I had severe issues as a kid with both my head and brain size (which well, still haunts me today, this big head, hehe), but I never got that autism diagnostic, or actively looked for a doctor for it.
A doctor wanted to operate my brain as a baby, but my mother didn't let it, and in the end, it was the right choice as it had a meaningful chance of my death.
I also struggled with language at first, and I went to many years of speech therapy, but eventually, it got better. My learning rate with languages is definitely not the best, but I still speak three languages after a good amount of effort and can communicate effectively.
It also gave me plenty of advantages; I always scored pretty high on IQ tests and had very good long-term memory.
Because I don't buy this narrative from the article or in medical research that there are two kinds of autism. In my opinion, there's only one, and that one has SEVERE conditions; I had a relative who had autism, and it was complicated for both the person and their parents. To me, this seems like a naming issue like software engineers do, who struggle to name an abstraction correctly, and after three years, that abstraction means everything.
Having a different kind of brain wiring isn't some sort of sickness or anomaly. All brains are very different, just like your toes. When you compare them to others, you'll see quite a few differences.
I think there's a communication issue with regards to how a syndrome is portrayed in non-technical media. And it doesn't get any better when we replace "syndrome" with "condition" or "spectrum disorder" or what have you.
A syndrome is just a description of what a black box looks like to us from the outside. We collect different outward expressions (symptoms) and give some sort of statistical baseline - e.g. a certain collection of symptoms clusters together in 70% of cases. In the case of psychological/neurological syndromes - our most poorly understood black boxes - we then create tests which are effectively subjective surveys, aggrandized Turing Tests. And to complete the picture, we also try to cluster with regard to treatment - assuming that if X modality treats Y cases well, those Y cases are all of the same syndrome.
All this is to say that while there might be one "source insult" that creates most of what we cluster as Autism, it is extremely unlikely. There are probably multiple different insults that create multiple conditions that we crudely cluster under the same Autistic umbrella. It is useless to try and define what is the "true" Autism - we need to understand the underlying mechanism first - maybe then we can give whatever we do understand better its own name.
As to why we are quick to label, I'll just say that in my country, as a child psychiatrist put it to me - before the mid-90s parents were angry with him when he made the autistic diagnosis, a trend that was then abruptly reversed and parents started to demand he label their neurodivergent kids autistic, even if he didn't find the diagnosis to be accurate. What changed? The country started to give disability benefits to parents with autistic children.
1) One big change is the recognition that Autism, regardless of particular definition, responds to therapeutic attempts much more effectively in early childhood, rather than later.
2) Much of the effective work is around "functioning" -- if you can't speak, well, an "autism" diagnosis is going to change what's attempted in response, but the goal is still going to be to get a kid to be able to speak. That's much easier when a child is still 2 or 3.
> Because I don't buy this narrative from the article or in medical research that there are two kinds of autism.
I'd like to preface this by saying I don't feel strongly about the naming issue in either direction.
Initially I figured the authors were using the word "Autism" as used in DSM-5, where it's a blanket term for a range of conditions. But, their repeated assertion of "two types" of autism doesn't line up with that theory: DSM-5 defines three levels, not two.
They definitely aren't using the DSM-IV definition of Autism (the stricter definition that you prefer), and they also aren't following the taxonomy laid out in DSM-5. Where did their definition of Autism come from?
Was it implied that their two-level model was derived from the results of their tests? If so, I missed that part. They mention a correlation between brain overgrowth and severity of symptoms, but they don't mention a clear separation in the test data that would justify classification into two distinct groups.
I understand that DSM isn't gospel, but if they're going to make up their own taxonomy, they should provide some rationale for it.
Hardly, the study it self refers to which subtypes they are talking about in the conclusion:
> the biological bases of two subtypes of ASD social and brain development—profound autism and mild autism.
The Methodology section actually specifies they are using DSM-V (sic) and “Mann–Whitney U to test ASD clinical subtype differences in symptom severity” as well as that they test for IQ. They also specify which instruments they used to test symptom severity, neither of which actually measures subtypes of autism.
This is highly confusing as DSM-5 does not have any subtypes of autism. It has 3 severity levels for two of the symptoms criteria which is used to specify the accommodation needs. Those symptoms criteria is social communication and repetitive and fixated behavior. Intellectual ability is not on this severity level, instead psychiatrists are instructed to specify whether or not autism is accompanied with intellectual impairment. Further if you look at their table 1[1] you can see what they mean by the two subtypes, which is basically, low IQ vs. normal IQ.
This is actually much closer to ICD-11 where one of the 8 subtype of autism is 6A02.0 - without disorder of intellectual development and with mild or not impairment of functional language. So it looks like the authors used DSM-5 to diagnose autism, and then used the philosophy behind ICD-11 amend the DSM-5 diagnosis. Note that the ICD-11 approach has been heavily criticized as researchers have shown pretty thoroughly that there is hardly any correlation between intellectual ability (or IQ) and other symptoms of autism. That is the only reason to specify intellectual impairment at all is so that autistic individuals with intellectual impairment need additional accommodations for their disabilities.
I suspect what happened here is that the reason they specified these two supposed sub-types of autism is political. That they basically took what used to be called Asperger’s and said that was one of two subtypes of autism.
> narrative from the article or in medical research that there are two kinds of autism. In my opinion, there's only one, and that one has SEVERE conditions
I'm not sure that's a narrative? In fact quite the opposite, currently anything from the 'different kind of brain wiring' you mention through to the 'SEVERE conditions' that you acknowledge as autism are all seen as varying aspects and varying degrees of the same underlying difference. Once you get more acquainted with the less dramatic forms of autism there are significant commonalities.
That said, however well-founded the reasons for merging Asperger's Syndrome with the umbrella Autism Spectrum Disorder, I do feel we've lost some nuance in the process. There definitely seems to be a qualitative difference between "person who's a bit different and struggles with some aspects of life, but may be exceptional in others" and "person who's severely impaired and will never be able to navigate life on their own (even if exceptional in others)." Having shorthand terms to identify the two independently was useful.
I fully agree. The amount of people that have “minor” autism and get upset at people looking for a cure is huge, for instance.
For them they’re just a little bit different, and they wouldn’t want to be someone else. They don’t realize there are people like my cousin that needs to live in a group home because he’s almost non-verbal.
> The amount of people that have “minor” autism and get upset at people looking for a cure is huge, for instance.
Yeah, it reminds me of that X-Men meme with Rogue talking about a cure and Storm saying there's nothing to cure because it's not a disease. "I'd take a cure" thinks the nonverbal kid with severe everything who needs 24/7 care. "Shut up, we're perf" says the girl who's the world expert on diffractometry but doesn't always pick up social cues.
I tend to liken the term ASD to saying 'lower limb impairment disorder'. Did I stub my toe? Is one leg off at the knee? Was I born with no legs at all? Who knows, it's just LLID! What are you meant to do with that information? No idea.
I really think in a lot of ways it'd help to have a couple of smaller buckets inside the giant bucket that is ASD.
> I really think in a lot of ways it'd help to have a couple of smaller buckets inside the giant bucket that is ASD.
The reason we don't is because it's not possible. Every time someone tries to make a high / medium / low-functioning distinction, some PhD gymnast running three companies and a dog shelter who can't reliably feed herself has a weeks-long non-verbal episode after she wore the wrong colours to an investor meeting, and completely ruins their categorisation system thereby.
If there's one thing all autistic people have in common, it's not being well-described by the paradigms according to which you want to bucket them.
That's not to say there aren't apparent subtypes of autism, just as there are apparent subtypes of allism. But they're hard to pin down, and they're not really useful for what you want to use them for: there are people in each of them who live happy, fulfilled lives, and who struggle to function on a daily basis – and who could be described by both of those clauses, for that matter.
I think this is a really good way to put it. It feels like there's a rush to label and self-diagnose which ultimately results in a ton of pathologization of relatively normal behaviors. That is: "normal" as in we expect to see some diversity of behavior. Maybe less labeling would lead to more acceptance and understanding, which seems after all to be one of the goals...
Judging by how things go at my kids' school, it's quite the opposite. I and several of my friends have neurodivergent kids. The kids are quite open about it at school, and generally don't pathologize it at all. It's a huge difference from the traumatic childhood I experienced, where I was undiagnosed and also openly bullied for being a little bit weird.
If I may get a bit direct, if you believe that the move toward classifying some things as spectrum disorders, and neurodiversity in general, is about pathologizing the range of human behavior, I'd encourage you to spend some more time looking into it.
"I had a childhood health complication that was somewhat similar to this, therefore I am very well suited to comment on something that affected a relative that is not in my immediate family."
I have a son who is on the spectrum, he is often assumed to be neuro-typical by people he doesn't spend a lot of time with. He is "high functioning", but is still vastly different to his peers with issues that I don't think anyone would categorise as "severe", but the impact on him emotionally and our family unit as a whole is severe and pervasive.
To be clear, I am not offended or upset, I just feel that you need to be made aware that you are deeply ignorant on a topic that is only a blip in your world.
We have a son, nearly five now, who matches this description. He has, in my amateur opinion, severe sensory processing issues. He is extremely highly strung, prone to meltdowns at the drop of a hat, has trouble regulating, focusing, and so on. He is only young, so it all may change, but he is behind in micro and gross motor skills, behind in writing because of this, and is almost impossible to help because any time he senses a hint that he isn't perfect he shuts down, eventually with a meltdown if pressed. A meltdown for him involves spinning around on the floor, hitting himself over and over. He calms himself by going into a dark space and sucking on a comforter.
And yet, in social environments, if he is kept stimulated and has a lot of positive attention, you would never guess at this other side and we feel that people look at us strangely when we mention how hard our family life is. The ironic thing is I'm sitting in my home office right now and I can hear him having a meltdown outside as my wife is trying to keep him entertained.
It causes huge issues for us, and we've been having a difficult time keeping things together as a family. My wife and my relationship has suffered a lot.
PS. We have another son, two years old, who is just a typical child. Challenging at times, but otherwise fine. So it's not like we did anything different.
> any time he senses a hint that he isn't perfect he shuts down, eventually with a meltdown if pressed
This is almost certainly not what is going on inside his head. I can't tell, from your description, what is happening – if you're not being deliberately vague, that suggests that if nothing changes with your schema, you're probably not going to learn what's going on until he figures it out himself, and then figures out how to tell you in terms you'll understand. That might take years.
I doubt it has very much to do with what you see as "him being perfect": that might be the way you conceptualise the pattern, but (except to the extent he's learned this concept from you) I doubt he's thinking anything remotely similar. It is more likely to be https://www.autism.org.uk/advice-and-guidance/topics/behavio... – but however good this description may be, this is not how it feels from the inside, aged 5. Likely any labels or schema you attempt to apply to this from the outside will be intensely distressing, and the perception (e.g. from your body language, or even just a routine expectation) that you're exhibiting judgement might be enough to tip a shutdown over into a meltdown. So… don't do that. (If this is a factor, what "don't do that" entails is beyond me, and probably beyond your son. It's perhaps not beyond you-plus-trial-and-error, and it's perhaps not beyond a child psychologist.)
If this is what's going on (and remember, this is just a guess), then… basically, you haven't a snowball's chance in hell of manipulating him out of it. You're going to have to be understanding, and you're going to have to be honest. Example: if he were refusing to eat / reluctant to eat / shut down over the prospect of eating, you would have to say something like "I don't want you to starve, but you don't have to eat this right now.", or "You can eat something else, if you make sure you're eating lots of different things, and make sure this food isn't wasted.", or whatever your actual requirements are, put in terms he can understand, with options available but not constraining. (If you couldn't do this honestly, you'd have to find some other approach. I cannot stress how important the honesty is: play-acted, exaggerated emotional responses are fine, so long as they're real. Five years old is old enough to see through it.) The details obviously depend, so I don't know how helpful this is.
You're using the usual words, so I expect you're already aware; but, in case you're not, consider the advice in https://www.autism.org.uk/advice-and-guidance/topics/behavio..., especially “identifying the causes” and “sensory considerations”. Be aware that social considerations might be significant (see above… I wrote this all out of order).
I suggest you seek professional help from a child psychologist, specialising in autism. The job of a child psychologist is to figure out what's going on with your child, and explain it: their job's to be a best-effort interpreter so you don't have to wait a decade until your son can invent a complete theory of psychology with which to explain things to you himself.
(Do not go to anyone who promises, or suggests, behavioural modification – especially not if they mention ABA. This will not help your son. (If they're framing some non-coercive play-like activity as giving him tools, teaching him to recognise his feelings, or something like that, it's probably fine – not at all what I'm suggesting in the previous paragraph, but if you've found someone safe, he might find that useful for other reasons. See https://www.autism.org.uk/advice-and-guidance/topics/positiv... for more information. (Stay away from Autism Speaks: they have a lot of webpages about this, but to a first approximation, they're a hate group.)))
> He calms himself by going into a dark space and sucking on a comforter.
Yeah, that points to sensory processing issues, but it sounds like he's already pretty good at self-regulating. That's something to work from. You'll know better than I, but you might be able to involve him in the process of working out what his needs are. If you do, that means you mustn't talk over his head about it. (So: don't listen to what he says, think of an idea, then immediately turn and tell somebody else about it. Not saying you have to involve him in everything, or that everything that happens should be something he understands, but make an actual effort and an obvious one.)
Involving him is probably just making sure he knows there's a puzzle, and he's best at finding the clues, and he can tell you the clues (or his guesses) whenever he wants to: I don't know whether interrogation would yield any results.
Females store fat on ass and hips first, males on the gut first. Not only, but primarily first. Once these regions get to a point, fat accumulates all over.
Kids are indeed fatter in the West, just as adults are.
Not related (at least as far as I can see), but I read a lot of startup materials translated from Portugal Portuguese to English and often was quite confused about what it said, indeed sentences like the gp here. Then I learned Portugal Portuguese proper and found out its sayings and humor that doesn't translate. Mostly because it's not funny (to me, which makes it hard to translate) but also because there is nothing useful to translate it to in English (sometimes there is in Scottish and Irish but often not in England or US english).
I don't think it's machine translation. The preceding sentence is this:
> The best illustration of “spillover” is the incredible increase in the size of the ass and thighs in girls. This is not due to squatting or implants, because you see it at very young ages.
