There's a movement to reframe things like autism as neurodiversity rather than strictly a disorder. I suppose the emphasis in that case would instead be on things people can do well, not what they do wrong by everyone else's standard.
Interesting. It's certainly a lighter way about talking about things but it does seem problematic from a pragmatic view. Likely it'd run into a wall when a person has more than one disorder (i.e. you can't composite things by listing them) or when the list of things that are affected is much shorter than the list that isn't (which should be the case for most folks).
The neurodiversity movement/argument really gained strength as improvements in diagnostic instrument sensitivity produced diagnoses with less profound forms of autism.
While I respect the message of neurodiversity, it has often come at the expense of individuals with profound autism where one would be hard-pressed to not apply labels like disability, impairment, and such. Profound autism represents a substantial proportion of the autistic spectrum, but they are the least able to represent and advocate for themselves.
I think it's difficult with autism because autism applies to people who cannot feed themselves as well as people who would be defined by others as 'quirky'. There's no differentiation, so it'd be like calling all men disabled because some men are disabled. Of course, calling all men completely healthy isn't right either. There's no granularity.
These days it's also a lot of pretty much random people who were sent to the school psychologist for some reason or other, plus a bunch of people who went to see a GP for things like a runny nose and were hoodwinked into a couple of psychiatric diagnoses they'll never get rid of, plus a lot of depressive narcissists who cling to their unfounded diagnosis to feel better about themselves, and the doctors play along because it's the easiest way to deal with them.
I suspect >90% of so called ASD cases have little real clinical basis these days and the entire disorder looks very fishy.
Dead people don't have higher income insurance premiums. The neurodiverse do because they're more likely to have problems holding down a job.... Because people keep perpetuating a society that punishes difference.
Autism is an extremely broad term. At one extreme, those who will never speak and spend their lives enraged by being unable to communicate. At the other, a very substantial fraction of the worlds finest science & engineering minds.
Okay, fair enough: that was a shit way for me to make a point.
There's nothing wrong with preferring that people have the ability to communicate with others (vs them not having that ability).
The moral issue is externally-enforced selection (AKA eugenics), which seems to persistently rear its ugly head as soon as you start talking about disability.
My friend (edit: redacted) chose not to have kids, because every ancestor he could trace on his paternal line had died of cancer around age 40, and he didn't think it was fair to inflict that on somebody else. I think that was a wise and moral choice - but it would not be wise or moral to take the choice away from him.
It's also true that a large portion of the high support needs cohort have other developmental disabilities. Autism is often co-diagnosed but doesn't account for the entirety of that demographic.
Many are diagnosed with “autism”, seemingly not for any lack of ability, but præferences the diagnostician does not necessarily agree with.
I also object to “neuro-” morpheme. The diagnosis of these conditions are psychiatric, not neurological, and in many cases where such a diagnosis was made, there is nothing neurologically unusual that could be found, but in some cases there is.
Autism is simply with the current understanding not a neurological, but a psychiatric disorder. — the understanding may grow such that it might become one one day, but that is not the current level of understanding, and such understanding would most likely lead to the realization that all which is currently grouped under “autism”, has many different underlying neurological causes.
Unless you believe in mind-body dualism, then your objection of the neuro morpheme is on shaky ground.
All psychiatric disorders ARE neurological...i.e. is rooted in the brain and associated systems. Moreover, there are plenty of neurological differences between ASD and TD groups, both at the cellular and morphological levels. However, a lot of the morphological differences are too small, and heterogeneity too large, to be useful as a means of diagnosis.
The problem with your reasoning is that you assume that what psychiatrists group together based on behavior and culture must share single identifiable neurological causes.
It's entirely possible that there is nothing neurologically objectively different about an autistic person from a non-autistic person, and that it's simply a cultural quirk that led to it; this has been the case with many historical diagnoses.
