9 ms·

Autism should not be treated as a single condition

265 points by bookofjoe 1y ago

https://archive.md/zOQv5 https://archive.md/zOQv5

bookofjoe 1y ago
https://archive.ph/zOQv5 https://archive.ph/zOQv5
- ilvez 1y ago
  What's with these archive links these days. I just get locked behind "Are you a human" clicking and random captchas.
  - windsignaling 1y ago
    I didn't realize these archive links were still working. Ever since the FBI order in November, these links have just been hanging for me. https://downforeveryoneorjustme.com/ https://downforeveryoneorjustme.com/ had been saying it was down so I just thought it actually was down for everyone, but I continue to see these links posted. Is the site still working for some people?
    - aspenmayer 1y ago
      The blocks tend to be implemented at the DNS level, so you can usually connect by using a different DNS server. The Tor onion link works fine as well, and that URL is on the archive.today Wikipedia page. https://en.wikipedia.org/wiki/Archive.today https://en.wikipedia.org/wiki/Archive.today > archiveiya74codqgiixo33q62qlrqtkgmcitqx5u2oeqnmn5bpcbiyd.onion via this post on their blog: https://blog.archive.today/post/711271973835227136/did-something-change-over-the-past-few-days-such https://blog.archive.today/post/711271973835227136/did-somet...
      - ilvez 1y ago
        Thank you both, this explains a lot..
  - Der_Einzige 1y ago
    I’m kind of glad it’s happening so that folks here have to reckon with being the world being full of copyright trolls rather than having some easy “let the nerds have it only for us” solution. Stop posting paywalled shit on HN please.
ceejayoz 1y ago
> Robert F. Kennedy junior, America’s health secretary, thinks that autism has become an “epidemic” in his country. His concern stems from figures from the Centres for Disease Control and Prevention, which shows that the condition now affects 32 per 1,000 eight-year-old children in America (see chart). That is in contrast, he says, with the near-absence of the condition in his childhood. Mr Kennedy was born in the 1950s, and studies estimate a prevalence of autism to around two to four per 10,000 in the 1960s. I'd note that RFK Jr.'s very own aunt was lobotomized then hidden away for something that sounds a lot like autism if diagnosed today. https://en.wikipedia.org/wiki/Rosemary_Kennedy https://en.wikipedia.org/wiki/Rosemary_Kennedy
- bluGill 1y ago
  Read any old book (like from the 1800s), or look into anyone's family history. There is always some version of "Larry never leaves the farm". Nobody every diagnosed "Larry" so we don't know what he had and often we only have a small fraction of the symptoms recorded, but what we have sounds suspiciously like Autism (and one of a dozen other things we now have names for)
  - ceejayoz 1y ago
    Yup. Or if they were rich, "eccentric". https://en.wikipedia.org/wiki/John_Bentinck,_5th_Duke_of_Portland https://en.wikipedia.org/wiki/John_Bentinck,_5th_Duke_of_Por... > The tunnels under the estate were reputed to have totalled 15 mi (24 km), connecting various underground chambers and above-ground buildings. They included a 1,000 yd (910 m) long tunnel between the house and the riding house, wide enough for several people to walk side by side. A more roughly constructed tunnel ran parallel to this for the use of his workmen. > The duke was highly introverted and well known for his eccentricity; he did not want to meet people and never invited anyone to his home. He employed hundreds through his various construction projects, and though well paid, the employees were not allowed to speak to him or acknowledge him. > He ventured outside mainly by night, when he was preceded by a lady servant carrying a lantern 40 yards (37 m) ahead of him. If he did walk out by day, the duke wore two overcoats, an extremely tall hat, an extremely high collar, and carried a very large umbrella behind which he tried to hide if someone addressed him. > He insisted on a chicken roasting at all hours of the day and the servants brought him his food on heated trucks that ran on rails through the tunnels.
nerdjon 1y ago
I will admit that I stopped reading the article because I think the article is completely mixing things up and honestly just did not feel like reading anymore of it. I think very few people actually consider it a single condition. To the point that most people that I know, including myself, say that we are "somewhere on the spectrum" or some variant of that. This isn't a post diagnoses understanding either, it is well understood by anyone I have talked to about this in the last 10ish years? (maybe less, I cant really pinpoint that). While I feel like there is value for professionals to be more specific about it, from an everyday person prospective I feel like "Autism" is well enough understood to be not just a single thing. Enough so that some phrasing along the lines of "my tism is..." is somewhat commonplace. The real problem is anti-science people joining the conversation, but splitting up Autism is not going to change that. Edit: To be very clear here I am not trying to say that most people in general are saying "I am somewhere on the spectrum". I am saying that most people I know which a larger portion of the people I regularly talk to are also diagnosed.
- jklinger410 1y ago
  > I think very few people actually consider it a single condition. To the point that most people that I know, including myself, say that we are "somewhere on the spectrum" or some variant of that. Couldn't disagree more. The "autism is my super power" movement is borderline offensive to people dealing with severe or low functioning autism. Dismissive, uninformed comment.
  - nerdjon 1y ago
    I have never in my life used "autism is my super power" so please don't put words in my mouth. I will agree that it is offensive but that is very different from saying "somewhere on the spectrum" when I don't feel like having a more in dept conversation. And again my point is that contrary to what the article seems to be trying to make, no one really considers Autism a single thing.
    - nxor 1y ago
      The article is about ASD.
Cypher 1y ago
Who was?
dboreham 1y ago
What's going on with the brain of any particular person is a point in a very high dimension space. What doctors call conditions are regions in that space. The definition of those regions has something to do with understanding and helping the humans and their families, but also something to do with the doctors making money. In the US Healthcare system nothing can be paid for unless it is in service of treating a "condition". Slightly odd that an article in The Economist doesn't mention this.
- o11c 1y ago
  Related: doctors will refuse to test you to see if what you're suffering from is a particular condition unless that condition actually has a known treatment.
  - ceejayoz 1y ago
    We test for plenty of incurable diseases.
  - deleted 1y ago
    [deleted]
__MatrixMan__ 1y ago
It has always bothered me that by "spectrum" they mean not the sort of continuous thing that spectra actually are, but instead some disjoint set of "colors" any one of which might describe a person. That's called a partition, and its in an entirely separate thing. When I tell this to people they understand immediately that I am in fact on that "spectrum".
- 4ndr3vv 1y ago
  > It has always bothered me that by "spectrum" they mean not the sort of continuous thing Oh but they do. the "spectrum" is by how socially acceptable someone's autism is.
  - rusk 1y ago
    > how socially acceptable someone I intuitively understand this but has it been clinically defined?
    - mikestorrent 1y ago
      Has social acceptability in any context ever been defined, beyond say, rules of etiquette? It's a free market and everyone is arguably entitled to test to see what it will bear.
    - lazide 1y ago
      The entire nature of the field of psychology and mental health treatment is relative to pain and dysfunction. If people fit in well and didn’t have issues (either internal pain/suffering or society interaction pain/suffering), they are not applicable to the field.
      - prepend 1y ago
        This is key and what makes something a disorder. Everyone experiences some obsession or compulsion. But only some experience it to the degree of a disorder. Just like everyone has some “autistic” tendencies. But it is only a disorder in some.
photochemsyn 1y ago
The Economist should not be treated as reliable source of information on medical issues. [edit] To be more specific, this is a lazy take and is about as insightful as saying 'cancer should not be treated as a single condition' which for HN is about as meaningful as saying 'the CPU and the GPU may both contain chips, but they should not be programmed the same.'
- zzzeek 1y ago
  and times a hundred, Robert F Kennedy Jr., an absolute con artist with no qualifications of any kind
mrguyorama 1y ago
It is called "Autism spectrum disorder" Disorder by definition means that we do not consider it to have a single cause or issue, and we acknowledge that we don't understand it well enough to give it a single name, cause, or objective diagnostic criteria. When we know what causes something, or how to strictly and objectively identify it, then we usually call it a disease. This is well understood by medical professionals, and a normal part of their job, and not confusing for the vast majority of people diagnosed with some disorder or other. This article is utter trash. As per the usual for the economist
- Lendal 1y ago
  Thanks for that insight. I previously had only a vague notion of why disorder is used. One of the main reasons I don't want to have an official diagnosis is because the word disorder has such a negative connotation. I really don't want any disorders, so if I just ignore it, try not to think about it, maybe it will go away, and then I won't have a disorder.
ilaksh 1y ago
We don't have any geniuses or stupid people anymore -- just autistic and ADHD. Are you shy, slightly socially awkward and very intelligent? You must be "on the spectrum". The most intelligent, knowledgeable, socially tuned and socially integrated people I see online claim to be autistic. I swear it is absolute nonsense.
- deleted 1y ago
  [deleted]
- dontwannahearit 1y ago
  I think a lot of it is peverse incentives. There are social (cut me some slack, I'm autistic) and in socialized medicine systems, financial benefits to an autism diagnosis. So yeah, why wouldn't you claim to be autistic, what's the downside? Add to that Gen-Z, socially awkward, isolated and poisoned by their obessive phone addictions frantically searching the internet "Why do I feel socially awkward?" and a million "Take out autism test!" links later get their answer. Yes indeed, they have autism, the test proved it.
  - JohnMakin 1y ago
    Autism is much more than social awkwardness, and I'm sure you're not intending to be, but this post is extremely dehumanizing and insulting to people dealing with the issues that an ASD diagnosis typically presents with. and, by the way, many high functioning individuals have to fight for their entire lives to even get a diagnosis, so I'm not sure where you're getting your information from that these are being "handed out like candy" or whatever. I can point you to a variety of sources online if you're interested in learning what this actually is.
    - dontwannahearit 1y ago
      With respect, I am not insulting people dealing with the issues of ASD diagnosis. Autism is real and can be debilitating. The comment I replied to said "...claim to be autistic" and that is what I am refering to. I am calling out self-diagnosing over vague feelings of "feeling different" and on the basis of online tests. Everyone who needs an autism diagnosis should get one. Not everyone who wants one.