Absent any supporting data it's just a weird personal observation and comes off a bit creepy. I'm not saying the author is a creep, it's just a very peculiar way to make a point that could be made much less oddly. Do 1st graders need to have assess commented on and compared to 16 year olds (another group whose asses most of us do not observe with intention)? Why not just make a comment about weight generally?
Because body development is a science. Alterations to development patterns are sometimes linked to exposure to chemicals and such. For instance, back in the 90s some male kids grew breast tissues after exposure to then-common synthetic fragrances. It may be creepy, but someone has to notice these things as the proverbial canary in the coalmine.
> It may be creepy, but someone has to notice these things as the proverbial canary in the coalmine.
I do not disagree, but there is a way to notice it and comment on it that has far less probability of being considered "creepy" by someone reading. The author is of course free to do as they please, doesn't make their point any more right or wrong.
I think it's just selection bias for women with fat asses. Baby got back came out in 1992, and remained popular for quite sometime. It puts the people most influenced by it right around the age on having first graders. And of course it didn't stand alone, lots of music and popular culture focused much more heavily on ass at that point. Previously almost all focus had been on being skinny with "alert" breasts.
After reading the whole thing, I am bit worried about all the logical leaps and this just being a weird mashup of ideas that don't make much sense.
That being said, as a person that is mildly on ASD spectrum I was bit intrigued by the hypothesis of higher lactate orinted energy production in autistics. It would match two of my lifelong problems, having strong exhaustion (food coma) after eating high carbs and having similar reaction to even short (5min) high-intensity workouts. I had to adapt by avoiding large doses of carbs and focusing more on resistance training with large pauses inbetween.
I am baffled how some of my friends can eat a mountain of white rice or workout hard for hour and be completely fine after.
>”Now that Courchesne and Muotri have established that brain overgrowth begins in the womb, they hope to pinpoint its cause, in a bid to develop a therapy that might ease intellectual and social functioning for those with the condition.”
There is a slight difference between “beginning in the womb” snd beginning in some odd organoid derived from blood cells.
Autism research imho tends to be flaky and this type of press release does not help.
They had a neurotypical control group, their effect size is massive, and clearly separates the autistic group from the control group. They reject the null hypothesis that there is no difference between the groups, and argue from literature for an alternative hypothesis. What's the problem?
There's a step left out, which is how they know that what happens in the BCO models also happens in real brains in developing fetuses. That might be context known from previous research, but it isn't explained in the linked article, as far as I can see.
I don't think you need that specific interpretation to decide that this work reveals something important. We have a phenotypic difference that leads to a big in vitro difference, and it's not a huge jump to infer that that would also lead to an in vivo difference, even if the in vivo presentation is unknown, or the exact details of the presentation aren't the same.
Here's the conclusions section from the research paper this article is summarizing:
By embryogenesis, the biological bases of two subtypes of ASD social and brain development - profound autism and mild autism — are already present and measurable and involve dysregulated cell proliferation and accelerated neurogenesis and growth. The larger the embryonic BCO size in ASD, the more severe the toddler’s social symptoms and the more reduced the social attention, language ability, and IQ, and the more atypical the growth of social and language brain regions.
This is not making any huge logical jumps that I noticed. All it's saying is they found a strong correlation. And the researchers seem to be well aware that there are still dots to connect. In the limitations section, it explicitly points out more-or-less the very thing that the researchers are being accused of not thinking about in this HN thread:
The genetic causes and cellular consequences of decreased Ndel1 activity and expression correlated with ASD BCOs enlargement remain to be specified. A limitation of most previous ASD patient-derived iPSC-based models is lack of within-subject statistical linkage of ASD molecular and cellular findings with variation in ASD social phenotypes. Without this, future ASD iPSC reports will continue to have limited impact on our understanding of the genetic, molecular and cellular mechanisms that cause the development and variation in the central feature of ASD: social affect and communication.
Which brings us to an important thing about interpreting popular science literature: it's unwise to assume that what's in the popularization of the research accurately reflects everything the scientists who published the work think or know. Attempting to eliminate these kinds of details is one of the primary goals of science journalism. For better or for worse.
I don't think the other poster was objecting to the excitement about this being a potentially important discovery, or criticizing the research or the researchers. They are objecting to the way the linked article presents it, specifically its claim that "Courchesne and Muotri have established that brain overgrowth begins in the womb."
As readers of this article we can fill in the blanks and imagine that there might be a well-understood and well-founded way to extrapolate observations of these BCO samples to fetal brain development, but we can equally well imagine that this extrapolation might be tricky or unreliable. So as lay readers we're left to guess which mistake the author made: did they overstate the conclusion based on a bad assumption, or, after already explaining so much about the research and connecting so many dots for the reader, did they forget to explain why we can confidently draw conclusions about real fetal brains from these in vitro models? Obviously the second is more forgivable, but it's annoying either way.
They don't. Doing studies on living human fetuses is an admin nightmare. So they use analogues. Black hole physicists also resort to analogues as thier subjects are similarly difficult to manipulate.
I did not see information on the ancestry of the 9-10 ASD toddlers or on the even fewer neurotypical controls. May have missed this.
As for large putative effect sizes this is often due to subtle batch processing differences between cases and controls. Where they all processed by the same tech in an interleaved way? All stored in the same way over this very long duration study? Authors do discuss batch controls but with single digit sample sizes I regard statistics as fundamentally unreliable.
I am also not convinced by the claim of any over-proliferation of neurons in autism during development. It is certainly a highly controversial result. See notes above by “subiculum…” and the Li et al paper he cites.
That’s true of most neuroimaging studies. Have you ever tried to get a bunch of people into an MRI for a study? Not easy, not cheap.
Like they said, the effect size is large. With a large enough difference, you can distinguish the effect from statistical randomness, even with a small sample size.
As with any study, this result must be replicated. But just waving around the sample size as if every study can be like a live caller poll with n = 2,000 is not helpful.
Also this idea that bigger is better with sample sizes can lead to problems on the other side, when we see people assuming an effect must be real because the sample size is so large. The problem is, sample size only helps you reduce sampling error, which is one of many possible sources of error. Most the others are much more difficult to manage or even quantify. At some point it becomes false precision because it turns out that the error you can't measure is vastly greater than the sampling error. Which in turn gets us into trouble with interpreting p-values. It gets us into a situation where the distinction between "probability of getting a result at least this extreme, assuming the null hypothesis" and "probability the alternative hypothesis is false" stops being pedantic hair-splitting and starts being a gaping chasm. I don't like getting into that situation, because, regardless of what we were all taught in undergrad, scientific practice still tends to lean toward the latter interpretation. (Except experimental physicists. You people are my heroes.)
For my part, the statistician in me rather likes methodologically clean controlled experiments with small sample sizes. You've got to be careful about how you define "methodologically clean", of course. Statistical power matters. But they've probably led us down a lot fewer blind alleys (and, in the case of medical research, led to fewer unnecessary deaths) than all the slapdash cohort studies that we trusted because of their large sample sizes that were so popular in the '80s and '90s.
Huge sample size, but all food intake is self reported, or a tiny sample size where test subjects were locked into a chamber that measures all energy output from their body while being fed a carefully controlled diet.
The later is super expensive, but you can be pretty confident of the results. On the flip side it also miss any conditions that only present in a small % of the population.
You can see this with larger dietary studies where out of 2 cohorts of 100 each doing different diets, 15 or 20% on each group does really well on some "extreme" diet (e.g. Keto) but the group on average has no unexpected results.
If your sample size is 5, it is quite possible none of your test subjects are going to be strong responders to, for example, keto.
So then the study deadline comes out "Keto doesn't work! Well controlled expensive trial!"
Meanwhile the large cohort study releases results saying "on average Keto doesn't work".
But in reality, it works really well for some % of the population!
Some non-stimulant ADHD drugs have a similar problem. If a drug only works for 20% of the population, you need to be aware of that when doing the study design.
You seem to be implying that subgroup analysis never happens?
I guess I don't follow weight loss research closely, but I would be genuinely amazed that they don't do it, too, given how ubiquitous it is everywhere else in medical science. And the literature on ketogenic diets goes back over a century now, so it's hard to imagine nobody has done one. Could it be instead that people did do the subgroup analysis, but didn't find a success predictor that was useful for the purposes of establishing medical standards of care or public health policy? Or some other wrinkle? Or maybe people are still actively working on it but have yet to figure out anything quite so conclusive as we might wish? But that this nuance didn't make it into any of the science reporting or popular weight loss literature, because of course it didn't, details like that never do?
Disclaimer, I'm absolutely not here to trash keto diets in general. I have loved ones who've had great success with such a diet. My concern is more about the tendency for health science discussions to devolve into a partisan flag-waving contest where the first useless thing to get chucked out the window is a sober and nuanced reading of the entirety of the available body of evidence.
> Could it be instead that people did do the subgroup analysis, but didn't find a success predictor that was useful for the purposes of establishing medical standards of care or public health policy?
If we are all being generous with assumptions, this could very well be the reason.
I haven't seen much research on efforts of trying to predict what dietary interventions will most effective an individualized treatment basis, but I also haven't kept up a literature for five or six years.
Then again the same promises for ADHD medicine where now they are some early genetic studies showing perhaps how we could guide treatments, but the current standard of care remain throw different pills at the patient and see what they works best with the fewest side effects.
Of course dietary stuff is complicated due to epigenetics, environmental factors, and gut microbiomes.
That said progress is being made and the knowledge we have now is world's different than the knowledge we had 20 years ago, but sadly it seems outcomes for weight loss are not improving.
That's a great point. If your experimental methodology is flawed, it doesn't matter how big your sample size is. A study like this lets you gather some compelling evidence that you may have a real effect. Then you can refine the technique. Autism is a very active area of research, so I suspect we'll see other groups attempt to replicate this study and adapt its techniques while the original authors refine the technique and get funding to perform larger studies.
I recognize the Catch 22 that the diagnosis is not possible until several years after birth. But a prospective study of this sort is “in scope” at UCSD. They already have big MRI studies of kids with hundred or even thousands of scans.
I don’t understand your complaint. The conclusion of the paper says this: “By embryogenesis, the biological bases of two subtypes of ASD social and brain development—profound autism and mild autism—are already present and measurable and involve dysregulated cell proliferation and accelerated neurogenesis and growth.” It is correct to describe that as “established that brain overgrowth begins in the womb”.
It seems you have an issue with that the researchers reached this conclusion from experiments with what you call “some odd organoid derived from blood cells”. I’m not an expert so I wouldn’t know if that is a valid way to make the conclusion but once they do it seems the summary in the article is correct.
What do you feel is wrong with the article and what do you feel is flaky with the research?
This growth pattern has been documented pretty well? I used to teach it in undergrad courses.
Autism spectrum issues are associated with overgrowth and then deceleration more than normal. This seems like a hyperexperimental version of it. Still interesting and good to see corroborating evidence, also useful as a model for therapies and other things.
Th predominant view in the field has been that there is early cerebral overgrowth followed by either normalization or regression of brain volume in adolescence. However, this conclusion is based on cross-sectional comparisons. This means, they look at different people at different ages, and make inferences on developmental trajectories based on these cross-sectional, age-related patterns. While this is often a starting point, cross-sectional research can suffer from sampling biases.
A huge weakness in autism neuroimaging research is the un-representativeness of
their samples. Nearly a third of individuals with autism have severe intellectual impairments (IQ's < 70) yet represent less than 1% of neuroimaging samples. Individuals with other immense behavioral, sensory and language challenges are also rarely make it through the rigors of imaging protocols.
A rare exception has been imaging research that performed brain imaging in very young children during natural sleep. and thus can hold still enough for quality MRI images to be acquired. This has allowed imaging of autistic children aged 2-6 years to include autism over a whole range of severities, challenges, and intellectual abilities.
This presents a problem though. The research that suggested there is brain overgrowth in early childhood sampled from a wide range of autism phenotypes and severities, while the normalization evidence in adolescents and adults came from autistic participants with normal ranged IQs and less severe challenges, a clear cross-sectional sampling bias that threatens the validity of the overgrowth normalization story.
Moreover, research indicated that disproportionate brain size in autism was associated with slower intellectual improvements with development.
I and my colleagues thus hypothesized that the discrepancy would be removed if we can follow the same children from childhood into adolescence longitudinally. Using a number of behavioral techniques and a lots of care and dedication, our team managed to acquire brain data in a broad spectrum of autism phenotypes and severity levels from early childhood into early adolescence.
Our conclusion: Longitudinal evidence does not support the notion that early brain overgrowth is followed by volumetric regression, at least from early to late childhood.
Don't count on it. My experience is that funding goes to those who are not serious about autism epidemiology. Back in the mid-1990s, I was at a startup in Silicon Valley with about 100 employees where, during a few year period, 5 of the employees had children diagnosed with autism severe enough that they were barely verbal at best. This struck me as a great opportunity to discover the cause so I contacted a Berkeley epidemiologist who had been funded to do autism research. His comment was simply that "Yes we know that these microclusters exist." and that was that. No follow up.
I used to joke to myself that I was the next step in evolution, home sapiens superior. I was aware enough no to provoke my classmates though ;)
But, I wonder if it is at all related to Neanderthal lineages. They had bigger brains and were basically autists: the species. Since we are a bastard of them and early Sapiens, maybe some of us present with more of their genome than others?
They don't need to be evenly distributed to be strong evidence against the Neanderthal connection. If autism was basically "latent Neanderthal ancestry", then you'd expect essentially no autism outside of people with European or Middle Eastern ancestry.
And it seems that the prevalence of autism is actually fairly even, but might actually be lower among white people.
I think you'd only expect to find a significant difference in the rates of autism between regions where interbreeding with Neanderthals occurred, and regions where it didn't.
That seems highly dubious. The global human population isn't that well connected, or at least wasn't until recently. And single genes aren't that easy to isolate, so if they could travel that quickly we would also see all kinds of more visible traits moving around, but instead for most people we can get a decent idea of their genetic heritage looking at their face.
All people on Earth are descended from Neanderthals, and East Asians have the highest ancestry. The idea that only Europeans are related to them is outdated.
blaming Neanderthals for most things is a gross over-simplification and misdirects reader's attention towards genetics. While there is some humour to it, I would be cautious of giving into unwarranted fixation towards genetics, as we no longer live in the world where it needs to be defended against Lamarckism and like.
