[jrq]

It was time ten years ago.

Autism is one of the most complex moving-parts mental disorders that I know of.

I'm speaking about kids mainly, because that's what I'm familiar with, but some kids have mood swings and some don't, some have cognitive tempo irregularities, some have sensory disruptive effects, some have learning disability effects, some have communication difficulties, some have spatial permanence issues, some have memory issues, there are a million different components to the autism spectrum.

The autism spectrum is often thought of as a number line, but it actually exists in several dozen dimensions, it's a very deep spectrum, with documented cases all over it.

It gets worse now that there's so much medication flowing around, there are kids who don't have attention disorders getting put on attention meds, kids with normal social skills getting out on psychotic stabilizers.

Autism has been affected strongly by how aggressively mobile the psychopharmaceutical industry has become. It's disgusting. It's completely demonic that mental illnesses are graphed and measured and these MEDICINE companies are optimizing for how much orange plastic bottles are being assigned to children!

The article is right, DSM did call for it a few years ago, but it will take time and effort to reeducate doctors, the public, the children... It will take time before parents begin to realize the extent to which they are being manipulated and profiteered upon, and the effects of all these drugs in these kids will be profound.

I feel strongly about this, but I'm so disenchanted with how America handles big pharma. It's a complete joke. Orange plastic and green paper is worth enough to violate the minds of our youth.

Edits: it's my phone keyboard!

[kemiller2002]

It doesn't help that assistance in schools is based on kids getting certain diagnoses (at least where I live in the U.S.), Autism being on of them. This means that a number of kids either have other disorders or really none at all are labeled with this because it's a way of working the system.

To make matters worse, I've had arguments with teachers about what constitutes being Autistic. My son was diagnosed with Autism when he was 3/4, and with therapy he's doing quite well, but he has his quirks. I have to remind people that just because he doesn't act the way their other children did who were diagnosed in the classroom, doesn't mean that he isn't on the spectrum, and I remind that they aren't qualified to officially determine his mental health. (And if they are, then we're going to have another discussion about performing a medical procedure on a child without the consent of their parent.)

[anewhnaccount2]

Diagnoses for conditions without a known causal mechanism should be thought of as much as a reflection on the social and institutional context as on the diagnosed person. It's only fair since it's the society and institution that needed the label in order to accommodate the diagnosed person in the first place.

[WoodenChair]

I agree if the people doing the labeling are qualified to do as much. I think OP is saying some of these teachers are not.

[loceng]

I'm curious what your background and experience is to classify the Autism spectrum as a mental disorder? I believe a better classification would be a developmental disorder - which I personally prefer to state as developmental blocks, which makes the spectrum of symptoms/behaviours and sets of behaviours as symptoms become easier to understand; and depending on when (and perhaps how) the developmental block started, will in part dictate where along natural evolution and brain development they are.

Pharma of course wants to classify it as a mental disorder so then doctors will be allowed to prescribe medications.

I'm curious too what you mean by several dozen dimensions? I wonder if you mean the same thing as I do when I say "set of behaviours?"

And yes, the industrial complex with pharma has learned how to indoctrinate the medical and educational system, and fine-tuned their marketing/advertising. I get sick to my stomach when I go to the US and put TV on, the constant flood of ads for medications that are all fluff information being presented.

[jrq]

I didn't diagnose anything.

Don't take my personal opinion and make it accountable to a professional one. I'm not a doctor. But before doing finance I used to do some basic tutoring and teachers assistant stuff for a place filled with kids with "autism" and there was a very wide array of personalities there.

As per dimensionality, yes that's what I was saying. Each symptom or descriptor exists on its own spectrum, not the entire disorder/illness/whatever it is medically classified.

Anyways, yeah. I don't know what's an illness, what's a disorder, I don't particularly care what the medical industry uses to distinguish those two words, but I've spent a chunk of time working with autistic students, and its close to my heart.