bolangi 1y ago
Reacting to the headline, I understand the basic concept of medicine is you treat a patient who presents with a condition, not a condition in isolation like some kind of abstract math problem. I think it's a mistake when doctors say to each other, even as a shorthand, I have a gallbladder to deal with, when it's a real person, and the best results come from considering the whole person when pondering how to care for them and which treatments to administer, with the medicine being only a part.
- rusk 1y ago
  You are speaking commendably from the point of view of diagnostics but from the point of view of physical operation you absolutely need that specialisation.
- LorenPechtel 11mo ago
  It is perfectly reasonable for the doctor to have "a gallbladder" to deal with--there are few failure modes and a standardized response to them. In specialized fields you will find professionals describe situations in terms of a baseline and any deviations from said baseline--just about completely unintelligible to anyone who doesn't know those baselines. To describe a patient as "a gallbladder" is saying it's a standard presentation of the problem. And doctors are not supposed to identify patients if not necessary.
jawns 1y ago
The main argument in favor of treating it as a single condition tends to come from the advocacy side, rather than from the diagnostic side. In terms of advocacy, there is strength in numbers, and arguably having such a large autism community has been good for both research and support. Potentially breaking that up into several smaller communities might lead to an overall decrease in impact. On the other hand, pretty much everyone with autism, or families who have children with autism, will tell you that there is wide variation in both severity and presentation. And I think most would welcome better definition of subtypes.
- pseudocomposer 1y ago
  I think “neurodivergence” is a better label if the goal is gaining strength in numbers. It fully encompasses autism and autism spectrum related conditions, plus ADHD and others. A lot of people don’t want the label “autistic,” but share experiences with people who do, and would love to offer solidarity as an “inside” rather than “outside” member of the community. We now have “AuDHD spectrum” as a thing, but really, I think optimum numbers might come from including folks who identify as “broadly neurodivergent.” It also leaves room to start distinguishing/separating out more subtle variants of what we currently umbrella as “autism,” perhaps making it better defined in the future. And I kind of suspect doing this with “less profound” neurodivergencies could help folks with “more profound” (and rarer) cases. To look at a historical case: Gay Rights didn’t make a lot of headway. But adding lesbians, trans folks, etc. ultimately did a lot of good for that community in the US.
  - reedf1 1y ago
    I was recently labelled neurodivergent by a colleague at work, as far as I can tell this is simply because I am good with numbers and don't like parties. I'm not sure how I feel about this, I wouldn't say I am Autistic or show any representative characteristics.
    - cardanome 1y ago
      Autism or well any form of neurodivergence are about how you work on the inside. It is not possible to observe how a person behaves and just diagnose someone. That is why getting a diagnosis is a whole process involving a trained professional. Your colleague is full of shit. Generally, neurodivergence is for everyone who regularly experiences that the way their brain works causes them trouble. Self diagnosis is surprisingly accurate but people also tend to under estimate the severity of their symptoms.
bena 1y ago
It's difficult because the variance is so wide. To compare: Three profiles of people with diagnosed Autism. Blindboy Boatclub: An Irish satirist who wears a plastic bag on his head in public appearances. Formerly of a band called The Rubberbandits. Today he is known for his podcast and has authored three books of short stories. He comes across as eccentric, but he's quite capable of managing in society otherwise. Side note, one of the other members of The Rubberbandits went by the moniker of Mr Chrome, but is better known to people as Bobby Fingers today. My stepson: Just a teenager navigating one of the more emotionally turbulent times while being noticeably different. He has fine motor issues and some social deficiencies. The best I could describe it is that he's emotionally a few years behind where other kids his age would be. He has few accommodations, mostly extra time and the ability to leave a situation that is overstimulating him. He's odd, probably always be a bit odd. May never be able to tie his shoes, but with work, he should be able to navigate society as a functioning adult one day. Wife's student: My wife is a special education teacher and she has a student who is completely non-verbal. However, he is noticeably intelligent and can form complex thoughts and can attempt to express them. Managed to use his visual communication device to insult one of his teachers based on her appearance. He will likely have issues for his entire life and will likely need constant therapy. Now, what one thing can we do for these three very different autistic people? There's a reason people say "When you've met one person with autism, you've met one person with autism". While there are some commonalities and typical comorbidities, what we regard as autism presents in so many different ways, it's incredibly difficult to construct a single program to address it. And I can see why we'd want to break it up. But that gets difficult as well. My stepson started low-verbal. Didn't speak for a while. Spoke rarely for a while longer. And now he speaks a lot. And he's learning when it is appropriate to speak and to handle people speaking around him but not to him. So he was non-verbal. But then became verbal. But not all autistic children cross that border. All that to say: I dunno. Shit's complicated, yo.
- toast0 1y ago
  > My stepson: Just a teenager navigating one of the more emotionally turbulent times while being noticeably different. He has fine motor issues and some social deficiencies. The best I could describe it is that he's emotionally a few years behind where other kids his age would be. He has few accommodations, mostly extra time and the ability to leave a situation that is overstimulating him. He's odd, probably always be a bit odd. May never be able to tie his shoes, but with work, he should be able to navigate society as a functioning adult one day. As someone with some similar issues, a) my motor skills are fine, b) the focus on tieing shoes is so frustrating; velcro shoes are everywhere, you can even get Dr. Martens high boots with zippers so you don't have to tie them... like sure, try laces and if it works great... but just provide the accommodation and move on. :P On the plus side, everyone said playing video games would help my fine motor skills, so I got an out to play a lot of video games, which I enjoyed. :D And my atrocious penmanship hasn't been an issue in adult life, because nobody writes anything anymore (and have you seen the penmanship for kids that were in 2-4th grade during covid ... it's worse than mine!)
BurningFrog 1y ago
Autism seems more like a symptom than a condition. "Stomach ache" is not a spectrum disorder, even though is comes in many severities. It's a symptom of dozens of different medical conditions. I suspect "autism" is similar.
- jermaustin1 1y ago
  Autism isn't a symptom because Autism Spectrum Disorder isn't a singular "thing" it is a combination of features that manifest in various "symptoms" - eye contact avoidance (or the opposite), sensory processing (over- or under-stimulating), restrictive interests (singular focus), etc. A stomach ache is a single manifestation of something happening. A stomach ache can have varying degrees and reasons behind it. The stomach ache is the signal. The disorder that causes it could be psychological (GAD) or external (someone punched you, and the flesh is bruised) or internal (someone fed you a weeks old egg salad sandwich). In autism the 'symptom' could be model train enthusiasm or being nonverbal. There are a lot of symptoms the fit under the umbrella of the disorder.
  - LoganDark 1y ago
    From my lived experience and also from the preprint I love very much https://www.thetransmitter.org/spectrum/untangling-biological-threads-from-autisms-phenotypic-patchwork-reveals-four-core-subtypes https://www.thetransmitter.org/spectrum/untangling-biologica... the autism spectrum is basically a collection of ways a brain can largely work differently than "normal". There's a limited number of these (4 according to current research). It's not that there's just individual small features that manifest in things like eye contact avoidance, over/understimulation, etc. it's that the entire brain will work a specific differently and result in a certain set of symptoms consistent with an autism diagnosis. I feel like autism helps form the basis that other neurological differences happen on top of, because it has such a large impact on how thinking and learning even works in the first place. Even in conditions like schizophrenia, psychosis, etc. you see thought loops or detachment from reality or delusions or any number of those kinds of dysfunctions but it all still happens on a base where there can be basically one of the four autisms; the autism seems to be a difference in the foundation that the rest of the brain is built on top of. It's very fascinating to me (I am very autistic). Of course I don't mean to say at all that each autistic type always results in the same brain function but just that usually other difficulties or differences are less fundamental than how autism changes practically everything.
pseudocomposer 1y ago
I’ve long thought that autism is basically a few thousand very normal, small neurodivergencies (which may each be compounded with social effects). The absence of any of them is “perfect functioning human cog/prime chunk of workmeat.” The presence of too many/particular ones of them is notably disabling for certain tasks, or makes perceiving some things difficult (and other things easier). But I think the presence of some is preferable to having none, and implies “can think abstractly for/about oneself.” (And yes, a lot of the “problems” that arise with folks on the spectrum happen because, well, being aware of yourself as a cog/workmeat creates friction… It’s important to keep in mind how much of our history of psychological medicine that created the label “autism” is ultimately oriented towards “fixing the cog/workmeat.”)
- aDyslecticCrow 1y ago
  > presence of too many/particular ones of them is notably disabling for certain tasks Setting asside the very clear science of neurodevelopmental causes, in practice your description is very helpful way to describe it. (Ive often myself described it as a standard deviation beyond 2 sigma in a normal distribution with 500 dimensions.) The traits associated with autism are naturally present in the population in healthy and useful ways. Matching a large fraction of the definition may pose no problem for alot of people. But another smaller deviation in another sub permutation may be detrimental to live a normal life. So it's really difficult to draw a line between "condition" that need assistance and just outlier human that like trains. I mildly match a significant fraction of the diagnostic criteria myself, but have had a rather easy time. I don't need special resources, and feel wierd to count under a medical term. But recognising the traits of ASD had allowed me to find quite a lot of good practical advice that improve my life significantly. So the broad definition has been helpful.