I posit that the "runtime environment" i.e. epigentics, among other things, has a far traceable cause than the smidge of related species. The nature and consequences of autism land me to believe that it's more likely a consequence of a compiler error, although shoddy source code could be a secondary/compounding cause for it. Take Down's Syndrome as an prime example of genetic disorder, and it becomes clear why such categorization does not work for autism: autism is too broad, it describes the effect rather than cause, and I'd argue that autism is far less debilitating (pronounced) and definitely not inherited.
Autism being "too broad" is why it doesn't have a genetic cause?
Autism's nomenclature not being descriptive enough is why it doesn't have a genetic cause?
Autism not being as debilitating as DS is why it doesn't have a genetic cause? (developmental logic aside, are you familiar with Type 2 and Type 3 autistic individuals?).
Extra dings for not for over-use of CS analogy, "unwarranted fixation", and "we no longer live in the world".
I think the real problem here is this can potentially be a politically heated take. I don't believe it is in this case, or they were making an effort to not make it so. Of course, that is just my reading of it.
In identical twins, autism and homosexuality both have about the same rate of non-occurrence between the twins: 50%. This means, of course, that autists and gays are "born, not made" by the environment. Move along. Nothing to see here.
Also macrocephaly is significantly more common in autistic people than the general population (that is, macrocephaly is a head circumference at the 97th percentile or higher, but ~20% of autistic people have it).
Overgrowth is a normal process in the development of the fetal brain. It is followed by a reorganization, which means the pruning and migration of neurons to the right locations in the brain.
New research? I remember years ago (2019-ish?) a young man in #aspergers asked how he can prune his neurons to cure his aspergers. (The residents however did not appreciate the suggestion that they needed curing.)
The typical method is short term alcohol abuse. Joking/not joking. The effect is mixed. Pruning may occur. Autism incurable.
There are ideologues who like to police others in every divergent group that falls in a normative IQ range. Try going to a deaf sub and happily announcing your pending cochlear implants (don't do this).
One might imagine how this may be worse in the autism group.
Heck, observe how politically oriented "totally normal" types at Psychology Today pretend to lecture the autism community on the only acceptable way to think of themselves. They're obsessed with the topic, and it'll change only every few years if lucky.
The fundamental idea at work here is "If I can't be fixed, then I can fix everyone else to be like me, thereby making what I am be considered "fixed"" or "If I can't be fixed, I need to change the definition of working"
A person ultimately has two options. He can either conform his mind to reality, or reality to his mind. The first leads to truth, the second leads to rationalization, delusion, and insanity.
Humility favors the first. Pride favors the second.
As Satan famously says in "Paradise Lost", "The mind is its own place, and in itself can make a heaven of hell, a hell of heaven." It's not an accident Milton puts those words in the lips of that particular character.
lol
The sample size in induced pluripotent stem cell research is often like this because of how laborious it is, and cutting edge. Moroever, while the parent sample is small, it doesn't mean that number of samples per individual is small.
I haven't read the paper yet, but if its like what our team is doing, we take blood, and turn the cells there into neurons, then organoids.
I can see that the research makes many organoid samples (4000+) mentioned in the paper. This is good to validate the organoid results are consistent.
however, then correlating the consistent organoid attributes back to attributes of a small parent sample group is weaker on small sample groups than larger ones. here the parent group is tiny… and the severe ASD sufferers is even smaller (n=2 or 3 by my understanding)
great foundational research! but surely larger group sizes are required before correlation is confirmed
I'm somewhere on the spectrum, with many of the stereotypical traits (special interests, sensory sensitivity, social difficulties, emotional processing trouble, sensitivity to disruptions, you name it). It makes me good at some things and bad at others. It has, at times, made my life very hard, and it has at times made things that are very difficult for others trivial for me.
But that's not really any different from how people vary from one another in general. It just so happens that the way in which I vary is shared with many others and has a name.
I'd say the same about ADHD. I don't know if I have ADHD, specifically, but I certainly have some form of related executive dysfunction. It makes it very hard to focus on something tedious (I spent a solid hour trying to type up a few paragraphs of interview feedback for someone earlier while getting constantly pulled off onto other things). But it also means I temperamentally have to constantly be learning and growing because I'll wither and die if I don't. That has made some things (like doing repetitive daily tasks) hard, but it makes other things (like the fact that as a founder I have to do about seven different jobs at a time) fun and easy when they would crush many people.
I agree with you that we don't need to pretend that things that hurt us don't. The difficulties matter, in part because acknowledging and understanding them is a part of finding our own personal brands of excellence. But I also don't think we need to treat the ways in which we're different as a curse, either. It's just how we are, and we have to figure out the best way to live within those constraints, the same as anyone else. Sometimes that means tolerating the things that we can't change, sometimes that means routing around them, sometimes that means figuring out ways to make them work in our favor.
I can't speak for everyone, but I can say that my life has gone far better starting from the premise of "this is the way I am and I have to work with that while recognizing the realities of interacting with a world that operates on different rules from mine" than it has from the premise of "I'm broken and I need to fix myself so I'm like others". In that sense, I think that acceptance, and even celebration in the right ways, can be good. It's just a way to say "it's not wrong to be what you are, and you should try to be the best version of that thing, not the best version of someone else".
> I can't speak for everyone, but I can say that my life has gone far better starting from the premise of "this is the way I am and I have to work with that while recognizing the realities of interacting with a world that operates on different rules from mine" than it has from the premise of "I'm broken and I need to fix myself so I'm like others".
One may accept without either self-hatred or celebration. This is the way things are, this is what there is. No need to embellish either negatively or positively. I think either path leads to poor outcomes societally.
I might sound like a stoic, but I am definitely not one. The reason is that I spent a lot of my life trying to pretend I was above my emotions, unperturbed by such forces in my higher realms of logic. This...uh, wasn't true. I was feeling as much as anybody, and my actions were being guided by my feelings as much as anybody. I just wasn't listening to my feelings or aware of how much they were dictating about my life.
Emotions are as essential a part of a person as cognition is. The Universe doesn't prescribe any particular things as good or bad, praiseworthy or evil, interesting or boring. In the world of pure logic, there is no difference between me deciding today to not drink any water and dying in a few days versus me living a long, full life of rich goodness to my fellow man.
The problem is not having emotions, but confusing them with beliefs. Emotions aren't there to tell us what's a good idea, they're there to tell us what's a fun one. Both are important. So we use our reason and our emotional regulation to make better decisions about how we may have the most fun (where "fun" here is standing in for whatever broader notion of personal utility you might choose). Even the literal Buddha was pretty clear on the idea that there's not much value in depriving oneself of one's human pleasures - only in not being controlled by those impulses.
And I would say that taking satisfaction in the positive traits you have is a pretty basic human pleasure.
Can't speak for GP, but I have similar feelings... some things are dramatically harder, others easier... for the most part I just develop coping mechanisms for as much as I can and try to accept other pieces. Not a matter of self-hatred or celebration so much. Though I have dealt with a lot of depression in my life from a general difficulty in interaction.
One can reason their way through a lot of things, even a lot of the why's of emotion over time. To recognize when you are going into a state of reacting on emotion over reason. It's hard.
My daughter faces a lot of similar issues and it's harder for her than it was for me. The best I can do is try to instill a sense of drive to adapt and overcome as opposed to just giving up and/or wallowing in things. I wish my parents were better equipped to do this for me. I was close to 40 before a lot of things started to fit together. A few years ago, working with someone that had similar personality issues dialed to 11 so to speak that a lot of things became much more clear.
I can recognize a lot of what you wrote to be true for myself,although my diagnostic was made very recently. The most difficult part for me is to be understood and accepted for who I'm, probably because it was hard for me to accept who I am. For years, I've been fighting to be like "anyone else" which eventually led me to be rejected, misunderstanding and considered "sick" (sic) by others, especially the most significant ones in my life. This is one of the trait of my life which is difficult to handle and makes me sometimes feel miserable.
A confounding variable is that neurodivergants are more culpable to being traumatized and suffer greater dysfunction when traumatized.
Being on the ND spectrum (and having been through the ringer of medical professionals, with god knows how many diagnoses) I know I have a different set of tools in my toolbox and I have painstakingly found my "niche" where I excel, and have worked hard to strengthen my weaknesses.
That's not to say I haven't seriously considered killing myself numerous times in the past due to foreseeing how hopeless and painful my life was to be. But that was primarily the trauma, and its effects on my executive function and the inability to adapt to my unique circumstances (ADHD being one).
However, I'm not blind to the fact others are not as lucky as I am to be able to have not only some semblance of free will and favorable circumstances to exploit to the best of my ability. Others are less fortunate, but I have to ask what portion of that (debilitating consequences) is simply a helplessness bestowed upon them from repeated trauma and a lack of favorable environment? I believe a good portion would fall under this camp. Ergo, their unique physchological makeups have not found an environment that fits.
I also suffer from ADD (non-H type). While I definitely acknowledge the validity of your point, having a view of the other side of the coin often helps to cope with these things. Not just cope, but moreso to keep in mind where we might best apply our efforts to have the greatest effect in our favor. It certainly helped me to have things reframed in such ways.
I think it's more a matter of degrees than a wholesale one view vs the other.
I didn't know that. Thank you.
I'll probably stick with ADD for most things though, because it seems like it's easier to say (barring my own qualifier for clarity) and people generally understand the distinction already. But this will be helpful in more technical circumstances, I imagine.
Nowadays the term ADD isn't even used casually by doctors or other people with ADHD... if someone told me they had ADD I would assume they were either self diagnosed, or diagnosed a long time ago and self treating, but not communicating with doctors or the ADHD community for at least a decade. The latter is important because there have been HUGE advances in practical advice on managing ADHD. Look at podcasts like "Hacking ADHD" and "How To ADHD."
It’s definitely not a superpower, but that doesn’t mean it’s not an adaptation that is well suited for certain niches. For example, it appears that individuals with ADHD are particularly adept at foraging.
It's tragic, that the whole "superhero" narrative around neurodiversity was probably meant to be hopeful, but yeah, it's almost the opposite nowadays. Plenty of people with autism e.g. don't have special skills, they just have it harder really.
Even despite that, I still find the idea hopeful and worth discussing. Whether something should be considered a strength or a weakness _does_ depend, at least in some cases and to some degree, on your perspective and actions.
Some superhero fiction even covers this aspect. A quite interesting example would be One Piece, where a number of people ate a special fruit that gave them superpowers, but they lose the ability to swim. Since the world is mostly ocean, that's a huge deal, and the main character is initially depressed about having made that trade, until he learns to appreciate his new powers.
So I guess this neurodiversity-is-a-super-power narrative can be both be bad (proper help and understanding is denied) and good (e.g. increased self confidence).
> We don't need to turn all pathologies into a positive trait to be cherished.
I don’t think your parent was doing that. As I understand this theory is that societies which take care of their disabled have a survival advantage over societies that don’t. Even though diversity is debilitating to the individual, it still benefits society as a whole.
A short description of the mechanism could be something like: Variability is the raw material for evolution through natural selection. Having a high cognitive and behavioral variability offers greater opportunities for societies to benefit from natural selection. Societies which take care of neuro-divergent individuals have a greater cognitive and behavioral variability.
Evolution is quite fine with individuals suffering, so long as it has a net effect of propagating genes being more likely.
There are likely many genetic and environmental factors that all contribute to ASD. A gene that is generally helpful, even if debilitating when paired with an unlucky combination of other factors, might still be very strongly selected for. Some people on the spectrum deeply suffer, but for every such case there are many more moderate cases, to the point we might not even recognize them as being on the spectrum, that can be very successful under the right circumstances.
I think you're taking this the wrong way. I understand that it probably feels patronizing and you don't give a shit that a trait you have that makes your life personally hell might be good for the health of the species overall, but I still think it is. I get into this with my wife every now and again because she had ADHD and has often argued she shouldn't procreate because of it.
That kind of perspective is narrow to the current human environment, which is not permanent. We're living in a tiny infinitesimal speck of the spectrum of the whole biological timeline of earth, let alone entirely different planets we might someday inhabit. Her constant worry and distractedness might be disadvantageous in a world that requires you to concentrate on unstimulating tasks and in which the threats you see yourself surrounded by are largely imagined and extremely unlikely to be realized. But that is because we currently live in a society of laws and stability, presumably somewhere near the height of civilization. There is no guarantee it will always be this way. When shit hits the fan and the threats get real, my perfectly well adapted to the current world self who fixates for days at a time on narrow tasks, pays little attention to surroundings, and worries about almost nothing, will get killed off within days if not hours. It'll be up to people like her and you to give humanity a chance to make it into the far future.
This is why we need diversity. Because even if it sucks to be you who isn't well adapted to the current moment, the current moment is short. It doesn't mean you're a superhero. It just means we have no idea what sorts of traits and behaviors might keep us going under drastically different future pressures and we may as well keep as many different traits around as possible just in case.
I reject your premise entirely. The decades spent living unmedicated taught me that even when I was free to pursue my own interests, I was unable to engage with any of them in any depth, even those artistic or that might otherwise be a more suitable fit to certain spheres of human activity some argue (ignorantly) I'd have an evolutionary advantage in.
It impacts everything: healthy regulation of emotions, satisfaction in relationships intimate and platonic, frequency of damaging behavior like substance abuse, and addiction to novel sensory media.
It's novelty-seeking that is broken, that's all there is to it. We are lucky medication is available. Others who struggle with other mental pathologies are not so lucky.
Self-hatred is not the answer. So is any attempt to make it a virtue. You can just be with the acknowledgement of a maladaptive state.
You reject his premise but you did not refute it. Reiterating the adaptive struggles you and other ADHD sufferers face does not invalidate the idea that it is a competitive advantage under certain circumstances.
I did refute it, vociferously. If you have evidence for it being an evolutionary advantage, you are welcome to present it. The only scientific argument I've seen presented is that it made us better foragers but I ask you, who is foraging today? It's an utterly absurd position to take that it is a competitive advantage in a scenario no one in the first world will ever encounter.
Sounds like you don’t even dispute his point, so how could you have refuted it?
