on the spectrum" they say). He is incredibly active for his age and more than other kids. His parents who are both very ill (ALS and MS) are used to seeing a doctor every few weeks to get injections, ... they have more exposure to doctors than to any other grown ups in their life, and meanwhile their friends are also all people who have "sick" kids. Whenever I play with the kid I think he is pretty normal, except for that he is a lot smarter than anyone else. Like a smart boy stuck in a smaller childs body. Another example: my gf is a nurse and occupational therapist. she literally works with disabled kids who are on the spectrum, have down-syndrome, cerebral palsy (to name the most common problems). She says if somebody has autism you can sure as hell tell. There is no "maybe", or "somewhere on the spectrum"- yes some cases are milder but she thinks that some doctors just diagnose and presribe solutions for things they don't fully understand themselves. could it be that a lot of these kids simply go through stages in their childhood at different speeds? like not every kid fits into our "systems-thinking" model and maybe totally grows out of it a year later? The horrid thing here is that the moment way start treating their behavior as a disease it has good potential to actually become one, ... which brings me to the last example. I worked with a US company remote. we were all on Jitsi every day even we weren't meeting so the mgmt could keep tabs (this was the rule for some reason). The assistant to the CEO a mid 30ies lady insisted that her child had autism. She constants forgot to switch her mic to mute and I could see how she talked to that child. He would get regular slaps in the face and get screamed at - then he would be told to take his meds. Also I think they might have been on some deal where they get benefits because their kids was "disabled". idk what to make of this but the whole medical profession seems like a racket to me. especially in the US (where this disease seems more of a fashion than anything) ... I hope these kids don't wake up one day and realize the crimes that have been committed against them. I'm glad I put my foot down and not put my child on pills (just to put money in some idiotic Dr. med. pocket). I would have destroyed my child! (and I see what it's like whenever I look at my best friends kid!

JacksonGariety 6y ago

I have high-functioning autism. Does anyone have some suggestions for making and keeping friends? When I meet a friend, things seem to go really well at first, and then my friend seems to slowly get bored of the interactions we have, and after a couple months I just don't hear from them again. Not sure what I'm doing wrong. Is there a scientific way to find out?

forgotmypw17 6y ago
Every day, try to think of something you can share with them, and then do it. Some ideas: Tell them about what made you smile that day. Neat moments that you appreciated, but they weren't there to share it with you. Food and drink. Whatever you're eating and enjoying, share it with that friend. Either invite them out or bring/send it to them. Text, pictures, and video. Funny and positive, no drama, politics, etc. Experiences. Think of something you like to do that can be shared, and invite them out to do it. Share your time and effort. Offer your help, once, maybe twice. Don't be pushy with it. If they accept, help them like a servant, doing exactly what they ask you. The basic idea is to consistently repeat the combination of "spending time together with you" and "day is improved". If you do one of these daily with five people for a month, I can almost guarantee you will end up with at least one friend. After that, you can focus on that one person more for a month to deepen your friendship. After that, add a few more people, but maintain friendship with the one person.
kstenerud 6y ago
I'm not sure if this helps, but after 45 years as a stranger in a strange land, the only friends I've managed to keep longer than a year have been autistic themselves. My wife is also autistic, and we both marvel over how, for the first time ever in our lives, our home is our sanctuary where we can just relax and be completely ourselves with all the weirdness that entails. All previous romantic relationships were stressful and ended badly because it felt like I was walking on eggshells, and couldn't understand why my SO kept getting upset. My wife had similar experiences in past relationships.
- bsder 6y ago

pgt 6y ago

What if all children start off as autistic and gradually develop situational and emotional awareness? Some never do.

wozer 6y ago
If that is true, it must happen very early. Some two year olds are already extremely non-autistic.
- Lammy 6y ago
  Two years old is well past "very early" development stages.
  - hanniabu 6y ago
    What constitutes very early? 6 months? 2 months?
    - Lammy 6y ago
      https://www.cdc.gov/ncbddd/actearly/milestones/index.html https://www.cdc.gov/ncbddd/actearly/milestones/index.html
- pbhjpbhj 6y ago
  Parents in the UK will some times describe a child as "flirty", it has nothing to do with sexuality - to head that one off. They have learnt, by only a few months old, to attract attention of adults by using facial expressions, coos, and such. They certainly seem to be the other end of the spectrum wrt commanding social interaction. But I'd suspect it's more that most children have the capacity but a few just happen upon the formula early. Like we mostly have capacity to walk but some take 14 months then just get up and walk, whilst others are walking at 8 months when they can barely raise their heads; and others are crawling backwards, or shuffling on their bums because walking didn't click quite so quickly.
  - 6y ago

conistonwater 6y ago

How do studies like this take regression to the mean into account? Seems like a hard problem.

stretchwithme 6y ago

I've read recently that supplementing zinc and sulforaphane can help autism. Is there any truth to that? Anyone have personal experience trying either?

chownie 6y ago
n=1 obviously I take a multivitamin with 15mg zinc in it, as far as I can tell none of the autism specific symptoms are affected. The biggest difference is that I feel sleepy in the afternoons when I take zinc, when I don't take it I feel more awake but less rested.