3 ms·

> It’s likely that ADHD and Autism prevalence has not changed Any evidence? Autism risk increases with paternal age and maternal diabetes status, so I find it

> It’s likely that ADHD and Autism prevalence has not changed Any evidence? Autism risk increases with paternal age and maternal diabetes status, so I find it hard to believe that prevalence is unchanged from 30 years ago.

bsder 3y ago
I really wish people wouldn't lump Autism and ADHD together. This is like lumping "cancer" all together. "Autism" isn't even a single disease just by itself. For autism, the correlation on age and diabetes status is real, but weak. The counterfactual is that autism in minority populations is growing much faster than it is in the non-minority population. The only good correlation is health care coverage and the correlation is very strong. That tends to suggest that the "increase" is mostly increased diagnosis and treatment. And, in my personal experience, "weak" ADHD is being HUGELY over diagnosed (for various reasons--some of which are non-medical) while "stronger" ADHD is being significantly underdiagnosed (because dealing with it is expensive on multiple fronts). However, note that none of these things are absolutes. Weak correlations do exist. The human organism is highly variable--some things work for some of the people some of the time. The problem is figuring out which things work for which individuals most of the time.
- faeriechangling 3y ago
  >Conflating ADHD and Autism The diagnostic overlap the two is quite striking and I’ve heard people seriously suggest that not only should the two be conflated, but that the two are the same thing. Realistically ADHD and Autism are arbitrary social constructs only loosely linked to biological reality popularized by the ICD and DSM and behaviourism, and I don’t find the unquestionable biological reality of ADHD -or- Autism all that convincing. One of the more interesting attempts at rethinking how we categorize people is this https://en.m.wikipedia.org/wiki/Research_Domain_Criteria https://en.m.wikipedia.org/wiki/Research_Domain_Criteria >weak ADHD overdiagnosis ADHD diagnosis is used to gatekeep methylphenidate and amphetamine access, and I think making those drugs more freely available would be helpful, so I have little issue with rising ADHD diagnosis. I do question the wisdom of forcing people to go to a doctor and convincing them to label them as “disordered” if they want access to drugs they find helpful, but that’s the system we have. Autism overdiagnosis I take more issue with because there are limited effacious treatments or accommodations for it. Diagnosis to me seems driven to me quite bluntly more by entitlements being connected to Autism than anything else and I find the rising diagnosis more perverse. Generally my support for a diagnosis hinges on my perception that being diagnosed helps the person diagnosed and the collective good. There was some research out of Texas after they passed a law forcing Sped enrollment to be capped at 8.5% with an allowed racial discrepancy of more than 1%. BOTH the GenEd and SpEd started graduating less, but the black students who were the most likely to be put in SpEd classes before the legal changes graduated more. To me this shows we have either already passed the point of overtreatment in the black population and are likely just above or below the line of an “optimal level of treatment” for the rest of the population. https://www.brookings.edu/articles/special-education-beneficial-to-some-harmful-to-others/ https://www.brookings.edu/articles/special-education-benefic...
mewpmewp2 3y ago
Do we even know if it is the risk of it or just a correlation? E.g. older parents could have more resources to get their kids to therapist where they get diagnosed? And so older parents will have higher likelihood of having kids with autism? Or maybe it is hereditary and fathers prone to autism are less likely to get children earlier in their life. It makes sense if you consider social awkwardness part of autism. Everytime I see research on those subjects it seems like those correlations could be explained away by also 1000 different factors. To me intuitively it feels like ADHD and Autism in many cases are largely just natural variance because of evolutionary process, seen as something wrong due to environment having been changed. And a lot of the research seems to make claims on just correlation. I have ADHD diagnosis and I almost got Autism diagnosis and multiple doctors have noted I have autistic tendencies, but I think it is just trade offs. It is where you direct your limited mental resources to. Sometimes it is acceptable to current society, sometimes not. To sum up both diagnosis for me seem to be because I have easier time to focus on other things that most other people can't while I have harder time focusing on what is easy for most.
- faeriechangling 3y ago
  I find the peculiar thing about ADHD and Autism is they can be imposed. As in, if you make less eye contact than others, have fewer deeper interests, and a few other traits you are treated as PERMANENTLY disordered from the date of your diagnosis. Such things are very unacceptable to society appearantly. > To sum up both diagnosis for me seem to be because I have easier time to focus on other things that most other people can't while I have harder time focusing on what is easy for most. If you read the criteria for both diagnosis’s, they both have nothing to do with you having positive traits, even if you do have positive traits which come hand in hand with positive ones, it’s simply not considered. I find it entirely ridiculous really and it’s comical how often Autism in particular is portrayed alongside savant traits. There is something deeply distorted about considering somebody disordered or not based on the sum of their weaknesses.
ImaCake 3y ago
What I was pointing out is that "awareness" is a confounder here. The statistic we have is that diagnosis rates have increased substantially. We cannot say why because there is no way to untangle the factors that may influence this statistic. So no, I don't have evidence, and neither do you. As someone who spent many years in medical biology and studied biostatistics, I am inclined to treat any biochemistry arguments with deep skepticism. It is in the author's interest to say they have found the answer for something because money is always in short supply. The more boring answer that society is not about to collapse into flapping mutes because we have learnt some new facts and our culture has changed doesn't get you research funding.