To your point about relevance : nobody here has claimed this competitive advantage is wildly useful in a “first world” context, something the GP actually framed explicitly.
Personally I don’t think one needs to invoke post apocalyptic scenarios, as there are plenty of “first world” professions or scenarios that benefit from the same skill sets - military, emergency medicine, firefighting, just to name a few. The first world isn’t all spreadsheets and jira tasks.
I honestly don't know where you're going with this. You're theorizing about a condition you presumably don't have and then extrapolating your theories to professions you imagine to fit your idea of the "skillset" people with ADHD supposedly have.
There is not a skillset attached to the diagnosis of ADHD. There is no time to develop a skillset when the mind is constantly roving and unable to concentrate.
Im diagonsed Adhd and I definitely had years of great success before being medicated. Theres advantages to all the things you're saying under the right circumstances.
Also quite frankly just about everyone suffers in one way or another. How do you know your issues were more than average?
I'm sorry to hear about the struggles this has put you through, but I might mention that it is not universal that diagnosed sufferers of ADHD are unable to engage with their interests. In fact often direct interests can be highly engaging, while things that need to be done but are not interesting are debilitatingly difficult (executive dysfunction).
As with ASD and neurodivergency at large, ADHD is a spectrum, with differing impacts for differing people.
Could not disagree more. Nothing is “interesting” in perpetuity. Hence why so many with ADHD engage with various topics in an intense but sporadic manner.
In the overwhelming majority of cases this scattershot approach is deeply frustrating for the individual, and orders of magnitude less productive - in terms of meaningful creation and innovation - than persevering on a focused set of tasks.
I don’t think your comments are in conflict, being engaged with an interest does not necessarily mean being directly engaged with a project/task related to that interest. I definitely empathize with the scattershot approach being frustrating, but i think that comes out of an intense interest in a topic, and a lack of ability to focus on a specific task, even if it is self-selected and related to an interest.
I can think of many examples of times where I was unable to complete a project (in part) due to a drive to answer every question that I encountered in the process, and questions branching from those answers. So yes it does definitely impact productivity and perseverance for specific tasks, but I would separate that from the unique ability to learn intensely about interesting topics with reasonable depth and exceptional breadth that ADHD seems to give.
Neurodiversity as an evolutionary survival trait is such a beautiful concept I haven't heard before, but it makes so much sense!
I think the concept pairs really well with the idea of social selection as a derivative of natural selection in which social structures create natural divisions in a population's gene expression to disfavor traits that don't benefit the population even if they benefit the individual.
But to me that reads like different statement than yours of neurodiversity being a survival trait, to which I have to disagree.
Being a neurodiverse, or more commonly known "on the spectrum", is a guaranteed way to get bullied (or worse) by your peers who are not. How is that supposed to help with survival?
Some neurodiverse kids and even adults get bullied so hard they commit self termination (to avoid using the 's' word). That's exactly the opposite of helping with survival.
Helping with survival to me means having features that help you get accepted by the heard and with finding a mate to reproduce, not features that get you shunned and outcasted till you end up wirtten off the gene pool.
I see it more as a survival trait for a population, not an individual. An individual does not need to procreate for a population to benefit from any trait they may have. In that sense, the trait may be a disadvantage for the individual, but increase the well-being of the population at large. An unimaginative example would be an autistic individual whose condition enables them to make a life-saving scientific or mathematical breakthrough, but due to the same condition ultimately dies alone and childless.
> Being a neurodiverse, or more commonly known "on the spectrum", is a guaranteed way to get bullied (or worse) by your peers who are not.
Is it? Hardly. I have been diagnosed, but was never bullied. I don't bully my neurodiverse peers, and I think new generations are, in some cases, more kind than our predecessors in this particular area.
I think unkindness towards neurodiversity is a particular facet of particular societies, and not a general aspect of the human organism.
>Being a neurodiverse, or more commonly known "on the spectrum", is a guaranteed way to get bullied (or worse) by your peers who are not. How is that supposed to help with survival?
Well, human life doesn't begin and end with school and bullying, nor was bullying like that necessarily as much of a thing in other eras (or other cultures), especially since we're talking prehistory.
It's easier for someone with ASD to have social relations and be accepted when everybody is part of small tribe or village and sees each other everyday for example - like for most of human history.
Also for the most part of history "being cool" wasn't really a preoccupation of people, even kids.
>Helping with survival to me means having features that help you get accepted by the heard and with finding a mate to reproduce, not features that get you shunned and outcasted till you end up wirtten off the gene pool.
It can also mean having traits that benefit the tribe, like problem solving and inventing things (or as researched regarding ADHD, "be better at hunting"), even if you're not very socially adept.
In many cultures even the "mad" were respected - considered touched by the spirits, samans, etc. Not just some ancient tribes either, all the way to modernity, including in aspects of Christianity ("holy fools").
> Being a neurodiverse, or more commonly known "on the spectrum", is a guaranteed way to get bullied (or worse) by your peers who are not. How is that supposed to help with survival?
Schools as a concept are a relatively new thing, historically speaking. Most children outside of those recruited by/given to the clergy used to be homeschooled, either by their parents or for privileged families by dedicated servants, and when they were of age, they went to trades training or the military. And that was fine, because most jobs were manual labor and didn't require a lot of actual knowledge - not even the ability to read and write, literacy rates were abysmal in the utter majority of the population [1]. Side note, that was also why religion got so entrenched - oftentimes, the local clergy were about the only people in town that were actually able to read the Bible and to speak/translate Latin. That gave them a loooot of power.
Only at the beginning of industrialization came the realization that societies and economies needed at least some common basic standard set of knowledge and that homeschooling could not provide this, so schools were introduced for efficiency reasons.
The root misunderstanding is the "social species" part of my statement. Neurodiversity benefits the species, so it will be selected for as a survival trait for the species, even if it is recessive or those who express it never reproduce. Those "genetically adjacent" benefit and keep the traits alive
If you think survival traits mean being healthy and happy, ask Darwin why the evolution of caterpillars killed his faith in god.
Assuming it's random.. it isn't like every divergent feature in nature is advantageous. My own theory is a lot of the neurodivergence stems from generational shifts in refined foods, fats in particular and especially the low fat efforts in the 80's that carries to today. That affects hormones, that shifts reproduction... and many shifts tend to amplify generationally.
I feel like this overgeneralizes autism. It's not the guaranteed social death sentence you seem to be describing. It's a spectrum, and there's more to it than social issues.
One aspect you're discounting is obsession. Imagine the stereotypical person who knows everything there is to know about trains. Now imagine they were born a millennia ago and focused instead on the weather or soil or logistics or taxes. I can see that being quite valuable, not just to the individual, but to society around them! Value can drive success (particularly if you obsess about it), and success is attractive.
As an extreme example, Elon Musk is autistic. I'm positive he got bullied in school, but I'm also sure he has more kids than you and me.
Not only those essential bodies of knowledge, but anyone who has tried to develop not even a novel product but simply a well executed brand knows the level of almost superhuman focus it takes. Implying that much of what is on the shelf is brought to us by such individuals.
That said, this observation is classically subject to survivorship bias. The real issue is the masses of failures underneath, and those who were never even given an opportunity to fail. Their lives were and are also valuable.
They are not similar at all really. Autism is correlated to, "accelerated formation of neurons"(1) and "an increase in the number of neural connections"(2). That partially explains some savant-like traits being connected to autism. Outside of that John Travolta movie where he got the brain tumor and got super smart I don't think people are evolving tumors to increase intelligence.
i'm not a biologist (and so maybe it's table-stakes for modern biological research), but this idea of creating personalized in-vitro synthetic biological models to study disease process in individual living beings seems pretty cool to me!
Autism is a sensory processing disorder in which symptoms are triggered by your brain receiving too much stimulus.
That’s why autistic people like to do repetitive behaviors (it’s easy to predict the outcome), don’t like change, and so on. It’s why autistic people tend to be highly sensitive to certain senses (loud noises, bright lights, touch). And it’s why they struggle in social situations-there is too much complexity to process it and decide what to do.
The research about too large brain size and too many connections seems consistent with this, being a physical explanation for these effects.
I am instantly skeptical of any article that boils down to, "here is one study that may point in one direction but is far from the final world on the matter." The comments are filled with anecdata that reeks of confirmation bias.
In other news, I have a big head and as a kid my older sister would bully me and call me "King Tut." She would also mock me by pointing out my long eyelashes and say, "You know, in ancient Egypt, long eyelashes were a sign of beauty in men." She was 10 or 11? Anyway, we're close now. I just wanted to share what bullying is like in an extremely dorky family.
We also used to play Lord of the Rings Trivial Pursuit with my other siblings. We couldn't let my sister go first because once it was her turn she answered every single question correct, continuing her turn until she won without us even getting to answer a single question.
It was a mix of movie and book trivia, but even if it had been all deep cut Silmarillion stuff it would have played out the same way. I can now never forget about the Uruk-hai Lurtz, invented for the first movie.
For those who's instinctive approach to autism (or other flavors of significant neruodivergence) is to treat it as something that has inherent tradeoffs, or as something that "obviously" people would want to manage or choose to not have when given the option: I highly recommend this article [1] and the book written by the same author, to recontextualize autism (in specific) and neurodiversity (in general) not as things to be managed but as forms of diversity in the human expression to be wholly welcomed in wider society.
Put differently: Autism is not something to be managed away.
> I don't think anyone who was somehow given the choice of autism or no autism at birth would choose autism would they?
I test in the statistically-likely range for autism on multiple diagnostic tests, though I don't carry a diagnosis from a psychiatric professional, so grain of salt, etc; but I find this kind of hypothetical offensive and degrading. It rings so much of how we approached queer identities throughout the years: blindly assuming that because wider society has difficulty interacting with autistic or otherwise neurodivergent people that THOSE PEOPLE would prefer to be like those more neurotypical members.
I like my brain. I don't want it to change. I don't want to be different. I don't want to be treated as someone suffering some condition, or like there's "tradeoffs" in my experience of the world that're any more significant or worthy of commentary than anyone else's experience of the world.
I have two severely autistic children who cannot talk and who need lifelong care. That's the REAL autism, the one Leo Kanner identified in 1943. Not the rebranded Aspergers with extra rainbows.
Unfortunately, I feel like the autism community's search for acceptance often puts on blinders to such individuals. That is particularly frustrating because those vocal about autism acceptance often do it while castigating therapy as if it's always a horrible thing aimed at hiding their true selves. We are working as hard as possible so that our child can hopefully advocate for themselves when we are worm food. If that means "breaking" their true selves to teach them to communicate (speech therapy), or using behavioral therapy to get them to brush their teeth (even though they hate everything about it), so be it.
I get why the DSM widened the definition, but what it means to have severe autism is very different from what it means to have mild autism. If my child has deep thoughts, they have very little ability to express them.
> If my child has deep thoughts, they have very little ability to express them
I'm sympathetic to much of your comment, but the "if" in this sentence really made me wince. Seems to me there's a lot of evidence that almost everyone with autism (including those with very "severe" autism) do indeed have deep intelligent thoughts and just can't communicate them (i.e. that autism is primarily a sensory disorder rather than a cognitive one). The best example I have of this is someone who was entirely non-verbal their entire life, but managed to write an entire book when taught to communicate via pointing at letters on a printed "keyboard" (perhaps someone else can find the reference- it was on HN a few years ago)
Which also points to something which I think is really key to helping those with autism: that often it is not about pushing past their boundaries to get them to do things in a "normal" way, but about working around them and finding other ways for them to engage with the world productively.
That might mean writing instead of speaking. Or using mouthwash instead of brushing their teeth. You might well have tried all of these kind of things, but if you haven't then please consider it!
Unfortunately there is no evidence that “facilitated communication” actually represents the ideas of the nonverbal person. It always involves someone else in control of the communication—if it really worked why would that person need to be there? And tests of privately given information generally find strong evidence against it.
I find the practice abhorrent and somewhat abusive.
> Seems to me there's a lot of evidence that almost everyone with autism
This is a true statement because almost everyone with autism does not have severe autism.
Like, I'm sorry, but the research I've read about autism does not paint such a rosy picture about the intellectual capabilities of kids with severe autism. That doesn't mean I'm going to treat my kid poorly because there are cases of kids with severe autism and no intellectual disabilities. That, however, is the exception and not the rule. Severe autism is very frequently accompanied with intellectual disability. [1]
I've read the same books authored by kids with no verbal communication. I've heard the stories of lawyers with severe autism. However, those are the exceptions. I certainly hope my kid is one of those exceptions, they are on border of severity which gives me a lot of hope. However, I do have to accept the fact that the most likely outcome for the rest of their life is needing support. It's a fact I've come to terms with over their life as improvements in communication have slowed.
> that often it is not about pushing past their boundaries to get them to do things in a "normal" way, but about working around them and finding other ways for them to engage with the world productively.
Sorry, but this severely misunderstands what we work on. It's not about doing the "normal" thing. My child, for example, has extreme food aversion problems. They have a very limited diet which ultimately is not healthy. We do food therapy because expanding their diet and tolerance to eating foods in non-preferred ways is super important. They attend school and unfortunately if the wrong aide is in charge of setting up their meal, they will frequently simply go hungry.
I'm not working on "normalizing" my kid. I'm working on getting my kid to be able to advocate their needs and to be self-reliant as much as they are capable.
> That might mean writing instead of speaking.
Already working on that. They have an AAC device and have been to therapy to learn how to use it for the last year.
> Or using mouthwash instead of brushing their teeth.
Or sedating them when they inevitably need to have cavities drilled? You can't replace brushing your teeth with mouthwash. Feel free to ask your dentist if that's acceptable on your next visit.
> As a double-blind test, her husband suggested Ido tell her about an event that happened without his mother’s presence (e.g., “Tell mom where we went today”). The facilitated message was clear: Don’t test. Apparently, Ido was too anxious to facilitate with his mother when she did not already know the answer
As a father of a child in the same situation as yours, who has been personally diagnosed with Aspergers:
100% agree. It’s not something you want. I’m completely over being polite to the people who spout this “I have the symptoms but no diagnosis” line then try to speak about it.
