Also see specialisms WITHIN Autism that are different to the mainstream Autism
The one I know most about is
PDA: Pathological Demand Avoidance [1]
PDA presents differently and needs very different strategies to mainstream Autism.
Main signs… kids under 12 attend school. However they explode at home or in private. At school the PDAers are masking (pretending to fit in) which is draining. When they get home the pent up frustration is released (explosively). So the family at home see a very different kid to the one that school/extended family witness. If this is an A-Ha lightbulb moment, see the questionnaire at the PDA Society[1]
But the one thing we know for sure it's that the world is more complex than even this set of 10 pigeonholes. These are more like good insults for people. Haha, a loner, that guy's a schizo! The clinical coldness is almost a perfect mirror for the way we express personal cruelty to others. To reduce them to a factoid, an epithet. It's no wonder people want to reclaim this words as terms of identity, of pride, of nuanced meaning.
You're saying that relative to the 'typical individual', autistic brains weigh sensory inputs more heavily than their internal model. And that in schizotypal brains, relative to the 'typical individual', the internal model is weighed more heavily than the sensory input, right?
I don't know much about this area, so I can't comment on the correctness. However, I think we should be cautious in saying 'over-weigh' and 'under-weigh' because I really do think that there may be a real normative undertone when we say 'over-weigh'. I think it needlessly elevates what the typical individual experiences into what we should consider to be the norm and, by implicit extension, the 'correct way' of doing cognition.
I don't say this to try to undermine the challenges by people with autism or schizotypy. However, I think it's also fair to say that if we consider what the 'typical' person really is and how the 'typical' person really acts, they frequently do a lot of illogical and --- simply-put --- 'crazy' things.
No biggie, there's a real normative undertone to the world in general too.
Norm itself means "what the majority does" or the socially (i.e. majority) accepted yardstick ("norma" in latin was a literal yardstick-like tool).
It's not about the typical person _always_ doing things in a better way, or the autistic person always doing things differently. It's about the distribution of typical vs atypical behavior. So, it's not very useful to characterize such atypical behavior better or worse based on absolute moral or technical judgement. Morality changes over time, cultures, and even social groups, to a bigger or smaller degree.
If, however, we use "degree of comformity with majority behaviors/expectations" as the measurement, autistics do perform worse on that.
Whether "normal" is also "correct" is a completely separate question. There are plenty of fields where the behavior of the typical person is also widely perceived to be incorrect, like personal finance or exercise routines.
I figured that this is probably something Scott Alexander has written about, and lo and behold: https://slatestarcodex.com/2018/12/11/diametrical-model-of-a...
And I disagree with that. There is a wide overlap of symptoms in all mood disorders. People with ASD show many traits of the negative symptoms of schizophrenia. This paper might change your mind:
Yeah, as the old adage goes: with an ADH?D diagnosis you get to try drugs like lisdex or methylphenidate (or the non-stim options if those aren't suitable), but with an Autism/ASD diagnosis you get some pamphlets, coffee morning invites and a reading list.
I don't have a formal diagnosis but my child does and that made me read lots on the subject. Authors like Eliza Fricker, Ellie Middleton, Pete Wharmby amongst others.
It's opened my eyes to many other related aspects, specifically Rejection Sensitivity Dysphoria (RSD) and Pathalogical Demand Avoidance (PDA) and how those play into both ADH?D and ASD. In reading about them I've worked out just how much they apply to my-undiagnosed-self and how understanding the triggers and recognising the early behaviour has allowed me to adapt to minimise their impact.
Often times it seems like the “soft diagnosis” of a condition can be used to hedge against less-than-desirable personality traits if the person is held in high enough esteem. If they aren’t held in popular regard to some extent or if there’s other factors that can be used to explain their behavior (e.g. the stereotypical “German coldness” or whatever) then they don’t get those benefits. Characteristics like their political views may also negatively affect the likelihood of this “psychiatric hedging”.
At what point do idiosyncrasies become subject to pathology.
Also, if someone is mean they are mean: Diagnosis is not a “get out of jail free” card for bad behavior.
I'm more dubious of clinicians who like to pick random dubious rare disorders that people can't even agree about the basic description of like schizoid out of the DSM like the author of this article.
“I suck at small talk.”
“I have rigid routines.”
“I hyper-focus on my hobbies.”
“I am always fidgeting.”
