Some people make it up

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I agree with this. And that is why I am worried about the widespread perception of this based on conjecture. For a lot of my life HFA was not well known, it was believed to be people refusing to grow up, making excuses etc. Progress was made, people were helped. Because of this perception we seem to be going back to the way it was based on conjecture. Yes I do have a dog in the hunt (as do you), If this is a significant issue we have to deal with it, but I do not feel like going back to the way it was based on conjecture or the probability that a few people are faking themselves or others.

You first.

Oh wait, this isn't a game with turns. OK, I only have a little bit here and some of it is old. But Wendy Chung, a geneticist actively researching this topic, seems to have drawn similar conclusions from data: the increase is due to an changes in diagnostic practice rather than an actual increase in cases or the efforts of large numbers of non-autistic individuals to deceive diagnosticians.
http://blog.ted.com/2014/03/20/what-we- ... t-ted2014/

Some support for the idea that part of what we are seeing is a movement of people from one diagnostic category to another:
http://pediatrics.aappublications.org/c ... /1028.long
http://blogs.discovermagazine.com/crux/ ... yrsL61dU1A
http://www.ncbi.nlm.nih.gov/pubmed/1838 ... d_RVDocSum
http://ije.oxfordjournals.org/content/38/5/1224.short
link to a related abstract

There is a Canadian study that says "diagnostic substitution" isn't what is happening because it on accounts for up to 1 in 3 diagnoses in Canada! Amazingly gymnastic logic, there.



I think this is a profoundly irrational argument. Why does the existence of some people who seek the diagnosis but don't have autism put the diagnosis of other people "rightly" into question? Does Munchausen's by Proxy put all pediatric illness into doubt? Naturally, not. Logically not. It doesn't follow.

Beyond the simple logic of the situation, most people don't know enough about any of the issues involved to have any opinion about this whatsoever. The people who suggest that autism is not a real diagnosis, or doesn't make any difference are ignorant. Why assume that information somehow strengthens their position in some way? it wasn't formed on the basis of information in the past. Why would they change practices now?

If I might paraphrase their supposed argument: "there is a theory out there that there is nothing really wrong with you. So I get to treat you badly and not feel bad about it." This isn't a rational argument. It's a nasty character revealing itself.



I think the emotion flows from exactly the idea that quoted: "The difference is that it makes it harder to be taken seriously." People don't like it when it's suggested that they are faking. They don't like not being taken seriously. This is something you seem to understand, unless I misread you.


That has always been true. I suspect that the very rapid advances in genetics an brain imaging that interested parties can read about daily will change this.

But the bigger issue for me is this: given a paucity of data, why assume that there are a great many successful liars and incompetent diagnosticians out there? This seems like a perverse projection of imagination onto the world.

I understand that some people are concerned about the cost of care and hope to save money by denying accommodations and so on.
I hear that some people feel that being part of a larger group of diagnosed people somehow makes them less special--what this has to do with practical day-to-day realities I can't imagine, but there it is.

It seems to me, and there seems to be some evidence pointing this way, that a very large part of the growth in diagnosis can be attributed to a combination of increasing familiarity with ASDs among diagnosticians and diagnostic substitution. There may be some cases of people who desire to be called autistic but are not, but it seems highly improbable that this might be a significant part of the growth in autism in the last two decades.

What percentage of the growth in autism diagnoses would you imagine comes from such cases? 0.1%? 0.5%? 1%?

Thanks for the links, but I already have stated, and which I think was obvious, that my opinions are my opinions - conjecture. So the "you first" line is unnecessary.

But a lot of this is subject to interpretation, this psychiatrist has a different view for example: http://www.project-syndicate.org/commen ... generation - http://www.huffingtonpost.com/allen-fra ... 37009.html



Maybe I should have worded my post differently. But yes it still gives some credence to those beliefs that it's over-diagnosed, especially if the diagnostic process is flawed. And even if it isn't statistically relevant now, depending on how you interpret the increase, isn't there a possibility it could be in the future?



I'm not saying it was. Are strawmen your thing? I just think there is some misdiagnosis and over-diagnosis now, in these times, more recently. I already have made a post about this elsewhere. I don't think what you're saying. I'll try and be more precise in the future.



And again....



And such a thought process could be given some credence by over-diagnosis.



