5 ms·

> Who are you accusing of a "dangerous misunderstanding" here – her, or me? I wasn't accusing anyone specifically, merely commenting on the idea you shared. Ho

> Who are you accusing of a "dangerous misunderstanding" here – her, or me? I wasn't accusing anyone specifically, merely commenting on the idea you shared. However, since you asked, I would say that the misunderstanding is on both your parts -- yours, for interpreting her arguments to mean "ASD doesn't exist" (as far as I can tell, she makes no such claim); and hers, for arguing that the formal definitions and categorizations of ASD need to be biologically valid (which they can't be, as we don't understand enough about the biology for that to be possible). It's common for many fields of research to start with "stamp-collecting", where people just identify and group diseases and conditions and birds based on shared characteristics; and later, as the field becomes more mature, to develop more meaningful categories. I think this same concept applies to ASD.

skissane 6y ago
> yours, for interpreting her arguments to mean "ASD doesn't exist" (as far as I can tell, she makes no such claim); To quote page 431 of her book Rethinking Autism (my emphasis): > Taken together, these three claims and associated lines of evidence argue against the existence of autism as a single disorder, spectrum, or set of autism subgroups. If autism symptoms are not one disorder, and are not many disorders, what are they? The most parsimonious and least speculative view is that autism symptoms must be symptoms. Her book is quite explicit in its claim that autism spectrum disorder does not exist. Her conclusion (p. 433) is given under the heading "AUTISM SYMPTOMS WITHOUT A DISORDER". The whole point of her book is to argue that the disorder "Autism Spectrum Disorder" does not exist, but the symptoms do. You might say she rejects the "Spectrum" and the "Disorder" in "ASD", but keeps the "Autism" as a reference to a set of symptoms – however, her "autism" is narrower than the DSM-5's "autism", since it only includes social impairment, and considers repetitive behaviours/restricted interests and sensory issues, to be distinct symptom sets coequal with attention-deficit/hyperactive-impulsive symptoms, intellectual disability, functional language impairment, seizures, see p.434-435 To quote the blurb on the back cover "Rethinking Autism... draws the potentially shocking conclusion that 'Autism' does not exist as a single disorder. The conglomeration of symptoms exists, but like fever, those symptoms aren't a disease in themselves..." (But, the book actually goes further than the blurb says it does, because it not only rejects the idea that autism exists as a single disorder, it also rejects the idea that autism exists as multiple disorders or a spectrum of disorders, as my quote above demonstrates.) > and hers, for arguing that the formal definitions and categorizations of ASD need to be biologically valid Biologically valid categories would be a lot more useful than biologically invalid categories, and one of her major points is that the research community's fixation on the later is getting in the way of actually discovering the former ([1], [2]). She argues that, in place of the current widespread practice of doing research with ASD-defined samples (a confirmed ASD diagnosis as a study inclusion criteria), samples should be based on all individuals showing neurodevelopmental symptoms (mixing together ASD, ADHD, epilepsy, intellectual disability, etc, into a single sample) and then trying to study the variation in the sample in order to derive biologically valid categories to replace the existing biologically invalid ones such as ASD. [3] is an example of a study along the lines of what she recommends (indeed, they've obviously read [1] since they reference it) [1] https://link.springer.com/article/10.1007/s40489-016-0085-x https://link.springer.com/article/10.1007/s40489-016-0085-x [2] https://pubmed.ncbi.nlm.nih.gov/28714261/ https://pubmed.ncbi.nlm.nih.gov/28714261/ [3] https://www.nature.com/articles/s41398-019-0631-2 https://www.nature.com/articles/s41398-019-0631-2

skissane 6y ago

> yours, for interpreting her arguments to mean "ASD doesn't exist" (as far as I can tell, she makes no such claim); To quote page 431 of her book Rethinking Autism (my emphasis): > Taken together, these three claims and associated lines of evidence argue against the existence of autism as a single disorder, spectrum, or set of autism subgroups. If autism symptoms are not one disorder, and are not many disorders, what are they? The most parsimonious and least speculative view is that autism symptoms must be symptoms. Her book is quite explicit in its claim that autism spectrum disorder does not exist. Her conclusion (p. 433) is given under the heading "AUTISM SYMPTOMS WITHOUT A DISORDER". The whole point of her book is to argue that the disorder "Autism Spectrum Disorder" does not exist, but the symptoms do. You might say she rejects the "Spectrum" and the "Disorder" in "ASD", but keeps the "Autism" as a reference to a set of symptoms – however, her "autism" is narrower than the DSM-5's "autism", since it only includes social impairment, and considers repetitive behaviours/restricted interests and sensory issues, to be distinct symptom sets coequal with attention-deficit/hyperactive-impulsive symptoms, intellectual disability, functional language impairment, seizures, see p.434-435 To quote the blurb on the back cover "Rethinking Autism... draws the potentially shocking conclusion that 'Autism' does not exist as a single disorder. The conglomeration of symptoms exists, but like fever, those symptoms aren't a disease in themselves..." (But, the book actually goes further than the blurb says it does, because it not only rejects the idea that autism exists as a single disorder, it also rejects the idea that autism exists as multiple disorders or a spectrum of disorders, as my quote above demonstrates.) > and hers, for arguing that the formal definitions and categorizations of ASD need to be biologically valid Biologically valid categories would be a lot more useful than biologically invalid categories, and one of her major points is that the research community's fixation on the later is getting in the way of actually discovering the former ([1], [2]). She argues that, in place of the current widespread practice of doing research with ASD-defined samples (a confirmed ASD diagnosis as a study inclusion criteria), samples should be based on all individuals showing neurodevelopmental symptoms (mixing together ASD, ADHD, epilepsy, intellectual disability, etc, into a single sample) and then trying to study the variation in the sample in order to derive biologically valid categories to replace the existing biologically invalid ones such as ASD. [3] is an example of a study along the lines of what she recommends (indeed, they've obviously read [1] since they reference it) [1] https://link.springer.com/article/10.1007/s40489-016-0085-x https://link.springer.com/article/10.1007/s40489-016-0085-x [2] https://pubmed.ncbi.nlm.nih.gov/28714261/ https://pubmed.ncbi.nlm.nih.gov/28714261/ [3] https://www.nature.com/articles/s41398-019-0631-2 https://www.nature.com/articles/s41398-019-0631-2