[faeriechangling]

>I really liked the beginning but personally am firmly convinced that autism is a serious biological problem/phenomenon that can only be understood by hard-science.

Autism is a sociopolitical concept which transcends science where anybody considered sufficiently impaired is deemed "Autistic" regardless of the underlying scientific cause of that impairment. Consequently, Autism is really multiple independent medical issues with overlapping symptoms all hiding in a big trench coat. It is hopelessly entangled with a ton of societal baggage and is not and most likely will never be a hard science concept.

>Frankly if we're seriously concerned about understanding whether autism is growing, we should develop software-administered questionnaires and take annual samples, you'd only need 2,000 people a year to have a very significant sample.

We have plenty of sampling to test autism incidence.

[zug_zug]

Hard disagree. Currently in the US the CDC puts incidence of Autism at 1/36, a number that has changed significantly every year for the last 30 years. There is no longer a scientific consensus that the rate is not changing because we have little incidence data that is judged by in a consistent manner over decades

[faeriechangling]

I mean, I understand that, yet I just see that as more evidence that Autism sociopolitical concept rather than a scientific one since we seem to keep changing our opinion of what Autism is. I see the incidence data as reflecting changes in the sociopolitical environment, and only being loosely connected to any actual population-wide biological changes.

I don't think you're ever going to objectively measure how much "Autism" as a scientific biological concept is in the population because again, Autism is a bunch of separate conditions wearing a trench coat. If you ever measured it scientifically and objectively, it would risk people losing their diagnosis and the would be unacceptable. You simply can't objectively measure a subjective concept.

More likely when we start measuring thing scientifically and independently we will start testing for the conditions in the trenchcoat rather than for "Autism" itself.

[LargeTomato]

I'm interested in understanding why you think autism is sociopolitical and not knowable through science. You state this many times as fact.

The term "autism" may be an umbrella term that defines multiple conditions. I don't know that to be true but it might be. If that is the case, then it seems likely because we simply don't understand autism well enough to categorize it further, not because autism is unknowable from a scientific or medical perspective. It may be an umbrella term today but so many concepts in science start out as flawed and are refined over time as we build our understanding.

[faeriechangling]

I think if we set out to understand "Autism" itself we will get hopelessly confused. My complaints are part of a more general complaint with the DSM-V rather than Autism specifically. I'm not hung-up on trying to understand what we call "Autism" scientifically, I'm more interested in addressing the symptoms people have.

Here's a paper on the subject, which promotes RDOC instead https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5154554/

"it has become increasingly evident that many central features of the DSM-ICD model do not map adequately onto the state of nature (Sanislow et al., 2010). The high levels of covariation among putatively distinct categories, the large number of intermediate cases, and the substantial phenotypic and etiological heterogeneity of numerous diagnostic categories, among other vexing anomalies, suggest that something is deeply awry with at least some core presuppositions underpinning the neo-Kraepelian model of psychiatric classification. Moreover, these problems have proven stubbornly resistant to repeated efforts at amelioration across multiple DSM and ICD revisions. The shortcomings of the DSM-ICD edifice therefore appear to reflect an inherent deficiency in its architectural floorplan that cannot be fixed merely by adjusting some of its walls."

"During his tenure as NIMH director, Steven Hyman expressed his concern at seeing preclinical researchers attempting to develop animal models that would mimic DSM-based diagnostic criteria. As Hyman put it “The DSM system…created an unintended epistemic prison that was palpably impeding scientific progress…Even animal studies that purported to develop disease models…were often judged by how closely they approximated DSM disorders.”"

Autism incidence as you brought up went from 1 in 10,000 to 1 in 30. If Autism diagnosis has NEVER been stable, isn't that a red flag that there's something going wrong at a conceptual level?

When you see the richest man in the world and some of the most disabled people in society diagnosed with the same condition, isn't that odd?

Why do Autistic people say "If you know one person with autism you know one person with autism" and seem to emphasise the heterogeneity of the condition? Why is there so much overlap with other conditions like ADHD, OCD, and Anxiety? Why do people diagnosed with comorbid conditions not seem to act like people with each condition independently?

Things like we're seeing with TikTok autism is examples of the reification of Autism and Autism presenting itself more as a social contagion than a neurological disorder.

[zug_zug]

So I understand the complaint that perhaps there's evidence that things currently classified as autism might be genetically or otherwise differentiable.

However to my mind that simply strengthens the need to have some sort of computerized system for measuring population samples. Removing human subjectivity from the equation will only give us more hard data to identify exactly what correlates with what.

Moreover I think somewhere in your logic you're making this assumption that autism rates can't be going up by a factor of 10+. I think there's no reason to assume that, we've seen other biological conditions (some even covariate with autism such as allergies) increase and let's just take nearsightedness as an example that has grown more than 10x.

In essence, I think it's entirely plausible that autism rates have gone up and tiktok merely happens to be informing people who have very mild symptoms of what's happening -- and to prove or disprove that hypothesis we'd want tests not administered by a biased human.

[faeriechangling]

Here's one approach in a very small study, which I wouldn't call a perfect approach but I think it's still probably a modest incremental improvement on the status quo.

https://www.spectrumnews.org/news/motor-sensory-traits-refin...