“Social interaction exhausts me.”
“I really bad at making friends.”
“I don’t fit in; people find me weird.”
I never considered it althought I'm ticking all the buttons (bad gear ? [0])
The HN crowd is surely over-represented in ASD, which makes sense for people enjoying debating nerdy topics and pedantry.
And "I like Lisp" should be an automatic qualifier.
I was involuntarily committed to a psychiatric hospital once and my behavior had them thinking I was Autistic.
At a bare minimum, it will give you a fresh perspective on things you already knew. In my experiences, there will be things you didn't realize about yourself.
They aren't going to tell you what the solution is to all your problems; that's for you and your doctor to figure out. They will give you everything you need to make well-informed decisions, and that's priceless.
Regardless of whether the conclusion is "yes you have x" or "no you don't have x" the diagnosis will be accompanied by a detailed analysis of your psychological condition. Whether or not you are diagnosed, that analysis will cover the issues that led you to believe you may have that condition.
Somewhat related, "Health Secretary Wes Streeting is launching an independent review into rising demand for mental health, ADHD and autism services in England." https://www.bbc.co.uk/news/articles/ce8q26q2r75o
Working in IT I've came across lots of extremely smart people with their quirks and eccentricity (not exclusive to smart people of course), I guess there's just a higher proportion of _quirky_ smart people in IT. A lot of the time it just seems to be introversion- it seems lack of interaction with society has to be justified.
For a long time ADHD was ignored or dismissed in the UK as an "americanitis", so it's no surprise that there's a backlog of people who weren't diagnosed in childhood.
[0] https://www.england.nhs.uk/long-read/report-of-the-independe...
In fact the pattern is almost the opposite of what you'd see in the US where it would be hard to get diagnosed with a SpLD and e.g. ADHD was more widely recognised. But the rub lies in the fact that ADHD, ASD and many SpLDs have fairly high rates of comorbidities with one another, to the point where if you've got dyspraxia and no other diagnosable comorbidity, you're actually in the minority of people with it.
In order to cope with this the NHS has spun out much of the ADHD/ASD assessments through the Right To Choose program (well, in England at least, Scotland/Wales/NI are on their own), which means that private companies are being paid by the NHS to make up the shortfall. Ref: https://adhduk.co.uk/right-to-choose/
Some people say some of the private companies are too lenient with their diagnoses. Some people say that the NHS is too strict with their diagnoses. I'm sure the real answer is somewhere in the middle.
As you say, the sharp rise in diagnoses is probably more due to people become more aware, with less stigma attached, and having better access to assessment.
Shit like _Rain Man_ almost 30 years ago or, more recently stuff like _The Good Doctor_ really don't help though, as those just reinforce the negative stereotypes of Autism.
ADHD also has a strong genetic component with heritability around 75% according to various studies. My parents (undiagnosed but one definitely ADD+ASD) have 1/4 children diagnosed (and another 2/4 almost certainly undiagnosed, one neurotypical), and 6/10 grandchildren diagnosed (the other 4 are neurotypical).
Who knows, in 20 years time mainstream schools could have switched from 20% SEND and 80% neurotypical to 80% SEND and 20% neurotypical.
I had one good PDoc who helped me, with my genetics, not to diagnose me, but to help me find what helped me and my specific symptoms. Diagnosis is not as helpful as looking at your own symptoms and own history and using that to find what helps you.
Back in the 90s early 00s the internet made us mesh together because each one of us there was a specific person. We had forum signatures and every single post was clearly made by a person, for a person.
Then social media took over and relegated every single person into a tiny unidentifiable avatar next to a non-prominent name, not unlike NPCs in CRPGs.
In turn this has been exploited by the powers that be to ensure the social glue gets even weaker: a society barely held together won't revolt. There's only one thing left to do: productivity, productivity, productivity.
The political opponent is no longer a person. Just a nameless, faceless NPC (personifying everything that's wrong) spawned there to be defeated and collect their social loot tokens.
But I might just be an old fart rambling about the good, old days.
Go on Discord. People have usernames, avatars. Discord Profile Bios are just as unique as forum signatures.
Server admins are just NPCs providing @everyone announcements from time to time, to keep the player engaged (spoiler: the average Joe is just irritated by those). Sometimes you get a quest from them.
Also: 99% won't read profile bios (and you have to pay for actual customization, don't you?) while forum signatures were front-and-center.