- amatecha 11mo ago
  Yeah I agree. I see it something like this as well. I often feel like calling it an "illness" or even "disability" is kind of a misnomer, because having traits that are encompassed by the definition of "autism" are often actually strengths and advantages (to an overwhelming extent, not in just some weird edge case situation).
- 11mo ago
ThinkBeat 1y ago
This is highly accurate. Presently its a whole set of entirely different diagnosis make up "the spectrum". They even eliminated "Asperger" and then just folded that into the spectrum as well. I sometimes think about two women sitting on down on a bench. Once says a bit uneasily "my son, well he is on the spectrum" The other responds with "Oh I know what you are going through my daughter is also on the spectrum" At this point neither has any idea whatsoever about what the others experience is like. One may be highly functional, socially awkward and doesn't think like normal people and processes sight and sounds the same. I find myself moderately down this path. The other may be non verbal and violent.
- cardanome 1y ago
  If you have met one person with autism you have met one person with autism. This is true for anything else and no argument against the current diagnosis. There are people with Covid that ended up in the hospital and people with Covid who barely had any symptoms. Both have Covid. Autism doesn't work from "little autism" to "a lot of autism". One person can have strong sensory issues but decent social skills. Another bad social skills but not sensory issues at all. And care needs can change over your life, they are not fixed.
  - suddenlybananas 1y ago
    The crucial difference is that we know the etiology of COVID and so are justified in treating those two people as having the same disease. Autism is much more complicated because we don't have a thing to define it other than a bunch of disparate symptoms. It might turn out like if we treated the cold, COVID, tuberculosis and lung cancer as the same thing because they all involve coughing.
    - cardanome 1y ago
      We know that autism has a strong genetic link. Furthermore we employ differential diagnostic and check whether your symptoms could be better explained by another condition. You don't just diagnose people with autism because they have a few symptoms. Furthermore autistic people can generally relate to each other. Even if two autistic people show very different symptoms there is often a feeling of belonging together. It is always possible that we will learn more in the future and maybe we will have other diagnosis criteria or discover some people currently diagnosed under autistism would fit better under something else. However the current diagnostic criteria for ASD is the current state of our scientific knowledge. A lot of clinical research is baked into it.
ChrisArchitect 1y ago
Previously: https://news.ycombinator.com/item?id=45451103 https://news.ycombinator.com/item?id=45451103
dr_dshiv 1y ago
Autism was split into autism and Asperger’s. But calling people with social challenges “Assburgers,” I mean, wow. Just wow.
- lcnPylGDnU4H9OF 1y ago
  > Asperger’s This term has a complicated history so people use "high-functioning" now. Many refer to Hans Asperger as a Nazi eugenicist. Reasonably, I'd say. https://en.wikipedia.org/wiki/Hans_Asperger#Children_sent_to_Am_Spiegelgrund https://en.wikipedia.org/wiki/Hans_Asperger#Children_sent_to... https://en.wikipedia.org/wiki/Am_Spiegelgrund_clinic#Experimentation_and_child_euthanasia https://en.wikipedia.org/wiki/Am_Spiegelgrund_clinic#Experim... > Just as the physician must often make painful incisions during the treatment of individuals, we must also make incisions in the national body, out of a sense of responsibility: we must make sure that those patients who would pass on their diseases to distant generations, to the detriment of the individual and of the Volk, are prevented from passing on their diseased hereditary material
- Der_Einzige 1y ago
  Same stuff with lisp being the name of a condition that people with lisps can’t pronounce. They did it on purpose and they know what they did. The same folks who cause all the Mandela effects did this cus they thought it’s funny. We are all job in his biblical story.
wslh 1y ago
https://archive.is/zOQv5 https://archive.is/zOQv5
prepend 1y ago
I’ve been using “autism that I care about” because a large number of people I encounter are on the spectrum / neurodivergent (hobbies and work I suppose) that require very different interventions and accommodations that people with whatever you call significantly affected people with autism are called (eg, Rain Man, etc). Not that people low on the spectrum aren’t important, they are, but that just using standard interaction tactics that I would with non-spectrum people works well enough. So trying to save time that someone doesn’t need to interrupt the conversation to say they are on the spectrum and can only eat smooth foods or whatever.
pessimizer 1y ago
[flagged]
- ien24sdq 1y ago
  This is a weird comment, and not surprising to see the downvotes - hope your day gets better! One important thing that’s being missed here, though, is the role of parents - getting an ASD diagnosis is extremely useful for parents in terms of understanding/excusing their personal struggles in being a parent.
austin-cheney 1y ago
The article does not mention Pathological Demand Avoidance as a form of autism. Everybody avoids chores they don't like, but people with PDA take it an extreme. For somebody to have PDA enough that it becomes a shade of autism the world exists only in the form of I want and I don't Want so much so that it limits the imagination and perceptions of the world. For example somebody with PDA autism cannot interpret the nonverbal communications of other people because they have already made the immediate decision that they want to be liked by others, so therefore they are. They cannot try new foods because they may not like it if they do try, so therefore they don't like it already. They would rather suffer hours of punishment grounded in their room than accomplish a 2 minute chore, because they already know in advance they would prefer to not do the chore given a choice to not do it. People with PDA autism often appear to be sociopaths and pathological liars. They are not either of those things, due only to a minor difference in motivation. Sociopaths don't care if somebody else gets hurt so long as they get what they want, while harm to others does impact somebody with PDA in a very normal way. Since they have no capacity for empathy and color every past observance to fit their world definition of saving face it takes a lot of time with a PDA person to see the distinctions between them and a sociopath.
nathias 1y ago
I think we will slowly come to understand that we all start neurodivergent and only some people converge.
- IAmBroom 1y ago
  Ironically very accurate for an en vogue theory of how autism occurs. Babies are born with many more neural connections than most adults have. The learning process appears to include a "winnowing" process. OTOH, autistic individuals appear to have a larger number of neural connections, which suggests that they did in fact "not converge" (or not weed out excessive connections that distract from more productive decision-making).
  - nathias 11mo ago
    ironic how?
creatonez 1y ago
This is an idiotic media talking point not actually reflected in the clinical evidence. Unifying autism diagnosis under the ASD label was not a mistake, for a lot of reasons.
squidsoup 1y ago
I'm concerned that the identification of genetic subtypes of ASD, as mentioned in the article, will lead to more terminations of pregnancy. We need people that see the world differently.
- scythe 1y ago
  The most easily identified "autism genes" (eg "fragile X") tend to lead to severe variants of the condition, which probably don't benefit anyone. We may eventually have a "Gattaca problem" but this isn't that, at least not yet.
- kulahan 1y ago
  There are 8 billion people from a multitude of backgrounds and experiences. We’ve got plenty of viewpoints. People get abortions because it’s financially inconvenient or a bad time or something else trivial constantly. Surely a lifelong affliction isn’t that hard to understand the motivations behind.
- 453yuh46 1y ago
  You are obviously a male - when it comes to providing best genes from rich individuals, there seems to have been no shortage of females that wanted to have babies from Elon Musk with his autistic genes... I am forgetting how serious ASD people can be without having able to make any jokes. Relax, dude - by the time when government will be able to provide such services, all the humans will have autistic genes - there clearly are some natural advantages to people, that are multiplying with those genes and spreading them around. And unfortunately to say this, but natural selection is the only thing that will weed out those so called "heavy autistic cases" and they will cease to be a problem in time.
  - LorenPechtel 11mo ago
    Yup, autism spectrum tends to strongly mess with your ability to find a romantic partner. And that is decidedly selected against. However, I don't think the random nature of evolution will have a meaningful effect on humanity going forward. We will soon reach the point of selecting for more desirable genes. Done badly it would be Gattaca.
carlCarlCarlCar 1y ago
Autism emerges from higher intelligence: https://pmc.ncbi.nlm.nih.gov/articles/PMC4927579/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4927579/ If anyone must be branded atypical (not saying anyone should but am willing to pushback on those who do) and in need of special attention it should be the historical story-mode dependent who cannot move on from childhood allegory.
ianberdin 1y ago
I have some sort of it and I built an AI tool to help myself to get emotional intelligence. https://getpartner.ai https://getpartner.ai
tiberriver256 1y ago
YES PLEASE. This actively harms diagnostics and encourages cure-all peddlers. Definitely has been good for financial benefits and such but... Once someone gets the "autistic" diagnosis all further research stops.
LoganDark 1y ago
This preprint inspired me greatly: https://www.thetransmitter.org/spectrum/untangling-biological-threads-from-autisms-phenotypic-patchwork-reveals-four-core-subtypes https://www.thetransmitter.org/spectrum/untangling-biologica... It looks like this article is talking about that exact preprint, but a quick skim didn't reveal any sort of link. Ever since I first read it, I've been training myself to identify the subtypes. I don't have good names for them, nor do I know how they correspond to the names in the preprint, but I can usually tell them apart. I have indeed seen exactly four. I would love for there to be more research into the intricacies of each subtype, because I feel that care and accommodation could get a lot more personalized and helpful if there were less of "anything goes / anything could happen" and more specialization to what's most likely to be effective for each particular subtype. As it is, a lot of care programs or individuals supporting them may be specialized to an unknown degree to particular subtypes and not really understand how to become less specialized or even specialize further. On top of that, I greatly want to understand better the subtypes other than my own, not least because a couple of them I can find very difficult to communicate with because my knowledge and arguments are formatted differently than how they learn. I want to learn how to format my knowledge in a way that's easier for them to understand and more convincing for them. I'm just very curious and interested and I really hope the idea of autistic subtypes takes off because it absolutely agrees with what I've seen in practice.