[loceng]

The wide array of personalities is why it's considered a spectrum - so either saying autism or autism spectrum is referencing the same thing. There are certainly severities of what behaviours and the level that they will present - they all fit within an evolving framework and understanding of autism though. Things can be difficult to diagnose, primarily because there can be multiple causes of symptoms. Someone with anxiety might be eating a food that makes them anxious, or they have unhealed PTS, etc.

A problem with taking the pharma approach to treatment of someone with autism is that, imaging being super hypersensitive to touch - the constant agitation from contact by clothing may make you constantly anxious right? So do you treat anxiety as a symptom of the sensitivity? It doesn't really make sense to do.

[makomk]

The complexity and the number of dimensions is exactly why the APA decided to delete AS as a diagnosis and create a single diagnostic label. Do you know why, out of all the many dimensional, we ended up categorizing based on the one specific aspect? Basically, it's because it determined what triggered the initial referral - it was an artifact of how our health system is set up, not anything actually intrinsic to the condition itself. It's not even clear what an actually-meaningful diagnostic classification would look like.

[fjsolwmv]

There are no drugs for autism, so I don't understand your comment.

[joejerryronnie]

There are drugs that have been shown to improve specific symptoms that can manifest with ASD. These drugs are not always effective but can be part of a wholistic support program (including therapy, school district support, and lifestyle changes). Any of these drugs should only be administered under the careful supervision of a psychiatrist.

[ShabbosGoy]

I wonder what role inhibitory control plays in the behaviors of ASD. Is it that an autistic person is unable to control their irregular behavior, or is it simply that their perception of the world is different than most neurotypical people?

[kosma]

Autism is not a mental illness. Please do not spread misinformation.

[dang]

Please don't post shallow dismissals. A good critical comment teaches us something.

https://news.ycombinator.com/newsguidelines.html

[scardine]

I can understand why high-functional individuals or even the parents dealing with moderate cases are afraid of the stigma but the whole "it is not a desease" is very harmful for families dealing with more severe cases: it is always taxing for the family and often very debilitating for the individual.

My 5 yers old son wouldn't be able to attend a regular school without 3 years of expensive therapy and a dedicated tutor in class so the last thing I want is an excuse for my health insurance to deny assistance. The safety network a lot worse than what is available for dawn's without this PC BS.

[astura]

The person you are replying to didn't say autism isn't a disease; they said it's not a mental illness.

As far as I know autism is classified as a developmental disorder.

[CydeWeys]

There's not much of a useful distinction between these categories and words, though. "Disease" is a very general category that, depending on who you ask, contains all disorders. Many psychiatric developmental disorders do have clear established physical causes, so in that sense they're not much different than being born with a malformed heart, other than that the defect is in a different location.

The only real consensus is that "disease" does not describe traumatic injuries, e.g. if you break your ankle in a bike accident that isn't a disease. Note that many people conflate "disease" with "infectious disease", but the actual general category "disease" is quite broad and encompasses much more.

Anyway, it's arguing over semantics, like the perennial argument over whether Java parameters are passed by reference, or if their references are passed by value, or if they're passed by value, etc. See here: https://news.ycombinator.com/item?id=16896150

[ythn]

Its a general term people use to mean "not normal". What else should we call it? Everyone loves to play semantics and politics when it comes to categorising mental abnormalities. No one wants their affliction to be considered an "illness"

[colomon]

Basically you're unleashing a horde of loaded words in an effort to explain why the first loaded word choice was appropriate.

For a significant portion of those with autism, the way their brain works is different than the median human but they are still basically fully functional human beings. My handy dictionary defines abnormal as "deviating from what is normal or usual, typically in a way that is undesirable or worrying." They match the first part of the definition, but the second part is very much open to question. Being different is not necessarily undesirable, nor worrying, nor an affliction, nor an illness.

[jklinger410]

People like you are one of the biggest reasons autism is too broad of a term.

Maybe these words seem loaded to self-diagnosed, asperger glorifying, "neurodivergent," ever-woke social justice armchair linguists like yourself.

