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ASDMommyASDKid
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17 Feb 2018, 4:15 pm

Due to how autism is defined (as an umbrella term for who knows how many different genetic/epigenetic/environmentally influenced things and as a spectrum) there will always be people on both sides of the clinical dividing line between diagnosed and undiagnosed who have varying proportions of NT and ASD traits. You have NTs with small touches of autism, just like you have people who are profoundly affected. The dividing line is placed where medical people have decided that line should be. The guiding principle is whether or not you are affected adversely and if you are sufficiently affected. Then they stratify the people who are diagnosed into arbitrarily defined severity levels.

If you look at the discussion sections regarding the development of the category in the DSM and look at how the proverbial sausage is made, there are tons of places where there is disagreement. In addition, the people who make the actual diagnosis do not operate perfectly consistently with each other and maybe not with themselves. There is still Type I statistical error and Type II statistical error, where people are diagnosed incorrectly or incorrectly not diagnosed.

As far as the original question about whether or not ASD is stigmatized in some way because the pool of people who are diagnosed do not include various categories of undiagnosed people with higher abilities -- I don't see how you would even adjust for that or what the point would be. Even if you decided to move the line (which you might want to do anyway if you felt the current line was not getting help to enough people who needed it) how far would you move it? How would you get the slightly affected to care? If you were overzealous, would you end up diluting the diagnosis so much that no one would get any help?



strings
Sea Gull
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17 Feb 2018, 7:22 pm

AnnaOMalley wrote:
The problem with this is that you can’t diagnose yourself with autism.


Hmmm...as a blanket statement that sounds a little dogmatic. As a legally valid diagnosis, entitling the person to benefits, accommodations in the workplace, etc., presumably it is true. Probably even a professionally-trained psychiatrist is not allowed, for the purpose of legal entitlements, to diagnose himself or herself as being autistic?

But if we are talking not about the legal status of the diagnosis, but rather about its accuracy as a statement of one's mental attributes, then it seems less clear cut. Medicine, especially when the mind is involved, is not an exact science. There will certainly be borderline cases where even medical professionals would disagree about whether someone qualifies as having an ASD or not. So in the end, it is really going to come down to a probability, somewhere between 0% and 100% but not always at one extreme end of the range or the other, as to whether a professional diagnosis of ASD is correct or not. Things are often not black and white.

Now, there will be different levels of probable accuracy of the diagnosis, depending upon who is performing the diagnosis, and on whom. But there is surely no way one can make such a blanket statement as that "one cannot diagnose one's own autism" (except, perhaps, in the sense of making a legally valid diagnosis). A psychiatric professional diagnosing themselves may achieve some rather high level of probable accuracy. A layman who has researched extensively may well achieve a quite high level of accuracy. A casual person who hasn't delved deeply into the subject may well make a rather unreliable diagnosis of themselves.

But I don't think self diagnosis based on detailed study and reading in the area should be dismissed as having no validity.



TallsUK
Tufted Titmouse
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19 Feb 2018, 4:33 am

As there is no biological test for autism it must be considered a social construction. This means that while diagnostic manuals and training helps with standardisation, there is always going to be a grey area with different psychologists using their own judgement. That is why an official diagnosis can only ever be a legal statement and little else. This is of course exasperated by the continually changing diagnostic criteria. However, the diagnosis element is a bet of a moot point.

That being said it does of course mean a lot to individuals on a personal level. I know that being official recognised helped me deal with a lot of issues I had previously faced and. Until I had that, the nagging doubt that it was just one of my strange special interests and that I was not really autistic (yes, i get the irony).

My real concern is that many people still think that autism is linked to intelligence. As a result many people are not that they are autistic and they are not likely to think they have something classed as a disability. I know teachers frequently say 'that pupil can't be autistic he is too smart'. The majority of autistic students have noticeable academic issues while I see others who have stereotypical autistic difficulties but are academically capable that are able to stay well under the radar.

Combine this with the fact that there is little reason, other than personal piece of mind, for a professional person to obtain a diagnosis. For an adult, the only support available just now is the stuff you pay for by yourself. While telling someone you are autistic should lead to lots of help but in reality that does not happen. Why would someone in that situation want to put them in a position of being discriminated against when there is so little to gain?

There are various reasons why I see this as important:

1. If intelligent autistics are not being officially diagnosed it in turn reinforces the stereotype linking ASD and intellectual challenges.

2. Some people with all the usual ASD challenges may not consider autism as a possibility because they are of average intelligence. Seeing other professionals in a similar situation may help them.

3. Having tried to get by on my own for many years, I now know that I need external help. I think there are many autistic professionals who could also help me and I might be able to help them. However, if they don't engage with the community none of us may benefit.