nerdralph 1y ago
I got my diagnosis shortly after the DSM-5 release but my psychologist also gave me the DSM-IV Asperger's diagnosis at my request. I tell people I'm an Aspie, and that it is considered to be on the autism spectrum. I prefer the Aspie label because it is more specific. My interpretation was that the DSM-5 grouped it under autism spectrum distorders. I've never met a psychologist or psychiatrist that considered the autism spectrum to be a single condition.
cyanydeez 1y ago
It should not, but it is because the healthcare system is broken; the education system is broken; and the social system is broken. So people who have problems get lumped together because these systems are all stripped for parts because of capitalism and religiousity. It'd be great to have a functional science based medical care but that won't help the children stuck in a hellhole of anti science, antisocial and pathological liars.
kristianp 1y ago
One thing that interests me is the overlap between ADHD and ASD. My family seems to have a mix of different strengths of both. Some overlap of problems, e.g. executive function, emotional regulation, hyperfocus on topics of interest, suggests to me there needs to be a re-assessment of both conditions. The overlap also makes it difficult to diagnose ADHD when both are present.
- Maxious 1y ago
  The co-diagnosis of autism and ADHD became possible with the DSM-5 in 2013. According to the scientific literature, 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD). https://pmc.ncbi.nlm.nih.gov/articles/PMC8918663/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8918663/
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shtzvhdx 1y ago
Which is probably why the causes of these diseases are so well masked.
QuadmasterXLII 1y ago
Approximately 50% of people with autism have intellectual disability. The people without intellectual disability are more convenient to recruit for studies. As a result, across a wide variety of studies on autism, only 6% of autistic participants had intellectual disability. https://link.springer.com/article/10.1186/s13229-019-0260-x https://link.springer.com/article/10.1186/s13229-019-0260-x
- hunta2097 1y ago
  My son has "autism". He is 25 and needs constant supervision and care. I feel that the word "autism" is now meaningless. I must know 50 of his cohorts and even though they're all "autistic" they can be quite different. I also agree that his needs are underrepresented and drowned out by those mildly-affected who have the mental capacity to speak out for themselves.
matrix87 1y ago
I remember back in the 2000s - 2012ish it used to actually mean something, if someone had autism then they were actually disabled and it was obvious. 90% of the "conversation" around autism today is a bunch of handwavey bullshit. There's no incentive for people to be intellectually honest. It's now a moral hazard because so many people are "attached" to the label and get accommodations out of it. You can pay phony therapists online to just go straight to a diagnosis so you can get accommodations. There are financial and political incentives in diagnosing more people. People can't have an honest conversation around it either because it's such a charged issue. We either get one side that wants to expand the scope of autism to infinity or the RFK vaccine bullshit
- deleted 11mo ago
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Hobadee 1y ago
My dad likely had Asperger's. (Undiagnosed, but pretty much 100% he did). I have close friends with children who are very autistic. (Not completely non-verbel, but they say very few words and are still more likely to have a screeching meltdown than talk.) My dad was highly successful; a leader in his industry and did a great job supporting us. His life was relatively easy (as easy as life can be in general) and he was a contributing member of society. We love my friends kids to death and they do have many positive things going for them, but they will likely never be able to live on their own. Even if they do, they are in for a very hard life. They will likely always need to be supported by family and will likely never be contributing members of society. To lump both those together is insane. It drives me crazy when people who are functional members of society run around laughing about how they are "autistic". I can't think of anything more disrespectful to those who can never have a "normal" life. With that being said, I do recognize that medically there is a spectrum. I, as someone with ADHD am likely on that spectrum somewhere as well, from how the science is sounding these days. We need to make this spectrum obvious and respectful though. Why can't we classify a level or something? For example "Autistic level 1" for Asperger's, "Autistic level 2" for barely verbal, "Autistic level 3" for non-verbel... Something like that, so we can unite the cause, but still differentiate the effects and potential outcomes.
- Ambroos 11mo ago
  These levels exist since the DSM-5, which is not yet in use everywhere: The DSM-5 introduced three ASD levels of severity: level 1 (“requiring support”), level 2 (“requiring substantial support”), and level 3 (“requiring very substantial support”). https://www.autismspeaks.org/levels-of-autism https://www.autismspeaks.org/levels-of-autism has a good complete overview.
- NoGravitas 11mo ago
  > It drives me crazy when people who are functional members of society run around laughing about how they are "autistic". A lot of us low-support-needs autistic people are functional members of society right up until we aren't (i.e., until we've been masking for too long while dealing with sensory stressors and One More Little Thing pushes us into the "screeching meltdown" or renders us temporarily nonverbal). And a lot of us have "normal" lives only in as much as you only see the normal parts. It's kind of fair to divide things up by support level, but you then also have to understand that there are a lot of different support needs people have and they can look very different at the same "level".
lutusp 11mo ago
Bad article title. It should be "Autism should be divided into more specific diagnoses, once we have reliable, evidence-based diagnostic criteria." There's a reason Asperger Syndrome was abandoned as a separate condition and folded into ASD (in DSM-5) -- until then, anyone who wanted the diagnosis could get it, by displaying symptoms popularly associated with the condition. So we had clinical indicators, but no objective biological tests -- still true for most DSM-listed conditions. This led to widespread abuse and uncertainty. The single label "autism" has many drawbacks, but one important advantage -- it reveals what we know in a scientific sense, which is next to nothing. Eventually neuroscience will change this and identify biological causes for many "mental" conditions. This will end diagnoses based on clinical interviews and replace them with objective biological tests. I imagine this scene in a future neuroscience clinic: Patient: "Let me tell you what I think is wrong with me." Clinician: "Don't bother, we have objective biological tests now -- your narrative would only confuse the process. Remember psychology?"
- tadfisher 11mo ago
  But it is divided into more specific diagnoses with distinguishing diagnostic criteria, and we call them "profiles". They are related, and thus are placed under the umbrella of ASD, because the DSM-5 is a diagnostic manual and not a full taxonomy of developmental disabilities. One such profile is pathological demand avoidance (PDA). Another is Asperger Syndrome, which has been reclassified as an ASD profile. They all exhibit the diagnostic criteria for ASD in one or more ways. Also, I want to point out that calling ASD a "mental condition" doesn't have a scientific basis; it is classified as a developmental disability. These terms matter, whether or not you consider this to be some kind of abuse.
  - lutusp 11mo ago
    > But it is divided into more specific diagnoses with distinguishing diagnostic criteria The criteria are based on effects, not causes. They lack depth. Let me put it this way -- if a trained actor can acquire a diagnosis, then it's not based on causes, only effects. This would be like gathering rocks from a field and classifying them based on their color or shape, but without a science of geology to inform the classifications. A trained actor can't pretend to have cancer, because we know what causes it, and we have meaningful clinical tests that categorically exclude anything but a specific biological source. Psychology doesn't have this property, and it may never have it. When Thomas Insel resigned as director of the NIMH, he frankly said that the agency hadn't "moved the needle" in terms of knowledge or treatment, in spite of 13 years of effort and a 20 billion dollar outlay (reference: http://blog.stevenreidbordmd.com/?p=1615 http://blog.stevenreidbordmd.com/?p=1615). I greatly respect Insel's candor and willingness to report facts in a field seemingly driven by illusion. > Also, I want to point out that calling ASD a "mental condition" doesn't have a scientific basis Sorry, but since the entire field has no scientific basis, it's unfair to single out a specific example without acknowledging this fact -- the elephant in the room. > ... it is classified as a developmental disability. That also has no scientific basis, it's a response to a fad, a transitory response to fashion (as were all the classifications that went before it). In point of fact, ASD has a biological cause, but we have no idea what it is. > These terms matter ... No. They don't. This is proven by the fact that they keep changing, but without any change in evidence or science. Neuroscience will change all this, but not any time soon.
nephihaha 11mo ago
I've been saying this for years. It is more of a cluster I think.
poulpy123 11mo ago
I think the popularity of the description of autism as socially awkward supergenius hurt a lot the children with the variant "I can't tie my shoes or even speak" and their family
AbstractH24 11mo ago
This is true of many conditions that seem to be one thing but are actually, in all likelihood, many unrelated conditions with overlapping symptoms. Particularly when it comes to the brain. It's a reflection of how little we know about it.
amai 11mo ago
The study mentioned in the article is Litman et. al (2025): Decomposition of phenotypic heterogeneity in autism reveals underlying genetic programs https://pmc.ncbi.nlm.nih.gov/articles/PMC12283356/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12283356/ The code is available at https://github.com/FunctionLab/asd-pheno-classes https://github.com/FunctionLab/asd-pheno-classes .
tsoukase 11mo ago
Since many years the only advancements in autism research are descriptive trends: "diffuse development disorder", "spectrum" and now "multiple conditions". As long as these words refer to syndromes and not to mechanisms or causes, they will only be word fanciness. I suggest a change of the autism term to something like "idiopathic apsychia" (loss of soul, empathy disorder etc) which demonstrates a common causal base and can focus the attention to more meaningful academic research and public acknowledgement.

