4 ms·

The reason we say "somewhere on the spectrum" is there are a lot of high functioning people who have a few autism like symptoms that benefit from some autism tr

by bluGill 11mo ago

The reason we say "somewhere on the spectrum" is there are a lot of high functioning people who have a few autism like symptoms that benefit from some autism treatments. You can change the name/diagnosis what you want, but in the end we need to get people the treatment they need.

cogman10 11mo ago
That's the benefit of a broad diagnosis. Narrow diagnoses make it hard to get specific treatments for problems. That's my main concern about trying to split up autism. It's all well and good for study purposes, but for "can I get my insurance to pay for my kid's occupational therapy" purposes I'm really skittish about such a breakup. All the sudden my kid might have "omegaism" or whatever and boom, it's uncommon for them to need OT so insurance won't cover it.
- phito 11mo ago
  That's exactly my issue with "autism" because it feels like lumping a bunch of things together just for the sake of simplifying health care. Meanwhile you have a bunch of people that have completely different symptoms, experiences and causes with the same diagnostic.
  - cogman10 11mo ago
    The vast amount of treatment for autism is therapies. It really doesn't matter if the underlying cause is very different in terms of treatment because a speech therapist works the same with a kid with autism as they do with a kid with down syndrome. If there were more pharmaceutical interventions then I might care a bit more. But there's just not. In terms of the research, the researchers already have tools to sort and filter individuals based on their specific set of symptoms. Just because 2 people share an autism diagnosis doesn't really impact the research. What objection do you have other than not liking that it's not a "pure" diagnosis?
  - mrguyorama 11mo ago
    It's lumping a bunch of things together because they are empirically linked together People with sensory issues often also have more cognitive rigidity for example. Autism, and many other psychological disorders, are quite literally just a lump of symptoms and presentations, because we do not have better options. Sure, it makes navigating american health insurance easier if you can just say "Autism" and get various treatments paid for, but very similar diagnostic criteria and definitions are used in countries with fully socialized medicine. Those people with those linked issues tend to benefit from similar treatment, and that's the entire point of a diagnostic criteria. All the complaints come from people who seem to just not like the vibe of that? Deal with it. Go fund more research into the heritability of neurodivergent pathologies if you want a blood test. Some day we WILL be able to separate "Autism" into very specific diseases with specific causes, and some of those causes will have a genetic test. Unless we kill the concept of medical research because we elected morons who tear apart our institutions. I have "Impaired vision", and I share that with people who are profoundly (but not totally) blind, and it does not matter that I can drive with glasses and they can't, and the name of that condition is not the important part. All this handwringing about "but but but my mildly autistic son is mostly functional and I'm sad that he has the same name of condition as someone who cannot be educated past a 3rd grade level" is stupid. It does not benefit anyone struggling with autism to complain about it. Are you aware that we have multiple medical conditions called "Palsy"s, and that they have drastically different causes and effects, such that my sister's Palsy which was caused by medical malpractice and prevented her from using her dominant hand in some cases is very different from my schoolmate's Palsy which left her wheelchair bound and requiring professional help day to day? They are both palsy because they are (partially) movement disorders stemming from nerve damage or dysfunction. The horror!