There's a lot of over self-diagnosis because autism is the trendiest disorder aside from ADHD. That being said, the majority of accurate adult diagnosis will at least begin and often end with self diagnosis. It will end with it sometimes due to lack of resources and sometimes due to the realization that there is virtually no benefit to formal diagnosis. Unless one needs formal accommodations.
Most undiagnosed child Asperger's, which turns into undiagnosed adult Asperger's, will never be diagnosed by the individual nor a professional. There's a lot of it out there.
I can’t argue with that; my diagnosis was a byproduct of a suicide attempt after a TBI. I doubt I would have pursued or ended up with one otherwise. It also doesn’t do anything at all for me; it’s not like there are accommodations I really need.
My main reaction is due to all the undiagnosed people who swear they have it and attack me for giving my son the help and treatment he needs. It’s an ongoing issue, stemming from ignorance on their part. Hence my lack of patience or sympathy any longer.
Curious question: Do psychiatrists still offer the Aspergers diagnostic? I was under the impression they removed it in the DSM-V revision in favor of Autism Spectrum Disorder.
A large part of the neuro-devergency community is not fan of the Asperger’s term. The primary reason is that the distinction between Aspergers and Autism was based on outdated—and frankly, problematic—believes around IQ.
That there is some kind of large community consensus on anything will always be a fallacy. There's an Ivory Tower, the Media, and then a lot of suffering individuals underneath both. People with issues like to exercise them on a vulnerable population that doesn't need to be lectured on long-standing identity. They need sorely missing help.
The term Asperger's was simply a holdover from the man who brought the condition to light. Period. Anything else is inference, and I hold with malice.
See the fact that the new categories still imply a categorical difference and there is therefore still a categorical difference. In fact, the difference between autism categories is generally massive. Whether or not that difference includes IQ would be down to the individual, but often it will. The term Asperger's having nothing to do with it.
What they didn't like was the implication that Asperger's isn't tightly connected to the other autism categories. It may or may not be. They don't know, either. The renaming was a weird point of focus and highly political. What is true is that almost anyone would have a difficult time observing that Type 1 autism (formerly Asperger's) bears any resemblance to Types 2 and 3.
This is the first time I heard of Type 1, 2, and 3 Autism. I was under the impression that DSM-V eliminated subtypes from the diagnostic, and favored a multi-dimensional under a single category (maybe it is still an ICD-11 thing, which I think has 8 subcategories).
Wikipedia has this to say:
> Disagreements persist about what should be included as part of the diagnosis, whether there are meaningful subtypes or stages of autism.
And cites a paper [1] claiming:
> The elimination of subcategories was controversial for various reasons, including concerns over the removal of an important part of an individual’s identity and community, specifically related to Asperger’s disorder, as well as concerns over losing services due to an individual no longer meeting more stringent diagnostic criteria. However, the evidence for the existence of subcategories within ASD has continued to be very weak (Miller and Ozonoff 1997, 2000). Furthermore, the shift from multiple subcategories to a single dimension resulted in improved diagnostic specificity and good diagnostic sensitivity, with over 90% of children with PDDs meeting DSM-5 ASD criteria (Huerta et al. 2012; Mandy et al. 2012), and with the remainder likely captured by the new social communication disorder diagnosis.
It looks to me that if they would have kept multiple categories, that would have been a political decision (in particular, identity politics for thous which identify as Asperger’s). It seems like the current single category / multiple dimensions has proven it self to be a much better approach for diagnostic. That is evidence suggest this is a successful change, with both autism advocates and psychiatrists preferring the current single category approach.
I actually went ahead and read both the ICD-11[1] and the DSM-5[2] criterion for Autism Spectrum Disorder. When you referred to Type 1, 2 or 3 Autism what I think you were talking about is actually severity levels in criterion A (social communication and social interaction across multiple contexts) and criterion B (restricted, repetitive patterns of behavior, interests, or activities) of DSM-5. Level 1 requires less accommodations and level 3 requires very substantial support. Note that even level 1 severity requires support and states that without support an autistic person will have impaired social interactions.
These severity levels do not specify intellectual impairment, only social communication impairment and restrictive and repetitive behavior. Intellectual impairment is specified as a boolean with or without. So basically—as I understand it—what was previously described as Asperger’s is basically Autism spectrum Disorder with this boolean set to false.
I actually went ahead and did some further reading and it turns out that people (both psychiatrists, researchers, and autism advocates) are very happy with this arrangement. Intellectual impairment does not correlate (or correlates rather barely) with other required specifications of the disorder (including impaired social communication) and the accommodations required are vastly different.
ICD-11 has 8 subcategories of Autism Spectrum Disorder, and what was previously called Asperger’s is probably 6A02.0 - without disorder of intellectual development and with mild or not impairment of functional language. (pp. 36)
Note that psychiatrists and researchers alike are no fans of the ICD-11 approach, claiming things like:
> As ICD-11 defines ASD in a broad constellation of symptoms or behaviors that can hardly be differentiated from other mental disorders and autism-like traits, the risk of false positive ASD diagnoses increases significantly. This will lead to further limitation of access to ASD-specific services for individuals with a true positive diagnosis of ASD and likewise disadvantages individuals with a false positive diagnosis of ASD due to delays in access to or even missing out on disorder-specific care (e.g., dialectical behavior therapy for borderline personality disorder). Further, since ICD-11 draws particular attention to high-functioning (adult) individuals with ASD, there is concern that “prototypical” as well as low-functioning cases increasingly become neglected in research and clinical practice. [3]
I’m guessing old habits die hard, especially among the expert classes. I think the ICD-11 standard (which is used in Europe instead of DSM-V) didn’t make the merge until a couple of years ago. Although as far as I’m aware psychiatrists generally use the DSM internally in their work, and mostly refer to ICD for e.g. insurance reasons.
Also—since I talking about this—I think many in the neuro-divergence community don’t like High Functioning Autism either (and it is not included in any of the diagnostic tools anyway). The reason cited is that it is rather ableist to call it “high functioning” and would much rather focus on the specif disabilities which needs accommodating.
I see. I did my bachelors in Psychology ~15 years ago (admittedly did not focus on psychiatry nor pathological psychology). At that point the diagnostic still existed in the DSM-IV, but the term was very much falling out of fashion. I think the (other) APA was drafting DSM-V as I was studying and people knew that Asperger‘s disorder would probably not exist much longer. In my class on pathological psychology I thing Asperger’s wasn’t even mentioned.
I was reading about HFA, and I don’t think that exists in the diagnostic tools either. I think the focus instead is to just diagnose people with autism spectrum disorder and then enlist the disabilities which needs accommodating. The more sever cases has a larger set of disabilities. I’m guessing you would have had a pretty limited set.
I think this is the right choice as there is a little bit risk of ableism in separating a disability as high functioning. The reason we give diagnostic is that some people need accommodation for their disabilities, being accurate about which sets of disabilities need accommodation is better in every way, as opposed to a blanket term like high functioning. The term also risks people perceiving some superiority (intended or not) when it is referred to as such.
Regardless of what you think, the fact is that psychiatrists and psychologists have done the research, and they have found that using IQ to create subcategories of autism is not useful. See your sibling threads for sources.
Of course you are free to disagree with people who’s actual job it is to diagnose autism. But I don’t see what that brings to this conversation.
That is certainly one of them. However if that was the case, the name would have simply shifted from Asperger’s to High Functioning Autism, which is not the case (neither in the diagnostic tools nor among neuro-diversity advocates).
The problematic beliefs I was referring to was the notion of high IQ. IQ is a very controversial term in psychology, and has a very problematic history. Even though it was initially conceived exactly for the purpose detecting individuals which may have learning disabilities, it has since grown into something which was integral to the eugenics movement. Today we know that IQ has some racial and class biases which we should probably avoid when creating taxonomies which are then used to describe people with disabilities.
I think the problem (apart from the biases) is actually the focus on the high IQ part. Finding disabilities by looking at significant deviations from expected values on a test is precisely what the IQ test was initially designed to do (before the eugenics movement got their hands on the construct).
The focus on high IQ is problematic for a number of reasons, including racial and class biases. There are also theoretical implications surrounding intelligence, there is no evidence that there is such a thing called general intelligence let alone that this g-factor can be measured and presented as a single number (why not a matrix or a tensor?).
Having a diagnostic based on such a murky concept as intelligence is indeed very problematic. It is much better to just leave the question of intelligence unanswered when we are diagnosing people with autism. And instead focus on the disabilities each person has. If an autistic person takes an IQ test and measures with a significant deviation (< 70) we can safely say that this person has a learning disability and should be accommodated accordingly. If another autistic person takes the same test and measures normally (~ 100) then that doesn’t add anything to the diagnosis.
All that said, I was curious about it a few months back, and decided to look up how popular IQ tests are among psychologists, and I found out that they are very much falling out of fashion in favor of more focused tools. If a psychologist uses an IQ test, they are much more likely to use the individual subtests and never actually measure the whole IQ of the individual. I didn’t search for how popular they are among psychiatrists though, so IQ might still be a popular tool when making diagnostics, but I would be very surprised if things were any different there, especially now that intelligence is no longer used to differentiate Asperger’s from Autism.
EDIT: I’ve been doing some reading, and I found an excellent secondary source on why some researches and autism advocates want to abolish the term high functioning and in particular to advocate against using IQ to separate autism into sub-categories.
I don’t tend to tie what I know to Wikipedia until I’ve done the research; too many things I’m knowledgeable about are blatantly wrong there.
My personal feeling is that it’s likely he did these things. At no point is there more than circumstantial evidence he actually did them. That evidence is strong (his job, it did happen, etc) but I don’t think there’s a signed order or the like that would cement it.
I'm reading NeuroTribes by Steve Silberman, and while I'm not all the way through, the narrative of there being a "real" autism (and specifically as identified by Kranner) is very problematic at several levels. First, Kranner hired multiple staff who had worked under Asperger and therefore there are questions about priority. But putting that aside, Asperger was actually aware of the more serious autism cases and intentionally hid them to protect his patients from Nazi concentration camps (or just straight up murder in their "psychiatric" facilities), which in the early days targeted many children who would today be diagnosed with autism (with horrible consequences, obviously).
Kranner also intentionally set up his referral network to filter out the lower end of the spectrum of cases, such that he missed what Asperger has correctly identified before him: that is, that it's a spectrum.
Being a spectrum means that there is an extreme end where things are really, really difficult. I'm sorry to hear you're experiencing that, but that's not to say the spectrum isn't real or there hasn't been a battle to get to the point of recognizing that it exists.
As to the GP's comments specifically, NeuroTribes provides a lot of evidence that searches for autism "cures" have almost universally hurt autistic people, and I mean this is a very practical, and frankly horrifying, sense, not in the "my feelings are being hurt" sense. The piercing irony of a lot of these cases was that Kranner's own follow up to some of his methods indicated that his own techniques were actually making children's lives worse, not better. Some of the children who did the best were frankly just left alone---which says a lot about what we've done for them.
So, I don't know what the answer is, but I think it's worth being at least aware of the history, because a lot of it is frankly really dark.
The history of all psychiatry is dark. The problem with pointing at the history and saying, "Look at the terrible history of autism treatment!" is it often treats all current treatments as being equally as horrible as the "Let's try and shock the autism out of these kids".
Modern treatment and therapy are not focused on "curing" autism. It's pretty much all about building out life skills. It doesn't do that by slapping the kids for doing the wrong thing.
For example, part of my kid's therapy has been around tolerance for brushing teeth. Are you seriously going to try and argue that my kid would be better off if they never went through that therapy? Even though they can now tolerate teeth brushing and even having the dentist poke around in their mouth.
Autism is a spectrum and so are the therapies for it. Certainly, kids with more mild forms of autism don't need as much therapy, but it's really frustrating to see "Look at the time a guy tried slapping kids with autism, all therapy is this bad".
To neurotypical people ABA may look successful, but its success comes from breaking the spirit of autistic children. It's just traumatizing you until you stop feeling anything and just learn how to fake the happy reactions expected of you while suffering silently.
In the short term it looks successful, in the long term it's the reason why meltdowns even exist and why so many autists unalive themselves.
I was an extremely autistic kid, barely able to exist in regular school, constantly hitting my head against walls, often nonverbal or having meltdowns.
To teachers, parents, caretakers therapy seemed to "fix" me, but it didn't, it caused even more trauma.
In reality, I didn't need fixing. What truly helped was an environment where I can manage how much stress I experience. Where I can take a quiet break whenever I need to.
20 years later, as an adult, I'm living a genuinely happy life, because I'm not forced to live according to a neurotypical schedule anymore.
This "breaking their spirit" is precisely why so many adults nowadays have major issues figuring out what they want to do with their life. Every bit of joy has been methodically stripped away from them over years.
That kind of schooling barely works for neurotypical kids, of course it can't work for much more sensitive neurodiverse children.
Schools shouldn't turn lively, active children into depressed obeying robots, and they're not the place to park your children while you're working either.
We need to rethink education as a whole, it's just the more vulnerable children (autists, immigrants, traumatized children) that act like a canary in the coal mine for our school systems.
> How about we encourage people to use the skills and passions they have, rather than box them into conforming to the vision of the few ?
Because life doesn't work like that. If you want to be a doctor you need to undergo a grueling training regimen. I'm deeply passionate about software, but that doesn't change that 80% of my time is spent doing boring, tedious work because that's what work is. Even if you're an artist. I know literally artists. There is no way to have fun all the time doing something productive.
That's why I teach my (admittedly, high functioning) ASD daughter about tolerating non-preferred activities to get what she wants. Yes, she finds having her face painted disgusting, revolting, skin crawling. She willingly endures it every time because she delights in the result. It's her choice every time to sit in a chair and have it done. That's the kind of thing I want her to take from childhood into adulthood because every adult has to do things they hate for the sake of society running and even the care of themselves.
Same way I don't like exercise because it's just actively awful because of my condition, but to not do it is to make myself deteriorate over the long term because of my condition. I want my daughter to be able to make those kinds of decisions. What sucks, but is good for her in the long run. We finally got bathing on the list. No one is going to argue with me that a person who never bathes is a functioning person.