In fact, I would argue that this is not simply possible, but likely, given that usually, if such a neurological discriminant exist, it is typically quickly found. That they have searched for so long without being able to find it, is indicative of a nonexistence.
No where did I assume a 1-1 correspondence between psychiatric label and neurological cause. Many disorders likely show variation precisely because they have different underlying causes....much like a car might not start for a number of reasons, including faulty wiring, bad battery, bad starter, no fuel, etc. It is also this heterogeneity of underlying causes that make precise neurological diagnosis difficult.
Nevertheless, the biggest claim is trying to claim that some behavior/symptomology/quirk does not involve the brain.
> Autism spectrum disorder (ASD) is characterized by [...] restricted interests and repetitive behaviors.
as
> ASD is characterized by an ability to focus intently on an area of special interest, developing an unusually detailed level of knowledge of that topic.
There's always a tension with efforts to depathologise things, because some people do need support and the way they get support at the moment is via diagnosis.
> ASD is characterized by an ability to focus intently on an area of special interest, developing an unusually detailed level of knowledge of that topic.
However, this is not true. It doesn't apply to all people with ASD. I volunteered with adults with ASD about ten years ago. One person in the group really had a special interest fixation (a person), but he didn't know more than the average person would know after reading a single biography. He was barely able to read or remember complex facts, so I don't think he had the ability to develop an unusually detailed level of knowledge of that topic or any other. The rest didn't have any memorable interests, but I guess it's also possible that it wasn't cultivated in them.
It's also true that none of the symptoms of autism apply universally.
I'm good friends with an autistic man, he's got a special interest for a certain branch of mathematics and swing dance. He's also great with regards to social interaction, he's seemed to keep close connections with every person he comes across when he's traveled.
There's a saying that "if you've met one person with autism, you've met one person with autism", symptoms present differently in everyone and they're highly responsive to environment. As a trend I'd say special interests are probably a decent contender for a hallmark, probably along with language difficulty and eye contact avoidance.
The thing is, while there may be a broader thing for which “Autism Spectrum Condition” is the most accurate label, modern psychiatry can only diagnose a disorder, and that's not just an arbitrary artifact of naming. We don't have the understanding of the mechanics beneath most psychological conditions, including Autism, to diagnose them other than by the combination of social dysfunction and accompanying factors. To the extent that there is an Autism or Autism-like-condition which is not a “badness” in the concrete conditions in which it is experienced it is outside the scope of what we can meaningfully discern.
> "Disorder" is a medical term for "badness", especially weird to apply to a condition that is notable for its extreme mental... orderliness.
I don't see anything weird about that; are you suggesting that there is no extreme of inflexible attachment to order which would be ever be bad?
Autism is understood to be a neurodevelopmental condition rather than a psychiatric one. This would make sense given sensory differences are common and that autism has comorbidity with prosapognosia.
I never understood autism to be noted for extreme orderliness in all cases. Orderliness from what I understand is just one of multiple possible symptoms that, collectively, are termed as autism.
(You can be extremely orderly and not have autism, for example, if you had Obsessive Compulsive Personality Disorder which is different from the more familiar OCD.)
Tim Burton – Movie Director /
Lewis Carroll – Author of “Alice in Wonderland” /
Charles Darwin – Naturalist, Geologist, and Biologist /
Emily Dickinson – Poet /
Albert Einstein – Scientist & Mathematician /
Bobby Fischer – Chess Grandmaster /
Bill Gates – Co-founder of the Microsoft Corporation /
Temple Grandin – Animal Scientist /
Thomas Jefferson – Early American Politician /
Steve Jobs – Former CEO of Apple /
Stanley Kubrick – Film Director /
Barbara McClintock – Scientist and Cytogeneticist /
Michelangelo – Sculptor, Painter, Architect, Poet /
Wolfgang Amadeus Mozart – Classical Composer /
Sir Isaac Newton – Mathematician, Astronomer, & Physicist /
Nikola Tesla – Inventor /
Andy Warhol – Artist
I'm sorry, but this hand-picked list of exceptional people with light symptoms of ASD is minimizing a spectrum that includes some very serious disorders. Bringing out Bill Gates, with speculated mild Asperger's, is simply not a reasonable argument that "ASD can be good".
