> It is time to realise that ‘autism’ has become a ragbag of different conditions.
Look, I get it and somewhat agree. However, the reason for the diagnosis (and any diagnosis) is treatment.
Maybe there are two different conditions that require speech, occupational, and behavior therapy to different degrees, however, in terms of convincing insurance companies in the US to cover those having a single diagnosis makes everything easier.
It's not as if a separate diagnosis would change how a speech therapist interacts with a child.
I applaud efforts to figure out what is going on and to categorize. But I also think that practically the ragbag diagnosis makes treatment a lot easier to access for patients.
Well of course, we basically expanded the ASD definition to cover a wide range in order to ensure that everyone gets access to support if needed, but in the process turned "autism" into a grab bag of different conditions which makes discussions about it difficult because everyone is talking about something else.
The overloading of the term autism has had a real damaging effect on some people. My cousin is profoundly autistic: he's nonverbal, and will never live independently. In the 90s most autism research was focused on helping people like him. He was involved in some pioneering studies at John's Hopkins University.
Today most of the money and advocacy is for high-performing or moderately-performing people with autism. Not just in relative terms, the amount of funding for people like my cousin has gone down. It makes sense; they are the larger group by volume and are able to advocate better than people like my cousin.
I wish it weren't a zero-sum game, and we recognized that autism is just a word for a broad series of conditions. It would be like if we called everyone with poor eyesight 'blind': yes, your vision is impaired. But the solutions you need are very different than the solutions Stevie Wonder needs.
But is it the profound autism or is there something else? I think we actually need to define the term a little differently for mental retardation and bring it back. Is he profoundly autistic with an average IQ? Or is he profoundly autistic and essentially incapable of communication? It's not the autism that's the problem. He might also be autistic but a lot of people started labeling retardation as autism. Which really tainted the term autistic for normal people. So I do actually agree with the shift. Not that they should take anything away from the profoundly autistic. They should offer them more. But there should be a program for that type of person. Assisting them greater than the autistic programs. Autistic help should be more about understanding the internal issues we face on a daily basis and how to deal with them. How does that help someone who can't communicate? The help he needs is probably different and more extreme than what an autistic person needs.
It's like saying I can't run. My arm hurts. Then you say. What do you mean? You're a quadriplegic!! He's like oh yea that too but I can feel a tingle in my arm. Treating the arm isn't fixing the problem lol. If that person was an advocate for treating tingles in their arm. You would think it's kind of silly because if they were to treat that. It doesn't really help the quadriplegic part. But he keeps saying it will. It's not that I don't believe he has a problem with his arm. I'm sure he does. But the problem on why he can't run isn't that.
Yeah, "thinks or reacts to things differently than most people" is way too broad.
It also shouldn't be a binary classifier. Some people are definitely "autistic", and some are definitely not, but many of the personality traits that define autism are continuous: e.g. some people are barely distracted by loud noises (normal), others are distracted by loud but not quiet noises (normal), others are distracted by specific quiet noises like chewing (autism?), others are very distracted by any noise even with noise-cancelling headphones (autism?).
I think people should just say "I have sensory issues" (or clarify "noise really distracts me"), "I'm bad at reading emotions", "my mood is really affected by others". And accommodations maybe do need to be binary (or graded), but should ideally be informal, and definitely be for specific traits instead of "autism": e.g. don't give someone who thinks methodically but isn't bothered by loud environments their own room (unless you give everyone that), but don't assign them vague tasks or they'll perform poorly.
My views may not carry much influence, but I’ve argued this point for years—and not only about ADHD, but about many psychiatric conditions, including Autism.
For what it is worth, I have ADHD -- 'cousin' disorder to Autism. Like Autism, ADHD has an array of presentations. I hold the belief that diagnostic labels are simply abstractions for grouping clusters of vague and often arbitrary symptoms. In that sense, many labels are tautological. For example, ADHD/Autism is defined by a set of behaviors, yet people are said to have ADHD/Autism because they exhibit that exact same set of behaviors.
