[h0l0cube]

The subset of ASD is really just BAP where the intensity of the traits and/or their particular expression come in conflict with the expectations and basic needs of daily life, requiring support (and diagnosis). Even in absence of this conflict, the acknowledgement of one's autism is useful from a self-compassion and tolerance standpoint

[skissane]

> Even in absence of this conflict, the acknowledgement of one's autism is useful from a self-compassion and tolerance standpoint

What is "autism"? It is a dimension, a continuum, (even a set of dimensions) not an either-or category. Of course, at certain level of extremity or severity of impairment, the dimensional becomes effectively categorical. But as you move along that continuum in the other direction, there is no clearcut boundary between it and "normality"/"neurotypicality", nor is there a clearcut boundary between it and other distinct forms of "aneurotypicality" with which it has significant overlap (e.g ADHD, OCD, the schizophrenia spectrum, personality disorders, PTSD, eating disorders, giftedness and intellectual disability). Clinical diagnosis is always going to have a subjective element – cases far from those boundaries almost everyone will diagnose the same way, but near those boundaries the diagnostic outcome often says more about the clinician than about the patient/client. The boundary is shifting over time, it varies geographically, and it is questionable to what extent the justification for that spatiotemporal variation is scientific, as opposed to social/cultural/political.

Do I have autism? Well, do I want to have autism? I once almost paid over $1000 for an ASD assessment for myself, but my psychologist and psychiatrist talked me out of – they both said "if you really want to pay over $1000 for a piece of paper telling you what you already know, go right ahead-but maybe there are other things you'd rather spend that money on?" I decided for now to take their advice. But if I ever decide I really want to add ASD to my personal diagnosis collection, I can fork that money out and I'd be rather surprised if I didn't get it.

I have the traits I have, but a diagnostic label is not the same thing as the traits it labels. Our son's psychiatrist once said to me something which will always stick in my head: "psychiatric diagnoses are these strange hybrids of scientific theories and cultural constructs; some clinicians put more emphasis on the scientific theory perspective and others more on the cultural construct perspective; I myself don't have a firm view on the correct balance between those two perspectives, because I haven't been keeping up to date with the research literature on those debates"

[h0l0cube]

I'm saying that ASD only really matters for when support is needed. Diagnosis can open doors to government provided support.

I think self-diagnosis is fine for people who don't require support. Though I've noticed that some people will both not acknowledge it, but at the same time unconsciously hold prejudices in relation to this 'difference' that they don't acknowledge, often in condescending ways.

[skissane]

Which I think was part of what my psychologist and psychiatrist's point was – in spite of my various issues, I somehow manage to have a job that pays well, a wife and two kids, cars, property, investments... I wouldn't be eligible for any government-provided support (nor should I be), no matter what pieces of paper I might purchase. Someone else who doesn't have those things, such a piece of paper can have some real practical benefits for them (irrespective of whether the piece of paper is an "accurate" or "correct" diagnosis)

> I think self-diagnosis is fine for people who don't require support.

This is what I don't agree with. I associate "self-diagnosis" with over-reification of ASD, which is a pet peeve of mine – emphasising categorical over dimensional understandings, ignorance of the doubts over ASD's validity as a scientific theory, ignorance of the evidence that it is (partially) socially constructed. And that's hardly a point unique to ASD, it applies to all psychiatric diagnoses – yet, many people seem to "identify with" ASD as their "true self" to a degree that rarely seen with other disorders – how many people identity with BPD or schizoaffective disorder or dysthymia in that way? And I don't like that identification. Whatever diagnoses I may or may not have, they are not me – and I don't want my children growing up identifying with their diagnoses either.

[h0l0cube]

> Whatever diagnoses I may or may not have, they are not me – and I don't want my children growing up identifying with their diagnoses either

It's not a matter of identity, but explanatory power. To reiterate, the self-acknowledgement/'diagnosis' as autistic (not ASD) is 'useful from a self-compassion and tolerance standpoint'. So instead of, why do I find X difficult when everyone else finds it easy (or even laughs/condescends/points it out), I can say, I'm autistic, that's not easy for me.