For perspective: Arguing "I know I guy who needs to squint to see things that are far away but he's an amazing pianist" doesn't add to a discussion about early detection of vision impairment and vision loss.
The ability to focus more deeply than the general population is quite valuable in a world where technological progress requires increasing specialisation.
You may discount the entirety of positives, but there are, in fact, positives. This does in no way minimize the severe cases, rather simply contends ASD is not always negative, which was your original concern.
I cannot agree with your perspective comparison. Vision many help someone learn piano more quickly at first, but is immaterial to their maximum ability as a pianist. A better comparison is early detection of the development of additional fingers or exceptionally large hands (example: Rachmaninoff), both of which directly and permanently affect a person's ability to play difficult piano pieces. This too would be a concerning eugenics issue.
Many people with ASD (not all! not most! but many) can barely survive on their own. I'm not talking about "too shy to buy groceries". ASD should be prevented medically. That is not to say people with ASD aren't often amazing people or that their lives aren't worth it, but minimizing the rate at which ASD occurs will mean far fewer people will suffer in the future from something that is (hopefully) preventable.
Barely can be an understatement. My youngest sister is severely autistic and absolutely couldn't survive without a strong support system, both from the state and our family. She lives in a group home with 19 other people in a similar state.
With that said, due to my exposure to autism through my sister, I have seen cases that are far worse than hers. Completely non-verbal people with autism, those who experience panic attacks when they see an unfamiliar person, the list goes on.
We tend to focus on the lighter end of the spectrum, where people can lead functional and fulfilling lives. Most people don't see the other side of the spectrum, where autism is devastating to every single person involved.
> We tend to focus on the lighter end of the spectrum, where people can lead functional and fulfilling lives.
There's a form of survivorship bias here: the greater the degree of impairment, the less broad social contacts the person is likely to have, so on average most people's experience is going to have people who have less severe impairments overrepresented compared to their relative frequency among those with the diagnosis.
And I'm sure most people that think about the issue recognize that on an intellectual level, but it's still difficult to tune out the effect that has on one’s “gut feeling” about the subject.
I worked with a guy that died from malnutrition. We worked hard on getting enough food in him, but he had so many issues related to food and eating that his body eventually capitulated. He was a really sweet dude, we talked a lot about computers.
His diagnosis didn't feel like a social judgement. The impairment literally killed him even though he wanted to live.
> Many people with ASD (not all! not most! but many) can barely survive on their own
That part is absolutely true.
> ASD should be prevented medically.
But this part (apart from the fact that it's not currently feasible) is just too categoric. I certainly know several autistic people who would prefer to get rid of their autism, if given a choice. But I know plenty on the milder end of the spectrum who would not — e.g. because their distress in social situations is outweighed by the benefits conveyed by an increased ability to focus.
I feel obliged to point out that when people try and equate behavior that is completely within the bounds of what society considers normal (being gay) with what can be a crippling and life affecting condition, it does nobody a service. Anymore than e.g. saying red hair used to be a sign of weakness, outdated views have no bearing on this discussion. Just because outdated views once existed and that normal behavior is now normal does not mean that we shouldn't label impairments as such in order to try and understand and help those affected by them.
Edit: very interested in feedback on why this either rubbed some people the wrong way or was perceived as a negative contribution to the discussion
> completely within the bounds of what society considers normal (being gay)
Feedback at your request -
This rubbed me the wrong way because homosexuality was classed as a disorder in my lifetime. (And that has an impact on me, still today - and it is still used as justification for criminalisation in 72 countries). So, there is fair reason to equate them.
