The line between neurotypical and autistic and severity

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The word "autism" may be used as a "synonym" for conditions from broader group of developmental disorders called "pervaisve developmental disorders" (PDD was a subcategory of disorders in ICD-10 and DSM-IV, but it is absent in DSM-V where are just autism spectrum disorder and social communication disorder).

In my country (Poland) there is a special category of disability called "pervasive developmental disorders" ("całościowe zaburzenia rozwoju") which has the symbol 12-C (from first letter of Polish word "całościowe"), not the category of "autism" or "autism spectrum disorder" and this category of disability is different from "metall illnesses" ("choroby psychiczne") category (which covers, for example, psychotic disorders, more significant affective disorders, severe anxiety disorders), this category has the symbol 02-P (from first letter of Polish word "psychiczne").

I think that not every PDD meet DSM-V criteria for ASD or even ICD-10 or DSM-IV criteria for any of PDDs. I think that PDDs can be not present in birth or infancy, but may develop later, but still weel before adolescence. Also PDDs have not to be genetic and (or) hereditary. And, of course, not all PDDs have to be related to bookish cases of childhood autism from DSM-IV/ICD-10 or autism spectrum disorder from DSM-V.

I think that people with social communication disorder from DSM-V or most of individuals with nonverbal learning disability (NLD, NVLD) or individuals with persistent personality disorders (at least ones of cluster A (odd-eccentric), like schizoid or schizotypal, or similar to it) which are present and noticeable since pre-adolescence in fact have certain forms of PDD also when they do not make DSM-V criteria of ASD. I think that they should have symbol 12-C on they ruling of disability when they have certain impairment in normal life (for example in occupational area) and do not meet criteria for autism spectrum disorder. Not every pervasive developmental disorder have to be autism spectrum disorder!

PDD tends to be similarily disabling as intellectual development disorder (IDD has diffrent level of severity from mild to profound, PDD also can have different levels of severity), both PDD and IDD last since childhood and are persistent, they can't be "generally cured" by meditations like, for example, depressive disorder, there are no remissions in PDD and IDD.

I would say that I definitely have a PDD but it differs clearly from stereotypical image of ASD (even better-functioning ASD). I did not have any speech delay, I think in words, I does not need sameness and predictability in the way in which people with typical autism need them, I do not have splinter skills, I learned how to lie early, I am not so bad in understanding figurative language, I am poor in tolerating unpleasant sensory feelings but I do not have idiosyncratic processing of sensory stimuli (I think that I do not have hyposensitivity or hypersensitivity of senses and I think that I have never experienced sensory overload(!))). I even have symbol 12-C (along with an other symbol, 02-P) on my ruling of moderate (not mild, but also not (the most) severe) level of disability.

People have varying amounts and intensity of autistic traits. How many and intensely one has to have these traits to be considered autistic is subjective and has changed radically over the years. If you are close to a subjective line be it enough traits to be autistic, enough sexual attraction to ones own sex to be considered bi sexual, or even being born in a year near a subjective generational divide it is going to cause difficulties for you. Yet we need to draw line a line somewhere, accepting that everybody is autistic renders the concept useless.

Logically having more autistic traits and having them more intensely makes you “more autistic”. Also by definition “less autistic” is not the same as “not autistic” but we pretend it is for a number of social and political reasons. The long history of “less autistic” being othered or being dismissed, as a very small minority any type of dividing us hurts our cause. People take offense to “less autistic” because of often justified fears of being judged as “not autistic enough” or even “not autistic”.

Well...being NT is like being "Goy". And autism is a spectrum. Like Judaism. You can be Orthodox, Conservative, or Reform. Level 1 autistics are "reform", level 2 are "Conservative", and level 3 are "Orthodox".

OK, I'll be serious for once.

This is where functioning labels ARE useful and DO exist. Usually high-functioning Aspies do a better job at masking and can come across as NT, how that drains them on the inside is a different thing but the way they can carry out day-to-day tasks and communication is to do with being high-functioning.
Moderate-functioning is a bit of both; the Aspie may be able to do certain things on certain days but can only mask for limited times, also their symptoms show a bit more like they might flap their hands in front of people or lack tone in their voice, and their functioning may fluctuate depending on their current state of mind.
Low-functioning Aspies are less likely to cope in most situations and may need support or care their entire lives. Intelligence doesn't always come into it, as some low-functioning Aspies might have a better IQ than me, but usually they have very minimal social and communication skills that they may not be capable of learning.