I'd love for all of you to be squarely outside of the same diagnosis my little brother has.

I can't stress how much your "fully functioning" "open to question" "non-illness difference" version of autism deeply offends those who have been touched by real autism. Not, got me a job at Google savante autism. Not, I'm a nerd who remembers every episode of Naruto and no one likes me because I never shower so my excuse is my neurodivergence autism.

I long for the day when my brother's socially crippling mood swings and severe learning disability is no longer trapped under the same umbrella as a group of people who want to remove disability, retardation, or illness from a definition that has literally destroyed the lives of many individuals and families across the world.

I am disgusted by this optimistic view on autism. Championed by the most privileged of those with the disorder. You all fight a "stigma" for a mental disorder that you find has some "perks" as if the child thrashing his head against a wall and screaming at the top of his lungs because his brain registers every other sensation as pain and pain as pleasure doesn't even exist.

I have no sympathy for your entire assessment yet we agree on one thing, me maybe more so than you. The sooner we redefine autism into a multitude of different mental disorders, the better.

[dang]

> People like you [...] I am disgusted [...] I have no sympathy

There's obviously deep personal experience behind your comment, and that commands respect, but you can't attack other users here, no matter how wrong they are. Please read https://news.ycombinator.com/newsguidelines.html and post civilly and substantively, or not at all.

I know it's not easy when one's struggles and wounds get suckerpunched by another comment. But we all need to remember that in a forum like this, where relational bandwidth is extremely limited, someone else's comment is constructed at least 50% out of our own interpretation of their words. Maybe a lot more than 50%. More here if anyone's interested: https://news.ycombinator.com/item?id=13102115.

[rwnspace]

I am also the older brother to an autistic sibling. Thank you for writing this, I have the same thoughts and fury.

To be glib, I wish there was a specific category of disorder for those people who reflect the tale of the Princess and the Pea when it comes to their 'neurodifferences'.

[whatshisface]

There used to be a distinction between aspergers and autism in the DSMV, although the eventually removed it on the grounds that the two groups were just different magnitudes of the same symptoms. I think that we should keep the term aspergers around for social reasons, maybe not in our medical lexicon but surely in our cultural one.

[SolaceQuantum]

Calling people who have autism to not have "real autism" is a misinterpretation of the many behaviors associated with autism and why it may be considered neurodivergence or a developmental illness instead.

There are people who are non-verbal but sign or write perfectly well, what are they considered?

There are people who are very vocal but speak with an awkward cadence and have mood swings, are they "really autistic"?

There are people who are verbally eloquent but constantly participate in stim behavior and need constant observation to make sure they clothe, bathe, and feed themselves appropriately, do they have "real autism"?

There are people who may be able to hold down a part time job but cannot have a full time position because they have no capacity towards basic organizational skills necessary to have regular hours, do they have "real autism"?

There are people who are nonverbal and constantly stim and have severe learning disabilities but have enough organizational ability to hold full-time hours in, say, construction, because they're highly organized and don't have sensory problems with the work. Do they have "real autism"?

Autism is complicated because it is more a set of descriptions of related symptoms, in which each individual may have more or less of each symptom. From what I understand, autism can't be viewed as a "rating" of better or worse autism. Instead it should be viewed as a gradient of behaviors, individually are considered more or less functional.

I should also note that your language is highly dehumanizing to your bother, emphasizing on the impact of his autism on the people around him, and defining "real autism" not by symptoms but by how it affects non-autistic people. I don't believe this is much different than trying to direct a conversation about autism to making it a conversation about how hard it is to be a non-autistic and live with autistic people.

EDIT: Of note, I agree that it may be more pertinent to create different categories of autism based on the group of symptoms, but I'm not sure (and I don't know if there are studies) if they can be so easily teased apart as implied here.

[dang]

> I should also note that your language is highly dehumanizing to your brother

No, please don't do that here. It's patronizing and, given the story we just heard, crosses into personal attack.

https://news.ycombinator.com/newsguidelines.html

[mannykannot]

> From what I understand, autism can't be viewed as a "rating" of better or worse autism.