265 points by bookofjoe 1y ago

https://archive.md/zOQv5 https://archive.md/zOQv5

bookofjoe 1y ago

https://archive.ph/zOQv5 https://archive.ph/zOQv5

ilvez 1y ago
What's with these archive links these days. I just get locked behind "Are you a human" clicking and random captchas.
- windsignaling 1y ago
  I didn't realize these archive links were still working. Ever since the FBI order in November, these links have just been hanging for me. https://downforeveryoneorjustme.com/ https://downforeveryoneorjustme.com/ had been saying it was down so I just thought it actually was down for everyone, but I continue to see these links posted. Is the site still working for some people?
  - aspenmayer 1y ago
    The blocks tend to be implemented at the DNS level, so you can usually connect by using a different DNS server. The Tor onion link works fine as well, and that URL is on the archive.today Wikipedia page. https://en.wikipedia.org/wiki/Archive.today https://en.wikipedia.org/wiki/Archive.today > archiveiya74codqgiixo33q62qlrqtkgmcitqx5u2oeqnmn5bpcbiyd.onion via this post on their blog: https://blog.archive.today/post/711271973835227136/did-something-change-over-the-past-few-days-such https://blog.archive.today/post/711271973835227136/did-somet...
    - ilvez 1y ago
      Thank you both, this explains a lot..
- Der_Einzige 1y ago
  I’m kind of glad it’s happening so that folks here have to reckon with being the world being full of copyright trolls rather than having some easy “let the nerds have it only for us” solution. Stop posting paywalled shit on HN please.

ceejayoz 1y ago

> Robert F. Kennedy junior, America’s health secretary, thinks that autism has become an “epidemic” in his country. His concern stems from figures from the Centres for Disease Control and Prevention, which shows that the condition now affects 32 per 1,000 eight-year-old children in America (see chart). That is in contrast, he says, with the near-absence of the condition in his childhood. Mr Kennedy was born in the 1950s, and studies estimate a prevalence of autism to around two to four per 10,000 in the 1960s. I'd note that RFK Jr.'s very own aunt was lobotomized then hidden away for something that sounds a lot like autism if diagnosed today. https://en.wikipedia.org/wiki/Rosemary_Kennedy https://en.wikipedia.org/wiki/Rosemary_Kennedy

bluGill 1y ago
Read any old book (like from the 1800s), or look into anyone's family history. There is always some version of "Larry never leaves the farm". Nobody every diagnosed "Larry" so we don't know what he had and often we only have a small fraction of the symptoms recorded, but what we have sounds suspiciously like Autism (and one of a dozen other things we now have names for)
- ceejayoz 1y ago
  Yup. Or if they were rich, "eccentric". https://en.wikipedia.org/wiki/John_Bentinck,_5th_Duke_of_Portland https://en.wikipedia.org/wiki/John_Bentinck,_5th_Duke_of_Por... > The tunnels under the estate were reputed to have totalled 15 mi (24 km), connecting various underground chambers and above-ground buildings. They included a 1,000 yd (910 m) long tunnel between the house and the riding house, wide enough for several people to walk side by side. A more roughly constructed tunnel ran parallel to this for the use of his workmen. > The duke was highly introverted and well known for his eccentricity; he did not want to meet people and never invited anyone to his home. He employed hundreds through his various construction projects, and though well paid, the employees were not allowed to speak to him or acknowledge him. > He ventured outside mainly by night, when he was preceded by a lady servant carrying a lantern 40 yards (37 m) ahead of him. If he did walk out by day, the duke wore two overcoats, an extremely tall hat, an extremely high collar, and carried a very large umbrella behind which he tried to hide if someone addressed him. > He insisted on a chicken roasting at all hours of the day and the servants brought him his food on heated trucks that ran on rails through the tunnels.

nerdjon 1y ago

I will admit that I stopped reading the article because I think the article is completely mixing things up and honestly just did not feel like reading anymore of it. I think very few people actually consider it a single condition. To the point that most people that I know, including myself, say that we are "somewhere on the spectrum" or some variant of that. This isn't a post diagnoses understanding either, it is well understood by anyone I have talked to about this in the last 10ish years? (maybe less, I cant really pinpoint that). While I feel like there is value for professionals to be more specific about it, from an everyday person prospective I feel like "Autism" is well enough understood to be not just a single thing. Enough so that some phrasing along the lines of "my tism is..." is somewhat commonplace. The real problem is anti-science people joining the conversation, but splitting up Autism is not going to change that. Edit: To be very clear here I am not trying to say that most people in general are saying "I am somewhere on the spectrum". I am saying that most people I know which a larger portion of the people I regularly talk to are also diagnosed.

jklinger410 1y ago
> I think very few people actually consider it a single condition. To the point that most people that I know, including myself, say that we are "somewhere on the spectrum" or some variant of that. Couldn't disagree more. The "autism is my super power" movement is borderline offensive to people dealing with severe or low functioning autism. Dismissive, uninformed comment.
- nerdjon 1y ago
  I have never in my life used "autism is my super power" so please don't put words in my mouth. I will agree that it is offensive but that is very different from saying "somewhere on the spectrum" when I don't feel like having a more in dept conversation. And again my point is that contrary to what the article seems to be trying to make, no one really considers Autism a single thing.
  - nxor 1y ago
    The article is about ASD.

Cypher 1y ago

Who was?

dboreham 1y ago

What's going on with the brain of any particular person is a point in a very high dimension space. What doctors call conditions are regions in that space. The definition of those regions has something to do with understanding and helping the humans and their families, but also something to do with the doctors making money. In the US Healthcare system nothing can be paid for unless it is in service of treating a "condition". Slightly odd that an article in The Economist doesn't mention this.

o11c 1y ago
Related: doctors will refuse to test you to see if what you're suffering from is a particular condition unless that condition actually has a known treatment.
- ceejayoz 1y ago
  We test for plenty of incurable diseases.
- deleted 1y ago
  [deleted]

__MatrixMan__ 1y ago

It has always bothered me that by "spectrum" they mean not the sort of continuous thing that spectra actually are, but instead some disjoint set of "colors" any one of which might describe a person. That's called a partition, and its in an entirely separate thing. When I tell this to people they understand immediately that I am in fact on that "spectrum".

4ndr3vv 1y ago
> It has always bothered me that by "spectrum" they mean not the sort of continuous thing Oh but they do. the "spectrum" is by how socially acceptable someone's autism is.
- rusk 1y ago
  > how socially acceptable someone I intuitively understand this but has it been clinically defined?
  - mikestorrent 1y ago
    Has social acceptability in any context ever been defined, beyond say, rules of etiquette? It's a free market and everyone is arguably entitled to test to see what it will bear.
  - lazide 1y ago
    The entire nature of the field of psychology and mental health treatment is relative to pain and dysfunction. If people fit in well and didn’t have issues (either internal pain/suffering or society interaction pain/suffering), they are not applicable to the field.
    - prepend 1y ago
      This is key and what makes something a disorder. Everyone experiences some obsession or compulsion. But only some experience it to the degree of a disorder. Just like everyone has some “autistic” tendencies. But it is only a disorder in some.

photochemsyn 1y ago

The Economist should not be treated as reliable source of information on medical issues. [edit] To be more specific, this is a lazy take and is about as insightful as saying 'cancer should not be treated as a single condition' which for HN is about as meaningful as saying 'the CPU and the GPU may both contain chips, but they should not be programmed the same.'

zzzeek 1y ago
and times a hundred, Robert F Kennedy Jr., an absolute con artist with no qualifications of any kind

mrguyorama 1y ago

It is called "Autism spectrum disorder" Disorder by definition means that we do not consider it to have a single cause or issue, and we acknowledge that we don't understand it well enough to give it a single name, cause, or objective diagnostic criteria. When we know what causes something, or how to strictly and objectively identify it, then we usually call it a disease. This is well understood by medical professionals, and a normal part of their job, and not confusing for the vast majority of people diagnosed with some disorder or other. This article is utter trash. As per the usual for the economist

Lendal 1y ago
Thanks for that insight. I previously had only a vague notion of why disorder is used. One of the main reasons I don't want to have an official diagnosis is because the word disorder has such a negative connotation. I really don't want any disorders, so if I just ignore it, try not to think about it, maybe it will go away, and then I won't have a disorder.

ilaksh 1y ago

We don't have any geniuses or stupid people anymore -- just autistic and ADHD. Are you shy, slightly socially awkward and very intelligent? You must be "on the spectrum". The most intelligent, knowledgeable, socially tuned and socially integrated people I see online claim to be autistic. I swear it is absolute nonsense.

deleted 1y ago
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dontwannahearit 1y ago
I think a lot of it is peverse incentives. There are social (cut me some slack, I'm autistic) and in socialized medicine systems, financial benefits to an autism diagnosis. So yeah, why wouldn't you claim to be autistic, what's the downside? Add to that Gen-Z, socially awkward, isolated and poisoned by their obessive phone addictions frantically searching the internet "Why do I feel socially awkward?" and a million "Take out autism test!" links later get their answer. Yes indeed, they have autism, the test proved it.
- JohnMakin 1y ago
  Autism is much more than social awkwardness, and I'm sure you're not intending to be, but this post is extremely dehumanizing and insulting to people dealing with the issues that an ASD diagnosis typically presents with. and, by the way, many high functioning individuals have to fight for their entire lives to even get a diagnosis, so I'm not sure where you're getting your information from that these are being "handed out like candy" or whatever. I can point you to a variety of sources online if you're interested in learning what this actually is.
  - dontwannahearit 1y ago
    With respect, I am not insulting people dealing with the issues of ASD diagnosis. Autism is real and can be debilitating. The comment I replied to said "...claim to be autistic" and that is what I am refering to. I am calling out self-diagnosing over vague feelings of "feeling different" and on the basis of online tests. Everyone who needs an autism diagnosis should get one. Not everyone who wants one.