I have to say I'm surprised to see Discord mentioned as an opposite to social media instead of... just yet another iteration of the same ploy.
Maybe you should join better servers. I'll also add that this was common back in the forum days too. Most admins would just... admin the site.
> Also: 99% won't read profile bios (and you have to pay for actual customization, don't you?) while forum signatures were front-and-center.
Wrong on both counts.
> I have to say I'm surprised to see Discord mentioned as an opposite to social media instead of... just yet another iteration of the same.
I did not present it as an "opposite to social media" - I presented it as a counter to the idea that we've lost the personality GP is talking about
All praise our VC overlords.
> Social awkwardness refers to social ineptness without meaningful impairment
Isn't social awkwardness sort of inherently impairing in social relationships?
I think a really good example of this is self-diagnosing with bipolar disorder (and thus mania). Let's forget for a second that mania must last at least a few days non stop; most people do not notice this part somehow :). If you read the DSM criteria you may think that you actually fit them sometimes: elevated/irritable mood, highly talkative, distractible, flight of ideas, ... . However, you probably don't, and it is mainly a matter of understanding the scale of the problem. Most people do not know just how wide the range of "mood" is in humans, and what does it mean to be on the far end of it. True mania is often diagnosable in under 5 seconds, as the person walks into the room.
(percentages are much more illustrative than accurate)
It seems very tightly focussed, and more behavioural - and open to behavioural training - than other categories.
Yes, but I think the distinction is explained in the article: "show significant improvement with practice and maturity" and "generally achieve life goals despite awkwardness".
To put it another way, those who are socially awkward can get better, whereas some of the other diagnoses are lifetime impairments with little or no possibility for improvement or cure.
I think it’s safe to say that if someone appears “weird” to the hive mind of a community, that person is more likely to be correctly diagnosed.
There are people who desire a diagnosis for special treatment, but if the first time you find out about a person’s diagnosis is after knowing them as “weird” the whole time, then they’re not acting weird on purpose, or saying they are X for attention or special treatment.
Disabled people, mentally or otherwise, usually like to keep their business to themselves, unless they absolutely don’t need to. Some mentally disabled people might even forgo getting special treatment via disability services at their colleges, or getting parking permits for disability because they’re not interested in bringing attention to their difficulties or differences, or using these issues as a cause for special treatment. Though, I’d advised that people who need accommodations should get them.
I also saw a comment about disability becoming normalized due to late stage capitalism, which sounds like a thesis out of postmodernist thinking. The fact is that group behavior has always isolated “weird” behaviors and put undue negative attention on them, but it just happened to be the case that that weird behavior was evolutionary helpful, which is why it has persisted for millions of generations of humans across their evolutionary history.
This only applies to high-functioning categories of behaviors. But I’ve found that more often than not, it’s the social reaction of groups that is the problem for high-functioning autists, and less the autism itself. Maybe neurotypical behavior or neurotypical mindedness is the disease because I don’t understand why or how some people find it so hard to think differently. Are they not individuals, are they zombies?
1) Not being mindful of hierarchy
2) Not being mindful of socially determined rules, that is rules which are not codified in any official language of conduct
3) Not wanting to socialize, or wanting to socialize differently
4) Trouble with emotional regulation, possibly due to social issues
Tell me, which of these points, and there are many more, point to this being an individual’s problem?
For high-functioning autists, the problem is other people.
People need to realize that they’re not great to deal with on average, and if someone chooses to not engage with you, don’t take that as an insult. Maybe you’re all better off not interacting with each other, but that doesn’t imply causing someone financial, emotional or physical harm just because they’re autistic.
Society both explicitly and implicitly punishes high-functioning autism.
That feels important
I so strongly agree with this and it's not just based on my own experience, but many people I know.
Growing up broke and in sketchy places with sketchy people will induce plenty of anxiety. Then I managed to get out of all that as an adult and starting a career.
The anxiety never fully went away, but it now presents itself the way one would expect instead of "weirdness". Maturing and having a more stable life happened to my friends also and nobody says "I think I'm autistic" anymore like we did in high school and college. Now it's hard to distinguish if we were saying that to ourselves as a slur in self-deprecation, or if we really believed it. Young people are just awkward and too many people get older without letting go of the things they told themselves a long time ago.
Make of that what you will. I know my story is super common, but the only reason I bothered to write this is that it doesn't get said enough.