I agree that autism is a fuzzy socially-defined phenomenon. The distinction, once again, is only as valuable as how much it comes into conflict with society. So, by example, if a child is being made fun of for not understanding the tacit social rules of the playground, or a teenager of the art of seduction, or an adult of polite conversation, this self-awareness could be useful as a way of understanding one's own difficulties, and also as a way of surmounting or managing them. It can also be useful for others to be more aware or tolerant. I also agree, it's not on the person themselves, they are not broken in some way.

[Firadeoclus]

> It's not a matter of identity, but explanatory power. To reiterate, the self-acknowledgement/'diagnosis' as autistic (not ASD) is 'useful from a self-compassion and tolerance standpoint'. So instead of, why do I find X difficult when everyone else finds it easy (or even laughs/condescends/points it out), I can say, I'm autistic, that's not easy for me.

It bothers me a bit that, if you turn it around, the lack of an explanation would be an impediment to self-compassion and tolerance. "I find X difficult" ought to be enough, whether that coincides with any other traits (autistic or otherwise) or not.

[h0l0cube]

You make a good point. The "I find X difficult" is a 'disability' trait, and disabilities are only really relevant where they conflict with the expectations of wider society. In all cases it's really the social exclusion that's the problem. If someone has a trait that either can't be changed, or takes exceptional effort to mask, it shouldn't be on them to do the impossible. If however it's just habit, or actual lack of effort to change, that's a completely different thing.

[skissane]

> It's not a matter of identity, but explanatory power. To reiterate, the self-acknowledgement/'diagnosis' as autistic (not ASD) is 'useful from a self-compassion and tolerance standpoint'. So instead of, why do I find X difficult when everyone else finds it easy (or even laughs/condescends/points it out), I can say, I'm autistic, that's not easy for me.

I have no problem saying I have autistic traits, as do both my children. I find some things easier than the average person and other things harder, and no doubt my autistic traits have something to do with both. But I'd much rather say "I have autistic traits" rather than "I am autistic". Traits have far greater reality – and scientific validity – than diagnoses.

Autistic traits are also very common in people with something other than autism – in fact, most psychiatric disorders, a significant subset of those diagnosed with them display heightened (even if subclinical) autistic traits. Identifying with a diagnosis rather than traits encourages ignorance of that reality.

[h0l0cube]

I think the word autism has become such a loaded term that it has become undesirable. The removal of the distinction between 'autistic person with significant access needs' and 'autistic person with low access needs' (formerly aspies) has been problematic, in that it took a term historically (and incorrectly) associated with Rain Man and conflated with someone who's socially awkward, might struggle with emotional regulation, be hypersensitive, may have difficulty with motor skills, have nervous ticks and habits, shutdown in overwhelming situations, burnout from normal tasks, etc. but otherwise can function in a day job, pay the bills, do the laundry, cook, eat, and bathe themselves, if only with more struggle.

I've heard this plaint a lot lately, that there needs to be different language to talk about this common neurological phenomenon. I heard that there was a push to write the DSM VI in terms of its biological mechanisms. It sounds like an almost insuperable challenge, and might explain why an updated revision of DSM V was released after a decade, instead of a new manual.

[Fnoord]

Broken or not depends on context and who you ask. In the end we are all HR and as many of us must function in society. Add to that that there's an abundance of jobs due to babyboomers quitting the workforce (though less in USA according to Peter Zeihan) and there is a large benefit having people in general function in society.

My daughter is 5 y.o. and has a best friend on school. Our daughter is undiagnosed for now, we both are. I get the feeling the mother of her best friend isn't happy with them being best friends. Why? Fear of being excluded, I suspect.

Right now I'm unemployed since December and the lack of employed role model for my kids is thus far more harmful than lack of income (though latter will become relevant again within time).

[h0l0cube]

When I was 18, I attended an elective subject at college about "Professional communication". It was the first time I learnt that body language is even a thing. There's definitely courses to help with communication skills, particularly in a professional context, though I imagine the quality of said courses would vary dramatically. Not to mention there's a whole cottage industry of unqualified 'life coaches', 'style coaches', and so on, though their value is probably even more variable. I'm not sure if they could help employability, but such services are available to everyone.