Find in my posts where I used the word/s great, many, droves....this is entirely inferred, but not stated. I think there is a growing trend. And yes it does concern me.

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Last edited by Acedia on 20 Mar 2014, 3:42 pm, edited 2 times in total.

The emotion is secondary to the conjecture. It's what I think, and it's sceptical, but it does make me concerned.



I agree.



Agree.

So the idea is that there is someone pretending to have autism, but who doesn't really and that person's good social cognition and communication skills are going to negate the many experiences people have of people who very obviously do have autism...?

I find this hard to believe. In my town, there are a number of people who have classic autism. They flap. They spend a huge amount of time in repetitive activity in the town pool. They are non verbal. When they engage you, they don't make eye contact. No amount of flim flam by fakers is going to change the impression those people make. That is what autism means, to most people.

When I (naively) called my insurance company to try to find out how to pay for diagnostic services (they don't) and told them what I was asking about, the people on the end of the line were suddenly really sorry for me and began to speak in kind tones and simple language, as though I was a child. This despite the fact that I have a large vocabulary and attended top universities. Nothing about the content of my clear speech did much to change their impression of what autism means.

I don't see how this small group of highly effective communicators is supposed to have the ability to put a dent in the Rain Man impression that dominates today.

I don't understand what the Rain Man thing has to do with anything. Why can't people who mistakenly believe that they have some form of high functioning autism that doesn't fit the Rain Man stereotype, but don't ackshuly have any form of autism and have good social cognition and communication skills of neurotypical to be vocal and influential negate the eggsperiences of people who ackshuly have autism but don't fit the Rain Man stereotype or non-verbal severe stereotype that most people have in their minds?

I have noticed that people with good social/communication skills and able to verbalize emotions and have rapport with others are listened to and have more influence and their idears are put into action more than people who are unskilled in these areas, which are the areas that autistic people generally have much lesser abilities.

Sorry--I did not express that with sufficient clarity. What I mean is: the Rain Man image is SO strong it dominates everything else in the popular imagination for everyone who doesn't have a reason to educate themselves more deeply in the subject.

How does this negating take place? I can see it if there were two people in a small group setting, one with autism and one claiming autism but without any real symptoms. The more socially skilled impostor would naturally form better connections with the NTs and be more persuasive in their arguments than the less socially skillful autistic person... in that context, I can see the thing you describe. But I don't see that having any ability to change the perception of autism on a wider scale, which I thought was the idea? Or did I misunderstand?

Naturally, a person who can influence and persuade others will be more effective in getting their ideas executed by a group. But I don't see how their false self-identification as autistic has an impact on this? If anything, I think that people tend to be more dismissive of the ideas that come from a person they believe is autistic because of unconscious prejudices they hold. I don't see how they would gain some kind fo advantage by associating themselves with the label.'

Sorry if we are talking at cross-purposes there, I am trying to make this fit in with the rest of the thread and I realize those ideas are not yours...

I agree, and this was exactly my point about faking ADHD, that the person could only succeed at faking it around people who don't really understand the disorder. And unfortunately a great many people, including doctors, psychologists, and psychiatrists, don't really understand ADHD, just as many also don't understand autism or Asperger's.

But I think the key difference is that professionals who are ignorant about ADHD are more likely to be supportive of an informal diagnosis and prescribe medication (perhaps, simply because they can readily prescribe medication for it). Some even consider the person's responsiveness to medication to be "good enough" as a diagnosis (my GP did) without doing a formal evaluation. Whereas those who are ignorant about autism are more likely to be skeptical or suspicious or downright dismissive of an adult who asks to be evaluated for autism.

It's possible, due to lack of self-awareness and/or lack of social cognition that people might be unaware of their social difficulties. I was unaware of them until they were pointed out to me, or I noticed in situations (after my diagnosis) where I was completely failing to communicate what I was trying to say. When I had my first evaluation for disability, the evaluating psychologist indicated that I had what she considered to be severe social impairments. When I was diagnosed, the notes regarding my diagnosis noted several instances of social cognition and communication failure.

I'm not saying it's like that in every case, but it is possible to simply not know how bad one is at communication and social cognition, especially when the system one would use to analyze their social cognition and communication is impaired.



Which objective tests? I am suspicious of the word "objective" because it is frequently used to grant certain kinds of subjectivity an objective perspective so as to weigh its value as greater than others.

