Why state of general autism knowledge is so bad...

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So the state of public knowledge about autism is pretty bad, and many myths about autism are very pervasive. This is true for pretty much anything mental health related, but the difference is that with autism, some the myths are wide spread among the medical community as well (the vaccine myth has been eradicated, but lack of empathy is still widespread), sometimes even to a greater degree than there are among the general public. I think this is due to a combination of the self-advocacy work among autistic people, which spreads faster among the public than the medical community because the public isn't held back by the same dogma the medical community is, and the fact that autism's history has been riddled with bad practices.

So one problem I think is due to the fact autism is classified as a developmental disorder rather than a mental one. As a result, pediatrician's are to some better educated about autism than most psychologists are, leading to some psychologists even holding the myth that only children get autism. However, the pediatricians still don't know anything about autism in adults, and hold many myths about autism as well as there training is specifically directed towards detecting more obvious autism in children, and is overly pathologized. It needs to be understood that autism is a lifelong condition, not a deviation that occurs at some point during childhood, and it can manifest in many different ways.

The greater problem is a history of psychology one, and the problem is that early autism research was dominated by behavioralists like Lovaas. Behaviorism strives to objective, and thus avoids assigning mental states, and just looks at patterns of behavior. This was probably initially associated with autism due to a combination of the time period, and that fact early researchers couldn't communicate well with those on the spectrum and thus tended towards behavioralism to avoid assuming. But even though we've moved away from behavioralism, it's dehumanizing legacy is still strongly felt in autism research. The dominant narrative right now is biological, which isn't really any less dehumanizing, it just looks at brains and chemicals in addition to behavior. The amount of money being put into biomedical research on autism is probably a large part of the reason for continuation of bad research, with researchers doing studies for the interest of money rather than actually finding out anything about autism. Even in cognitive psychology the same mistakes are being made.

Say someone does a thing, and other people can see that she did the thing. They can make guesses about why she did it, but the only person who knows for sure why she did is herself (well, at least that's the assumption). She can tell others why, and they may or may not believe her, but regardless of whether they believe her or not she still knows it's true. Technically that's not quite true due to cognitive biases, but it's a valuable insight for cognitive psychologists. Generally this insight can be used as the starting point for a theory which can then be studied to see if it's consistent with experimental evidence to account for cognitive biases.

But for some reason, that doesn't seem to happen much with autism. Instead of starting with the input, there is the pattern to start with the conclusion and then inductively support it by rejecting all input from people on the spectrum, as well as their family members, writing it all off as biases even if that makes no sense. For example, let's take Simon Baron-Cohen's assumption that autistic people lack empathy. This is based on the claim that if autistic people lack cognitive empathy, as hypothesized from observations of people apparently acting unempathetically, then they wouldn't realize when they acted unempathetically. Granted, he has taken enough input from autistic people at face value to realize we don't lack affective empathy as well, but the reasoning is still inductive and flawed, as there still may be situations where the autistic person DID realize they were acting unempathetically, but decided they had to do what they were doing anyway due to adherence to routines or the like. Or overlooking emotions may be more due to sensory issues that social cognition. I'm surprised those two factors, which are core traits of autism, are rarely factored into explaining autistic social behavior.

The most ridiculous case of this are those who hold the myth that autistic people lack the capacity for introspection completely. I believe the origin of this came first from a philosopher who theorized how a person who lacked introspection would behave. Then a psychologist read his work, and concluded autistic people lacked introspection from it based on similarities he found between autistic behavior and that description. Even though observations from autistic directly contradiction that notion, those who hold said belief either dismiss such observations if they are researchers, or won't diagnosis people with those observations if they are autistic. Which leads to one large problem with all these myths in the medical community.

Because autism myths are so prevalent, many people on the spectrum are denied diagnoses based on them. Again, they are myths, not changes in diagnosis criteria, as people on the spectrum NEVER were restricted to these myths. Common myths are lacking empathy, imagination, or humor, lacking specific social skills, not being able to talk or be successful by any measure including just having friends, or requiring cognitive impairment. These are particularly biased against girls on the spectrum, as people interpret the behavior of girls differently (eg. the same behavior may be interpreted as empathetic in a girl, but self-serving in a boy), girls socialize differently (eg. girls on the spectrum are more likely to have friends because girls reach out more to socially unassertive people), and girls are socialized differently (eg. social skills like eye contact can be learned, social skills are more emphasized when teaching girls than boys, so it's stupid to not diagnosis a girl for lacking a specific social skill like eye contact).

Fortunately, in recent years some researchers have started to actually listen, and progress has been making bounds, at least in some parts of the community. However, the progress has been slow to assimilate as the young learn the new ideas faster than the old (especially when they are still undergoing training), and myths are still wide spread toxic memes. Dogma is hard to throw out. I'm a psychology minor, and I remember in the intro to psych textbook it still has the myth that autistic people lack theory of mind, despite that obviously being untrue for autistic adults, and little other information about the disorder (while it had plenty of information about mental illnesses in that section, autism was only mentioned during the chapter on development). After all, if someone actually lacks theory of mind, they would be unable to lie, and thus unable to lie about having theory of mind! So when most people in the field's initial exposure to include dogmatic myths about autism and little details, it no wonder so many myths are so wide spread, and it's at the rate things are going to take a long time to weed them all out.