The reason we say "somewhere on the spectrum" is there are a lot of high functioning people who have a few autism like symptoms that benefit from some autism treatments. You can change the name/diagnosis what you want, but in the end we need to get people the treatment they need.
That's the benefit of a broad diagnosis. Narrow diagnoses make it hard to get specific treatments for problems.
That's my main concern about trying to split up autism. It's all well and good for study purposes, but for "can I get my insurance to pay for my kid's occupational therapy" purposes I'm really skittish about such a breakup. All the sudden my kid might have "omegaism" or whatever and boom, it's uncommon for them to need OT so insurance won't cover it.
That's exactly my issue with "autism" because it feels like lumping a bunch of things together just for the sake of simplifying health care. Meanwhile you have a bunch of people that have completely different symptoms, experiences and causes with the same diagnostic.
The vast amount of treatment for autism is therapies.
It really doesn't matter if the underlying cause is very different in terms of treatment because a speech therapist works the same with a kid with autism as they do with a kid with down syndrome.
If there were more pharmaceutical interventions then I might care a bit more. But there's just not.
In terms of the research, the researchers already have tools to sort and filter individuals based on their specific set of symptoms. Just because 2 people share an autism diagnosis doesn't really impact the research.
What objection do you have other than not liking that it's not a "pure" diagnosis?
It's lumping a bunch of things together because they are empirically linked together
People with sensory issues often also have more cognitive rigidity for example.
Autism, and many other psychological disorders, are quite literally just a lump of symptoms and presentations, because we do not have better options.
Sure, it makes navigating american health insurance easier if you can just say "Autism" and get various treatments paid for, but very similar diagnostic criteria and definitions are used in countries with fully socialized medicine.
Those people with those linked issues tend to benefit from similar treatment, and that's the entire point of a diagnostic criteria.
All the complaints come from people who seem to just not like the vibe of that?
Deal with it. Go fund more research into the heritability of neurodivergent pathologies if you want a blood test.
Some day we WILL be able to separate "Autism" into very specific diseases with specific causes, and some of those causes will have a genetic test. Unless we kill the concept of medical research because we elected morons who tear apart our institutions.
I have "Impaired vision", and I share that with people who are profoundly (but not totally) blind, and it does not matter that I can drive with glasses and they can't, and the name of that condition is not the important part.
All this handwringing about "but but but my mildly autistic son is mostly functional and I'm sad that he has the same name of condition as someone who cannot be educated past a 3rd grade level" is stupid. It does not benefit anyone struggling with autism to complain about it.
Are you aware that we have multiple medical conditions called "Palsy"s, and that they have drastically different causes and effects, such that my sister's Palsy which was caused by medical malpractice and prevented her from using her dominant hand in some cases is very different from my schoolmate's Palsy which left her wheelchair bound and requiring professional help day to day? They are both palsy because they are (partially) movement disorders stemming from nerve damage or dysfunction.
I honestly can't help but feel like the main point of people whinging at autism being a broad diagnosis is because they don't like that it makes getting treatment easy (especially coming from "the economist").
Maybe I'm not being charitable. But that really does feel like the only real outcome of trying to piecemeal the diagnosis.
I don't believe research or treatment is negatively impacted in anyway by the diagnosis being broad. If anything, that opens doors so that research isn't accidentally too narrowly focused.
The problem with broad definitions is that it causes false negatives in potential treatments. If you have a treatment that's effective on 10% of your group and useless on the rest you need a sample ten times as large to find an effect.
Or, consider TPA. It is an extremely dangerous drug (used correctly it still has greater than a 1% chance of killing the patient), if you administer it to "stroke" patients you almost certainly do more harm than good. The reality is that if you use it on a bleed type stroke it can (and likely will) only make things worse. Use it on a clot type stroke and you might save them. We of course know this and only use it when a CAT has confirmed it's a clot--but what would happen if we didn't distinguish the two cases?
> The vast amount of treatment for autism is therapies.
> It really doesn't matter if the underlying cause is very different in terms of treatment because a speech therapist works the same with a kid with autism as they do with a kid with down syndrome.