People who are not autistic but believing and saying that they are (or not believing that they are and faking autism outright) contribute to misinformation about autism by representing their eggsperiences as autistic eggsperiences, and sometimes they try to redefine autism to fit themselves when they have different disorder or are neurotypical but having issues in life that make them think that they have autism and wanting to have autism as eggsplanation for issues, but without having key traits of autism.

I have poor social cognition, and worse before I knew that I was autistic, and thinking that I was able to pick up on what people are thinking and feeling was not in the realm of possibility for me to think, as I wasn't aware that there was any picking up to be done. The people I am referring to posting that they don't have key traits of autism are aware of these things and say that they perform them in real-time, face-to-face interactions, so I don't believe the idear that they have poor social cognition that makes them think that they have good social cognition, when they are able to state what good social cognition is.

Objective tests for autism are in development, but not yet available for diagnosis. These would be tests on a computer or through automated system with person doing tasks and numerical results from a few stats to complex models of brain functions and may include brain scans, but cognitive/behavioral tests are less costly.

Yeah I hear you but the problem for me if I don't think there is one true definition of autism maybe when we get the brain scans there will be more likely it will be just as complex as how nt's are defined they're all different but their still NTs.

I don't fall into the category myself of claiming that I perform anything like that in real-time face-to-face interactions (I don't think you said that, but since I used myself as an example it seemed useful to add), but rather my point is that people can believe they have skills they do not. Your experience of autism is yours, but it's not everyone's, and I have encountered other (diagnosed) autistic people who claim to have social cognition, sometimes claiming they have better social cognition than other people around them. That doesn't mean they can do it for real,.

I remember getting into a huge argument with an acquaintance once because he asserted that true communication is impossible online because a very high percentage of communication is nonverbal. I didn't believe this to be the case because I get more out of communication online than off (offline has too many variables and confounding factors for me). I also thought that communication meant "stating what I meant and intended to convey" and didn't give it much thought beyond that. Perhaps that's why I had a tendency to get into arguments that usually involved my own confusion and frustration at people reading things into my words and having to spend more time saying "No, I never said that. I said something else" than actually advancing the discussion. Part of my problem too was not understanding that other people actually had different "social cognition" than I did. I simply assumed that on some level everyone was like me.

Part of why this got my attention is because of our past discussions about what you called additional interpretations with regards to specifically identifying prejudiced attitudes through certain kinds of language, but that's not applicable for me in a real time discussion. I don't mean I thought you were referring to me. I just meant your statement reminded me of those conversations.



Okay, that's interesting and not at all what I thought you meant. I'm used to people referring to human professionals as objective, so I didn't think to extrapolate to automated systems and computers.

Last edited by Verdandi on 20 Mar 2014, 9:57 pm, edited 1 time in total.

@Jenisautistic-The thing is ASD is a disorder so even though people with ASD can be very different from one another they must still have symptoms and impairments in common. The "if you've met one autistic , you've met one" idea is just that there is variation within the group of people diagnosed with ASD. There is variation in any group really. If you've met one schizophrenic , you've met one schizophrenic, if you've met one ADHDer , you've met only one but two people with any disorder will still have impairments in common. They have the diagnostic criteria for the disorder in common.

That "if you've met one person" mantra is quite useful, especially when running into dogmatic definitions of what a person must be like based on diagnosis. For example people who say "I do not experience that particular thing the same way you do, so you're doing it wrong." This is an issue I've seen come up in relation to a few different disorders.

With autism, it seems more pervasive. Like telling people I knew I was autistic, they'd bring up 10 year old boys in comparison to me as (at the time) a 41-year old woman. They don't see what I was like at 10, and they don't account for gender. They also seem to not understand that while autism is a developmental disorder, it's not a matter of just "not developing" after a certain age.

Last edited by Verdandi on 20 Mar 2014, 9:56 pm, edited 1 time in total.

This is what I meant to say also what I meant was people have different ways of having the same symptoms if you know what I mean like they have the same symptoms but they show them in different ways and forms .

Last edited by jenisautistic on 20 Mar 2014, 10:03 pm, edited 1 time in total.

I really think a lot of people see themselves as suave and kind and the best ever to be around, never missing a social beat, but in reality they have no idea.

I know some people like this who are not liked or respected but they just don't know. They iconize themselves and can't see beyond that.