    - cogman10 11mo ago
      I honestly can't help but feel like the main point of people whinging at autism being a broad diagnosis is because they don't like that it makes getting treatment easy (especially coming from "the economist"). Maybe I'm not being charitable. But that really does feel like the only real outcome of trying to piecemeal the diagnosis. I don't believe research or treatment is negatively impacted in anyway by the diagnosis being broad. If anything, that opens doors so that research isn't accidentally too narrowly focused.
nerdjon 11mo ago
So... you agree with what I am saying? My point is, if it is commonplace to refer to Autism as a spectrum we are already acknowledging that it is not a single thing. Which seems to be the entire basis of this article while also mixing in the rambling of someone anti-science that frankly won't change even if it was split up.
- bluGill 11mo ago
  I don't know enough above the subject (and what I could make of the article isn't helpful) to know if I agree or not. We should split Autism if we can conclusively separate people into the different diagnoses and then give them the correct treatment (which would be wrong for the other). However if we still give the same treatments in the end there isn't any point even if we can find different symptoms to result in a different diagnosis. As science learns more (or I learn more) I reserve the right to change my position.
SoftTalker 11mo ago
If a person can take care of himself, hold a job, and generally not burden anyone else why does he need treatment? To try to make him into whatever we consider "more normal?" Just let him be who he is.
- bluGill 11mo ago
  Is that person happy? Would/could they be more happy?
- cogman10 11mo ago
  The entire point of diagnosis is because a person needs help. The point of treatment isn't to "fix" or "make normal" someone. It's to give them the tools needed to participate. For example, someone with autism might be more prone to having a meltdown. What therapy does is give them the tools to both identify that they are on the verge of such a meltdown and to de-escalate themselves. The point of treatment is to help someone take care of themselves, hold a job, and generally not burden anyone. It's also to help a person feel better about themselves.
- abigail95 11mo ago
  The diagnostic criteria would exclude someone from an autism diagnosis unless they had persistent deficits across time and context. Your example person may function well within a narrow band of capability - the purpose of treatment/support is to expand that band and help maintain it. I'm not advocating forcing support on someone that doesn't want it, but I am for improving someones quality of life by expanding their choice of occupation and social environment. Without any external support I would wake up, work, sleep, repeat. Eating? Cleaning? annoyances that just interrupt work. I've made a lot of money doing that but it's unfulfilling and at times, disgusting. If you want to live in a society that leaves me be - I won't starve to death but I'm never going to have a partner or a family without external services like psychology, occupational therapy, social events. Whether I pay for these services or someone else does it doesn't matter. I want them to be available for people like me to understand that we are not alone, there's a reason we can only exist comfortably in our narrow slice of the world, and if we want to leave our bubble there is support available.
- 11mo ago
staticman2 11mo ago
The diagnostic criteria isn't based on whether the condition is treatable. For example, nobody who is diagnosed with autism is proclaimed "not autistic" if they find therapy to be unhelpful.
- bluGill 11mo ago
  Yes, but the whole point of diagnosis is we have treatments for those things that usually [sometimes] work and so we need to diagnosis people because that is the first step in getting them treatment.

