What is autism? How the term became too broad to have meanin

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ASPartOfMe
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27 Aug 2019, 6:37 pm

Mona Pereth wrote:
ASPartOfMe wrote:
More research into helping people with impairments communicate and function better without curing them is not without precedent. Sign language, hearing aids, and glasses serve that purpose.

Yep. Probably a lot more nonverbal autistic kids could learn to read and write, type, and/or use sign language if these were emphasized more in therapy for all autistic children, at as early an age as possible.

However, this probably wouldn't solve the problem for all autistic kids. There may well be some whose brains just can't process language in any form at all, or at least not without extreme difficulty. Hence I think it would be highly desirable for there to be more research into the neurological basis of language ability and language disabilities, with the eventual aim of curing or at least alleviating this neurological basis if possible.

Also I'd like to see more research into the motor difficulties that often accompany autism, and that are probably the basis for at least some severely disabled autistic people's inability to talk and, in some cases, inability to write or type either.

ASPartOfMe wrote:
Contrary to popular stereotypes Aspergers disorder/syndrome was not in any manual limited to highly intelligent to genius people with autistic traits. One problem with the dropping of Aspergers diagnosis is it exacerbated these stereotypes. People can define Aspergers as they please and because it is now an informal/colloquial term there is nothing to be realistically done about the term having meanings it was never intended to have. We can complain, but it is a lost cause.

Except when people use these "meanings it was never intended to have" as the basis of an expressed desire to go back to the DSM IV categorization. Then it's highly relevant to look at what the DSM IV actually said about both "Asperger's disorder" and "autistic disorder."

Also, for people who think "classic autism" meant "low IQ, can't communicate at all," it's highly relevant to look not only at the DSM IV definition of "autistic disorder," but also at Kanner's paper (PDF copy), in which he described some of the boys he studied as highly intelligent.

Clinicians do not always follow the DSM GUIDELINES. Aspergers often became "High Functioning Autism"(average to above average intelligence" without language delays which became Autism with high to savant intelligence because why did it really matter after a certain age what language delays a person had before age three.


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Mona Pereth
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27 Aug 2019, 7:56 pm

ASPartOfMe wrote:
Clinicians do not always follow the DSM GUIDELINES. Aspergers often became "High Functioning Autism"(average to above average intelligence" without language delays which became Autism with high to savant intelligence because why did it really matter after a certain age what language delays a person had before age three.

Indeed, this frequent inconsistent use of the "Asperger's" category by clinicians is, if I understand correctly, one of the reasons why the "Asperger's" category was gotten rid of, along with the fact that its correct meaning (according to the DSM) entails a distinction that (as you pointed out) doesn't really make much difference after early childhood. The common informal meaning of "Asperger's" is much better encompassed by "ASD Level 1 without intellectual disability."


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Last edited by Mona Pereth on 27 Aug 2019, 8:42 pm, edited 2 times in total.

Mona Pereth
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27 Aug 2019, 8:00 pm

Back to the subject of autism research:

As I've mentioned elsewhere, there have been plenty of complaints about the more severely disabled autistic people being under-represented in studies. Here's an article reviewing those complaints: Are Children Severely Affected by Autism Spectrum Disorder Underrepresented in Treatment Studies? An Analysis of the Literature by Amy Stedman, Briana Taylor, [...], and Matthew Siegel, Journal of Autism and Developmental Disorders, 2019. According to the abstract:

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We found that the proportion of studies that included the severely affected population decreased significantly over time, as well as wide variability in measurement and reporting. Inadequate representation of the full autism spectrum in the literature could lead to an unbalanced picture of ASD and leave behind those with arguably the greatest need.


Again there needs to be more research focussed on the specific problems of the most severely disabled autistic people, rather than on trying to "cure autism" in general.


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28 Aug 2019, 11:25 am

The Guardian article linked by the O.P. contains a link to "Is it autism? The line is being increasingly blurred," Université de Montréal Udem Nouvelles, 08/21/2019, about the opinions of "Dr. Laurent Mottron, a professor at Université de Montréal's Department of Psychiatry and a psychiatrist at Hôpital Rivière-des-Prairies of the CIUSSS du Nord-de-l’Île-de-Montréal."

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After studying meta-analyses of autism data, his research team found that the differences between people diagnosed with autism and the rest of the population are shrinking.

This study was published today in JAMA Psychiatry, the most prestigious journal in the field of psychiatry. Given the importance of its findings, the study is also the subject of the journal’s editorial.


Here are links to the JAMA Psychiatry study and an abstract of an editorial. (JAMA = Journal of the American Medical Association.)


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BTDT
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28 Aug 2019, 11:36 am

Mona Pereth wrote:
Again there needs to be more research focussed on the specific problems of the most severely disabled autistic people, rather than on trying to "cure autism" in general.


Perhaps the researchers wanting funding prefer not to work with people?



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28 Aug 2019, 12:56 pm

In the article "Is it autism? The line is being increasingly blurred," Université de Montréal Udem Nouvelles, 08/21/2019, Dr. Laurent Mottron is quoted as saying some things that, to me, sound surprisingly ignorant, both about autistic people and about today's diagnostic practices. For example:

Quote:
“Three of the criteria for an autism diagnosis are related to sociability,” he said. Fifty years ago, one sign of autism was a lack of apparent interest in others. Nowadays, it's simply having fewer friends than others. Interest in others can be measured in various ways, such as making eye contact. But shyness, not autism, can also prevent some people from looking at others.”