I will continue to "train" my kid. Her life is better for it. Ever since she got therapy she has been happier, more stable, less disturbed by the world, and more able to connect with people both like her and not like her. If any parent could get an outcome like mine from "training" they'd pick it every time. No one is gonna tell me when my kid used to slap herself and cower under chairs is better than my kid who is probably too obsessed with trains and rainbows and spins while she walks when happy. I think I like her spinning better than her cowering.
There is a difference between support towards a better life, which is what you are describing, than 'breaking their spirit' which is often what schools and very commonly what employers do.
It's not about always getting your way or doing things you like, but by the same measure, people should never be forced to 'conform' if it's not critical to society.
It's great that you support your daughter, and that therapy is available. We don't have the same degree of difficulty in our family (myself and daughter both very 'high functioning') but that makes it almost impossible to get support and the world is just typically set on 'breaking our spirit'.
It sounds like you're doing the right thing, but conformance would not be. So many of the most successful and inspiration people, are not those who conformed, but perhaps were more privileged in their opportunities.
However we may disagree in part though, I commend you on your approach and absolutely agree that if it can become a person's choice, so long as it doesn't take advantage of their vulnerability in choosing, it's often for the better.
So much of what is 'boring' or 'tedious' is also contextual. Two different software companies offering the exact same role, may have vastly different expectations and the experience to the employee also vastly different.
I don't expect 'fun' all of the time, but I do expect work to be engaging and driven towards the value I bring - if I'm expected to become 'someone else', then there is no point.
> 20 years later, as an adult, I'm living a genuinely happy life, because I'm not forced to live according to a neurotypical schedule anymore.
Perhaps you can appreciate that 20 years is a long time and therapy/medicine has changed a lot since then.
I'm really sorry that therapy was terrible for you. That sucks. However, you do need to realize that not all therapy is ABA and that ABA itself has changed substantially in the last 20 years. A lot of the therapy that my kid gets has built in breaks for the kid to make sure they aren't overwhelmed, there are certainly days when the session is basically "we couldn't do anything today because your child seems overwhelmed".
School is also different. My kid's school has a dedicated room for kids to volunarily go to when they are feeling overstimulated. Most IEPs (US) provision that for kids primarily in general education they get pull outs as needed if they are feeling (or appear to be) overstimulated. My kid wears headphones most of the day because noise bothers them.
The goals of my kid's therapies are life skills, Communication and personal care. We aren't trying to make them not autistic, we are trying to make sure they can brush their teeth and dress themselves. Do you really think those sorts of therapy goals should be abandoned?
As an autistic (yes, medically diagnosed, with obviously difficulties in communication and self care) who has survived to adulthood and is able to care for themselves with support now: fuck you for this "real autism" bullshit.
Yes, some people are hit real fucking hard, some of us improve into adulthood, some of us don't get hit that hard in childhood but suffer more as adults.
You don't get to decide what real autism is, especially as an outsider, and excluding people who have that diagnosis is shitty, petty behavior. Grow the fuck up.
I think your ideas around ‘tradeoffs’ here are very confusing.
Tradeoff is such an intrinsically correct term to use here. People with autism/adhd are worse at some tasks, and better at others. That’s what a tradeoff is.
There are similar discussions around deafness. Deaf people often don’t like to see their deafness as a disability, but as something that defines their culture and experience. That’s still a tradeoff. You can decide to give your child cochlear implants, and integrate them into mainstream schooling - or you can opt out of that, and integrate them into the deaf community. That’s the very definition of a trade off, and it’s a very valid and difficult question.
The issue I have with your take is that its adoption can reduce people’s feelings of agency around their way of life. What works for you isn’t necessarily universal. The idea of a tradeoff is that the same decision can have different meaning to people in varying contexts. You might suggest that people have been conditioned to want to be ‘normal,’ but that is an oversimplification that ignores individuals’ agency, and again, unique contexts.
It's so hard too because the people tasked with making the tradeoff decision are almost always the parents of the child, because the most effective interventions have to take place before the child can make her own decisions. They love and desperately want the best for their child, but likely have little direct experience with either side of the set of tradeoffs.
The main exception seems to be deaf parents of deaf children, but I don't know what the data says about what they usually choose.
> You can decide to give your child cochlear implants, and integrate them into mainstream schooling - or you can opt out of that, and integrate them into the deaf community.
The use of "or" here reads as exclusive: one or the other, but not both. In the last 15 years, since child cochlear implants became mainstream, many children have taken both routes, simultaneously. This is most frequent when one or both of their parents are also deaf. They are full members of their deaf community (learn to sign, plus all of the associated culture), and they are full member of the mainstream, non-deaf community (learn to listen and speak, plus all of the associated culture).
Same, -ish. I do wish I had this knowledge early in life - it’s been unnecessarily hard. But I think that while “aut-ish” is difficult, severe autism has an entirely different impact and we must protect these people: a “cure” would have a huge positive impact on so many, and in order to have a cure we first need to admit there is a disease. I have no problem being perceived as “queer” (after all, I’ve been “weird” or “odd” for 40 years, and synonyms can’t hurt that much).
I feel almost lucky - sure, life has sucked and I’ve missed out on so much, but I have a few things that really get my juices flowing and I feel bad for those who don’t. One of those things is currently in demand by society, and I am happy to take their money in exchange for software that came from my brain.
Edit: thanks for that link, I’d never heard that term and I like it.
Maybe you can go about daily life and relationships with no major hurdles, but plenty of us have gone though a lifetime of suffering to barely scrape through daily life on our own. Even more cannot live an independent life and require a caretaker forever. Some can't talk, can't feed or dress themselves.
I've been through some shit due to my autism, including a period of homelessness and trauma. It's caused me massive amounts of pain over the decades, but... despite needing support to function, I'd still keep it.
I don't think it's necessarily wrong for people to say they are autistic and would stay autistic given the choice. I don't think it's wrong to say the opposite. I get much, much more uncomfortable when that choice is external. If my parents knew I would be autistic, they would have aborted me. I think I've been a force for good in the world even with my trauma. I dunno, that makes me sad to think about.
If we structured society to provide that management and support, would that change your opinion? If the government offered community caregivers who would come and assist parents with autistic children, helping both ease the load and also teaching skills to the kids and parents, do you think that might change the calculus?
Our options aren't just "cure", and status quo. We can choose to adapt in other ways.
> If we structured society to provide that management and support, would that change your opinion?
Severely disabled people receive a lot of gov't support in most highly developed countries (G7 levels). I am confused by your question. Society already does this pretty well in these wealthy countries.
"I'd normalize if I could" and "People with Type 1 Autism should have more social room" can be held at the same time.
This isn't always the case, but much of the time the trauma is due to an ill fit rather than being inevitable.
An example of inevitability might be the trauma experienced due to unexpected deaths of loved ones. An "ill fit" needs no elaboration. The few people with autism who manage to succeed and thereby improve their environment seem to suffer less frequent trauma, if any unless it is of the inevitable type. And then, for example, would people with autism have such an unusually difficult time with loss if their support network wasn't so tenuous? Maybe, or maybe to some lesser degree.
I think that a reasonable starting point would be the question: if someone with type 1 autism could have everything that they wanted including socially, would they still want to change their nature? I think that responses would be mixed.
For example, take the young autistic woman who just underwent assisted suicide in the Netherlands. Does it seem more likely that her nature was fatally flawed or that her society didn't think to get off of its ass, sing to her in unison, and then make room?
I always cringe when people try to apply this take to something like Downs. It’s always a bunch of pandering about how they are happy and have a childlike sense of wonder
What about when people with Down's syndrome say they are living fulfilling lives? Obviously paternalistic "look how happy they are" is a shit take, but "I'm genuinely content with my life" from a person with Down's syndrome seems like a pretty important voice to listen to, surely.
Just be careful with this line of reasoning though please. It's already hard enough for people outside of the USA to access treatment for things like ADHD when they want to, it doesn't help to have a bunch of people walking around saying "it's not actually a disadvantage at all... It's REALLY more of a gift".
Without my ADHD meds, I have ZERO ability to actually leverage the "gift" part...
It reminds me of the movements that existed to push for the non-medication of schizophrenic patients, and to treat them as just differently abled. It completely ignores the quality of life impacts that these things can have. Obviously ADHD/Autism is completely different from schizophrenia, but it’s the same principle.
> It's already hard enough for people outside of the USA to access treatment for things like ADHD when they want to
I'm confused here. I would expect that all highly developed countries would provide access to treatment. Do you have any counter-examples, or do I misunderstand your original statement?
> About 1 in every 10 people in the US who uses Adderall or similar combination drugs to treat attention-deficit/hyperactivity disorder (ADHD) has been affected by an ongoing shortage, a new analysis suggests.
> The US Food and Drug Administration announced that Adderall was in shortage in mid-October 2022, and the share of people with ADHD who filled their prescriptions for Adderall and related medications plunged in the following months.
> In an exclusive analysis for CNN, data from the health data platform Truveta shows that the prescription fill rate for amphetamine/dextroamphetamine medications fell from nearly 49% in October 2022 to a low of less than 41% in February 2023. Overall, the average monthly prescription fill rate was 11% lower in the first half of 2023 than it was in the first half of 2022, and it did not show steady signs of improvement through the end of 2023.
It is extremely difficult to get an ADHD / autism diagnosis and the needed support as an adult. Look up clinics dealing with these in your area, then exclude the ones that deal with children only, then exclude those who don't accept new patients unless in acute crisis, then check the wait times to be seen. Then try to actually message the few left and again, exclude those for more.
> I would expect that all highly developed countries would provide access to treatment.
And yet, it's completely illegal for me to travel to Japan for even a day with my ADHD medication. I could be carrying my script, a letter from my doctor, and have literally only a single days supply, and I'd be risking a very serious prison sentence.
Outside of North America, even in places like Europe and Australia, ADHD is still close to non-recognised. Take Australia for example, if you assume 2-3% of the population has ADHD, and that every single one of them has to see a psychiatrist once a year to get their medication permit renewed so that their normal doctor can proscribe their medication (which is the legal requirement for ADHD in Australia), it would consume 2x the entire Australian psychiatrist workforce to deliver that many consultations... And that's if they were EXCLUSIVELY seeing ADHD patients...
> And yet, it's completely illegal for me to travel to Japan for even a day with my ADHD medication. I could be carrying my script, a letter from my doctor, and have literally only a single days supply, and I'd be risking a very serious prison sentence.
They recommend to ask in advance. If denied, skip it for the trip (I know how people will react on HN to that suggestion!) or carry an allowed alternative.
Your last paragraph feels like it was lifted from a non-profit that advocates for ADHD disability rights. It is incredibly specific. Also, I'm really tired of repeating myself on HN: Saying "Europe" doesn't say much. Europe is huge. It is (at least) 44 countries and 27 belong to the EU. There are huge differences between each country. Do you really expect us to believe that in the Nordics that "ADHD is still close to non-recognised"? I find it hard to believe.
Well yes, just because it can be helpful doesn't mean that it perse doesn't need to have any help with meds. I am also on ritalin. And I have had an enormous amount of struggles in things in life and I realise were related. But I also have some upside. A bunch more now that I take ritalin.
There are a ton of different classes of ADHD medications that are all very different. The most popular- stimulants like adderall and ritalin are probably the most well studied psychiatric drugs in history, and not without some risk of adverse effects, but overall are quite safe even for young kids.
Untreated ADHD itself is far more dangerous than any of the medications: high rates of mortality, suicide, addiction, job loss, relationship difficulties, car accidents, etc.
There is also some evidence that giving children stimulant medications for ADHD can make it less likely that they will continue to have ADHD as adults.
The non-stimulant ADHD drugs actually all have worse side effects than the stimulant ones, and they're harder to stop taking. You can quit Vyvanse cold turkey or take it as needed and be pretty OK, but if you quit Strattera it takes weeks to work again once you start it.
And you can't quit Intuniv without titrating off for a week or two or you'll feel pretty sick.
I think it has a lot to do with the dose and delivery method... if you take massive doses or inject/snort the medications like people trying to get high on stimulants, the rate at which the drug takes effect causes euphoria, which is addicting. There is no euphoria with properly taken low dose stimulant medications for ADHD- they aren't "enjoyable."
Partly, but the main effect is simply the different neurology. Neurotypical people actually get a kind of high from amphetamines, whereas ADHD people just get balanced. The drug just has a fundamentally different effect on people with ADHD.
I'm pretty sure that is a myth, and it only appears that way because the circumstances are different:
People with ADHD are treated on a very low dose, and slowly titrated up which makes you much less likely to feel high. People without ADHD that are illegally using stimulants aren't getting treated by a doctor, and aren't going to slowly titrate up the dose, or take it consistently in low doses over a long period of time. People with ADHD sometimes do feel a small high or euphoria for a short time when they first start a new medication.
People without ADHD but using adderall illegally, e.g. as a "study drug" are not getting a high or euphoria if they consistently use a low dose like an ADHD person.
I have clinically diagnosed ADHD, but even the lowest possible dose of adderall makes me extremely high in an uncomfortable way and unable to sleep for days. Most likely, I also have a liver enzyme mutation that causes me to not metabolize amphetamines properly. Ritalin I metabolize quickly, and don't feel a high at all.
You can't diagnose ADHD by giving a medication and seeing how people respond. Even people with ADHD respond very differently to the same medications.
There is also the fact that medication with ADHD can give people executive control over hyperactive physical movement, so they may seem to be "slowing down," which kind-of looks like the opposite of a stimulant effect, especially to adults watching hyperactive kids calm down. But that is basically the opposite of what is actually happening- the increased stimulation allows the brain to regain executive control of behavior.
I'm normally on a very minimal dose. I have, prior to getting timer tops and forgetting that I'd already taken med, taken >100mg of dextroamphetamine without feeling high and without titrating up. Instead, I got very focused and methodical to an uncomfortable degree, but there's absolutely zero high or euphoria.
Across ~4 doctors (1 PCP, 3 pysch), none have titrated up. They've ballparked and said things like "let me know and we'll reduce if you can't sleep and increase if it doesn't work. If you want, try doubling up or cut it in half (for non-XR)".
Given the variation in dosage visible in the literature (such as this case report of megadosing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407707/ ) I'd suggest that there are multiple underlying physical causes for the condition described as ADHD to the extent that sweeping statements like that aren't accurate. E.g. my (very different) experience and your experience being different indicates that we probably have different underlying causes, not that one is a myth or misperception and the other is the real take.
