[genderwhy]

Science has improved, yes. We've discovered there are many people who are able to produce a set of coping strategies that effectively mask their autism.

This is what science does -- we continuously challenge what we know and change our definitions when we learn. The people who are experiencing diagnosis with autism and ADHD today will seem totally different than the diagnoses 50 years from now.

You cannot hold on to one, old definition for something like autism (or any other non-neurotypical behavior) and expect it to remain the definition, unchanging.

[faeriechangling]

If somebody has coping strategies that effectively mask their autism (in the early childhood/developmental stage specifically), they DO NOT HAVE autism, because autism is defined by others perceptions of you particularly as a child. You're going to have to change how autism is diagnosed if you don't want this to be true, which would be a great idea, the DSM approach to diagnosis is fundamentally flawed.

How SPECIFICALLY are these additional people getting diagnosed? Is there special training diagnosticians get to unveil the secret masked signs of autism? What are these scientific advances I've heard vaguely cited for the rise in autism diagnosis over the years? Why is it even possible for a diagnostic criteria that hasn't changed to result in dramatically different diagnostic rates over time, doesn't that prove the diagnostic process is fundamentally unreliable and thus fundamentally scientifically invalid?

The fundamental cause of the rise of Autism is that both schools and parents both financially benefit from a child being labelled as "Autistic" and because the diagnostic criteria is so vague to begin with you can interpret it as it suits you. The driver isn't "science", there aren't scientists and doctors marching into schools outraged at improper diagnostic practices and making changes happen. It's driven by parents and schools looking for money, money is the dynamo driving this, autistics are rainmakers. Then schools will often restrict some of their resources to those with special needs or whatever, which only drives up the need for other parents to play the same game. I've seen how the sausage is made too, with parents and teachers and doctors outright committing fraud to ensure a child looked appropriately disabled on paper, downplaying their ability as much as possible, which further jades me regarding how "scientific" this all is. I've also seen no analysis on if this practice actually helps kids, which you really think there should be because all these kids we labelled as disordered all reported being suicidal later in life.

[genderwhy]

You should understand that your definition is out of date, but I'll respond:

> If somebody has coping strategies that effectively mask their autism (in the early childhood/developmental stage specifically), they DO NOT HAVE autism

The DSM V diagnoses autism much more broadly -- https://www.cdc.gov/ncbddd/autism/hcp-dsm.html -- and it's very plausible that a child might not be identified. (For example, my parents were drunkards, I was not assessed as a child.) A child might also learn that they are punished for some behaviors such as stimming, and learn not to do it publicly, but still engage in that behavior privately.

Autism diagnoses only require that person needs 'support', and explicitly calls out that symptoms may be masked by coping strategies.

> How SPECIFICALLY are these additional people getting diagnosed?

Psychologists and psychiatrists usually start with a series of screening questions, followed by several in person discussions sessions where they probe into both your own self perceptions and the perceptions of others.

There is a 2018 paper that specifically identifies camoflauging traits and a screener that can be used to help identify adults (and others) who have built systems to survive in the world. It's called the CAT-Q. See the paper: https://link.springer.com/article/10.1007/s10803-018-3792-6

> Is there special training diagnosticians get to unveil the secret masked signs of autism?

Yes. Typically a psych degree (doctorate) with an emphasis on ASD, but sometimes masters level mental health professionals working in concert with an MD.

> What are these scientific advances I've heard vaguely cited for the rise in autism diagnosis over the years?

Well, see the 2018 paper I linked above. If it would be helpful, there are many other papers from 2000 onward that specifically address everything from repetitive behaviors to social isolation to meltdowns, etc. Mostly, we've improved our screening processes, which means we've got better, more accurate criteria.

> Why is it even possible for a diagnostic criteria that hasn't changed to result in dramatically different diagnostic rates over time, doesn't that prove the diagnostic process is fundamentally unreliable and thus fundamentally scientifically invalid?

The DSM criteria have changed between DSM 4 and DSM 5, in 2013. The DSM used to separate Autism and Aspergers as categorically different, but they've removed the Asperger's category and adjusted the criteria for a diagnosis.

It's also important to remember that science is never stable. The point of science is to revise over time our criteria. The point is to evaluate what new information we have.

And observed rates have risen, from about 1% to about 2% over the past decade, which you've correctly identified, but you would expect that because screenings have improved, diagnosticians have evolved, and we've put more emphasis on testing people.

That's not a huge number of people, and it's fairly reasonable to assume that as we've developed the science, we're catching people who previously would have been missed by less accurate tests.

It could also be that whatever causes autism is also happening more. There's a whole lot of factors, but no, that doesn't mean the science is bad it just means we haven't answered all the questions we have yet.

> The fundamental cause of the rise of Autism is that both schools and parents both financially benefit from a child being labelled as "Autistic"

That's a pretty conspiratorial claim for an increase in diagnoses that can adequately be explained by "we're better at testing for it now."

> It's driven by parents and schools looking for money, money is the dynamo driving this, autistics are rainmakers.

This is likewise a conspiratorial claim. Can you provide evidence of this? Because "I've seen it" is at best anecdotal, and runs counter to the prevailing idea that being labelled as autistic by the medical community can deny you agency in academic, medical, and social contexts.

[gowld]

> You cannot hold on to one, old definition for something [...] and expect it to remain the definition, unchanging.

If I'm autistic I absolutely will.

[silverwasthere]

Then you'll just have to include a date of diagnosis and we'll all be good. No worries. We still support you.

(This is not meant with sarcasm, only a slight nod at programming language version numbers)

[genderwhy]

I assume this is a joke about autistic folks disliking change?