alt Hacker NewsAutism should not be treated as a single condition
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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.
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.
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.
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.
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.”)
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.
> 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
Autism was split into autism and Asperger’s.
But calling people with social challenges “Assburgers,” I mean, wow. Just wow.
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.
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.
Previously: https://news.ycombinator.com/item?id=45451103
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.
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
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.'
Who was?
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.
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".