bolangi 1y ago

Reacting to the headline, I understand the basic concept of medicine is you treat a patient who presents with a condition, not a condition in isolation like some kind of abstract math problem. I think it's a mistake when doctors say to each other, even as a shorthand, I have a gallbladder to deal with, when it's a real person, and the best results come from considering the whole person when pondering how to care for them and which treatments to administer, with the medicine being only a part.

rusk 1y ago
You are speaking commendably from the point of view of diagnostics but from the point of view of physical operation you absolutely need that specialisation.
LorenPechtel 11mo ago
It is perfectly reasonable for the doctor to have "a gallbladder" to deal with--there are few failure modes and a standardized response to them. In specialized fields you will find professionals describe situations in terms of a baseline and any deviations from said baseline--just about completely unintelligible to anyone who doesn't know those baselines. To describe a patient as "a gallbladder" is saying it's a standard presentation of the problem. And doctors are not supposed to identify patients if not necessary.

jawns 1y ago

The main argument in favor of treating it as a single condition tends to come from the advocacy side, rather than from the diagnostic side. In terms of advocacy, there is strength in numbers, and arguably having such a large autism community has been good for both research and support. Potentially breaking that up into several smaller communities might lead to an overall decrease in impact. On the other hand, pretty much everyone with autism, or families who have children with autism, will tell you that there is wide variation in both severity and presentation. And I think most would welcome better definition of subtypes.

pseudocomposer 1y ago
I think “neurodivergence” is a better label if the goal is gaining strength in numbers. It fully encompasses autism and autism spectrum related conditions, plus ADHD and others. A lot of people don’t want the label “autistic,” but share experiences with people who do, and would love to offer solidarity as an “inside” rather than “outside” member of the community. We now have “AuDHD spectrum” as a thing, but really, I think optimum numbers might come from including folks who identify as “broadly neurodivergent.” It also leaves room to start distinguishing/separating out more subtle variants of what we currently umbrella as “autism,” perhaps making it better defined in the future. And I kind of suspect doing this with “less profound” neurodivergencies could help folks with “more profound” (and rarer) cases. To look at a historical case: Gay Rights didn’t make a lot of headway. But adding lesbians, trans folks, etc. ultimately did a lot of good for that community in the US.
- reedf1 1y ago
  I was recently labelled neurodivergent by a colleague at work, as far as I can tell this is simply because I am good with numbers and don't like parties. I'm not sure how I feel about this, I wouldn't say I am Autistic or show any representative characteristics.
  - cardanome 1y ago
    Autism or well any form of neurodivergence are about how you work on the inside. It is not possible to observe how a person behaves and just diagnose someone. That is why getting a diagnosis is a whole process involving a trained professional. Your colleague is full of shit. Generally, neurodivergence is for everyone who regularly experiences that the way their brain works causes them trouble. Self diagnosis is surprisingly accurate but people also tend to under estimate the severity of their symptoms.

bena 1y ago

It's difficult because the variance is so wide. To compare: Three profiles of people with diagnosed Autism. Blindboy Boatclub: An Irish satirist who wears a plastic bag on his head in public appearances. Formerly of a band called The Rubberbandits. Today he is known for his podcast and has authored three books of short stories. He comes across as eccentric, but he's quite capable of managing in society otherwise. Side note, one of the other members of The Rubberbandits went by the moniker of Mr Chrome, but is better known to people as Bobby Fingers today. My stepson: Just a teenager navigating one of the more emotionally turbulent times while being noticeably different. He has fine motor issues and some social deficiencies. The best I could describe it is that he's emotionally a few years behind where other kids his age would be. He has few accommodations, mostly extra time and the ability to leave a situation that is overstimulating him. He's odd, probably always be a bit odd. May never be able to tie his shoes, but with work, he should be able to navigate society as a functioning adult one day. Wife's student: My wife is a special education teacher and she has a student who is completely non-verbal. However, he is noticeably intelligent and can form complex thoughts and can attempt to express them. Managed to use his visual communication device to insult one of his teachers based on her appearance. He will likely have issues for his entire life and will likely need constant therapy. Now, what one thing can we do for these three very different autistic people? There's a reason people say "When you've met one person with autism, you've met one person with autism". While there are some commonalities and typical comorbidities, what we regard as autism presents in so many different ways, it's incredibly difficult to construct a single program to address it. And I can see why we'd want to break it up. But that gets difficult as well. My stepson started low-verbal. Didn't speak for a while. Spoke rarely for a while longer. And now he speaks a lot. And he's learning when it is appropriate to speak and to handle people speaking around him but not to him. So he was non-verbal. But then became verbal. But not all autistic children cross that border. All that to say: I dunno. Shit's complicated, yo.

toast0 1y ago
> My stepson: Just a teenager navigating one of the more emotionally turbulent times while being noticeably different. He has fine motor issues and some social deficiencies. The best I could describe it is that he's emotionally a few years behind where other kids his age would be. He has few accommodations, mostly extra time and the ability to leave a situation that is overstimulating him. He's odd, probably always be a bit odd. May never be able to tie his shoes, but with work, he should be able to navigate society as a functioning adult one day. As someone with some similar issues, a) my motor skills are fine, b) the focus on tieing shoes is so frustrating; velcro shoes are everywhere, you can even get Dr. Martens high boots with zippers so you don't have to tie them... like sure, try laces and if it works great... but just provide the accommodation and move on. :P On the plus side, everyone said playing video games would help my fine motor skills, so I got an out to play a lot of video games, which I enjoyed. :D And my atrocious penmanship hasn't been an issue in adult life, because nobody writes anything anymore (and have you seen the penmanship for kids that were in 2-4th grade during covid ... it's worse than mine!)

BurningFrog 1y ago

Autism seems more like a symptom than a condition. "Stomach ache" is not a spectrum disorder, even though is comes in many severities. It's a symptom of dozens of different medical conditions. I suspect "autism" is similar.

jermaustin1 1y ago
Autism isn't a symptom because Autism Spectrum Disorder isn't a singular "thing" it is a combination of features that manifest in various "symptoms" - eye contact avoidance (or the opposite), sensory processing (over- or under-stimulating), restrictive interests (singular focus), etc. A stomach ache is a single manifestation of something happening. A stomach ache can have varying degrees and reasons behind it. The stomach ache is the signal. The disorder that causes it could be psychological (GAD) or external (someone punched you, and the flesh is bruised) or internal (someone fed you a weeks old egg salad sandwich). In autism the 'symptom' could be model train enthusiasm or being nonverbal. There are a lot of symptoms the fit under the umbrella of the disorder.
- LoganDark 1y ago
  From my lived experience and also from the preprint I love very much https://www.thetransmitter.org/spectrum/untangling-biological-threads-from-autisms-phenotypic-patchwork-reveals-four-core-subtypes https://www.thetransmitter.org/spectrum/untangling-biologica... the autism spectrum is basically a collection of ways a brain can largely work differently than "normal". There's a limited number of these (4 according to current research). It's not that there's just individual small features that manifest in things like eye contact avoidance, over/understimulation, etc. it's that the entire brain will work a specific differently and result in a certain set of symptoms consistent with an autism diagnosis. I feel like autism helps form the basis that other neurological differences happen on top of, because it has such a large impact on how thinking and learning even works in the first place. Even in conditions like schizophrenia, psychosis, etc. you see thought loops or detachment from reality or delusions or any number of those kinds of dysfunctions but it all still happens on a base where there can be basically one of the four autisms; the autism seems to be a difference in the foundation that the rest of the brain is built on top of. It's very fascinating to me (I am very autistic). Of course I don't mean to say at all that each autistic type always results in the same brain function but just that usually other difficulties or differences are less fundamental than how autism changes practically everything.

pseudocomposer 1y ago

I’ve long thought that autism is basically a few thousand very normal, small neurodivergencies (which may each be compounded with social effects). The absence of any of them is “perfect functioning human cog/prime chunk of workmeat.” The presence of too many/particular ones of them is notably disabling for certain tasks, or makes perceiving some things difficult (and other things easier). But I think the presence of some is preferable to having none, and implies “can think abstractly for/about oneself.” (And yes, a lot of the “problems” that arise with folks on the spectrum happen because, well, being aware of yourself as a cog/workmeat creates friction… It’s important to keep in mind how much of our history of psychological medicine that created the label “autism” is ultimately oriented towards “fixing the cog/workmeat.”)

