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Acedia
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08 Apr 2014, 5:34 pm

Sarah Walker's radio interview with Uta Frith.

Fast forward to 01:28:06 http://www.bbc.co.uk/programmes/b03z9kdk

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Rocket123
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08 Apr 2014, 6:28 pm

Acedia wrote:
I think wrong self-diagnosis can happen because people without autism who write about autism try to relate it to something they can understand. Does that make sense?


Makes sense to me. Though, I am now wondering how people without autism can skillfully diagnose someone who is high functioning. What obvious signs do they look for (other than conducting neuropsychological testing)?

Acedia wrote:
As you can see from the documentary people with autism are not just shy. But their social difficulties are obvious.


For me, the social difficulties for some of the people were obvious. But not for all.



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08 Apr 2014, 6:37 pm

LupaLuna wrote:
F**K the BBC for there god damn region restriction.



Lving with autism bbc



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08 Apr 2014, 7:39 pm

Acedia wrote:
I think wrong self-diagnosis can happen because people without autism who write about autism try to relate it to something they can understand. Does that make sense?

Like when autistic people rock back and forth, NTs assume they are doing it because they are anxious, this is because they can relate to that, even if the rocking that people with autism do is mechanical and sustained, and doesn't even look like the subtle rocking people do when sad or anxious.

Many people on here post things like they think they might flap, but then go on to describe normal physical expressions of emotions. People confuse their interests and hobbies with the narrow and circumscribed interests people with autism have. And people confuse the normal sensory annoyances they have, like the hatred of certain sounds, with the sustained sensory problems that people with autism have.


Although there is another thing that people do here, which is demarcate particular behaviors done in particular ways as the only way autistic people would do them. Like, autistic people can and do rock in response to anxiety, and can and do flap in ways that might be perceived as "normal expressions of emotions" at least in description but perhaps not so much in reality. Or talking about sensory issues might be confused with "normal sensory annoyances" even if the description is not intended to communicate that, and the experience is quite atypical.



Acedia
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08 Apr 2014, 7:49 pm

Verdandi wrote:
Although there is another thing that people do here, which is demarcate particular behaviors done in particular ways as the only way autistic people would do them. Like, autistic people can and do rock in response to anxiety, and can and do flap in ways that might be perceived as "normal expressions of emotions" at least in description but perhaps not so much in reality. Or talking about sensory issues might be confused with "normal sensory annoyances" even if the description is not intended to communicate that, and the experience is quite atypical.


Yes, you're right. And figuring out yourself and explaining it can lead you to describe it in a way you think others may understand. And self-reflection can be hard. However, I do think people look for traits in their personality and give an autistic spin to them, if that makes sense.

It also leads to others dismissively saying, "well, everyone does those kinds of things", or "experiences that".

Rocket123 wrote:
Makes sense to me. Though, I am now wondering how people without autism can skillfully diagnose someone who is high functioning. What obvious signs do they look for (other than conducting neuropsychological testing)?


I don't know really. It's not perfect.

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08 Apr 2014, 8:01 pm

Acedia wrote:
Verdandi wrote:
Although there is another thing that people do here, which is demarcate particular behaviors done in particular ways as the only way autistic people would do them. Like, autistic people can and do rock in response to anxiety, and can and do flap in ways that might be perceived as "normal expressions of emotions" at least in description but perhaps not so much in reality. Or talking about sensory issues might be confused with "normal sensory annoyances" even if the description is not intended to communicate that, and the experience is quite atypical.


Yes, you're right. And figuring out yourself and explaining it can lead you to describe it in a way you think others may understand. And self-reflection can be hard. However, I do think people look for traits in their personality and give an autistic spin to them, if that makes sense.

It also leads to others dismissively saying, "well, everyone does those kinds of things", or "experiences that".

---


Yep, very true.

When I was first working through this stuff, trying to understand it, I thought all the stuff I did/experienced was normal. Having a therapist helped a lot in this regard, because she'd say "No, most people don't do or go through that." There was a lot of sensory stuff I didn't even consciously grasp as sensory.

