5 ms·

This. I think the problem is simply we're over-diagnosing autism. Basically borderline people would've been considered normal in the past, but are now considere

by Rury 4y ago

This. I think the problem is simply we're over-diagnosing autism. Basically borderline people would've been considered normal in the past, but are now considered autistic. Frankly, the entirety of symptoms involved in diagnosis sounds subject to a person's opinion of what people's behavior should be vs shouldn't be. Since this line is hard for everyone to agree on, we've come up with degrees of autism, like "high functioning" autism such as Asperger's syndrome. I'd argue, it's only when it's obvious (i.e. the person is largely dependent) while having said symptoms, that they're autistic... Just because someone behave's abnormally socially, has peculiar interests, and/or has delayed abilities (unless extreme), isn't sufficient IMO. Additionally, two different doctors may end up giving different diagnoses.

sascha_sl 4y ago
Autism (and ASD) should really not be seen as this essentialist "yes or no". There are degrees to which people, considered autistic or not by your favorite arbitrary standard, exhibit autistic traits. And those traits are not strictly inherently better or worse than neurotypical traits. The standard for consideration as disorder should be the same as with most psychiatric disorders: Not mere presence, but causing issues that need support. But at the same time, the people that are doing fine with autistic traits are no less autistic. (Also, Asperger's has ceased existing a while ago)
- skissane 4y ago
  > But at the same time, the people that are doing fine with autistic traits are no less autistic. I’d question that statement. People with BAP (broad autism phenotype) have autistic traits and are doing fine with them, but by definition are “less autistic” than people with ASD. A lot of people with other psychiatric disorders such as schizophrenia, can have significant autistic traits as symptoms of that other disorder (the symptomatic overlap between ASD and schizophrenia is much larger than many people appreciate, although it is believed that the similar symptoms nonetheless are caused by rather different processes) and obviously are not “doing fine”, but nonetheless are in a very real sense “less autistic” than a person with an actual ASD diagnosis > (Also, Asperger's has ceased existing a while ago) That’s not really true; the DSM-IV still exists, and professionals are still free to use it if they wish. Our son’s psychiatrist told me that he still sometimes gives children DSM-IV Asperger’s diagnoses if the parents feel particularly uncomfortable with the label of “autism” inherent in DSM-5 ASD.
  - aidenn0 4y ago
    If you have ASD, but learn coping skills are you not "less autistic?"
bayesianbot 4y ago
I and many other autistic people would strongly disagree. Neurotypical vs ASD isn't some gradient like you seem to think, it's much bigger, clearer wall between us. I am one of those that you wouldn't diagnose autistic, but in reality me and my thoughts are much much much closer to the ones you would than neurotypicals. I wasn't diagnosed as a kid, partly because autism wasn't diagnosed at least in my country when I was born, partly because even though it was obvious to everyone how different I was my parents tried to pretend I'm just a normal kid. And partly because with time I honed my high quality human emulator to the perfection so at some point I could play that almost-"normal" kid part that they and society wanted from me. Doesn't mean I didn't constantly feel there's been a mistake, I've been born on wrong planet, in middle of different species that doesn't understand me and which I don't understand. Absolutely nothing about the world made sense, life was hard and strange even if I was extremely good at pretending it isn't. It all changed when I found out and found others like me. Nowadays I'd be diagnosed at two years old, and my life would have been so much easier. I wouldn't have the need to pretend (or mask as we call it) as much, which is a HUGE constant stress. I could understand the world and myself much better, and adjust my life knowing better why and how I'm different. I feel like I could have grown up to be much less of a broken person. There are millions and millions like me, many of whom still don't know and are thinking what is going on in this world. They should be diagnosed as early as possible so they could start enjoying life like I have in much healthier way after finding out. It's not really surprising that it was - and is - underdiagnosed and we're now finding more cases, as not that long time ago we didn't really diagnose it at all, and after that we only diagnosed the minority of cases who couldn't come up with an acceptable human emulator. And because the mental image we have of autism is so wrong. I spent decades trying to find people like me, disorders that would explain the things. I gave up, thinking I'm unique. But my mental image was wrong also, so I didn't really give it enough thought - autism was a list of symptoms on wikipedia page and Rainman - that's not me, it's just that my brain and thinking is completely different and nobody understands, I can't even tell anyone because it's impossible to explain. It wasn't until I randomly read an article written by autistic person, and like 1/4 way through it I knew I found my kind - before that nobody understood, and that article could have been word to word written by me, except he knew the reasons behind it.
- 4y ago
seba_dos1 4y ago
> Just because someone behave's abnormally socially, has peculiar interests, and/or has delayed abilities (unless extreme), isn't sufficient IMO. Then it's a good thing that this is absolutely not sufficient to declare someone autistic (even "high functioning", although this kind of categorization is frowned upon these days) even now. Those are just some of possible externally visible symptoms.