aDyslecticCrow 1y ago
> presence of too many/particular ones of them is notably disabling for certain tasks Setting asside the very clear science of neurodevelopmental causes, in practice your description is very helpful way to describe it. (Ive often myself described it as a standard deviation beyond 2 sigma in a normal distribution with 500 dimensions.) The traits associated with autism are naturally present in the population in healthy and useful ways. Matching a large fraction of the definition may pose no problem for alot of people. But another smaller deviation in another sub permutation may be detrimental to live a normal life. So it's really difficult to draw a line between "condition" that need assistance and just outlier human that like trains. I mildly match a significant fraction of the diagnostic criteria myself, but have had a rather easy time. I don't need special resources, and feel wierd to count under a medical term. But recognising the traits of ASD had allowed me to find quite a lot of good practical advice that improve my life significantly. So the broad definition has been helpful.
amatecha 11mo ago
Yeah I agree. I see it something like this as well. I often feel like calling it an "illness" or even "disability" is kind of a misnomer, because having traits that are encompassed by the definition of "autism" are often actually strengths and advantages (to an overwhelming extent, not in just some weird edge case situation).
11mo ago

ThinkBeat 1y ago

This is highly accurate. Presently its a whole set of entirely different diagnosis make up "the spectrum". They even eliminated "Asperger" and then just folded that into the spectrum as well. I sometimes think about two women sitting on down on a bench. Once says a bit uneasily "my son, well he is on the spectrum" The other responds with "Oh I know what you are going through my daughter is also on the spectrum" At this point neither has any idea whatsoever about what the others experience is like. One may be highly functional, socially awkward and doesn't think like normal people and processes sight and sounds the same. I find myself moderately down this path. The other may be non verbal and violent.

cardanome 1y ago
If you have met one person with autism you have met one person with autism. This is true for anything else and no argument against the current diagnosis. There are people with Covid that ended up in the hospital and people with Covid who barely had any symptoms. Both have Covid. Autism doesn't work from "little autism" to "a lot of autism". One person can have strong sensory issues but decent social skills. Another bad social skills but not sensory issues at all. And care needs can change over your life, they are not fixed.
- suddenlybananas 1y ago
  The crucial difference is that we know the etiology of COVID and so are justified in treating those two people as having the same disease. Autism is much more complicated because we don't have a thing to define it other than a bunch of disparate symptoms. It might turn out like if we treated the cold, COVID, tuberculosis and lung cancer as the same thing because they all involve coughing.
  - cardanome 1y ago
    We know that autism has a strong genetic link. Furthermore we employ differential diagnostic and check whether your symptoms could be better explained by another condition. You don't just diagnose people with autism because they have a few symptoms. Furthermore autistic people can generally relate to each other. Even if two autistic people show very different symptoms there is often a feeling of belonging together. It is always possible that we will learn more in the future and maybe we will have other diagnosis criteria or discover some people currently diagnosed under autistism would fit better under something else. However the current diagnostic criteria for ASD is the current state of our scientific knowledge. A lot of clinical research is baked into it.

ChrisArchitect 1y ago

Previously: https://news.ycombinator.com/item?id=45451103 https://news.ycombinator.com/item?id=45451103

dr_dshiv 1y ago

Autism was split into autism and Asperger’s. But calling people with social challenges “Assburgers,” I mean, wow. Just wow.

lcnPylGDnU4H9OF 1y ago
> Asperger’s This term has a complicated history so people use "high-functioning" now. Many refer to Hans Asperger as a Nazi eugenicist. Reasonably, I'd say. https://en.wikipedia.org/wiki/Hans_Asperger#Children_sent_to_Am_Spiegelgrund https://en.wikipedia.org/wiki/Hans_Asperger#Children_sent_to... https://en.wikipedia.org/wiki/Am_Spiegelgrund_clinic#Experimentation_and_child_euthanasia https://en.wikipedia.org/wiki/Am_Spiegelgrund_clinic#Experim... > Just as the physician must often make painful incisions during the treatment of individuals, we must also make incisions in the national body, out of a sense of responsibility: we must make sure that those patients who would pass on their diseases to distant generations, to the detriment of the individual and of the Volk, are prevented from passing on their diseased hereditary material
Der_Einzige 1y ago
Same stuff with lisp being the name of a condition that people with lisps can’t pronounce. They did it on purpose and they know what they did. The same folks who cause all the Mandela effects did this cus they thought it’s funny. We are all job in his biblical story.

wslh 1y ago

https://archive.is/zOQv5 https://archive.is/zOQv5

prepend 1y ago

I’ve been using “autism that I care about” because a large number of people I encounter are on the spectrum / neurodivergent (hobbies and work I suppose) that require very different interventions and accommodations that people with whatever you call significantly affected people with autism are called (eg, Rain Man, etc). Not that people low on the spectrum aren’t important, they are, but that just using standard interaction tactics that I would with non-spectrum people works well enough. So trying to save time that someone doesn’t need to interrupt the conversation to say they are on the spectrum and can only eat smooth foods or whatever.

pessimizer 1y ago

[flagged]

ien24sdq 1y ago
This is a weird comment, and not surprising to see the downvotes - hope your day gets better! One important thing that’s being missed here, though, is the role of parents - getting an ASD diagnosis is extremely useful for parents in terms of understanding/excusing their personal struggles in being a parent.

austin-cheney 1y ago

The article does not mention Pathological Demand Avoidance as a form of autism. Everybody avoids chores they don't like, but people with PDA take it an extreme. For somebody to have PDA enough that it becomes a shade of autism the world exists only in the form of I want and I don't Want so much so that it limits the imagination and perceptions of the world. For example somebody with PDA autism cannot interpret the nonverbal communications of other people because they have already made the immediate decision that they want to be liked by others, so therefore they are. They cannot try new foods because they may not like it if they do try, so therefore they don't like it already. They would rather suffer hours of punishment grounded in their room than accomplish a 2 minute chore, because they already know in advance they would prefer to not do the chore given a choice to not do it. People with PDA autism often appear to be sociopaths and pathological liars. They are not either of those things, due only to a minor difference in motivation. Sociopaths don't care if somebody else gets hurt so long as they get what they want, while harm to others does impact somebody with PDA in a very normal way. Since they have no capacity for empathy and color every past observance to fit their world definition of saving face it takes a lot of time with a PDA person to see the distinctions between them and a sociopath.

nathias 1y ago

I think we will slowly come to understand that we all start neurodivergent and only some people converge.

IAmBroom 1y ago
Ironically very accurate for an en vogue theory of how autism occurs. Babies are born with many more neural connections than most adults have. The learning process appears to include a "winnowing" process. OTOH, autistic individuals appear to have a larger number of neural connections, which suggests that they did in fact "not converge" (or not weed out excessive connections that distract from more productive decision-making).
- nathias 11mo ago
  ironic how?

creatonez 1y ago

This is an idiotic media talking point not actually reflected in the clinical evidence. Unifying autism diagnosis under the ASD label was not a mistake, for a lot of reasons.

squidsoup 1y ago

I'm concerned that the identification of genetic subtypes of ASD, as mentioned in the article, will lead to more terminations of pregnancy. We need people that see the world differently.

scythe 1y ago
The most easily identified "autism genes" (eg "fragile X") tend to lead to severe variants of the condition, which probably don't benefit anyone. We may eventually have a "Gattaca problem" but this isn't that, at least not yet.
kulahan 1y ago
There are 8 billion people from a multitude of backgrounds and experiences. We’ve got plenty of viewpoints. People get abortions because it’s financially inconvenient or a bad time or something else trivial constantly. Surely a lifelong affliction isn’t that hard to understand the motivations behind.
453yuh46 1y ago
You are obviously a male - when it comes to providing best genes from rich individuals, there seems to have been no shortage of females that wanted to have babies from Elon Musk with his autistic genes... I am forgetting how serious ASD people can be without having able to make any jokes. Relax, dude - by the time when government will be able to provide such services, all the humans will have autistic genes - there clearly are some natural advantages to people, that are multiplying with those genes and spreading them around. And unfortunately to say this, but natural selection is the only thing that will weed out those so called "heavy autistic cases" and they will cease to be a problem in time.
- LorenPechtel 11mo ago
  Yup, autism spectrum tends to strongly mess with your ability to find a romantic partner. And that is decidedly selected against. However, I don't think the random nature of evolution will have a meaningful effect on humanity going forward. We will soon reach the point of selecting for more desirable genes. Done badly it would be Gattaca.

carlCarlCarlCar 1y ago

Autism emerges from higher intelligence: https://pmc.ncbi.nlm.nih.gov/articles/PMC4927579/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4927579/ If anyone must be branded atypical (not saying anyone should but am willing to pushback on those who do) and in need of special attention it should be the historical story-mode dependent who cannot move on from childhood allegory.

ianberdin 1y ago

I have some sort of it and I built an AI tool to help myself to get emotional intelligence. https://getpartner.ai https://getpartner.ai

tiberriver256 1y ago

YES PLEASE. This actively harms diagnostics and encourages cure-all peddlers. Definitely has been good for financial benefits and such but... Once someone gets the "autistic" diagnosis all further research stops.

