The Broader Amish Autism Phenotype vs. The Autistic Matrix

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I figured that you were arguing towards non-social enviromental factors, while I personally disagree, I'm not opposed to discussing it.

Hopefully, I adequately addressed most of the points you are making here in my last post.

My suggestion is not one that the inherent problems or propensity toward problems of adaptation do not exist. That seems clear even among individuals with substantial traits of introversion, discussed in detail in the Time Magazine article on Introversion, I linked in the previous post.

One person's stress is another person's pleasure where the stimulus of social environment and other sources of stimulus in the environment are increased.

Currently, it is also identified in clinical practice that, overall, across what is currently identified as a spectrum, per DSMIV criteria, the majority of individuals are actually hypo-sensitive to the environment and some seek stimulus through "stimming" rather than stimming to focus attention away from other sources of overwhelming stimulus.

It is also worth noting that online Autism Communities, such as this community and many others are far from representative from all the different identified Autism Subgroups that exist. The results I linked from the Myers-Briggs Informal Poll are restricted to that limitation.

There are likely relatively few of those responses coming from individuals clinically sub-typed among the 25% of individuals with Regressive Autism in Childhood, the 5% assessed with Fragile X syndrome, the 38% assessed with co-morbid intellectual disability, or even the 24% assessed with co-morbid borderline intellectual disability in childhood.

I agree that if I made the statement you paraphrased from my quote below that "People over 40 are not getting dx'd because 'society is changing' ", it would not be a reasonable one but I am not suggesting a universal phenomenon for all people on the spectrum.

I am suggesting that an increasing demand from the social environment is POTENTIALLY having an impact among SOME people currently identified on the spectrum, from the DSMIV Criteria that exists now. The DSMIV has been in effect close two decades now.

That is part of the reason I restricted my suggestion specific to a two decade generational gap, in specifying age 40 vs. age 20, not those individuals over age 40.

Considering factors of new diagnostic criteria and increasing social stress and environmental stress from increasing stimulus and social demands, this would be the generation up to age 20 most likely impacted by an actual diagnosis taking new factors of social environment into account along with more loosely described DSMIV criteria for some type of ASD.

However, I still see a potential impact across the life span.



The Gillberg Criteria adequately captures a neurodevelopmental disorder from Childhood for Asperger's syndrome, because motor development impairments and language development delay and/or speech impairment are mandatory criterion elements.

As described in my last post, the DSMIV does not do that in the more loosely defined and described disorders.

The DSM5 criteria for ASD is more restricted but it still has the potential to capture more environmental influenced factors than the Gillberg Critera because it is based on observed behavioral impairment, rather than inherent issues of motor development impairment and verbal language development and/or speech impairment that will continue to be captured under Gillberg Criteria.

The new "mandatory" requirement of non-verbal impairment, taken to the clinically significant level, instead of common behavior seen in the general population such as looking away when focusing on memory in conversation to avoiding distracting stimulus from the facial expressions of others, is more likely to capture an inherent condition in the DSM5 than what was defined as minimum diagnostic requirements for DSMIV ASD in PDDNOS.

Link on common elements of eye aversion among people on the spectrum and the general population:

http://www.myhealthnewsdaily.com/2321-a ... avior.html

The diagnostic inefficiencies in the current DSMIV criteria and designed assessment tools is described better in the analysis provided in the two links below, than what I have seen from any other Autism Research Scientist or other associated Professional.

http://crackingtheenigma.blogspot.com/2 ... usion.html

http://crackingtheenigma.blogspot.com/2 ... o-get.html

Three out of three instead of two out of four, previously described Social Interaction Criterion Elements now described as Social-Communication Criterion is much more restrictive.

According to the APA representative, Sue Swedo, chair of the DSM5 ASD committee, the three mandatory Social Communication elements are required observed at time of diagnosis, not met by history alone, whereas RRBI's can be met by history alone, no longer necessary as observed clinically significant impairments at the time of diagnosis.

Gillberg Criteria, overall, is still a more restrictive criteria, to meet diagnosis of Asperger's than what the DSM5/APA representative , Sue Swedo, now describes as ASD, in the link below:

http://www.psychiatry.org/practice/dsm/ ... m-disorder

Link to Gillberg Criteria:

http://www.bbbautism.com/asp_gillberg.htm

All that said, as stated at the end of my last post, the substantial problems remain. The needs of appropriate accommodation and support remain.

I do not think the new Social Communication disorder will adequately capture the issues of difficulty some people have that remain that in some cases will also no longer be captured by the DSM5 ASD criteria.

The potential to do further research associated with other cultures like the Amish, capturing the full scale of difficulties, will likely be significantly reduced in the US, after DSM5 criteria goes into effect.

For some time to come, a similar existing potential remains in countries where the ICD10 continues to be used for diagnosis, where criteria is more loosely described.

A) Thanks for admitting that you're 'full of it". If you cant state what you're saying in plain English- then you're admitting that you have nothing to say.

B) Thanks for reminding of us the aburdity of your sentence.

"People who are getting diagnosed to today at age 40 who wouldve been diagnosed TODAY at age 20-had they been born 20 years later.."

Thats like saying "people who are celebrating their 40th birthday today WOULDVE been celebrating their 20th birthday today- if they had been born 20 years later."