Although I agree that is possible, the extreme variations in dosage between individuals could be explained simply by variations in the liver enzymes that metabolize stimulants, and don't necessarily point to different underlying causes of ADHD itself. However- I think the fact that entirely different classes of drugs, including non-stimulant medications, seem to work better for different people with ADHD does point to what you are saying.
In my case I can't tolerate even 2.5mg of adderall, and I also have hypersensitivity to several other non-psychiatric medications that happen to be metabolized by the same enzymes as adderall/amphetamine, so I am nearly certain it is a liver enzyme issue. I do tolerate a reasonably high dose of methylphenidate (ritalin) without any euphoria or insomnia.
>Neurotypical people actually get a kind of high from amphetamines
This is intellectual dishonesty to the point of nausea.
Amphetamine is very well understood as far as drugs go and affects those with and without ADHD in the same way. Neurotypicals also experience increased focus at therapeutic doses, just ask anyone who's taken it as a study aid, and ADHD-sufferers also experience a high from the flood of dopamine.
The most damning evidence for me is the absolutely obsessive relationship many ADHD patients have with their medication. It's immediately obvious and unlike any I know of.
Society (American society in particular) has just decided that the medical benefits of amphetamine outweigh the risks for people with ADHD vice versa for those without.
Isn't there evidence for neurotypicals only _thinking_ they are focussing better and actually not? Also note that this 'high' you are talking about would likely only apply at higher doses than ADHDers actually get.
I think you are generally correct- but just because someone disagrees with you, or hasn't seen the same information you've seen, doesn't mean it is intellectual dishonesty.
There are good reasons why this seems to be true even if it isn't... you take a hyperactive person with ADHD, because they have poor executive control of motor function, and give them a therapeutic dose of a stimulant, suddenly they can control motor function. It appears on the surface to be almost exactly the opposite of giving someone a high stimulant dose. They appear to be opposite responses, but in fact are the same type of response... it's just that the ADHD person is regaining a level of executive control that the non-ADHD person already had anyways.
Wait what? It’s the exact opposite. ADHD tends to be correlated with addiction
> Research has shown that those with attention-deficit/hyperactivity disorder (ADHD) have an increased risk for addiction disorders like alcoholism and substance abuse.
At therapeutic doses this is literally the opposite of true.
There have been studies done that show therapeutic doses of amphetamines over a multi-year period actually INCREASED the level of dopamine receptor expression in the brain.
It was by a very small amount, don't get me wrong (3-4%). But it absolutely debunked this entirely assumed theory that long term therapeutic amphetamine use would result in some kind of pseudo-addiction.
well said. everything needs to be diagnosed and treated with drugs. it is better to persevere with CBT, meditation, and self discipline than to cop out to some prescriptive drug regimen because neurodivergence is viewed as something a drug company can profit of off.
There are cases where drugs might be used, for teens with severe emotional problems or kids with seizures (which are common in people with autism). However, that's not what treatment looks like for everyone (or I dare say most people diagnosed with autism).
By and large, treatment for autism is centered around therapy. Occupational, food, physical, and behavioral are all common treatment routes for someone with autism.
A lot of people I’ve met the neurodivergent camp end up on a soup of anti depressants, adhd meds, and other random antis. All because they are treating symptoms rather than the underlying issue.
> All because they are treating symptoms rather than the underlying issue.
There is nothing that treats ASD directly. But there sure are a whole host of charlatans that will try to convince desperate parents otherwise. As with pretty much every psychological problem the best we have is treatments to make the symptoms livable. Even what you mentioned earlier could be considered a treatment that addresses the symptoms not the underlying issue.
For some people, meditation and exercise only go so far. Shaming people/parents for needing medication and going with the "You just need to try harder" is what gets people killed. Medication isn't a personal failing.
Yeah I'm curious if the negative effects of autism could be due to the brain physically running out of space and getting "compressed?"
It reminds me of trepanation, the old-school mental health procedure to just drill a hole in the skull. Some people still do it and swear by it [0], saying that it relieves pressure.
Autism is a sensory processing disorder in which your brain receives too much stimulus. This it makes sense it would occur when you have too many neurons (or connections) as that would cause increased response to any external stimulus.
Well, it seems logical that any "overgrowth" would need more space - but it looks like our skulls are malleable and continue to fuse into adulthood. I wonder if there's a process where they grow to the size needed by the brain?
TIL that our heads grow by about ~8% (in circumference) after we're tweens [0]. Cool!
That's... complicated. There are multiple opinions about aborting fetuses that test positive for Down's syndrome. For one, the tests aren't always accurate. For two, people with Down's syndrome can live fulfilling lives, and have spoken out against the practice. But also it does place an additional burden on parents, and parenting well is already a hard job.
But I don't think it's a reasonable comparison -- autism has a much wider variability in how it expresses, from relatively benign (but still impactful) to fully incapable of self sufficiency.
I'd also argue just because we practice eugenics in case makes it ok to generalize to other cases (and furthermore, just because we practice it doesn't necessarily make it ok even in that case).
People abort babies for reasons far less than "lifelong disability requiring constant care". I'm not saying it's done lightly but surely that kind of issue is as valid a reason as any.
If its not genetic, which autism isn't, then it has nothing to do with eugenics. People have the right to choose how they raise children, trying to dictate that is much more similar to eugenics imo
Your claim that ASD is not genetic is extraordinary and counter to the prevailing scientific understanding, and requires significant evidence to back up.
It’s a shame that some media still call this a disease where it is clearly not a disadvantage in some contexts for some instances. Where’s as the words disease doesn’t conjure up any impressions of upside.
> it is clearly not a disadvantage in some contexts for some instances
Putting aside that this isn't exactly "clear", you qualified this statement with "some" twice - ignoring the vast majority of other contexts where it is decidedly not an "advantage"
Yes, I've deliberately reduced the scope to scope with which I have experience. I'm not qualified to talk on the behalf of everyone. Am I not allowed to talk in restricted scope for the experience that I have ? And I chose my words to make it clear that I wasn't speaking for everyone.
The choice of the word disease comes hand in hand with the desire to eradicate this. Then I just wonder how much tech we would actually have in this world, I think that everyone would be too busy out at parties to get anything done. Then everyone would be like the people in Bridgerton :) OMG!! Probably the state of technology would be about the same still as well :)
What’s more is that people aren’t sensitive to it. Unsaid social rules really make the lives of some of the differently abled who have an eye for things the rest of us don’t difficult. Heart goes out for all those on the spectrum dealing with family and social issues
Yes and no, as in any case to challenge power you'd need a rigorous understanding of it, which you can't get if you're severely autistic. The greatest works of humanity have been made with social co-operation.
That's trivial. Atrocity goes hand in hand with power, the same power that decimates a whole people also builds the city over their graves. The powerless cannot challenge power, there is nothing honourable in ineptitude. If you want to feel good about yourself for being weak you can go back to church and pray that a god will save you, but for those who wish to triumph in the world there is only one path available, and it is not bloodless.
I'm medically diagnosed autistic. I struggle with a lot. But some upsides I've encountered:
I tend to form stronger empathy and justice models, and commit to them wholly. This has allowed me to, for instance, work on improving access to benefits or healthcare for others while other people around me burn out. But I often fight way too long, and I get upset when people disagree.
I often hyperfocus on projects I'm interested in and can produce a high level of output if given an interesting task.
I enjoy counting, categorization, and organization tasks. Find all bugs that meet these rules, or, double check every unit test to check we're meeting coverage goals. Give me those tedious, repeatable, rules based gardening tasks and I'll churn through them all day every day.
I believe I have a more systemic way of thinking than my peers, and while this does cause problems sometimes it also enables me to decompose systems more easily.
I tend to maintain my cool under pressure or bullying. I simply do not notice nor care about emotionally loaded conversations. This causes problems often but also helps often, I can mediate with "we're here now, let's focus on how to improve".
These, of course, are not the upsides of every autistic person. They are my upsides for me. Again, I am medically diagnosed and do require support to operate as an adult. My childhood was... not good.
I do not want to say it's only upsides, but I do think for some autistic people there are things those people do consider up sides.
Edit: if I could choose to not be autistic, even with the massive burden it has for me, I would choose to remain autistic and I would fight tooth and nail against anyone who tried to change me to remove it.
That's an optimistic take, a more pessimistic one I've had is it seems to me for every trait that an autistic person has that is "good" there's some neurotypical person that has it as well without the suffering.
But it's also not clear what "being you but not autistic" would even mean, since it's an exercise in an imaginary hypothetical.
Mostly access to healthcare, like, "why don't we offer this? Why are there barriers? Why can't we get automatic approvals for this?" Etc.
It turns out there are lots of groups who have greater than median barriers to access even basic care (trans folks, Black folks, immigrants, neurodiverse folks, disabled folks, etc). I happen to have a "I'll just keep calling and escalating until I've called every person in the company" attitude that doesn't seem to find that exhausting.
Interesting. I’m working on a similar project/idea (?app, I don’t know what to call it, doesn’t matter), about helping patients understand what they need to do for primary prevention. I hadn’t thought of the specific barriers that each group might face. I’m a doctor and feel that too much is reliant on the doctor remembering to ask (“oh have we checked your blood sugars btw!”) I want to empower patients with this info.
A strong sense of right and wrong, ability to use the outside lens on allistic societal structures, a rich internal experience, deep interests that actually give you something to talk about other than "the weather" and "the football" and gossip.
These can all, of course, be framed as downsides: difficulty acting immorally / being a bystander, tendency to confuse others in what "should" be formulaic social interactions, Theory of Mind® Deficit™ (#NotPseudoscience), "specific and limited interests" / deficit in "small talk" ability.
What I was referring to is hard to explain, but it is apparent after a few hours of observation and conversation. I'm not saying allistics are in some sense lesser,¹ but you can tell, when talking to them, that most allistics just… don't have anything going on between the ears except future plans, the occasional daydream, and worries about their positions in status hierarchies – that is, when they're not actively engaged in a task. (When they are, they can have insights into what they're doing as deep as anyone else.) Most allistics need to explicitly meditate in order to pay attention to anything beyond their narrow internal subjective experience – and, not coincidentally, most allistics who sing the praises of "meditation" and "mindfulness" actually have no clue what it is or how it works or even how to do it.
¹: Yes, I am being deliberately provocative. No, this isn't an acceptable way to talk about entire categories of people, but in my experience, most allistics don't notice what they're doing to other people until somebody does it to them. The Golden Rule is, it seems, a heuristic that they have to deliberately and consciously employ, rather than something they have an intuitive understanding of: undeliberated-upon allistic morality is "do unto others what your neighbours are also doing unto those Others". So: if this wording upset you, that was deliberate. I'm still sorry for it.
>>>most allistics just… don't have anything going on between the ears except future plans, the occasional daydream, and worries about their positions in status hierarchies
This obviously isn't true, since finding a partner and raising children doesn't neatly fall into any of those categories.
Have you read how allistics talk about that sort of thing? Pick up a 19th-century romance novel, or just head over to Reddit: finding a partner is about status hierarchies, too! This observation has even got its own witty aphorisms: https://quoteinvestigator.com/2018/06/05/sex-power/
> “Everything in human life is really about sex, except sex. Sex is about power.”
It's salacious daydreams and status hierarchies! All the way down!
I do find it really hard to imagine how raising children could fit into these categories – I was figuring out how to word my concession on that point from the moment I read your comment –, but then I turn to my fiction books, and what do I find there? So much talk of honour, or parents projecting a desired future on their children, and such little mention of anything else except when it's actually happening. In the real world, too: how often do we see people hurting their children "for their own good", where the only possible good is to the future plans or social status of the parent?
I'm sure many allistics are capable of loving their children for their own sakes, but from what I've seen, it's not the norm: it's something that has to be learned, and actively practised ("engagement in a task"), rather than something that comes naturally to most. (And there's nothing wrong with that – provided that one puts the effort in. There is something wrong with being a self-absorbed, neglectful parent, too absorbed in the Proper Way of Parenting to let the village make up for one's own deficiencies.)
You can call 19th century romance fiction as being about "status hierarchies" in the same sense you can say "There's only 3 types of stories, man verse man, man verse nature, man verse himself".
I don't see how reducing this to a succinct label shows whether or not there is a "rich inner life" at play, going back to your earlier statement about neurotypical people.
Lord of the Rings might be a book about "man vs man" and maybe Frodo's resistence of the ring is about "man vs self" but there's probably some richness to be found in those 1000 pages, for example.
I guess I'd push back at the idea what you call "status hierarchies" is less "rich" in terms of inner life.
> You can call 19th century romance fiction as being about "status hierarchies" in the same sense you can say "There's only 3 types of stories, man verse man, man verse nature, man verse himself".
Have you read 19th-century romance fiction? The most notable examples in the genre are literally about status hierarchies: that's why they're interesting, that's why they were contemporary wish fulfilment. Take Pride and Prejudice (https://en.wikisource.org/wiki/Pride_and_Prejudice_(1813)/Vo...):
⸻ ⁂ ⸻
It is a truth universally acknowledged, that a single man in possession of a good fortune, must be in want of a wife.
However little known the feelings or views of such a man may be on his first entering a neighbourhood, this truth is so well fixed in the minds of the surrounding families, that he is considered as the rightful property of some one or other of their daughters.
"My dear Mr. Bennet," said his lady to him one day, "have you heard that Netherfield Park is let at last?"
Mr. Bennet replied that he had not.
"But it is," returned she; "for Mrs. Long has just been here, and she told me all about it."
Mr. Bennet made no answer.
"Do not you want to know who has taken it?" cried his wife impatiently.
"You want to tell me, and I have no objection to hearing it."
This was invitation enough.
"Why, my dear, you must know, Mrs. Long says that Netherfield is taken by a young man of large fortune from the north of England; that he came down on Monday in a chaise and four to see the place, and was so much delighted with it that he agreed with Mr. Morris immediately; that he is to take possession before Michaelmas, and some of his servants are to be in the house by the end of next week."
"What is his name?"
"Bingley."
"Is he married or single?"
"Oh! single, my dear, to be sure! A single man of large fortune; four or five thousand a year. What a fine thing for our girls!"