LoganDark 1y ago

This preprint inspired me greatly: https://www.thetransmitter.org/spectrum/untangling-biological-threads-from-autisms-phenotypic-patchwork-reveals-four-core-subtypes https://www.thetransmitter.org/spectrum/untangling-biologica... It looks like this article is talking about that exact preprint, but a quick skim didn't reveal any sort of link. Ever since I first read it, I've been training myself to identify the subtypes. I don't have good names for them, nor do I know how they correspond to the names in the preprint, but I can usually tell them apart. I have indeed seen exactly four. I would love for there to be more research into the intricacies of each subtype, because I feel that care and accommodation could get a lot more personalized and helpful if there were less of "anything goes / anything could happen" and more specialization to what's most likely to be effective for each particular subtype. As it is, a lot of care programs or individuals supporting them may be specialized to an unknown degree to particular subtypes and not really understand how to become less specialized or even specialize further. On top of that, I greatly want to understand better the subtypes other than my own, not least because a couple of them I can find very difficult to communicate with because my knowledge and arguments are formatted differently than how they learn. I want to learn how to format my knowledge in a way that's easier for them to understand and more convincing for them. I'm just very curious and interested and I really hope the idea of autistic subtypes takes off because it absolutely agrees with what I've seen in practice.

nerdralph 1y ago

I got my diagnosis shortly after the DSM-5 release but my psychologist also gave me the DSM-IV Asperger's diagnosis at my request. I tell people I'm an Aspie, and that it is considered to be on the autism spectrum. I prefer the Aspie label because it is more specific. My interpretation was that the DSM-5 grouped it under autism spectrum distorders. I've never met a psychologist or psychiatrist that considered the autism spectrum to be a single condition.

cyanydeez 1y ago

It should not, but it is because the healthcare system is broken; the education system is broken; and the social system is broken. So people who have problems get lumped together because these systems are all stripped for parts because of capitalism and religiousity. It'd be great to have a functional science based medical care but that won't help the children stuck in a hellhole of anti science, antisocial and pathological liars.

kristianp 1y ago

One thing that interests me is the overlap between ADHD and ASD. My family seems to have a mix of different strengths of both. Some overlap of problems, e.g. executive function, emotional regulation, hyperfocus on topics of interest, suggests to me there needs to be a re-assessment of both conditions. The overlap also makes it difficult to diagnose ADHD when both are present.

Maxious 1y ago
The co-diagnosis of autism and ADHD became possible with the DSM-5 in 2013. According to the scientific literature, 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD). https://pmc.ncbi.nlm.nih.gov/articles/PMC8918663/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8918663/

deleted 1y ago

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shtzvhdx 1y ago

Which is probably why the causes of these diseases are so well masked.

QuadmasterXLII 1y ago

Approximately 50% of people with autism have intellectual disability. The people without intellectual disability are more convenient to recruit for studies. As a result, across a wide variety of studies on autism, only 6% of autistic participants had intellectual disability. https://link.springer.com/article/10.1186/s13229-019-0260-x https://link.springer.com/article/10.1186/s13229-019-0260-x

hunta2097 1y ago
My son has "autism". He is 25 and needs constant supervision and care. I feel that the word "autism" is now meaningless. I must know 50 of his cohorts and even though they're all "autistic" they can be quite different. I also agree that his needs are underrepresented and drowned out by those mildly-affected who have the mental capacity to speak out for themselves.

matrix87 1y ago

I remember back in the 2000s - 2012ish it used to actually mean something, if someone had autism then they were actually disabled and it was obvious. 90% of the "conversation" around autism today is a bunch of handwavey bullshit. There's no incentive for people to be intellectually honest. It's now a moral hazard because so many people are "attached" to the label and get accommodations out of it. You can pay phony therapists online to just go straight to a diagnosis so you can get accommodations. There are financial and political incentives in diagnosing more people. People can't have an honest conversation around it either because it's such a charged issue. We either get one side that wants to expand the scope of autism to infinity or the RFK vaccine bullshit

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Hobadee 1y ago

My dad likely had Asperger's. (Undiagnosed, but pretty much 100% he did). I have close friends with children who are very autistic. (Not completely non-verbel, but they say very few words and are still more likely to have a screeching meltdown than talk.) My dad was highly successful; a leader in his industry and did a great job supporting us. His life was relatively easy (as easy as life can be in general) and he was a contributing member of society. We love my friends kids to death and they do have many positive things going for them, but they will likely never be able to live on their own. Even if they do, they are in for a very hard life. They will likely always need to be supported by family and will likely never be contributing members of society. To lump both those together is insane. It drives me crazy when people who are functional members of society run around laughing about how they are "autistic". I can't think of anything more disrespectful to those who can never have a "normal" life. With that being said, I do recognize that medically there is a spectrum. I, as someone with ADHD am likely on that spectrum somewhere as well, from how the science is sounding these days. We need to make this spectrum obvious and respectful though. Why can't we classify a level or something? For example "Autistic level 1" for Asperger's, "Autistic level 2" for barely verbal, "Autistic level 3" for non-verbel... Something like that, so we can unite the cause, but still differentiate the effects and potential outcomes.

Ambroos 11mo ago
These levels exist since the DSM-5, which is not yet in use everywhere: The DSM-5 introduced three ASD levels of severity: level 1 (“requiring support”), level 2 (“requiring substantial support”), and level 3 (“requiring very substantial support”). https://www.autismspeaks.org/levels-of-autism https://www.autismspeaks.org/levels-of-autism has a good complete overview.
NoGravitas 11mo ago
> It drives me crazy when people who are functional members of society run around laughing about how they are "autistic". A lot of us low-support-needs autistic people are functional members of society right up until we aren't (i.e., until we've been masking for too long while dealing with sensory stressors and One More Little Thing pushes us into the "screeching meltdown" or renders us temporarily nonverbal). And a lot of us have "normal" lives only in as much as you only see the normal parts. It's kind of fair to divide things up by support level, but you then also have to understand that there are a lot of different support needs people have and they can look very different at the same "level".

lutusp 11mo ago

Bad article title. It should be "Autism should be divided into more specific diagnoses, once we have reliable, evidence-based diagnostic criteria." There's a reason Asperger Syndrome was abandoned as a separate condition and folded into ASD (in DSM-5) -- until then, anyone who wanted the diagnosis could get it, by displaying symptoms popularly associated with the condition. So we had clinical indicators, but no objective biological tests -- still true for most DSM-listed conditions. This led to widespread abuse and uncertainty. The single label "autism" has many drawbacks, but one important advantage -- it reveals what we know in a scientific sense, which is next to nothing. Eventually neuroscience will change this and identify biological causes for many "mental" conditions. This will end diagnoses based on clinical interviews and replace them with objective biological tests. I imagine this scene in a future neuroscience clinic: Patient: "Let me tell you what I think is wrong with me." Clinician: "Don't bother, we have objective biological tests now -- your narrative would only confuse the process. Remember psychology?"

tadfisher 11mo ago
But it is divided into more specific diagnoses with distinguishing diagnostic criteria, and we call them "profiles". They are related, and thus are placed under the umbrella of ASD, because the DSM-5 is a diagnostic manual and not a full taxonomy of developmental disabilities. One such profile is pathological demand avoidance (PDA). Another is Asperger Syndrome, which has been reclassified as an ASD profile. They all exhibit the diagnostic criteria for ASD in one or more ways. Also, I want to point out that calling ASD a "mental condition" doesn't have a scientific basis; it is classified as a developmental disability. These terms matter, whether or not you consider this to be some kind of abuse.
- lutusp 11mo ago
  > But it is divided into more specific diagnoses with distinguishing diagnostic criteria The criteria are based on effects, not causes. They lack depth. Let me put it this way -- if a trained actor can acquire a diagnosis, then it's not based on causes, only effects. This would be like gathering rocks from a field and classifying them based on their color or shape, but without a science of geology to inform the classifications. A trained actor can't pretend to have cancer, because we know what causes it, and we have meaningful clinical tests that categorically exclude anything but a specific biological source. Psychology doesn't have this property, and it may never have it. When Thomas Insel resigned as director of the NIMH, he frankly said that the agency hadn't "moved the needle" in terms of knowledge or treatment, in spite of 13 years of effort and a 20 billion dollar outlay (reference: http://blog.stevenreidbordmd.com/?p=1615 http://blog.stevenreidbordmd.com/?p=1615). I greatly respect Insel's candor and willingness to report facts in a field seemingly driven by illusion. > Also, I want to point out that calling ASD a "mental condition" doesn't have a scientific basis Sorry, but since the entire field has no scientific basis, it's unfair to single out a specific example without acknowledging this fact -- the elephant in the room. > ... it is classified as a developmental disability. That also has no scientific basis, it's a response to a fad, a transitory response to fashion (as were all the classifications that went before it). In point of fact, ASD has a biological cause, but we have no idea what it is. > These terms matter ... No. They don't. This is proven by the fact that they keep changing, but without any change in evidence or science. Neuroscience will change all this, but not any time soon.

nephihaha 11mo ago

I've been saying this for years. It is more of a cluster I think.

poulpy123 11mo ago

I think the popularity of the description of autism as socially awkward supergenius hurt a lot the children with the variant "I can't tie my shoes or even speak" and their family

AbstractH24 11mo ago

This is true of many conditions that seem to be one thing but are actually, in all likelihood, many unrelated conditions with overlapping symptoms. Particularly when it comes to the brain. It's a reflection of how little we know about it.

amai 11mo ago

The study mentioned in the article is Litman et. al (2025): Decomposition of phenotypic heterogeneity in autism reveals underlying genetic programs https://pmc.ncbi.nlm.nih.gov/articles/PMC12283356/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12283356/ The code is available at https://github.com/FunctionLab/asd-pheno-classes https://github.com/FunctionLab/asd-pheno-classes .

tsoukase 11mo ago

Since many years the only advancements in autism research are descriptive trends: "diffuse development disorder", "spectrum" and now "multiple conditions". As long as these words refer to syndromes and not to mechanisms or causes, they will only be word fanciness. I suggest a change of the autism term to something like "idiopathic apsychia" (loss of soul, empathy disorder etc) which demonstrates a common causal base and can focus the attention to more meaningful academic research and public acknowledgement.