From my perspective, conditions like ADHD and Autism are unusual conditions in terms of their pathology. I suspect some autistic people might agree when I say this: ADHD (and certain forms of Autism) seem to be treated less for the benefit of the individual and more for the benefit of those around them. Compare this to depression -- a condition where the primary suffering is internal -- experienced by the person themselves. With ADHD and Autism, the person is not necessarily suffering directly, but their behaviors often cause difficulty for others, and in turn those others impose suffering on the individual. Treatment, then, improves behavior (somewhat), which first benefits those around the person, and only indirectly improves the individual's own quality of life.
I may be struggling to articulate it perfectly, but I can’t shake the sense that there’s something unsettling about the pathology of these conditions. It has become almost imperative that I take amphetamines every single day. A practice that is far from pleasant, to say the least. Technically, no one forces me to medicate myself, yet the pressures of society make it feel obligatory. I alter myself not primarily for my own sake, but because society has deemed my natural state defective, disruptive, or unworthy. Treatment to me seems less about addressing my own suffering and more about making me tolerable to others.
Nobody is saying that it is caused by one thing, only that one of the causes are directly attributed by acetaminophen.
This is coming from studies by Johns Hopkins University, Harvard University, and Mount Sinai to name a few.
Is there anything we can infer about the nature of Autism Spectrum Disorder from the fact that it's a spectrum, as opposed to some binary thing?
If ASD is comprised of a variety of qualities that may not all be expressed at once, and they are expressed in varying degrees, what does that mean?
For example, it seems unlikely its just the existence of single gene that determines if you have it or not.
Or maybe its cause is continuous as well. More microplastics more autism (massively simplifying here, but just illustrating).
I dont really know... seems like maybe there are more interesting instincts people might have here. The fact that it's kind of an amorphous mess seems to suggest something about the nature of the thing we are talking about here.
"Autism spectrum disorder", by virtue of being a "disorder" ISN'T a single condition with one cause.
That's what disorder means
Every single medical professional is aware of that.
None of the neurodivergent conditions have a single "cause" yet. None of them are "diseases" yet because we don't know what causes them.
Yes, lots of people have small amounts of the "symptoms" that get labeled as a condition. That is not meaningful.
Everyone gets diarrhea sometimes. But if you get diarrhea regularly, or really bad diarrhea, or diarrhea that includes severe pain, then it might be IBD. IBD doesn't have one cause. It's very unlikely that it's even a single problem.
If you eat too much greasy food and have bad shits, you do not have IBD even though you have that "symptom". If you claim to have IBD, you are just wrong.
Yes, some people on tiktok who think they have ADHD or Autism are just wrong. If Americans could afford to go to the doctor for non-life threatening problems, they could get a psychologist to tell them that. Americans self diagnose because they can't go to the doctor.
This is all true of "Cancer" as well, but there isn't a giant PR campaign to convince Americans that we are diagnosing too many people as having cancer. Nobody gives a shit that both they guy who dies in a month from metastasizing brain tumors and the guy who had to remove a benign skin mole both had "Cancer". Every kind of cancer has a name, but people will still say "I have Cancer" just fine.
It's only with Autism and ADHD that people insist we have somehow done something wrong by using the exact same language structures as other medical problems.
Meanwhile, with attacks against Social Security, this admin who claims to care so much about helping Autistic people is ensuring that people who cannot function in society will die miserably and uncared for.
Maybe Tylenol while pregnant is a risk factor for people who are already genetically predisposed to it or something. The data sucks so far, but maybe further study will show something. My sister worked on a study in the 2000s that was looking at this, as well as looking at getting the flu while pregnant. Nothing came of it.
Except autism, or as it was called then "autistic psychopathy" is anything but a condition or discovery https://archive.ph/nOH4z (note: it's a nature.com link)
Autism is exactly one thing, according to its discoverer, Hans Asperger: a diagnosis to remove the mentally undesirable from society to safeguard the genetic purity of the noble aryan race (translated from the paper by Hans Asperger)
Note: by removing he meant killing anyone with the "diagnosis", child or adult. Hans Asperger signed the orders to kill at least 5 children, probably many more.