If we were having this discussion in 1973, would you be saying "it does nobody a service to see homosexuality as normal"? Because a large proportion of psychiatrists and people were saying that.
What makes those people (in the past) wrong to say that, while you (in the present) are right to say this?
> "behavioral impairment" is a social judgement, not a biological flaw.
Yes, pretty much all of modern psychiatric diagnosis are explicitly diagnosing a combination of inability to succeed in the concrete social conditions one finds oneself in combined with concurrent behavioral or other symptoms, not “biological flaws”. (Which, incidentally, would also be subjective judgments; biological features are objective, that an objective feature is a flaw is a subjective judgement call.)
There are a great many psychiatric disorders that highly correlate with the arbitrary definitions of success used to justify that those that correlate negatively are to be called “disorders”.
It's not even about success in society; it's simply about whether the psychiatric authority considers it undesirable, and in want of eradication.
Drapetomania even existed, which had nothing to do with success. The authority simply considered it undesirable that slaves fled.
Many behaviors that correlate very negatively with success are not considered mental disorders, for they the authority considers them desirable.
And of course, it's an entirely circular argument. There are also some disorders that correlate very negatively with success and thus called disorders, but the disorder is more or less “not caring about success”. — there are disorders characterized by the subject's indifference how he is socially perceived.
It might be neutral if they listed specific attributes (or said the word 'attribute' rather than 'impairment').
Saying only 'impairment' implies that all attributes associated with autism are negative compared to some mythical baseline, and creates a circular definition which stigmatises autistic people.
The fact that this research paper is classifying all such attributes as negative without justification is inappropriate. It's not scientific - it's not the science that this paper is doing.
> Saying only 'impairment' implies that all attributes associated with autism are negative
The ones that are diagnostic (except those that are about ruling out other diagnoses) are. If we understood the mechanism enough to identify anything other than observed dysfunction, that might be different.
And, yes, like virtually every mental disease, the negative attributes are defined in reference to the concrete social context in which the individual exists, and could equally be viewed as problems with society. That's a problem for a different domain than the medical though.
Something that has struck out to me for many years now is the rather striking lack of reporting on the incredibly strong correlation between parental (both maternal/paternal) age at time of conception and ASM.
My nephew is autistic. He is my sister's youngest, and is 10 years younger than his sibling. This isn't a coincidence.
Parents who have their children in their mid 30s and later are orders of magnitude more likely to have an autistic child than people who conceive in their 20s/early 30s. It's a massive increase in probability.
I've found that the topic of delayed parenthood and the very real health impacts it results in are almost taboo amongst the media elites who have driven huge amounts of attention to autism due to so many of them having autistic kids. An additional topic related to this that goes undiscussed is the massive increase in twins (and consequentially premature births) caused by couples who had to use fertility drugs to conceive for the same reason.
I want to emphasize that I'm not criticizing anyone for making the decision to delay having kids until they are older. I just wish it was discussed more because I personally think that corporate structures should be changed to not punish women for having kids. It's a horrible injustice that our most successful citizens are forced to suffer medical side-effects because corporations were designed for men, and sweeping discussion of these side-effects under the rug results in flawed approaches like Sandberg describes in "Lean In", where the solution is to just embrace the existing structure to a ridiculous degree. It's horrifying to me that work culture has impacted human culture to a point where we are forced to step in and correct for biology.
Paternal (not maternal) age is highly correlated with ne novo mutations, a portion of which are associated with autism, depending on the location of the mutation. Perhaps this is less well known among news reporters, but among autism researchers, paternal age is often considered as an important factor, and is well accepted in that respect.
Edit: I am a post-doc at the autism institute at which this research was conducted. While I am not associated with this research, Judy does solid, impactful research, and I know beyond a doubt that she is aware of the association between autism and de novo mutations in older fathers.
And "Advanced Maternal Age" is extremely well known among mothers (in broad strokes if not technical details), who have generational experience with the issue.