For the sake of making a pedantic and spurious semantic argument, you are willing to ignore the life-altering severity of jklinger410's brother's symptoms.

> I don't believe this is much different than trying to direct a conversation about autism to making it a conversation about how hard it is to be a non-autistic and live with autistic people.

Here you are not only ignoring the very severe consequences that autism has for jklinger410's brother, you try to dismiss jklinger410's evident distress and concern as self-serving.

[tejohnso]

> Autism is complicated because it is more a set of descriptions of related symptoms, in which each individual may have more or less of each symptom. From what I understand, autism can't be viewed as a "rating" of better or worse autism. Instead it should be viewed as a gradient of behaviors, individually are considered more or less functional.

I guess that's what the article is about, but it doesn't communicate the range as well as your post does. I wonder though, what's the purpose of having such an amorphous definition? The word becomes completely useless the more symptoms it describes. And the more symptoms it describes, the more unlikely it is that they're even at all related in terms of root cause and treatment. And I would think that results in a reduction in research progress.

> I agree that it may be more pertinent to create different categories of autism based on the group of symptoms

I know little about this topic, but this seems destined to fail and unnecessary. What's wrong with simply describing the actual symptoms? They're clear enough on their own. And boxing them up into a convenient single word diagnosis doesn't seem helpful at this stage of understanding.

For example:

> There are people who are non-verbal but sign or write perfectly well, what are they considered?

I would consider these as people who communicate well via non-verbal methods only.

> There are people who are very vocal but speak with an awkward cadence and have mood swings, are they "really autistic"?

Drop the autistic binary and just call them people with mood swings. Perhaps clarify that the mood swings can be disruptive and uncontrollable, or if that isn't the case, don't mention it at all because everybody has non-disruptive mood swings and deals with it. The awkward cadence doesn't even require mentioning if they can communicate effectively.

> There are people who are verbally eloquent but constantly participate in stim behavior and need constant observation to make sure they clothe, bathe, and feed themselves appropriately, do they have "real autism"?

The description stands on its own perfectly well without trying to determine if it's "autism". How does it help to make that distinction?

[smittywerben]

>> if the child thrashing his head against a wall and screaming at the top of his lungs because his brain registers every other sensation as pain and pain as pleasure

This is sad. Is this the right way for me to speak about it? Your just jerking your internet boner to someone who is in pain.

[mannykannot]

This response, describing autism as being merely different, is exactly why the single diagnostic label was a mistake, and should be immediately reversed. I know an autistic person whose ability to use language is so impaired that only his parents and siblings can communicate in any meaningful way with him. Effective use of language is a signature feature of being human, and to dismiss an inability to do so as being merely 'different' is a cruel dismissal of some very serious problems that have come to define the life of this family - most of all, of course, for the victim himself (and yes, he is a victim of circumstance.)

[jrq]

You're absolutely right, but in the scientific autismverse, this is a very hot topic, and there are often flame wars and arguments. This is the equivalent of a psychologist using tabs instead of spaces.

We all know what you and I meant, but the lingo in the academic side of all this has very distinct connotations, etc.

It's an unsolved issue, really.

[fruiet]

I don't know why this post has been voted down. Autism most definitely is not a mental illness. It's a disability.

[xapata]

What's the difference? Would you prefer "condition"?

[iand]

The difference is that autism cannot be eliminated via psychiatric methods. It's a neurological condition.

[jnwatson]

Nor can schizophrenia be eliminated via psychiatric methods.

[xapata]

I think many aspects of a mind cannot be eliminated by psychiatric methods, yet most we would simply call personality.

[loceng]

Developmental disorder is more widely used, and more correct.

[seattle_spring]

> autism spectrum js

These js frameworks are getting weirder by the day.

[jrq]

I have one of those """smart" "" keyboards on my phone

It even fucked that up