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by snrji 2584 days ago
Since always. What is it otherwise?
1 comments

There was an HN thread the other day about how some (many?) autistic people don't think there is anything wrong with them and that they wouldn't "cure" themselves even if there were a "cure" because from their point of view there is nothing to cure and they are happy the way they are.
That's always puzzled me. It's certainly an individual's right to decline treatment for any medical condition, and to some extent I can understand why someone with autism might choose to do so, but that doesn't make it any less of a medical condition.
I think it's different because, at least in some forms, it comes with advantages as well as disadvantages.

For some people it's debilitating, but for others it's not.

What possible advantage is there to having any form of autism?
Speaking only for myself:

Logical thinking is really easy for me. Also abstracting, pattern matching, "out-of-the-box" thinking.. Loyalty, honesty and helpfulness are also positive traits common among autistic people.

Having a unique worldview certainly is helpful in some situations. However it also makes other situations, especially pertaining to social interactions with strangers, rather challenging at times..

Greater general logical reasoning ability. Also, many people with ASD resent 'NTs' ((N)euro(T)ypical people), and view their existence with—not animosity, but as something they would not like for themselves.
Sounds like sour grapes more than anything, honestly
Isn't there a correlation between Asperger's and high IQ?
AFAIK that's just because an Aspergers diagnosis requires an IQ>70.
Does that translate at all to general life satisfaction?
It's still their medical condition and as long as it doesn't manifest itself in ways affecting other people it should be up to each individual how to deal with their medical conditions and not have treatment forced on them.

Because forced treatments rarely work for anything as patient compliance is a massive factor for actual treatment success.

I'm really happy for them, but they are among the lucky ones. The less lucky can't say what they think.
Some highly functioning adults which some medical professionals advocate shouldn’t even be on the spectrum might feel like that.

Most people on the spectrum will require help to go to the bathroom or complete other basic tasks so them making medical decisions is unlikely.

There is now a pretty big concern about the over-diagnosing of ASD especially amongst functioning adults.

In many countries you can be diagnosed in a commercial center without even seeing a doctor, it has become almost a business similar to the ADHD “epidemic” of the early 2000’s.

So I'd consider myself one of these people. And I think it's really important that people like myself are grouped with those with more severe forms of autism. Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction.

It's difderent to the ADHD "epidemic", because it generally doesn't involve medication. Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing.

I agree that those with more debilitating forms might want treatment.

>I agree that those with more debilitating forms might want treatment.

Those are the majority.

>So I'd consider myself one of these people.

I got myself positively diagnosed also, not autistic in any way, the behaviour therapists that can diagnose anyone in the UK should be thrown out, any diagnosis especially in adulthood that does not involve multiple doctors including neurologists and psychiatrists is not something I take too seriously.

>And I think it's really important that people like myself are grouped with those with more severe forms of autism.

Why? there is no clinical significance to this. I'm being honest here, from your perspective what is the clinical significance of your diagnosis in general not to mention of being grouped with people who will suffer from fecal leakage all their life?

If your diagnosis is not used to treat or manage your condition it is not clinically significant.

>Bascially because I'm pretty sure the root cause is the same, I react to all the same triggers as classically autistic people, I'm just better able to control my reaction.

Considering that you are highly unlikely to suffer from any of syndromes that are comorbid to low functioning autistic individuals I would strongly disagree, and I have a strong feeling that once we understand the genetics of this disease better especially in relation to FXS and mitochondrial syndromes I will be right.

>It's difderent to the ADHD "epidemic", because it generally doesn't involve medication.

The epidemic is about just how many diagnosis centers are popping up targeting adults as a business with little to no oversight. This is really terrifying that we've watered down the diagnosis of autism to a behaviour therapist who had a 6 week course that can diagnose you in a single session.

>Rather it enables an awareness of the sorts of things that one might find difficult, and aids them in avoiding, dealing with, and working around those things. I fail to see how this can bea bad thing.

No it doesn't in fact it detracts severely from those who actually need help the most, those without a six figure salary. Just look at where the funding and attention goes these days vs 10 or 20 years ago.

> I got myself positively diagnosed also, not autistic in any way

I'm the opposite, I have never gotten myself diagnosed. As you say, there doesn't seem to be much point to this.

> Why? there is no clinical significance to this.

I'm not really looking at this from a clinical perspective, but from a research perspective. From the perspective of finding out more about why this condition exists and what causes it, I think it is pretty significant there are large number of people who seem to be affected in similar ways, but for whom the condition is not so problematic.

> Why? there is no clinical significance to this.

Some people just like systemizing for its own sake :)

Well depending under what they've been diagnosed, most likely PDD-NOS which the NOS stands for not otherwise specified which was a catch all branch of the ASD spectrum that has been removed from the DSM. It's still a condition under the ICD but the ICD being international tends to severely lag behind the DSM. So if they were diagnosed after 2013 they likely were diagnosed with F84.1 Atypical Autism.

Asperger's is still on the DSM but might also be moved to its own category since it's the only "distinct" classification in the ASD where there isn't clear ~4:1 ratio (or higher) of males to females. The extreme dimorphism of autism and it's comorbidity with other x chromosome related syndromes including FXS is quite distinctive and Asperger's does not usually exhibits this.

"Most people on the spectrum will require help to go to the bathroom or complete other basic tasks so them making medical decisions is unlikely."

What's your source for this claim? Is this the majority of all people diagnosed with ASD, or just the majority of people diagnosed with ASD that you believe should have been diagnosed?

1/3rd of people diagnosed with ASD are non-verbal. 56% would have an IQ below 85, 83% would have a other developmental, neurologic, chromosomal, and genetic conditions, with down syndrome, fragile X syndrome and tuberous sclerosis accounting for about 10% of these.

https://www.ncbi.nlm.nih.gov/pubmed/20431403 https://www.cdc.gov/mmwr/volumes/67/ss/ss6706a1.htm https://www.ncbi.nlm.nih.gov/pubmed/19268036

Overall this varies based on how many things you tack into the ASD, with PDD-NOS being thrown out of the DSM in 2013 it would take probably another decade if the needle moved.

Your statistics don't support your claim. Non-verbal people can use toilets. People with an IQ less than 85% can learn to use toilets. 'Developmental, neurologic, chromosonal and genetic conditions, includes ADHD and dyslexia, neither of which prevents the autonomous use of toilets.

Also, all three of these studies were conducted either before or shortly after the release of the DSM V, and explicitly use the DSM VI diagnostic criteria for autism.:

"Although new diagnostic criteria became available in 2013, the children under surveillance in 2014 would have grown up primarily under the DSM-IV-TR definitions for ASD, which are prioritized in this report."

You seem to be arguing that the relaxed criteria of the DSM V is invalid because the studies on people diagnosed with the stricter methods suggest a more severe condition. This is circular reasoning.

> 56% would have an IQ below 85

14% of the population have an IQ below 85. It's low, but not to the point of being a disability.

> 83% would have a other developmental, neurologic, chromosomal, and genetic conditions

What qualifies as a "condition" for the purpose of that statistic? What's the percentage for the general population? Frankly, if you actually include all genetic conditions, I'd be surprised if much less than 100% of the general population have one.