Its a laughable tautology.

Its certainly not evidence of society changing.

Maybe you MEANT to say "people are getting dx'd today at age 40 who would NOT have been dx'd 20 years earlier when they were 20 because they didnt have problems back then" ( or the problems werent as manifest)." And that is somehow evidence of this goofy theory of yours.

That would in theory make sense.

But 20 years ago NO body got dx'd with aspergers because the label would still be nonexistant for the next almost decade. And even if you're talking about autism in general folks just werent as aware of neurodiversity 20 years ago anyway ( like folks were atleast as neurotic in the thirties as in the sixties- but going to a shrink was not as socially acceptable in the earlier decade as the later hense lower rate of folks going ot shrinks in the thirties compared to the 60's).

It is also potentially part of the reason that some folks, who are being diagnosed at 40 now, would likely be diagnosed at 20 now if born 20 years later because the social demands of this fast paced chaotic culture, now exceed capacity for fuller social adaptation.

Natural Plastic, it appears that you are reading more out my statement than the intended communication. I am off by one year, technically, as the Asperger's diagnosis was not available until 1994. I apologize for that discrepancy.

But to that regard, my statement is not one of evidence at all. It is a statement of analogy in potentiality, and possibility, not evidence.

There is no evidence because there is no research.

The DSM5 recognizes that symptoms in early childhood may not manifest for diagnosed disorder until social demands exceed social capacity to meet those demands.

As stated earlier, this is not applicable to forms of Autism that are related to more severe conditions, however it is applicable to whatever it is in the environment that is part of that social demand associated with SOME people on the spectrum who eventually are diagnosed. Whether that be at 5, 10, 15, 20, or 60 years old.

My suggestion is research to determine what those factors may be. That research is already well underway for medical association of contributing factors that contribute to what is currently diagnosed as ASD's. The Social Environment is certainly a factor in play as a contributing factor in what may eventually be part of associated factors that lead to an observed NEED for diagnosis in SOME people on the spectrum.

Your hypothesis is that society has become more demanding ( or sensorily overloading or something) and that that causes older people to find that they cant coup who wouldve been able to coup 20 years ago- and that drives them to seek a shrink- and that then the shrinks discover that these people have aspergers.

I think you have interesting theories, OP, but I've lived in Amish Country for most of my life and can tell you the Amish Community as a collective whole does not deal well with non-conformity. (Are you familiar with the concept of 'shunning,' as it's used in Amish communities?) I would think that anyone who has difficulty understanding and conforming to social norms would have a very difficult time in their culture.

Something else to consider is that because the Amish community is so small and closed-off, they have a much, much smaller genetic 'pool' than the general population. Because of this, there are (a) some genetic conditions that are common in Amish communities that are rare in the general population and (b) some genetic conditions that are rare in the Amish population that are fairly common in the general population. That said, it's possible the low Amish incidence of ASD is due to nature (ie. genetics), rather than nurture (ie. environmental or culturally-related triggers).

This is just the kind of sentence that makes me smell blood and go on the attack!

Lol!

You do NOT think..that from an anecdotal perspective...many people visiting this site WOULD argue..that stress and social stimulus do NOT contribute to thier difficulties...in functioning in blah blah...

In plain English that would be: most folks here would say that "stress and social stimulus DO contribute to their problems".

Their problems in WHAT though?

The defining problems of autistics and aspies are social awkwardness and fitting in. So you're just saying that social pressure causes problems with ...social pressure! Which is a tautology.

Am I the only one here who finds it hilarious that you take that much verbiage to say so little- and what little you're saying- is essentially a self evident tautology?

I realize that we are speaking in different languages: you in socialsciencese, and I in colloguial english. But still. It sounds like you're trying to snow either the reader, or snow yourself, or both. So thats why I see red.

You might be on to something- that living in a slow paced more insular community causes spectrumites to stay in the woodwork and not stand out as being dysfunctional the way they might in the wider society.

But there are so many variables that it would take alot to tease that theory out for testing. As blueroses said-there is the genetic issue, And as Im saying- our grandparents werent into going to shrinks, and niether are the modern Amish- so ofcourse they are not going to get diagnosed with neurolgical labels as often as the rest of americans (or even as often as South Koreans).

Did you seriously post on an Aspergers forum complaining about wordiness? lol

Why not drop the useless criticism of his communication and get straight to your comments on his theory? You have some interesting points, but they are obscured behind an aggressive approach. How is that better than being wordy?

BTW- Aghogday already addressed "the Amish not visiting shrinks" by using data from a door to door assessment done on Amish children.

I'm following both sides of this one (aghogday, channeling Inventor) and NaturalPlastic. This is one of the most entertaining threads going at the moment.

Where's my popcorn?

I appreciate your help in clarifying my communication.

The DSM5 now defines Autism as symptoms of a broader autism phenotype that occur in early childhood but may not fully manifest as symptoms of an actual diagnosed condition until social demands exceed social adaptation.

Every child, later diagnosed with Autism, starts on a broader autism phenotype first.

There can be many associated factors that lead to the actual diagnosis, including superficial issues such as how the condition may be defined, how it is subjectively assessed, and awareness and accessibility of health care leading to a diagnosing professional.