"Fewer friends"? Yes, it is now generally accepted that many autistic people are capable of making friends, though with much greater difficulty than NT's. However, since when was this difficulty measured in terms of just the quantity of one's friends?

As for lack of eye contact, there are other things it can represent besides shyness and lack of interest in others. How has Dr. Mottron managed not to notice that, for many autistic people, difficulties with eye contact pertain to attention issues (i.e. the very difficulties with "cognitive flexibility" he was quoted as mentioning earlier in the article) and/or sensory issues?

This surprises me because, years ago, he was one of the more autistic-friendly researchers around, famous for, among other things, having Michelle Dawson as a research assistant and praising her attention to detail.


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Last edited by Mona Pereth on 28 Aug 2019, 2:28 pm, edited 2 times in total.

JustFoundHere
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28 Aug 2019, 1:54 pm

Oh yes, it's natural to "split hairs" (or to "pull our hair") on defining, or redefining the terms in referring to the Autism Spectrum without stretching the English language to it's limits (this doesn't include the challenge of yielding an understandable context) e.g., terms/acronyms like HFA, AS, and in a sentence, "those concerned with the Autism Spectrum."

Personally, and many of us here on WP feel that clarifying the meanings/context of the Autism Spectrum becomes nothing more than increasingly futile and tiring exercises.

Long before the awareness of Autism Spectrum, the term "slower learners" was applied. Of all the labels, terms etc. etc., the term (more or less formal) "slower learners" was very helpful esp. when thoughtful teachers, counselors, family, and friends were in the loop at the time.

Can the term "slower learners" to make a comeback - a term which might just boost that much needed context on the Autism Spectrum?



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28 Aug 2019, 2:20 pm

I'm anything but slow learner... but I have sensory issues, shutdowns, meltdowns (in childhood) and problems with social things people claim to be obvious.

My view is, autism has become so broad after looking for what all those extreme autistic have in common. Then it turned out, the traits deeply autistic kids share with each other, they also share with much greater part of the population, including fully functional and possibly successsful people.

It's not "one extreme". It's an enormously broad spectrum of extreme autism configurations, all resulting in poor functioning.


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28 Aug 2019, 4:50 pm

I think we have to redefine what severely Autistic means.


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28 Aug 2019, 5:12 pm

skibum wrote:
I think we have to redefine what severely Autistic means.


How would you define it ?



BDavro
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28 Aug 2019, 5:14 pm

Well, it's a spectrum of disorders so it's going to be rather wide and broad.

By definition.



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28 Aug 2019, 5:22 pm

First off, I would not say that the only people who are severe are the ones who do not have linguistic skills and who have communication barriers or issues with motor skills. Yes, those are severities and they should definitely be considered very heavily and focused on. But there are so many people like me and other Autistics that I know who are so neurologically damaged after years of living in an nt society that our Autistic issues have become life threatening. Those needs are completely ignored and not even acknowledged and the severity of the crippling that that gives us is very severe. And what we would need to mitigate those effects is not that expensive or that complicated. Just because we can talk and communicate does not mean that the severity of some of our issues are not as severe or even more severe than some of the issues of people who cannot speak or communicate clearly. Yet we will always be ignored because we don't look the part.


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28 Aug 2019, 5:51 pm

^ I went for years being seen by mental health professionals as ' awkward,demanding and troublesome ' . It was not considered how difficult I could find some things , because of my verbal intelligence .

Unfortunately pre 1994 there was little help anyway for people like me . It became the norm to dismiss things as being character flaws .

c1981 while an inpatient I was sent to do a cookery course . I got kicked off it because I was peeling potatoes too slowly . I was seen as being obstructive . There was no recognition that I might have a genuine difficulty . Such a difficulty ,while not a criteria for Asperger's/autism, is the kind of thing that points to dyspraxia which is often co-morbid with Asperger's /autism .

I would hate to think that people would be reduced to the character assassination and lack of help, support and understanding I was subjected to because people wanted to roll back the diagnosis to a not so golden era .
That would be a seriously retrograde step.



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28 Aug 2019, 5:57 pm

firemonkey wrote:
^^ Whilst I can see that that there probably isn't low functioning Asperger's I don't think it's exclusively high functioning either . IMO it straddles moderate and high functioning .


I'd go further and say that situational functioning may be a better way to look at it. Some will be high in certain situations, and low in others.



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28 Aug 2019, 6:11 pm

HighLlama wrote:


I'd go further and say that situational functioning may be a better way to look at it. Some will be high in certain situations, and low in others.


I can't disagree with that. An important point .



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28 Aug 2019, 6:55 pm

firemonkey wrote:
HighLlama wrote:


I'd go further and say that situational functioning may be a better way to look at it. Some will be high in certain situations, and low in others.


I can't disagree with that. An important point .
I agree with Llama as well. And I can relate to your potato story. It really stings when people do that.


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