In other words: the "discovery of autism" was nothing other than an excuse to massacre children deemed to be a burden on families for whatever reason. If you were diagnosed with autism and weren't hyperintelligent, you were sent away to be killed. It was the absolute opposite of neurodiversity, of tolerance, of neurodivergent people and it was never meant as a real diagnosis of a real condition. It was an excuse for murder.
Of course, psychology sees no problem with this little part of history and still revere Hans Asperger as a hero, as opposed to someone who should have been hanged at Nuremberg along with his colleagues. Psychology has a history of doing this. If you check what happened to Freud's patients, especially the women, you'll see that he was a seriously disturbed person as well. He made (in today's dollars) billions testifying in court that women who accused rich Austrians, often their own family, of rape they wanted to be raped and should be locked up for this deviant behavior ("not" to protect and satisfy the desire for revenge in their rapists). Oh and in a few cases, that male victims of murder by their own family were guilty of their own murder.
17 comments
[ 4.2 ms ] story [ 50.0 ms ] threadIn what reality would we be living if we listened to knowledgeable people?
Like myocarditis or auto immune diseases.
Look, I get it and somewhat agree. However, the reason for the diagnosis (and any diagnosis) is treatment.
Maybe there are two different conditions that require speech, occupational, and behavior therapy to different degrees, however, in terms of convincing insurance companies in the US to cover those having a single diagnosis makes everything easier.
It's not as if a separate diagnosis would change how a speech therapist interacts with a child.
I applaud efforts to figure out what is going on and to categorize. But I also think that practically the ragbag diagnosis makes treatment a lot easier to access for patients.
Today most of the money and advocacy is for high-performing or moderately-performing people with autism. Not just in relative terms, the amount of funding for people like my cousin has gone down. It makes sense; they are the larger group by volume and are able to advocate better than people like my cousin.
I wish it weren't a zero-sum game, and we recognized that autism is just a word for a broad series of conditions. It would be like if we called everyone with poor eyesight 'blind': yes, your vision is impaired. But the solutions you need are very different than the solutions Stevie Wonder needs.
See also: https://www.nytimes.com/2025/10/01/health/autism-spectrum-ne...
It's like saying I can't run. My arm hurts. Then you say. What do you mean? You're a quadriplegic!! He's like oh yea that too but I can feel a tingle in my arm. Treating the arm isn't fixing the problem lol. If that person was an advocate for treating tingles in their arm. You would think it's kind of silly because if they were to treat that. It doesn't really help the quadriplegic part. But he keeps saying it will. It's not that I don't believe he has a problem with his arm. I'm sure he does. But the problem on why he can't run isn't that.
It also shouldn't be a binary classifier. Some people are definitely "autistic", and some are definitely not, but many of the personality traits that define autism are continuous: e.g. some people are barely distracted by loud noises (normal), others are distracted by loud but not quiet noises (normal), others are distracted by specific quiet noises like chewing (autism?), others are very distracted by any noise even with noise-cancelling headphones (autism?).
I think people should just say "I have sensory issues" (or clarify "noise really distracts me"), "I'm bad at reading emotions", "my mood is really affected by others". And accommodations maybe do need to be binary (or graded), but should ideally be informal, and definitely be for specific traits instead of "autism": e.g. don't give someone who thinks methodically but isn't bothered by loud environments their own room (unless you give everyone that), but don't assign them vague tasks or they'll perform poorly.
For what it is worth, I have ADHD -- 'cousin' disorder to Autism. Like Autism, ADHD has an array of presentations. I hold the belief that diagnostic labels are simply abstractions for grouping clusters of vague and often arbitrary symptoms. In that sense, many labels are tautological. For example, ADHD/Autism is defined by a set of behaviors, yet people are said to have ADHD/Autism because they exhibit that exact same set of behaviors.
From my perspective, conditions like ADHD and Autism are unusual conditions in terms of their pathology. I suspect some autistic people might agree when I say this: ADHD (and certain forms of Autism) seem to be treated less for the benefit of the individual and more for the benefit of those around them. Compare this to depression -- a condition where the primary suffering is internal -- experienced by the person themselves. With ADHD and Autism, the person is not necessarily suffering directly, but their behaviors often cause difficulty for others, and in turn those others impose suffering on the individual. Treatment, then, improves behavior (somewhat), which first benefits those around the person, and only indirectly improves the individual's own quality of life.