I've never managed to understand this when it comes to autism. Autism used to be considered something as extreme as a severe disability (e.g. Rain Man), and latterly with the inclusion of Asperger's into the spectrum, at the very least a collection of undesirable behavioural characteristics. Do people really want to be diagnosed with something wrong with them, or has the perception of autism shifted to at least neutral (if not positive)?
It may genuinely be that their dog is their emotional support, but it's ultimately a bit of selfishness and wanting to be treated preferentially in a world that feels crowded and rigid.
Spend a moderate amount of time with some humans-- e.g., war veterans-- and you'll find that denial of a diagnosis is common enough to trivially disprove this statement.
Either deliberately or because that's how all of the other train spotters/board gamers/coders they've ended up hanging out with are.
Anxiety with intrusive and obsessive thoughts is definitely a real phenomena, but nowadays it's just a sign I'm getting fussy and need a break or a nap.
My niece has a disibility that they haven't really been able to diagnose.
If it is Autism, there is all kinds of free care available.
Usually when you follow the money, you get answers.
Someone with Autism can act out and people will be like "That's OK, he has Autism". But when I act out, there is no understanding.
What is missing in the article is there does exist overlap in these condiations, not only symptomatically, but also genetically. As far as genetics, just take a look at the calcium channel gene CACNA1C:
https://pubmed.ncbi.nlm.nih.gov/31805042/
I would probably had an Asperger's diagnosis when I was a kid, but most of my Autism was beaten out of my by my older brother's and kids in school. I mean, I was so deep into astronomy when I was 10 and I would not let go if it even though everyone teased me about it and I talked about it all the time anyway.
I am in my early 60's now, homeless, living in a Minivan, driving around, researching my genetics obsessively to the point where I communicate with some leading specialists in the United States, but still no one cares.
So yeah, do I wish I could say I had clinical Asperger's? Yes. Yes. Only so I can be accepted for my neurodivergence.
I personally believe that "normal", when it comes to people's behavior, social interactions, and the way their mind works, is a completely broken idea. All of these attributes are completely fluid, depending on the when, where and who with you happen to be.
On that premise, the whole idea of neuro-divergence and the idea that you can classify people in arbitrary categories such as ADHD, Autism, etc ... and that this classification will lead to a way to "fix them" is complete and utter BS.
The problem is that no-one can easily understand how their brain works compared to other people. People on both sides don't talk about it enough or openly enough. If you look at the science it quickly descends in to endless confusing/impenetrable psychiatric terminology.
You can study things like anaemia as you can objectively measure the red blood cell count of a patient's blood. You can't objectively measure a patient's "focus" or "motivation". It's really hard to even get a good subjective measure of those things.
For example, it's just one aspect, but prior to diagnosis and taking methylphenidate (Ritalin/Concerta) I thought everyone had hundreds of competing thoughts running through their head all the time. I thought everyone just had better ways of dealing with it than I did. I had no idea that's not the case. I'd got to 50+ years old, got several degrees, married and had a family, had a successful career, not quite FAANG but earning more than 6 figures, all in spite of how my brain works. Surely there can't be anything "wrong" with me.
But when the medication first kicked in I was simply astounded how quiet my brain became and how clearly I could think about just one thing (it may not be the thing I actually wanted to focus on at that time but that's another facet of the fun). How the hell did I manage to get by all this time without this? It's only then in speaking to other people do I find out that, no, most other people don't have hundreds of competing thoughts running through their head all the time snapping at their focus.
> On that premise, the whole idea of neuro-divergence and the idea that you can classify people in arbitrary categories such as ADHD, Autism, etc ... and that this classification will lead to a way to "fix them" is complete and utter BS.
I agree with point about broad classifications, but medicine is far from the exact science that people believe it is. Got these symptoms? Does medication A improve them? Can you live with the side effects of medication A? Does medication B help with the side effects of medication A and not interfere with the improvements given my medication A? etc...
https://www.clinical-partners.co.uk/for-adults/autism-and-as...
"I prefer to do things on my own, rather than with others."
"I prefer doing things the same way - for instance my morning routine or trip to the supermarket"
"I find myself becoming strongly absorbed in something – even obsessional"
These are all questions everybody living in a modern society can relate to.
Of course autism is a real condition, but modern society somewhat requires people to be machine like and that can easily look like someone is on the spectrum.