I don't understand the intention behind your final sentence, and to whom it referred. If directed at my post, all I can say is that in respect to autism, it is paternal age which is the most critical, per the science, which, by the way, isn't something I just learned, its related to my career.
Thank goodness there’s a throwaway here to make unsourced claims to argue with a postdoc in the field. Otherwise we might not get both sides of the story.
> Something that has struck out to me for many years now is the rather striking lack of reporting on the incredibly strong correlation between parental (both maternal/paternal) age at time of conception and ASM.
I thought this was common knowledge? I’ve certainly read this frequently and it’s something that is brought up (anecdotally) by OB/GYNs as women enter their 30’s. My wife and several family members ruefully will tell stories about how their doc let them know that they’ll be considered of “advanced maternal age” when they hit 35. They were then reminded of the increased risk of birth defects, autism, and complications.
Perhaps not common enough. For instance, both my wife and I knew about the ~35 point of "advanced maternal age" and that there are risks associated with late conception, but it's the first time I hear autism is one of these risks.
> Something that has struck out to me for many years now is the rather striking lack of reporting on the incredibly strong correlation between parental (both maternal/paternal) age at time of conception and ASM.
Thee's a strong link to paternal age that seems well established. Maternal age effects seem to be all over the map: I've seen weaker positive correlation with advancing maternal age than paternal age, no correlation with maternal age, and negative correlation with maternal age in different studies (possibly with varying degrees of controlling for other known contributors; e.g., apparently women with autism tend to have first children older, which by itself can create the impression of a maternal age effect of not controlled for.)
> An additional topic related to this that goes undiscussed is the massive increase in twins
That's not just the realm of IVF. My wife and I have fraternal twins. She was 35 when we conceived. It turns out that as women approach menopause they may drop more than one egg during ovulation. This effect is noticed dramatically at age 35. I think I recall reading that your chances of a natural twins birth goes from < 1% to > 4% at age 35...
And, of course, in addition to that, once you have your first multiples pregnancy the odds of any subsequent pregnancy being a multiples also goes up.
For anyone interested in the history of ASD, I highly recommend the book NeuroTribes [1] - I read this shortly after my son was diagnosed with ASD and it goes through a lot of history, up to the most recent DSM V definition.
I agree, and own the book, and have had lunch with the author, but I would just add that NeuroTribes represents a very opinionated take on autism that has some sharp critics.
This is mind blowing... if I understand correctly basically it’s moms immune system that induces autism, is this the correct interpretation? I’d imagine it’s more complicated but still... it gives hope that early intervention and maybe prenatal and postnatal treatments to reduce the incidence.
What's super crazy is that if it's an autoimmune problem then the idea that vaccines cause autism might actually be right for a very small percentage of the population. If that were to be true (a HUGE if) and we could figure out the precursor markers then we could exempt the folks who need exemption and still keep herd immunity by vaccinating all the folks who wouldn't be harmed.
As usual, while scientists cannot prove a negative, in terms of vaccine causing autism in a subset, all I can say that there is no proposed mechanism, nor evidence of that mechanism, for vaccines to cause autism in anyone.
A growing body of evidence has implicated that a portion of the autism spectrum is probably produced my maternal infection and subsequent immune response during pregnancy. However, this cause of autism is not thought to account for all forms of autism.
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[ 3.5 ms ] story [ 133 ms ] threadThis seems like a very negative view of autism.
While I respect the message of neurodiversity, it has often come at the expense of individuals with profound autism where one would be hard-pressed to not apply labels like disability, impairment, and such. Profound autism represents a substantial proportion of the autistic spectrum, but they are the least able to represent and advocate for themselves.
I suspect >90% of so called ASD cases have little real clinical basis these days and the entire disorder looks very fishy.
Death redefined as a situation where people continue to have the ability to occupy space and don't require any food or oxygen.
I wouldn't mind a few more of the latter.
