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The symptoms cluster together and are related. Someone with sensory issues is also likely to have food aversions, for example. It's also useful for diagnostic

The symptoms cluster together and are related. Someone with sensory issues is also likely to have food aversions, for example. It's also useful for diagnostics and treatment. It means you don't have to fight insurance as much or need rediagnostics to get needed therapies. I don't need to get my child with food aversions, speech delay, and sensory issues a new diagnosis for each just because some people with autism don't have those issues.

mindslight 2y ago
That sounds like a problem with the medical gatekeeping industry rather than anything fundamental. Like a blanket diagnosis of "human" would get you the same thing, but for the middlemen realizing that would completely destroy one of the levers they use to defraud.
- idiotsecant 2y ago
  So it solves a problem, then? Its useful? Saying a problem would not be a problem if the universe was a little better is not particularly useful.
- lox 2y ago
  With a prevalence rate of < 2% (at least in Australia) this seems like an incredibly mathematically flawed take. Whilst a broad/blanket diagnosis isn't useful for making generalisations about individuals in that group, it's certainly societally useful.
  - mindslight 2y ago
    All models are wrong, some are useful. Of course it has some utility, otherwise it would drop out of use on its own. The problem with big catchall symptom based diagnoses are what they drive focus towards and away from. I get that the scientific process has to start somewhere, by putting similar things in a bag, before it can tease out mechanisms and groupings. But when such simplistic models remain how doctors communicate with patients, it crowds out more nuanced understanding. Like even the word "spectrum", trying to add some depth to the pop culture model, is really just a fancy word for a single scalar.
    - lox 2y ago
      I don’t disagree that pop culture has distilled spectrum down into a magnitude, but that isn’t how the DSM describes it or how professionals diagnose it (or in my experience how they communicate it). The metaphor is supposed to be like the light spectrum not “less autism ranging to more autism”. Severity scale is distinct to interacting traits of social issues and restricted interests and repetitive behaviors (the spectrum bit).
      - mindslight 2y ago
        When I said single scalar, I was referencing the light spectrum - it is literally just less energy ranging to more energy (per photon). We just experience it so vibrantly as different colors (etc) because the difference between specific energies are quite important at the level of our existence. So unless there is a single underlying factor whose magnitude causes all of the different distinct traits of autism, it's a poor analogy.
        BoiledCabbage 2y ago
        Two beams of light of equal intensity and different frequency contain equal energy not differing amounts of energy. The actual difference in frequency is the composition of that energy. If of course you compare a dimmer beam of light with a brighter one the dimmer one will have less energy. So no less energy is due to lower intensity light, not due to different frequency. You can pretty trivially have 5 flashlights each with a different color of light and all with the same energy.
        mindslight 2y ago
        Sure. The varying "composition" of that energy is what forms the spectrum - it's a single scalar. You're adding one more dimension of dim/bright, making the entire description be two scalars. Look up the definition of "spectrum", and contrast with "gamut".
        2y ago
zug_zug 2y ago
I guess then my thought is that whether it's one disorder or 4 or any number perhaps is best understood as a statistical question. For example, if a parent exhibit autism symptom X (e.g. trouble understanding emotions), are there kids more likely to inherit symptom X, or ANY autism symptom. If X is uniquely heritable, then perhaps it's best as multiple disorders. But if X leads equally likely to X, Y, or Z then it's better understood as one disorder.

mindslight 2y ago

That sounds like a problem with the medical gatekeeping industry rather than anything fundamental. Like a blanket diagnosis of "human" would get you the same thing, but for the middlemen realizing that would completely destroy one of the levers they use to defraud.

idiotsecant 2y ago
So it solves a problem, then? Its useful? Saying a problem would not be a problem if the universe was a little better is not particularly useful.
lox 2y ago
With a prevalence rate of < 2% (at least in Australia) this seems like an incredibly mathematically flawed take. Whilst a broad/blanket diagnosis isn't useful for making generalisations about individuals in that group, it's certainly societally useful.
- mindslight 2y ago
  All models are wrong, some are useful. Of course it has some utility, otherwise it would drop out of use on its own. The problem with big catchall symptom based diagnoses are what they drive focus towards and away from. I get that the scientific process has to start somewhere, by putting similar things in a bag, before it can tease out mechanisms and groupings. But when such simplistic models remain how doctors communicate with patients, it crowds out more nuanced understanding. Like even the word "spectrum", trying to add some depth to the pop culture model, is really just a fancy word for a single scalar.
  - lox 2y ago
    I don’t disagree that pop culture has distilled spectrum down into a magnitude, but that isn’t how the DSM describes it or how professionals diagnose it (or in my experience how they communicate it). The metaphor is supposed to be like the light spectrum not “less autism ranging to more autism”. Severity scale is distinct to interacting traits of social issues and restricted interests and repetitive behaviors (the spectrum bit).
    - mindslight 2y ago
      When I said single scalar, I was referencing the light spectrum - it is literally just less energy ranging to more energy (per photon). We just experience it so vibrantly as different colors (etc) because the difference between specific energies are quite important at the level of our existence. So unless there is a single underlying factor whose magnitude causes all of the different distinct traits of autism, it's a poor analogy.
      - BoiledCabbage 2y ago
        Two beams of light of equal intensity and different frequency contain equal energy not differing amounts of energy. The actual difference in frequency is the composition of that energy. If of course you compare a dimmer beam of light with a brighter one the dimmer one will have less energy. So no less energy is due to lower intensity light, not due to different frequency. You can pretty trivially have 5 flashlights each with a different color of light and all with the same energy.
        mindslight 2y ago
        Sure. The varying "composition" of that energy is what forms the spectrum - it's a single scalar. You're adding one more dimension of dim/bright, making the entire description be two scalars. Look up the definition of "spectrum", and contrast with "gamut".
        2y ago

zug_zug 2y ago

I guess then my thought is that whether it's one disorder or 4 or any number perhaps is best understood as a statistical question. For example, if a parent exhibit autism symptom X (e.g. trouble understanding emotions), are there kids more likely to inherit symptom X, or ANY autism symptom. If X is uniquely heritable, then perhaps it's best as multiple disorders. But if X leads equally likely to X, Y, or Z then it's better understood as one disorder.