But it's not as black and white as that, it's just a rough idea of different types of autism.

(Ps. In this post Aspies = all autistics)


That's how I see it.

Maybe someone should start a thread asking what your diagnosis was (where you are medically considered to be on the spectrum), then ask questions about your daily functioning and social skills. Just to see how different people answer and to see if there are any patterns.

Yep....There will be a DSM-VI---some day.

LOL....it really was much easier pre DSM-IV. There was only one "autism," and it had very definite symptoms. The Spectrum idea didn't take hold until the 90s.

I'm fairly comfortable with no line at all. To me, everybody has ASD, but some have so little ASD that you'd need a microscope to find it. But it's still there. What a person considers negligible depends on how they feel about the matter and what they're trying to do. It does make some things easier to think about if you use reductionism, but it's wise not to forget that in doing that, to some extent you're ignoring the truth.

You know, whenever someone says "I think I have teeny-weeny, mild case of Asperger's," it makes me pause. Since Asperger's is already on the "milder" end of Autism, extremely mild Asperger's may as well be NT. But I suspect some of these people are on the spectrum, but can't fully accept it. They're testing the waters by saying, "I'm practically normal, except..." then go on to list why they are rather autistic.

In contrast, actual NTs typically tend to say things like, "Everyone feels that way sometimes..." not realizing we feel that way more often than not.

I do not believe a neurotypical can be a little bit autistic, allow me to explain?

I read somewhere that the traits of autism develop when there is a neurological problem in the brain, maybe related to nerve function or synaptic conditions. What happens is that the brain "rewires" itself into an autistic configuration, so to speak, as it tries to adapt to the underlying neurological issue.

So there are several reasons why autism is so heterogeneous:
- One is that there are many different neurological problems which can cause autism, and some may affect the nerve signalling more than others and hence lead to a greater degree of autism. In severe and non-verbal autism, for example, it may be that the rewiring is quite extreme but still not enough to fully compensate enough for the underlying neurological issue.
- Another reason for the heterogeneity is that, although the "rewiring" tends to occur in enough of a pattern to form a recognisable disorder (i.e. autism), there are individual differences in the details of that rewiring. Some autistics have connections between senses for example (synaesthesia) while others do not.
- A third reason is that individuals vary in their personalities, intelligence and aptitudes, which means that some may be better able to compensate for their autism by learning work-arounds and/or masking difficulties than others. So even with the same underlying neurological issue, autism presentation and behaviours will vary.

So my opinion is that there is huge variation amongst autistic people in the degree and presentation of their autism, and it is truly a wide spectrum. I also believe there is some overlap with the neurotypical spectrum, in the degree of autistic behaviours that individuals might exhibit. That is, when people score around, say, 30 to 35 on the AQ, we cannot be sure based on that score alone whether they have autism or not.

However, if as I believe there is always an underlying neurological issue involved, I do not believe that neurotypicals can be "a little bit autistic". Either their brain was affected by an underlying neurological issue or it was not. So even if neurotypicals have personality traits which overlap with autistic traits to some extent, that does not make them autistic. I believe the diagnostic criteria have been developed over time with intent to capture the particular pattern of traits associated with autistic brain rewiring.

It is always debatable, though, whether diagnostic criteria based on behavioural issues can be reflective of underlying neurology. It seems to me that in the old days pre-1990s, only those with more severe traits were diagnosed as autistic - but since the 1990s there has been greater recognition of the spectrum nature of autism and adjustment of the criteria to include those with less obvious traits. However, it seems to me that the same diagnostic criteria might inevitably include some neurotypicals within the diagnosis due to that overlap.

But perhaps overdiagnosis is no bad thing? For myself, with Asperger-type autism, I wonder sometimes if the autism diagnosis truly fits me or whether I might just be at an extreme in terms of my personality traits, so that I lie within that overlap zone. But I know that my autistic traits, whether true autism or not, cause me many difficulties in life and am very grateful to have the opportunity to be included in fora such as this, and for the usefulness of the autism label in explaining to others the oddities of my behaviour.