⸻ ⁂ ⸻
Of course, there are plenty of 19th-century erotic novels, which I haven't read, but do not appear to be about status hierarchies. I guess I'm not counting those as romance novels. Maybe I should?
> I guess I'd push back at the idea what you call "status hierarchies" is less "rich" in terms of inner life.
(I entirely agree. The way I've been talking is completely unacceptable. However, I'm committed to the bit, now, so I'll backpedal academic-style.)
On an individual scale, yes, there is no particular reason to elevate one kind of idle pre-occupation over another. However, the diversity of the autistic population as a whole attains a level of richness that the allistic population does not possess. No citation is needed for this claim, since it is sufficiently-obvious, and my substitution of poetic language in the place of argument is a perfectly objective editorial decision. It's totally legit, everyone. You don't even need to check.
(I'm not being entirely faithful to the bit. The academic would, of course, deny your assertion outright: my assertion is (by virtue of being published first) self-evident common wisdom, whereas yours is, like, just your opinion.)
I wouldn't summarise it as being about status hierarchies either, because that's not what summarising is. I could describe Lord of the Rings as a low-fantasy epic novel about war, spirituality and the feudal system, but that's not a summary.
> Claude 3 […] Gpt4-o […]
That's a description of the title, plus the knowledge that it's in the romance genre. That's not really what the plot is about. For a start, the stuff going on elsewhere is at least as plot-relevant as the titular Fitzwilliam Darcy / Elizabeth Bennet interactions. It's forthright criticism that overcomes the pride, reformed conduct that overcomes the prejudice (if you can even call it that), and their engagement near the end is due to mutual appreciation and respect. With the confident implication that this happy engagement will lead to a long and loving marriage, the curtain falls – but love has no impact on the plot of the book (ignoring the background Mr / Mrs Bennet relationship, whose interactions kick the whole thing off, and the one-sided Lydia / George Wickham subplot… I guess we could say that Mr Darcy loves Lydia? But his actions there have a lot to do with maintaining the social status of various parties).
There's no point giving specific criticisms of AI slop, but I'll do it anyway.
> "Love overcomes class prejudice and personal pride."
It's personal prejudice and class pride. There's no class prejudice to be found in the novel, as far as I remember.
> "Love transcends class and prejudice in early 19th-century England."
At a stretch, you could say that Mr Darcy's mild infatuation "transcends class", but it's communication (chiefly, a letter received at the beginning of chapter 13) that overcomes Elizabeth's “strong prejudice”. Not love. (And the prejudice isn't transcended: it's eliminated, as a prerequisite for any kind of positive feeling to blossom.)
Ask the bots to state the theme of the 19th-century romance novel “Cutlasses and Nationalism” in 10 words or fewer. You'll get comparable results.
Well, here's the non GPT version of the book, my personal interpretation: From what I remember of Pride and Prejudice the plot involves various women choosing to marry for economic reasons, lust, or love, in a society that gives them little to no economic opportunities outside of marriage and therefore pressures them to marrying for economic reasons.
The protagonist refuses to marry for wealth but in "have your cake and eat it too" fashion, fate rewards her with the love of a wealthy man as a reward for supposedly not caring about marrying a wealthy man.
A character marries for economic reasons and is comfortable but bored in life. Another character has out of wedlock sex and is punished by the hand of fate and miserable.
I'd argue saying it's about "status hierarchies" is not particularly informative.
I can see where you're coming from, and I'd say your first paragraph is spot-on. Although, talking about “the hand of fate” is missing a lot, I think. Elizabeth's success comes from her authenticity (see https://www.existentialcomics.com/comic/46), Mr Darcy's comes from his bettering himself, Lydia gets conned (and Mr Darcy arranges a marriage to at least preserve her social status, since happiness wasn't really an option for her after that)… Really, the only person in the story who gets what they're initially after is Mrs Bennet, and possibly Elizabeth (I don't remember whether she was against marrying someone wealthy, or just objected to marrying for wealth).
> I'd argue saying it's about "status hierarchies" is not particularly informative.
Saying it's about "status hierarchies" is only slightly more informative than saying it's about humans. (Note: there are plenty of books about neither.) I brought up Pride and Prejudice to begin with in order to make this point.
> I'd wager 1% or less of readers, if asked what the novel would summarize it as being about status hierarchies.
I would be inclined to agree.
> It is said that fish do not see water, nor do Polar bears feel the cold. Native writers on subjects like those the present work deals with do not even think that anything which has been happening daily in their own immediate surroundings ever since their infancy can possibly be worthy of notice;
The idea that you think only autistic people have deep experiences is kind of hilarious. Also I don't think you understand small talk, which I guess is not surprising... But people don't talk about the weather because they are super interested in the weather.
“Rich internal experience” doesn't mean the same as “deep experiences”, any more than “rich flour” (e.g. powdered rye grain) means the same as “deep flowers” (e.g. the bright yellow bit of a daffodil plant); and I was speaking in generalities, not universals. You're right: it would have been kind of hilarious had I been insisting upon what you said, because even I can see it's very false. Most allistics are, after all, capable of creating and appreciating meaningful art (albeit, usually limited to the types and genres of art considered conventional by local society during the first couple dozen years of their lives, unless they've been through particularly-significant external experiences).
> people don't talk about the weather because they are super interested in the weather
Meteorologists do.
I get that small talk is a social bonding exercise, and that "the weather" is just a common example of an inoffensive, vaguely-relevant shared experience. I understand why people would default to this if they didn't have much else to talk about, and they felt an instinctive obligation to prioritise perceived inoffensiveness to society-at-large over the actual joy of the actual conversation participants.
I just don't understand why this limitation is considered a good thing. Surely people would prefer to talk about something they enjoy talking about, and hear about something they enjoy hearing about? The fact that people can't – or feel they can't – is surely a bad thing… or, at least, morally neutral. The downsides of autism are paraded around everywhere, yet the downsides of allism are, via Tall Poppy Syndrome, somehow transmuted into downsides of autism? Like, do people not notice they're doing this? Clearly not, if https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296736/ (2006) is anything to go by.
What you see as talking about the weather is like seeing two women looking at each other whereas it's really a picture of a vase and 4D part-subconscious dog-butt-sniffing status/value computations between you and the other person. Also there's few other opener topics.
Usually it isn't but it definitely can be. E.g. at a party asking people what they do.
It's not necessarily about winning a social power battle, but it can be used to discover what sort of person someone is so you can interact with them easier.
I'm sure the parents of an autistic kid who's nonverbal at age 10 and punches himself in the face are comforted online when they hear about how discourse around autism downplays its advantages.
I was that kid (though I'd hit my head against walls, not punch myself), and 20 years later I can tell you that autism does have its advantages.
The suffering wasn't caused by my autism, but by society forcing me to behave in a way that was unnatural to me.
Now that I'm living on my own, able to shape my environment according to my needs, I'm not suffering anymore. I'm genuinely happy, and I've got a successful career in software engineering. And every day I experience situations where my autism helps me understand logical issues much more deeply, care for order much more (refactoring is <3), and allows me to speak out when needed.
Very few people are incapable of communication. Mutism is neither exclusively nor inherently autistic, and there are many other communication options available beyond voice (though they'd have to be made available to the child – that includes tools, where necessary, and training). Real-time spoken language is a complicated skill, and we shouldn't require that people master it before their needs are respected.
Punching yourself in the face is a sign of unmet needs. Sadly, the usual response to something like that is to (1) restrain the person, then (2) not try to figure out those needs, much less address them. I don't make a habit of blaming caregivers, but if an autistic kid's punching themself in the face enough for it to count as a character trait, there have been significant failures at multiple levels.
I'll repeat that. Punching yourself in the face is not an autistic trait. It's a caged lion trait. Put an allistic kid in the right (wrong) situation, and they'll do the same.
It's not an illness at all- it's a neurodevelopmental disorder. Although not well understood, it involves physically measurable differences in brain development during childhood like the one this post is about, and cannot be treated with things like psychotherapy.
It correlates to physically measurable brain differences, autism is considered heterogenous for a reason and has no single cause.
Given autistics don’t even seem to have the same symptoms, severity of symptoms, or etiologies, and opinions on what treatment even constitutes, I also hesitate to make any strong statements about what may or may not be effective medical treatment for them. There’s a reason Americans research on autism has to use RDOC domains which at least gives some insight into specific symptoms and their severity so hopefully this heterogeneity problem which results in really bad treatment options and guidance for autistic patients will get better.
It really depends on what you mean by treatment. Because therapy absolutely can ease things like anxiety, depression, and fear while building strategies for managing sensory processing issues, change anxiety, and executive functioning.
And further, these configurations are driven by chemical exchanges that are entirely biological in nature, regulated by other configurations, and all driven by a combination of gene expression, experiences, and the physical environment.
The amount of gray and white matter that the brain has is very much a combination of nature and nurture, as shown by the study on London cab drivers who grew more gray matter in the parts of their brain related to navigation while they were learning to navigate the streets of the city.
So a study showing a difference in gray or white matter between men and women does not immediately prove that this difference has to be due to a biological sex difference, since social gender roles can directly influence this. What makes it even harder is that it would be highly unlikely that any research in this topic can control for all the differences in how men and women lead their daily lives.
Anyway, I'm not criticizing the study cited, but just be careful that to not draw any conclusions about why those brains ended up the way they were from it.
This post has skill issues. The cab driver study has no bearing on a sex difference study. The subject groups are intentionally too different. One cannot port a conclusion from it to the other study. Only as a theme in a hypothesis. Ergo, you can not say that a study that showed a difference in gender brain matter "does not immediately prove" the conclusion due to the cab driver study. It may immediately prove, and it may not. But the reason that it would not is not the cab driver study. The reason would be other aspects of the gender study. Such aspects, like deficiencies in study design, should be in the discussion regardless of the cab driver study. But the real issue is that "immediately prove" is simply unscientific language that should be revised. You're also asking everyone to accept that cross-gender nurture, all other variables accounted for and including "gender role" volunteerism, is definitely the deciding factor. Sorry. And I say that as someone who could care less if my opposite gender has a brain that has 3x "better" architecture according to any study.
Even if, for the sake of argument, the amount of gray matter was 100% nurture, that would show that men for some reason pursue particularly those activities which cause them to end up with 7x more GM on average.
That would still be a very relevant (and curious) finding that would support my argument, given the correlation between GM and Autism, do I see that right?
"useful for what most men do in life" - What are you referring to here? Because my answer to that would be just going through the motions and not thinking very much about anything, like most women too ("most men" is the bottom half of the bell curve plus a few more).
Pursuing professions and passions to do with things rather than people, and in particular with abstract and logical thinking, such as mathematics, technology but even philosophy and musical composition. Generally! (Obv. it's normal distributions all the way down, though with different centers between male and female)
For more fascinating insights on how his starts at birth, see this enlightening classic lecture which is an absolute must watch on this topic:
Lol, most men are barely scraping by and thinking what to eat. Even in richer countries like US or Poland only like top 5% would partake in such activities like you described. On average men do more manual labour that required no abstract thinkng than women.
> In general, men have approximately 6.5 times the amount of gray matter related to general intelligence than women, and women have nearly 10 times the amount of white matter related to intelligence than men. Gray matter represents information processing centers in the brain, and white matter represents the networking of – or connections between – these processing centers.
> finds that size is the only clear-cut difference between male and female brains. Women's brains are about 11% smaller than men's, in proportion to their body size.
> "This means that the brain differences between large- and small-headed men are as great as the brain differences between the average man and woman," Dr. Eliot said. "And importantly, none of these size-related differences can account for familiar behavioral differences between men and women, such as empathy or spatial skills."
> This means that the brain differences between large- and small-headed men are as great
Well, kind of like a shorter male is still shorter than a taller male yet males are taller than females on average ... which makes it a bit of a 'duh' assessment. Obviously these are distributions.
> And importantly, none of these size-related differences can account for familiar behavioral differences between men and women, such as empathy or spatial skills.
That's a rather unscientific assertion and certainly false, besides the fact that it doesn't even seem to follow from the study itself.
If more gray matter by itself already explains autism, then certainly the gray matter and brain size differences between the sexes must account at least in part for similar cognitive and behavioral differences between the sexes.
The key part here is "related to general intelligence" (not sure how they measured that as I haven't read the whole study). They obviously don't have 6.5 times more gray matter as a whole.
What do you mean by 'obviously' here? How precisely has that manifested to you in such obvious manner? Genuinely curious since you seem to take that as a given.
the positive correlation between vitamin D deficiency during pregnancy and autism has been known for quite some time. One more aspect of this correlation related to the original post:
"the vitamin D-deficient infants have a greater brain mass than pups born to vitamin D-sufficient mothers, indicating impairment of appropriate neuronal pruning"
"deficiency early in pregnancy is more likely to affect brain structure during the period of organogenesis whereas the pruning of neuronal cells occurs later in gestation, so later deficiency would likely present with differences in brain size. "
That also dovetails with that Sweden study that autism is more correlated with vitamin D deficiency in the 3rd trimester.
because i wrote a short internet comment, not a science article. I just linked to the article most prominently stating the 3rd correlation in the triangle of correlations between those 3 vertices - autism, vitamin D deficiency and brain size. For people who interested it is just a simple google to get more related articles, in particular stating all 3 together though in more diffuse way and/or bridged by the pruning. And simple google also would bring you the Sweden study.
A doctor wanted to operate my brain as a baby, but my mother didn't let it, and in the end, it was the right choice as it had a meaningful chance of my death.
I also struggled with language at first, and I went to many years of speech therapy, but eventually, it got better. My learning rate with languages is definitely not the best, but I still speak three languages after a good amount of effort and can communicate effectively.
It also gave me plenty of advantages; I always scored pretty high on IQ tests and had very good long-term memory.
Because I don't buy this narrative from the article or in medical research that there are two kinds of autism. In my opinion, there's only one, and that one has SEVERE conditions; I had a relative who had autism, and it was complicated for both the person and their parents. To me, this seems like a naming issue like software engineers do, who struggle to name an abstraction correctly, and after three years, that abstraction means everything.
Having a different kind of brain wiring isn't some sort of sickness or anomaly. All brains are very different, just like your toes. When you compare them to others, you'll see quite a few differences.