by bluGill 11mo ago

cogman10 11mo ago

That's the benefit of a broad diagnosis. Narrow diagnoses make it hard to get specific treatments for problems. That's my main concern about trying to split up autism. It's all well and good for study purposes, but for "can I get my insurance to pay for my kid's occupational therapy" purposes I'm really skittish about such a breakup. All the sudden my kid might have "omegaism" or whatever and boom, it's uncommon for them to need OT so insurance won't cover it.

phito 11mo ago
That's exactly my issue with "autism" because it feels like lumping a bunch of things together just for the sake of simplifying health care. Meanwhile you have a bunch of people that have completely different symptoms, experiences and causes with the same diagnostic.
- cogman10 11mo ago
  The vast amount of treatment for autism is therapies. It really doesn't matter if the underlying cause is very different in terms of treatment because a speech therapist works the same with a kid with autism as they do with a kid with down syndrome. If there were more pharmaceutical interventions then I might care a bit more. But there's just not. In terms of the research, the researchers already have tools to sort and filter individuals based on their specific set of symptoms. Just because 2 people share an autism diagnosis doesn't really impact the research. What objection do you have other than not liking that it's not a "pure" diagnosis?
- mrguyorama 11mo ago
  It's lumping a bunch of things together because they are empirically linked together People with sensory issues often also have more cognitive rigidity for example. Autism, and many other psychological disorders, are quite literally just a lump of symptoms and presentations, because we do not have better options. Sure, it makes navigating american health insurance easier if you can just say "Autism" and get various treatments paid for, but very similar diagnostic criteria and definitions are used in countries with fully socialized medicine. Those people with those linked issues tend to benefit from similar treatment, and that's the entire point of a diagnostic criteria. All the complaints come from people who seem to just not like the vibe of that? Deal with it. Go fund more research into the heritability of neurodivergent pathologies if you want a blood test. Some day we WILL be able to separate "Autism" into very specific diseases with specific causes, and some of those causes will have a genetic test. Unless we kill the concept of medical research because we elected morons who tear apart our institutions. I have "Impaired vision", and I share that with people who are profoundly (but not totally) blind, and it does not matter that I can drive with glasses and they can't, and the name of that condition is not the important part. All this handwringing about "but but but my mildly autistic son is mostly functional and I'm sad that he has the same name of condition as someone who cannot be educated past a 3rd grade level" is stupid. It does not benefit anyone struggling with autism to complain about it. Are you aware that we have multiple medical conditions called "Palsy"s, and that they have drastically different causes and effects, such that my sister's Palsy which was caused by medical malpractice and prevented her from using her dominant hand in some cases is very different from my schoolmate's Palsy which left her wheelchair bound and requiring professional help day to day? They are both palsy because they are (partially) movement disorders stemming from nerve damage or dysfunction. The horror!
  - cogman10 11mo ago
    I honestly can't help but feel like the main point of people whinging at autism being a broad diagnosis is because they don't like that it makes getting treatment easy (especially coming from "the economist"). Maybe I'm not being charitable. But that really does feel like the only real outcome of trying to piecemeal the diagnosis. I don't believe research or treatment is negatively impacted in anyway by the diagnosis being broad. If anything, that opens doors so that research isn't accidentally too narrowly focused.

nerdjon 11mo ago

So... you agree with what I am saying? My point is, if it is commonplace to refer to Autism as a spectrum we are already acknowledging that it is not a single thing. Which seems to be the entire basis of this article while also mixing in the rambling of someone anti-science that frankly won't change even if it was split up.

bluGill 11mo ago
I don't know enough above the subject (and what I could make of the article isn't helpful) to know if I agree or not. We should split Autism if we can conclusively separate people into the different diagnoses and then give them the correct treatment (which would be wrong for the other). However if we still give the same treatments in the end there isn't any point even if we can find different symptoms to result in a different diagnosis. As science learns more (or I learn more) I reserve the right to change my position.

SoftTalker 11mo ago

If a person can take care of himself, hold a job, and generally not burden anyone else why does he need treatment? To try to make him into whatever we consider "more normal?" Just let him be who he is.

bluGill 11mo ago
Is that person happy? Would/could they be more happy?
cogman10 11mo ago
The entire point of diagnosis is because a person needs help. The point of treatment isn't to "fix" or "make normal" someone. It's to give them the tools needed to participate. For example, someone with autism might be more prone to having a meltdown. What therapy does is give them the tools to both identify that they are on the verge of such a meltdown and to de-escalate themselves. The point of treatment is to help someone take care of themselves, hold a job, and generally not burden anyone. It's also to help a person feel better about themselves.
abigail95 11mo ago
The diagnostic criteria would exclude someone from an autism diagnosis unless they had persistent deficits across time and context. Your example person may function well within a narrow band of capability - the purpose of treatment/support is to expand that band and help maintain it. I'm not advocating forcing support on someone that doesn't want it, but I am for improving someones quality of life by expanding their choice of occupation and social environment. Without any external support I would wake up, work, sleep, repeat. Eating? Cleaning? annoyances that just interrupt work. I've made a lot of money doing that but it's unfulfilling and at times, disgusting. If you want to live in a society that leaves me be - I won't starve to death but I'm never going to have a partner or a family without external services like psychology, occupational therapy, social events. Whether I pay for these services or someone else does it doesn't matter. I want them to be available for people like me to understand that we are not alone, there's a reason we can only exist comfortably in our narrow slice of the world, and if we want to leave our bubble there is support available.
11mo ago

staticman2 11mo ago

The diagnostic criteria isn't based on whether the condition is treatable. For example, nobody who is diagnosed with autism is proclaimed "not autistic" if they find therapy to be unhelpful.

bluGill 11mo ago
Yes, but the whole point of diagnosis is we have treatments for those things that usually [sometimes] work and so we need to diagnosis people because that is the first step in getting them treatment.