4 ms·

Well it sort of is, actually. Autism is quite literally what we define it to be: there’s no physiological or neurological test we can use to diagnose it, there

Well it sort of is, actually. Autism is quite literally what we define it to be: there’s no physiological or neurological test we can use to diagnose it, there’s no biomarker that defines autism. If we change how we diagnose autism, we change how we define it. The evidence by the way seems to indicate that there is a significant increase in diagnoses, and not all of that can be attributed to changing definitions.

ceejayoz 1y ago
> If we change how we diagnose autism, we change how we define it. But the incredibly obvious corollary to this is "you can't then turn around and compare case rates before and after that definition". You can't go back to the 1400s and reassess cases of witchcraft and demonic possession to get an accurate, modernly-accurate rate of autistic people in that era to compare against. RFK Jr. is out there saying things like "autism epidemic" and implying the cases come out of nowhere, when many of those cases are just changing a diagnosis code on an existing condition. Simpler version: We didn't see bacteria until 1676, and didn't give them a name until 1828… but it would be deeply wrong to claim no one got bacterial infections prior to that.
- d1sxeyes 1y ago
  A bacterial infection is an objectively verifiable condition. You can see the bacteria under a strong enough microscope. There’s no such definitive way to diagnose autism, it’s diagnosed based on the definition we came up with to describe a cluster of symptoms. If everyone dismissed the increase in diagnosed bacterial infections as due to the discovery of bacteria, a lot of medical research into diseases like TB would have stalled. It is worth looking at the increase in diagnoses to understand if there is some kind of underlying mechanism (for example parental age or environmental pollutants for autism) which could explain it rather than just dismissing it as an illusion, especially if we don’t understand the underlying cause of autism. RFKs rhetoric is clearly unhelpful and aimed at targeting autistic people, but the idea that “we have more people diagnosed with this condition than we ever had before, is there something to it beyond just relabelling?” is a valuable starting point for research. Caution is warranted (vaccines causing autism, despite being completely debunked, is an example of how NOT to research something like this), but throwing the baby out with the bathwater helps no one.
  - ceejayoz 1y ago
    > A bacterial infection is an objectively verifiable condition. You can see the bacteria under a strong enough microscope. Not until 1676! (And they weren't re-observed for another hundred years after that.) But they existed and made people sick before that date. We may discover a diagnostic test for autism in the future. People are certainly working on it. Similarly, autism existed long before the name autism was assigned to it. But the case count of autism was zero until the 1900s. https://en.wikipedia.org/wiki/History_of_autism https://en.wikipedia.org/wiki/History_of_autism "The term autism was first introduced by Eugen Bleuler in his description of schizophrenia in 1911. The diagnosis of schizophrenia was broader than its modern equivalent; autistic children were often diagnosed with childhood schizophrenia."
    - d1sxeyes 1y ago
      I completely agree. But autism is what we say it is (until we understand better and find some kind of absolute test). A bacterial infection doesn’t care what we think it is. Anyway it feels almost like the crux of what you’re saying now is “cases of autism have increased because we define autism differently now”. This is true, and I don’t disagree. I objected to your suggestion that the increase in cases is largely illusory because it discards possible environmental factors, and encourages people to “stop looking”. I don’t agree with demonisation of autistic people, but I do think trying to better understand autism and its causes is useful.
      - ceejayoz 1y ago
        > A bacterial infection doesn’t care what we think it is. Neither does autism. > Anyway it feels almost like the crux of what you’re saying now is “cases of autism have increased because we define autism differently now”. Yes. I've been saying that all along. The increase in case numbers - and the inferred conclusion that something environmental has changed to cause that - is an illusion. See also: CVEs per Pope. https://infosec.exchange/@SecurityWriter/114397760184324654 https://infosec.exchange/@SecurityWriter/114397760184324654 "Autism epidemic" is like claiming Pope Francis is responsible for a huge rise in insecure code.

ceejayoz 1y ago

> If we change how we diagnose autism, we change how we define it. But the incredibly obvious corollary to this is "you can't then turn around and compare case rates before and after that definition". You can't go back to the 1400s and reassess cases of witchcraft and demonic possession to get an accurate, modernly-accurate rate of autistic people in that era to compare against. RFK Jr. is out there saying things like "autism epidemic" and implying the cases come out of nowhere, when many of those cases are just changing a diagnosis code on an existing condition. Simpler version: We didn't see bacteria until 1676, and didn't give them a name until 1828… but it would be deeply wrong to claim no one got bacterial infections prior to that.

d1sxeyes 1y ago
A bacterial infection is an objectively verifiable condition. You can see the bacteria under a strong enough microscope. There’s no such definitive way to diagnose autism, it’s diagnosed based on the definition we came up with to describe a cluster of symptoms. If everyone dismissed the increase in diagnosed bacterial infections as due to the discovery of bacteria, a lot of medical research into diseases like TB would have stalled. It is worth looking at the increase in diagnoses to understand if there is some kind of underlying mechanism (for example parental age or environmental pollutants for autism) which could explain it rather than just dismissing it as an illusion, especially if we don’t understand the underlying cause of autism. RFKs rhetoric is clearly unhelpful and aimed at targeting autistic people, but the idea that “we have more people diagnosed with this condition than we ever had before, is there something to it beyond just relabelling?” is a valuable starting point for research. Caution is warranted (vaccines causing autism, despite being completely debunked, is an example of how NOT to research something like this), but throwing the baby out with the bathwater helps no one.
- ceejayoz 1y ago
  > A bacterial infection is an objectively verifiable condition. You can see the bacteria under a strong enough microscope. Not until 1676! (And they weren't re-observed for another hundred years after that.) But they existed and made people sick before that date. We may discover a diagnostic test for autism in the future. People are certainly working on it. Similarly, autism existed long before the name autism was assigned to it. But the case count of autism was zero until the 1900s. https://en.wikipedia.org/wiki/History_of_autism https://en.wikipedia.org/wiki/History_of_autism "The term autism was first introduced by Eugen Bleuler in his description of schizophrenia in 1911. The diagnosis of schizophrenia was broader than its modern equivalent; autistic children were often diagnosed with childhood schizophrenia."
  - d1sxeyes 1y ago
    I completely agree. But autism is what we say it is (until we understand better and find some kind of absolute test). A bacterial infection doesn’t care what we think it is. Anyway it feels almost like the crux of what you’re saying now is “cases of autism have increased because we define autism differently now”. This is true, and I don’t disagree. I objected to your suggestion that the increase in cases is largely illusory because it discards possible environmental factors, and encourages people to “stop looking”. I don’t agree with demonisation of autistic people, but I do think trying to better understand autism and its causes is useful.
    - ceejayoz 1y ago
      > A bacterial infection doesn’t care what we think it is. Neither does autism. > Anyway it feels almost like the crux of what you’re saying now is “cases of autism have increased because we define autism differently now”. Yes. I've been saying that all along. The increase in case numbers - and the inferred conclusion that something environmental has changed to cause that - is an illusion. See also: CVEs per Pope. https://infosec.exchange/@SecurityWriter/114397760184324654 https://infosec.exchange/@SecurityWriter/114397760184324654 "Autism epidemic" is like claiming Pope Francis is responsible for a huge rise in insecure code.