3 ms·

> TFA is saying that we should've been moving towards more categories with more nuance and detail, even back when we were at just 2 categories, not towards fewe

> TFA is saying that we should've been moving towards more categories with more nuance and detail, even back when we were at just 2 categories, not towards fewer categories with even less nuance, as the DSM-5 chose to do. TFA explicitly says the opposite > “The term ‘autism’ likely describes multiple conditions,” said Dr Varun Warrier, from Cambridge’s department of psychiatry, senior author of the research. “For the first time, we have found that earlier and later diagnosed autism have different underlying biological and developmental profiles.” > The scientists are *not* advocating for a move towards two diagnostic categories, saying that this could be unhelpful for the many who fall somewhere in the middle. > “It is a gradient,” said Warrier. “There are also many other factors that contribute to age of diagnosis, so the moment you go from averages to anything that is applicable to an individual, it’s false equivalency.” The Nature article and the guardian article are both just saying that these are likely multiple genetic disorders with similar symptoms and treatments. Classifying and understanding them is useful valid research to do, nobody doing this research is suggesting that actually DSM 4 had it right. These will split into different diagnoses if it's found that significant differences in treatments can yield better results. Otherwise, they are just going to call it autism. Much like, for example, we call uncontrolled tumor growth cancer even though it's really 1000 different diseases that all manifest the same way.

anonym29 1y ago
Sorry, I forget not everyone is as up-to-date on related studies on the subject from earlier this year that are not TFA: https://www.nature.com/articles/s41588-025-02224-z https://www.nature.com/articles/s41588-025-02224-z The study "speaks to the need to be a bit more fine-grained in our approaches to diagnosis" with subtypes rather than a single condition, as one of the authors put it, there. Additional context: https://www.scientificamerican.com/article/four-new-autism-subtypes-link-genes-to-childrens-traits/ https://www.scientificamerican.com/article/four-new-autism-s... Nobody's making the argument that the DSM-4 had it right: the argument being made is that the DSM-5's direction of fewer categories and more generalization was the wrong direction, and going instead towards more categories and less generalization was and is the right direction for increasing understanding, treatment attempt outcomes, and greater efficiency in diagnosing and serving those with greater needs.
in_cahoots 1y ago
Do blind people and nearsighted people have the same treatment? Saying people with profound autism need the same treatment as people with autism commenting on Hacker News is patently absurd. Go ahead and try offering therapy and workplace accommodations to nonverbal people living in a residential home. You're proving my point for me, we've lost sight of these people. Even with cancer- the diagnosis and treatment vary tremendously depending on what type of cancer you have, how far along it is, and more recently how your particular genome responds to that version of cancer and each version of treatment. We don't just say, "whoops you have cancer" and start chemotherapy on the targeted area. Your argument doesn't make any sense.
- cogman10 1y ago
  > Do blind people and nearsighted people have the same treatment? Yes, they both need to see optometrists on a regular basis. They get the same therapy even though a blind person won't get glasses. It's the same for autism. Someone with profound autism will still see occupational, behavior, and speech therapists. The therapy will be different from what someone with mild autism gets, but the specialists involved will largely be the same. The OT for someone with profound autism can be identical to mild autism because there are many different aspects. Profound autism simply means several aspects have severe problems. That's my point. Very similar to how with an oncologist you might have a specialist for your cancer but ultimately you deal with a team that often treat different cancers. For example, people to draw your blood and run labs. That's why hospitals have an oncology department and not a lung cancer department.
  - in_cahoots 1y ago
    They see the same people but definitely don't get the same treatment. The insurance codes are different and the body of research is different. Putting $1 of research into genetic blindness does nothing for preventing astigmatism, even though patients may go to the same doctor. Saying that everyone who goes to a therapist, or an oncologist gets the same treatment and therefore should be lumped together is absurd. Most other specialties are moving toward taxonomic differentiation, not away from it.

anonym29 1y ago

Sorry, I forget not everyone is as up-to-date on related studies on the subject from earlier this year that are not TFA: https://www.nature.com/articles/s41588-025-02224-z https://www.nature.com/articles/s41588-025-02224-z The study "speaks to the need to be a bit more fine-grained in our approaches to diagnosis" with subtypes rather than a single condition, as one of the authors put it, there. Additional context: https://www.scientificamerican.com/article/four-new-autism-subtypes-link-genes-to-childrens-traits/ https://www.scientificamerican.com/article/four-new-autism-s... Nobody's making the argument that the DSM-4 had it right: the argument being made is that the DSM-5's direction of fewer categories and more generalization was the wrong direction, and going instead towards more categories and less generalization was and is the right direction for increasing understanding, treatment attempt outcomes, and greater efficiency in diagnosing and serving those with greater needs.

in_cahoots 1y ago

Do blind people and nearsighted people have the same treatment? Saying people with profound autism need the same treatment as people with autism commenting on Hacker News is patently absurd. Go ahead and try offering therapy and workplace accommodations to nonverbal people living in a residential home. You're proving my point for me, we've lost sight of these people. Even with cancer- the diagnosis and treatment vary tremendously depending on what type of cancer you have, how far along it is, and more recently how your particular genome responds to that version of cancer and each version of treatment. We don't just say, "whoops you have cancer" and start chemotherapy on the targeted area. Your argument doesn't make any sense.

cogman10 1y ago
> Do blind people and nearsighted people have the same treatment? Yes, they both need to see optometrists on a regular basis. They get the same therapy even though a blind person won't get glasses. It's the same for autism. Someone with profound autism will still see occupational, behavior, and speech therapists. The therapy will be different from what someone with mild autism gets, but the specialists involved will largely be the same. The OT for someone with profound autism can be identical to mild autism because there are many different aspects. Profound autism simply means several aspects have severe problems. That's my point. Very similar to how with an oncologist you might have a specialist for your cancer but ultimately you deal with a team that often treat different cancers. For example, people to draw your blood and run labs. That's why hospitals have an oncology department and not a lung cancer department.
- in_cahoots 1y ago
  They see the same people but definitely don't get the same treatment. The insurance codes are different and the body of research is different. Putting $1 of research into genetic blindness does nothing for preventing astigmatism, even though patients may go to the same doctor. Saying that everyone who goes to a therapist, or an oncologist gets the same treatment and therefore should be lumped together is absurd. Most other specialties are moving toward taxonomic differentiation, not away from it.