bsder 3y ago

I really wish people wouldn't lump Autism and ADHD together. This is like lumping "cancer" all together. "Autism" isn't even a single disease just by itself. For autism, the correlation on age and diabetes status is real, but weak. The counterfactual is that autism in minority populations is growing much faster than it is in the non-minority population. The only good correlation is health care coverage and the correlation is very strong. That tends to suggest that the "increase" is mostly increased diagnosis and treatment. And, in my personal experience, "weak" ADHD is being HUGELY over diagnosed (for various reasons--some of which are non-medical) while "stronger" ADHD is being significantly underdiagnosed (because dealing with it is expensive on multiple fronts). However, note that none of these things are absolutes. Weak correlations do exist. The human organism is highly variable--some things work for some of the people some of the time. The problem is figuring out which things work for which individuals most of the time.

faeriechangling 3y ago
>Conflating ADHD and Autism The diagnostic overlap the two is quite striking and I’ve heard people seriously suggest that not only should the two be conflated, but that the two are the same thing. Realistically ADHD and Autism are arbitrary social constructs only loosely linked to biological reality popularized by the ICD and DSM and behaviourism, and I don’t find the unquestionable biological reality of ADHD -or- Autism all that convincing. One of the more interesting attempts at rethinking how we categorize people is this https://en.m.wikipedia.org/wiki/Research_Domain_Criteria https://en.m.wikipedia.org/wiki/Research_Domain_Criteria >weak ADHD overdiagnosis ADHD diagnosis is used to gatekeep methylphenidate and amphetamine access, and I think making those drugs more freely available would be helpful, so I have little issue with rising ADHD diagnosis. I do question the wisdom of forcing people to go to a doctor and convincing them to label them as “disordered” if they want access to drugs they find helpful, but that’s the system we have. Autism overdiagnosis I take more issue with because there are limited effacious treatments or accommodations for it. Diagnosis to me seems driven to me quite bluntly more by entitlements being connected to Autism than anything else and I find the rising diagnosis more perverse. Generally my support for a diagnosis hinges on my perception that being diagnosed helps the person diagnosed and the collective good. There was some research out of Texas after they passed a law forcing Sped enrollment to be capped at 8.5% with an allowed racial discrepancy of more than 1%. BOTH the GenEd and SpEd started graduating less, but the black students who were the most likely to be put in SpEd classes before the legal changes graduated more. To me this shows we have either already passed the point of overtreatment in the black population and are likely just above or below the line of an “optimal level of treatment” for the rest of the population. https://www.brookings.edu/articles/special-education-beneficial-to-some-harmful-to-others/ https://www.brookings.edu/articles/special-education-benefic...

mewpmewp2 3y ago

Do we even know if it is the risk of it or just a correlation? E.g. older parents could have more resources to get their kids to therapist where they get diagnosed? And so older parents will have higher likelihood of having kids with autism? Or maybe it is hereditary and fathers prone to autism are less likely to get children earlier in their life. It makes sense if you consider social awkwardness part of autism. Everytime I see research on those subjects it seems like those correlations could be explained away by also 1000 different factors. To me intuitively it feels like ADHD and Autism in many cases are largely just natural variance because of evolutionary process, seen as something wrong due to environment having been changed. And a lot of the research seems to make claims on just correlation. I have ADHD diagnosis and I almost got Autism diagnosis and multiple doctors have noted I have autistic tendencies, but I think it is just trade offs. It is where you direct your limited mental resources to. Sometimes it is acceptable to current society, sometimes not. To sum up both diagnosis for me seem to be because I have easier time to focus on other things that most other people can't while I have harder time focusing on what is easy for most.

faeriechangling 3y ago
I find the peculiar thing about ADHD and Autism is they can be imposed. As in, if you make less eye contact than others, have fewer deeper interests, and a few other traits you are treated as PERMANENTLY disordered from the date of your diagnosis. Such things are very unacceptable to society appearantly. > To sum up both diagnosis for me seem to be because I have easier time to focus on other things that most other people can't while I have harder time focusing on what is easy for most. If you read the criteria for both diagnosis’s, they both have nothing to do with you having positive traits, even if you do have positive traits which come hand in hand with positive ones, it’s simply not considered. I find it entirely ridiculous really and it’s comical how often Autism in particular is portrayed alongside savant traits. There is something deeply distorted about considering somebody disordered or not based on the sum of their weaknesses.

ImaCake 3y ago

What I was pointing out is that "awareness" is a confounder here. The statistic we have is that diagnosis rates have increased substantially. We cannot say why because there is no way to untangle the factors that may influence this statistic. So no, I don't have evidence, and neither do you. As someone who spent many years in medical biology and studied biostatistics, I am inclined to treat any biochemistry arguments with deep skepticism. It is in the author's interest to say they have found the answer for something because money is always in short supply. The more boring answer that society is not about to collapse into flapping mutes because we have learnt some new facts and our culture has changed doesn't get you research funding.