[faeriechangling]

Glad they're working away at this.

I've stopped identifying as autistic despite having a dx because I was tired of the way it got me treated worse by the general public who presume I'm far more incompetent than I actually am and medical practitioners who do the same. Last time I sought help for a totally unrelated issue they asked if I had any prior dx and I was foolishly honest so I was subsequently referred to a day program for unemployed people with severe mental health issues. I'm full time employed so I couldn't even attend. This is the outcome of treating "autistics" as a monolith.

After the DSM-IV they decided to consolidate 3 different autism spectrum diagnosis's into one. They said this was scientific, but IMHO, this was done so everybody with Aspergers or PDD-NOS to be eligible for the higher funding levels those categorised as "Autistic" got. Which has done nothing but take away funding from severely disabled people while causing more mildly impaired people to receive inappropriate and condescending treatment, I am fucking eligible for a full time day program where a social worker will be paid to chaperone me because I'm just so fucking needy that's just what needs to be done. This change was great for the psychiatrists through, who simply received more money as a result of making this diagnostic change, nice conflict of interest there.

As a society, we decided having certain labels of disability entitled you to special legal rights and certain financial benefits. Where I live any autism diagnosis, no matter how severe or mild, gets you a flat amount of money, whereas other diagnosis's even if the condition is more severe than autism get nothing. What do you think parents, who can shop around from a variety of private psychiatrists, looking to access therapy for their child that autistic kids also get do? So you might get a kid with ADHD or Anxiety or some speech disorder, and not getting an autism DX, but getting treated like a moderately impaired autistic.

I honestly loathe, absolutely loathe the status quo of autism diagnosis and treatment and am happy for any change to be made that splits the diagnosis up because it creates at least a hope of "Severe autism" receiving higher funding levels than the rest, and "autism light" starting to get similar funding levels to other disabilities so there isn't a perverse incentive. I have not made an online comment on any website in 1 month but this inspired me.

[__turbobrew__]

This may be spicy, but I wonder if autism has a higher rate of occurrence in upper middle class homes which is why it has got so much more attention and funding than more serious illnesses as you say.

[sakjur]

It seems to me that we’ve always had many people both on the spectrum and with ADHD, but our modern society has such stiff norms that the people who are the most involved with society sees these otherwise often fairly benign variations as diseases to be medicated away.

Schools herd children through something so rigid that a lot of people are told they’re problematic, lazy, stupid, or insufficient in one of millions of ways. And then that continues into adulthood with work and, in a context familiar to many around this site, frameworks for how work should be done. People talk about estimates, and working in bursts or worrying about something your professionalism tells you is important but your boss tells you to ignore become a problem to fix. Finding a level in the hierarchy and a pace that works well for you and being content there is lacking ambition and being lazy.

I guess when a society is sick, its members are diagnosed.

[faeriechangling]

Counterpoint: https://www.youtube.com/watch?v=dntgFIzNKrc First Reference to ADHD Found to be in 1753 by Kloekhof. ADHD has been observed since pre-modern times.

Autism on the other hand is a modern condition, but I don't think there's really much dispute there's SOMETHING there because you see things like savants who are just inexplicable.

However, the rate at which we're diagnosing people today is totally unprecedented. The DSM and ICD-11 are also more like medical dictionaries than rigorously scientific reflections of underlying biological reality. They describe what Autism and ADHD are, but the categorisation is largely based on convention, clinical convenience, and a desire to fit a certain nosology rather than actual science. I've been looking into the alternative frameworks like RDOC and HITOP.

Anyways we're diagnosing people a lot more often nowadays, increasing the patient population, but still acting like research done on a much smaller patient population still holes up. Adaptive Behaviour Analysis therapy for instance is still insured in the United States based on research from the 90s when the average autistic child was very different than an average 2024 autistic child (not to say there hasn't been more research since than), and generally I see money and entrenched laws and bureaucratic guidelines and incentives as creating a sort of system which has no evidence of helping anybody which coincidentally results in a lot more money changing hands and more people getting government money.

Anyways I think the current system we have where we pretend that it's useful to say that Elon Musk and some guy who smashes his head into the wall until it bleeds to self-stimulate have the same disability strains credulity.

[throwaway6579]

Throwaway, speaking from personal experience. I will note up front that none of what follows should be read as advocating a value judgement (I have certainly failed to conceal my own biases, regardless).

Lower middle and working class families lack the knowledge and financial resources necessary to obtain diagnoses, if they should feel it worthwhile. In working class families especially, autism and ADHD traits are either vilified as gross character defects or minimized as typical immaturity, with some variation with respect to gender role. In any case, diagnosis is less likely. In middle class families, where expectations of social function and independence are different, the same behaviors are treated very differently.

[kreyenborgi]

In Norway (with a completely different system of public health funding), children of immigrants have several times higher chance of being diagnosed as autistic. Results were "adjusted for parents' education and income". I have no idea how to interpret this. (Hopefully diagnoses didn't involve testing immigrant children on their command of the Norwegian language.)

https://www.nrk.no/norge/barn-av-innvandrere-far-oftere-auti... https://pubmed.ncbi.nlm.nih.gov/36609392/