There's nothing wrong with preferring that people have the ability to communicate with others (vs them not having that ability).
The moral issue is externally-enforced selection (AKA eugenics), which seems to persistently rear its ugly head as soon as you start talking about disability.
My friend (edit: redacted) chose not to have kids, because every ancestor he could trace on his paternal line had died of cancer around age 40, and he didn't think it was fair to inflict that on somebody else. I think that was a wise and moral choice - but it would not be wise or moral to take the choice away from him.
Then you merely have to marry someone from that same family.
Or just marry a single mother who already has children.
And calling any single person "diverse" is icky.
Many are diagnosed with “autism”, seemingly not for any lack of ability, but præferences the diagnostician does not necessarily agree with.
I also object to “neuro-” morpheme. The diagnosis of these conditions are psychiatric, not neurological, and in many cases where such a diagnosis was made, there is nothing neurologically unusual that could be found, but in some cases there is.
Autism is simply with the current understanding not a neurological, but a psychiatric disorder. — the understanding may grow such that it might become one one day, but that is not the current level of understanding, and such understanding would most likely lead to the realization that all which is currently grouped under “autism”, has many different underlying neurological causes.
Oh, I'm pretty new to this myself, but my understanding was that autism was considered a neurological disorder, not a psychiatric one. [1]
"Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders..."
1. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat...
All psychiatric disorders ARE neurological...i.e. is rooted in the brain and associated systems. Moreover, there are plenty of neurological differences between ASD and TD groups, both at the cellular and morphological levels. However, a lot of the morphological differences are too small, and heterogeneity too large, to be useful as a means of diagnosis.
It's entirely possible that there is nothing neurologically objectively different about an autistic person from a non-autistic person, and that it's simply a cultural quirk that led to it; this has been the case with many historical diagnoses.
In fact, I would argue that this is not simply possible, but likely, given that usually, if such a neurological discriminant exist, it is typically quickly found. That they have searched for so long without being able to find it, is indicative of a nonexistence.
Nevertheless, the biggest claim is trying to claim that some behavior/symptomology/quirk does not involve the brain.
> Autism spectrum disorder (ASD) is characterized by [...] restricted interests and repetitive behaviors.
as
> ASD is characterized by an ability to focus intently on an area of special interest, developing an unusually detailed level of knowledge of that topic.
There's always a tension with efforts to depathologise things, because some people do need support and the way they get support at the moment is via diagnosis.
However, this is not true. It doesn't apply to all people with ASD. I volunteered with adults with ASD about ten years ago. One person in the group really had a special interest fixation (a person), but he didn't know more than the average person would know after reading a single biography. He was barely able to read or remember complex facts, so I don't think he had the ability to develop an unusually detailed level of knowledge of that topic or any other. The rest didn't have any memorable interests, but I guess it's also possible that it wasn't cultivated in them.
I'm good friends with an autistic man, he's got a special interest for a certain branch of mathematics and swing dance. He's also great with regards to social interaction, he's seemed to keep close connections with every person he comes across when he's traveled.
There's a saying that "if you've met one person with autism, you've met one person with autism", symptoms present differently in everyone and they're highly responsive to environment. As a trend I'd say special interests are probably a decent contender for a hallmark, probably along with language difficulty and eye contact avoidance.
"Disorder" is a medical term for "badness", especially weird to apply to a condition that is notable for its extreme mental... orderliness.
> "Disorder" is a medical term for "badness", especially weird to apply to a condition that is notable for its extreme mental... orderliness.
I don't see anything weird about that; are you suggesting that there is no extreme of inflexible attachment to order which would be ever be bad?
(You can be extremely orderly and not have autism, for example, if you had Obsessive Compulsive Personality Disorder which is different from the more familiar OCD.)