I may be struggling to articulate it perfectly, but I can’t shake the sense that there’s something unsettling about the pathology of these conditions. It has become almost imperative that I take amphetamines every single day. A practice that is far from pleasant, to say the least. Technically, no one forces me to medicate myself, yet the pressures of society make it feel obligatory. I alter myself not primarily for my own sake, but because society has deemed my natural state defective, disruptive, or unworthy. Treatment to me seems less about addressing my own suffering and more about making me tolerable to others.
If ASD is comprised of a variety of qualities that may not all be expressed at once, and they are expressed in varying degrees, what does that mean?
For example, it seems unlikely its just the existence of single gene that determines if you have it or not.
Or maybe its cause is continuous as well. More microplastics more autism (massively simplifying here, but just illustrating).
I dont really know... seems like maybe there are more interesting instincts people might have here. The fact that it's kind of an amorphous mess seems to suggest something about the nature of the thing we are talking about here.
That's what disorder means
Every single medical professional is aware of that.
None of the neurodivergent conditions have a single "cause" yet. None of them are "diseases" yet because we don't know what causes them.
Yes, lots of people have small amounts of the "symptoms" that get labeled as a condition. That is not meaningful.
Everyone gets diarrhea sometimes. But if you get diarrhea regularly, or really bad diarrhea, or diarrhea that includes severe pain, then it might be IBD. IBD doesn't have one cause. It's very unlikely that it's even a single problem.
If you eat too much greasy food and have bad shits, you do not have IBD even though you have that "symptom". If you claim to have IBD, you are just wrong.
Yes, some people on tiktok who think they have ADHD or Autism are just wrong. If Americans could afford to go to the doctor for non-life threatening problems, they could get a psychologist to tell them that. Americans self diagnose because they can't go to the doctor.
This is all true of "Cancer" as well, but there isn't a giant PR campaign to convince Americans that we are diagnosing too many people as having cancer. Nobody gives a shit that both they guy who dies in a month from metastasizing brain tumors and the guy who had to remove a benign skin mole both had "Cancer". Every kind of cancer has a name, but people will still say "I have Cancer" just fine.
It's only with Autism and ADHD that people insist we have somehow done something wrong by using the exact same language structures as other medical problems.
Meanwhile, with attacks against Social Security, this admin who claims to care so much about helping Autistic people is ensuring that people who cannot function in society will die miserably and uncared for.
Maybe Tylenol while pregnant is a risk factor for people who are already genetically predisposed to it or something. The data sucks so far, but maybe further study will show something. My sister worked on a study in the 2000s that was looking at this, as well as looking at getting the flu while pregnant. Nothing came of it.
https://www.bbc.com/news/world-europe-43820794
Autism is exactly one thing, according to its discoverer, Hans Asperger: a diagnosis to remove the mentally undesirable from society to safeguard the genetic purity of the noble aryan race (translated from the paper by Hans Asperger)
Note: by removing he meant killing anyone with the "diagnosis", child or adult. Hans Asperger signed the orders to kill at least 5 children, probably many more.
In other words: the "discovery of autism" was nothing other than an excuse to massacre children deemed to be a burden on families for whatever reason. If you were diagnosed with autism and weren't hyperintelligent, you were sent away to be killed. It was the absolute opposite of neurodiversity, of tolerance, of neurodivergent people and it was never meant as a real diagnosis of a real condition. It was an excuse for murder.
Of course, psychology sees no problem with this little part of history and still revere Hans Asperger as a hero, as opposed to someone who should have been hanged at Nuremberg along with his colleagues. Psychology has a history of doing this. If you check what happened to Freud's patients, especially the women, you'll see that he was a seriously disturbed person as well. He made (in today's dollars) billions testifying in court that women who accused rich Austrians, often their own family, of rape they wanted to be raped and should be locked up for this deviant behavior ("not" to protect and satisfy the desire for revenge in their rapists). Oh and in a few cases, that male victims of murder by their own family were guilty of their own murder.