> If there were more pharmaceutical interventions then I might care a bit more. But there's just not.
There are a limited set of drugs involved in autism therapies, but they are general drugs that would be applied regardless the diagnosis (for example, antidepressants.)
In fact, it's much like depression in that sense in that it's a very broad definition with a number of causes. Some antidepressants even work better or worse for people.
I can't help but notice people want to define 'real autism' as only those who are impaired to the extent that they can't advocate for themselves, which conveniently means never having to listen to an autistic person's opinion on things. If you're communicating clearly, even through text on the internet, then you're just a quirky adult who is talking over the people with 'real problems'.
I'm rather dismayed by the recent outpouring of articles about splitting the diagnosis up by people who don't even have a horse in this race but have somehow become qualified to weigh in on psychiatric diagnosis.
Yes, but the whole point of diagnosis is we have treatments for those things that usually [sometimes] work and so we need to diagnosis people because that is the first step in getting them treatment.
My point is, if it is commonplace to refer to Autism as a spectrum we are already acknowledging that it is not a single thing.
Which seems to be the entire basis of this article while also mixing in the rambling of someone anti-science that frankly won't change even if it was split up.
I don't know enough above the subject (and what I could make of the article isn't helpful) to know if I agree or not. We should split Autism if we can conclusively separate people into the different diagnoses and then give them the correct treatment (which would be wrong for the other). However if we still give the same treatments in the end there isn't any point even if we can find different symptoms to result in a different diagnosis.
As science learns more (or I learn more) I reserve the right to change my position.
If a person can take care of himself, hold a job, and generally not burden anyone else why does he need treatment? To try to make him into whatever we consider "more normal?" Just let him be who he is.
The entire point of diagnosis is because a person needs help.
The point of treatment isn't to "fix" or "make normal" someone. It's to give them the tools needed to participate.
For example, someone with autism might be more prone to having a meltdown. What therapy does is give them the tools to both identify that they are on the verge of such a meltdown and to de-escalate themselves.
The point of treatment is to help someone take care of themselves, hold a job, and generally not burden anyone. It's also to help a person feel better about themselves.
It's a personal decision. I haven't gotten a diagnosis because I've been able to hold a job for many years, and I'm married, so I'm mostly fine. But I have spent my life avoiding most human contact, precisely because I know I'm incompatible with them, and people often want to know why I never leave the house.
I don't think there is any treatment. I think it's just a set of skills that you learn in case you want to try to pursue activities that most neurotypicals take for granted. It seems like a lot of work to me, and maybe it would be easier to just let things be, as you're saying.
I know what my limitations are and I can observe others doing the things that I can't do, including my own wife, and I imagine what life would be like if I could do those things too. But it mainly boils down to having FOMO, and thinking about how much work you want to go through in order to be able to do some of the things that you're having FOMO about.
Because deficits in social functioning often lead to the person experiencing emotional suffering and difficulty in friendship, career and relationships, often causing them to develop other conditions like depression and anxiety. This can be true even if the person is holding down a job.
The diagnostic criteria would exclude someone from an autism diagnosis unless they had persistent deficits across time and context.
Your example person may function well within a narrow band of capability - the purpose of treatment/support is to expand that band and help maintain it. I'm not advocating forcing support on someone that doesn't want it, but I am for improving someones quality of life by expanding their choice of occupation and social environment.
Without any external support I would wake up, work, sleep, repeat. Eating? Cleaning? annoyances that just interrupt work.
I've made a lot of money doing that but it's unfulfilling and at times, disgusting.
If you want to live in a society that leaves me be - I won't starve to death but I'm never going to have a partner or a family without external services like psychology, occupational therapy, social events.
Whether I pay for these services or someone else does it doesn't matter. I want them to be available for people like me to understand that we are not alone, there's a reason we can only exist comfortably in our narrow slice of the world, and if we want to leave our bubble there is support available.
Look at the percent of those with autism who never marry. You think that's because they don't want to?!
Look at the percent of those with autism that commit suicide. (And how many slow suicides of drugs or alcohol?? I don't think we even have a ballpark for this.)
It's not just whether they can take care of themselves.