Tim Burton – Movie Director / Lewis Carroll – Author of “Alice in Wonderland” / Charles Darwin – Naturalist, Geologist, and Biologist / Emily Dickinson – Poet / Albert Einstein – Scientist & Mathematician / Bobby Fischer – Chess Grandmaster / Bill Gates – Co-founder of the Microsoft Corporation / Temple Grandin – Animal Scientist / Thomas Jefferson – Early American Politician / Steve Jobs – Former CEO of Apple / Stanley Kubrick – Film Director / Barbara McClintock – Scientist and Cytogeneticist / Michelangelo – Sculptor, Painter, Architect, Poet / Wolfgang Amadeus Mozart – Classical Composer / Sir Isaac Newton – Mathematician, Astronomer, & Physicist / Nikola Tesla – Inventor / Andy Warhol – Artist
https://www.appliedbehavioranalysisprograms.com/historys-30-...
For perspective: Arguing "I know I guy who needs to squint to see things that are far away but he's an amazing pianist" doesn't add to a discussion about early detection of vision impairment and vision loss.
They typically can’t deliberately choose the subject of the focus, but it’s usually the case that any bit of deep knowledge is useful for something.
I cannot agree with your perspective comparison. Vision many help someone learn piano more quickly at first, but is immaterial to their maximum ability as a pianist. A better comparison is early detection of the development of additional fingers or exceptionally large hands (example: Rachmaninoff), both of which directly and permanently affect a person's ability to play difficult piano pieces. This too would be a concerning eugenics issue.
Homosexuality was long considered a psychiatric disorder, so be careful putting blind faith in psychiatric judgements.
With that said, due to my exposure to autism through my sister, I have seen cases that are far worse than hers. Completely non-verbal people with autism, those who experience panic attacks when they see an unfamiliar person, the list goes on.
We tend to focus on the lighter end of the spectrum, where people can lead functional and fulfilling lives. Most people don't see the other side of the spectrum, where autism is devastating to every single person involved.
There's a form of survivorship bias here: the greater the degree of impairment, the less broad social contacts the person is likely to have, so on average most people's experience is going to have people who have less severe impairments overrepresented compared to their relative frequency among those with the diagnosis.
And I'm sure most people that think about the issue recognize that on an intellectual level, but it's still difficult to tune out the effect that has on one’s “gut feeling” about the subject.
His diagnosis didn't feel like a social judgement. The impairment literally killed him even though he wanted to live.
That part is absolutely true.
> ASD should be prevented medically.
But this part (apart from the fact that it's not currently feasible) is just too categoric. I certainly know several autistic people who would prefer to get rid of their autism, if given a choice. But I know plenty on the milder end of the spectrum who would not — e.g. because their distress in social situations is outweighed by the benefits conveyed by an increased ability to focus.
Edit: very interested in feedback on why this either rubbed some people the wrong way or was perceived as a negative contribution to the discussion
Feedback at your request -
This rubbed me the wrong way because homosexuality was classed as a disorder in my lifetime. (And that has an impact on me, still today - and it is still used as justification for criminalisation in 72 countries). So, there is fair reason to equate them.
If we were having this discussion in 1973, would you be saying "it does nobody a service to see homosexuality as normal"? Because a large proportion of psychiatrists and people were saying that.
What makes those people (in the past) wrong to say that, while you (in the present) are right to say this?
Yes, pretty much all of modern psychiatric diagnosis are explicitly diagnosing a combination of inability to succeed in the concrete social conditions one finds oneself in combined with concurrent behavioral or other symptoms, not “biological flaws”. (Which, incidentally, would also be subjective judgments; biological features are objective, that an objective feature is a flaw is a subjective judgement call.)
It's not even about success in society; it's simply about whether the psychiatric authority considers it undesirable, and in want of eradication.
Drapetomania even existed, which had nothing to do with success. The authority simply considered it undesirable that slaves fled.
Many behaviors that correlate very negatively with success are not considered mental disorders, for they the authority considers them desirable.