by Rury 4y ago

sascha_sl 4y ago

Autism (and ASD) should really not be seen as this essentialist "yes or no". There are degrees to which people, considered autistic or not by your favorite arbitrary standard, exhibit autistic traits. And those traits are not strictly inherently better or worse than neurotypical traits. The standard for consideration as disorder should be the same as with most psychiatric disorders: Not mere presence, but causing issues that need support. But at the same time, the people that are doing fine with autistic traits are no less autistic. (Also, Asperger's has ceased existing a while ago)

skissane 4y ago
> But at the same time, the people that are doing fine with autistic traits are no less autistic. I’d question that statement. People with BAP (broad autism phenotype) have autistic traits and are doing fine with them, but by definition are “less autistic” than people with ASD. A lot of people with other psychiatric disorders such as schizophrenia, can have significant autistic traits as symptoms of that other disorder (the symptomatic overlap between ASD and schizophrenia is much larger than many people appreciate, although it is believed that the similar symptoms nonetheless are caused by rather different processes) and obviously are not “doing fine”, but nonetheless are in a very real sense “less autistic” than a person with an actual ASD diagnosis > (Also, Asperger's has ceased existing a while ago) That’s not really true; the DSM-IV still exists, and professionals are still free to use it if they wish. Our son’s psychiatrist told me that he still sometimes gives children DSM-IV Asperger’s diagnoses if the parents feel particularly uncomfortable with the label of “autism” inherent in DSM-5 ASD.
- aidenn0 4y ago
  If you have ASD, but learn coping skills are you not "less autistic?"

bayesianbot 4y ago

I and many other autistic people would strongly disagree. Neurotypical vs ASD isn't some gradient like you seem to think, it's much bigger, clearer wall between us. I am one of those that you wouldn't diagnose autistic, but in reality me and my thoughts are much much much closer to the ones you would than neurotypicals. I wasn't diagnosed as a kid, partly because autism wasn't diagnosed at least in my country when I was born, partly because even though it was obvious to everyone how different I was my parents tried to pretend I'm just a normal kid. And partly because with time I honed my high quality human emulator to the perfection so at some point I could play that almost-"normal" kid part that they and society wanted from me. Doesn't mean I didn't constantly feel there's been a mistake, I've been born on wrong planet, in middle of different species that doesn't understand me and which I don't understand. Absolutely nothing about the world made sense, life was hard and strange even if I was extremely good at pretending it isn't. It all changed when I found out and found others like me. Nowadays I'd be diagnosed at two years old, and my life would have been so much easier. I wouldn't have the need to pretend (or mask as we call it) as much, which is a HUGE constant stress. I could understand the world and myself much better, and adjust my life knowing better why and how I'm different. I feel like I could have grown up to be much less of a broken person. There are millions and millions like me, many of whom still don't know and are thinking what is going on in this world. They should be diagnosed as early as possible so they could start enjoying life like I have in much healthier way after finding out. It's not really surprising that it was - and is - underdiagnosed and we're now finding more cases, as not that long time ago we didn't really diagnose it at all, and after that we only diagnosed the minority of cases who couldn't come up with an acceptable human emulator. And because the mental image we have of autism is so wrong. I spent decades trying to find people like me, disorders that would explain the things. I gave up, thinking I'm unique. But my mental image was wrong also, so I didn't really give it enough thought - autism was a list of symptoms on wikipedia page and Rainman - that's not me, it's just that my brain and thinking is completely different and nobody understands, I can't even tell anyone because it's impossible to explain. It wasn't until I randomly read an article written by autistic person, and like 1/4 way through it I knew I found my kind - before that nobody understood, and that article could have been word to word written by me, except he knew the reasons behind it.

4y ago

seba_dos1 4y ago

> Just because someone behave's abnormally socially, has peculiar interests, and/or has delayed abilities (unless extreme), isn't sufficient IMO. Then it's a good thing that this is absolutely not sufficient to declare someone autistic (even "high functioning", although this kind of categorization is frowned upon these days) even now. Those are just some of possible externally visible symptoms.