And of course, it's an entirely circular argument. There are also some disorders that correlate very negatively with success and thus called disorders, but the disorder is more or less “not caring about success”. — there are disorders characterized by the subject's indifference how he is socially perceived.
Saying only 'impairment' implies that all attributes associated with autism are negative compared to some mythical baseline, and creates a circular definition which stigmatises autistic people.
The ones that are diagnostic (except those that are about ruling out other diagnoses) are. If we understood the mechanism enough to identify anything other than observed dysfunction, that might be different.
And, yes, like virtually every mental disease, the negative attributes are defined in reference to the concrete social context in which the individual exists, and could equally be viewed as problems with society. That's a problem for a different domain than the medical though.
A neutral approach would acknowledge that hammers are good at certain tasks, while screwdrivers are good at others.
My nephew is autistic. He is my sister's youngest, and is 10 years younger than his sibling. This isn't a coincidence.
Parents who have their children in their mid 30s and later are orders of magnitude more likely to have an autistic child than people who conceive in their 20s/early 30s. It's a massive increase in probability.
I've found that the topic of delayed parenthood and the very real health impacts it results in are almost taboo amongst the media elites who have driven huge amounts of attention to autism due to so many of them having autistic kids. An additional topic related to this that goes undiscussed is the massive increase in twins (and consequentially premature births) caused by couples who had to use fertility drugs to conceive for the same reason.
I want to emphasize that I'm not criticizing anyone for making the decision to delay having kids until they are older. I just wish it was discussed more because I personally think that corporate structures should be changed to not punish women for having kids. It's a horrible injustice that our most successful citizens are forced to suffer medical side-effects because corporations were designed for men, and sweeping discussion of these side-effects under the rug results in flawed approaches like Sandberg describes in "Lean In", where the solution is to just embrace the existing structure to a ridiculous degree. It's horrifying to me that work culture has impacted human culture to a point where we are forced to step in and correct for biology.
Edit: I am a post-doc at the autism institute at which this research was conducted. While I am not associated with this research, Judy does solid, impactful research, and I know beyond a doubt that she is aware of the association between autism and de novo mutations in older fathers.
Of course gynecologists are also well aware.
https://www.mayoclinic.org/healthy-lifestyle/getting-pregnan...
It's a little bit disconcerting to see men pontificating about things they discovered that women already know quite well.
https://consumer.healthday.com/disabilities-information-11/c...
https://www.theguardian.com/society/2018/feb/02/doctors-urge...
I thought this was common knowledge? I’ve certainly read this frequently and it’s something that is brought up (anecdotally) by OB/GYNs as women enter their 30’s. My wife and several family members ruefully will tell stories about how their doc let them know that they’ll be considered of “advanced maternal age” when they hit 35. They were then reminded of the increased risk of birth defects, autism, and complications.
I'm old enough (ironically) that I was taught the term as "geriatric pregnancy"
Thee's a strong link to paternal age that seems well established. Maternal age effects seem to be all over the map: I've seen weaker positive correlation with advancing maternal age than paternal age, no correlation with maternal age, and negative correlation with maternal age in different studies (possibly with varying degrees of controlling for other known contributors; e.g., apparently women with autism tend to have first children older, which by itself can create the impression of a maternal age effect of not controlled for.)
That's not just the realm of IVF. My wife and I have fraternal twins. She was 35 when we conceived. It turns out that as women approach menopause they may drop more than one egg during ovulation. This effect is noticed dramatically at age 35. I think I recall reading that your chances of a natural twins birth goes from < 1% to > 4% at age 35...
And, of course, in addition to that, once you have your first multiples pregnancy the odds of any subsequent pregnancy being a multiples also goes up.
[1] https://en.wikipedia.org/wiki/NeuroTribes
The book was the first thing I read after we received the diagnosis for my son - although a friend had recommended it prior to this.
It also helped me as person feel less different and accepting of myself (I do not have an ASD diagnosis).