But yeah, people can try too hard, even autistic people can do this, especially early on. It's easy to try to make everything fit, when everything doesn't need to fit. Just "enough" needs to fit to qualify for a diagnosis, but every single thing need not be autistic. And if enough doesn't fit, it's better to accept not being autistic instead of continually trying to fit one's self into a diagnosis that fails.

I don't really disagree with you, I just got hung up on details.



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09 Apr 2014, 7:04 am

Acedia wrote:
Like when autistic people rock back and forth, NTs assume they are doing it because they are anxious, this is because they can relate to that, even if the rocking that people with autism do is mechanical and sustained, and doesn't even look like the subtle rocking people do when sad or anxious.


But autism is diagnosed based on observations of a persons behaviours, not on the reasons behind the behaviours.

If someone displays all the behaviours related to autism, then they HAVE autism, whatever the reasons behind those behaviours. This is how modern psychiatry works.

You cannot claim that someone who acts in every way like an autistic person actually isn't really autistic because they are behaving like that for the wrong reasons. Such a distinction doesn't exist.



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09 Apr 2014, 7:17 am

foxfield wrote:
If someone displays all the behaviours related to autism, then they HAVE autism, whatever the reasons behind those behaviours. This is how modern psychiatry works.

You cannot claim that someone who acts in every way like an autistic person actually isn't really autistic because they are behaving like that for the wrong reasons. Such a distinction doesn't exist.


That is not true. For someone to be affected they need to show certain impairments, not everyone with autism displays the same type or levels of behaviour. This is an issue with autism being a spectrum condition, it's not black and white, there is a large grey area between where many people like myself find themselves.



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09 Apr 2014, 9:40 am

neilson_wheels wrote:
foxfield wrote:
If someone displays all the behaviours related to autism, then they HAVE autism, whatever the reasons behind those behaviours. This is how modern psychiatry works.

You cannot claim that someone who acts in every way like an autistic person actually isn't really autistic because they are behaving like that for the wrong reasons. Such a distinction doesn't exist.


That is not true. For someone to be affected they need to show certain impairments, not everyone with autism displays the same type or levels of behaviour. This is an issue with autism being a spectrum condition, it's not black and white, there is a large grey area between where many people like myself find themselves.


I think that's not quite right because the definition includes the requirement of impairment.

You can't (or should not) be diagnosed if you meet, for example, the DSM 5 A, B and C criteria but not criterion D: "Symptoms together limit and impair everyday functioning." 
If you have the persistent deficits in social communication and social interaction across contexts and the restricted and repetitive patterns of behavior, interests or activities and these limit and impair everyday functioning, and these are not better explained by another cause, then anyone who says you are not autistic is a crackpot.

The grey area would seem to be at the edges of not requiring any support, not actually limiting and impairing everyday functioning.

But seriously, if you can't get on in life without help because of criteria A and B issues not caused by some other condition, it's autism.

This seems helpful in clarifying things: http://depts.washington.edu/dbpeds/Scre ... Guidelines)Feb2013.pdf



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09 Apr 2014, 9:56 am

Verdandi wrote:
Acedia wrote:
I think wrong self-diagnosis can happen because people without autism who write about autism try to relate it to something they can understand. Does that make sense?

Like when autistic people rock back and forth, NTs assume they are doing it because they are anxious, this is because they can relate to that, even if the rocking that people with autism do is mechanical and sustained, and doesn't even look like the subtle rocking people do when sad or anxious.

Many people on here post things like they think they might flap, but then go on to describe normal physical expressions of emotions. People confuse their interests and hobbies with the narrow and circumscribed interests people with autism have. And people confuse the normal sensory annoyances they have, like the hatred of certain sounds, with the sustained sensory problems that people with autism have.


Although there is another thing that people do here, which is demarcate particular behaviors done in particular ways as the only way autistic people would do them. Like, autistic people can and do rock in response to anxiety, and can and do flap in ways that might be perceived as "normal expressions of emotions" at least in description but perhaps not so much in reality. Or talking about sensory issues might be confused with "normal sensory annoyances" even if the description is not intended to communicate that, and the experience is quite atypical.


I think this is at least partly related to the aspect of selective attention sometimes called the "Baader-Meinhoff phenomenon"-
http://www.psmag.com/culture/theres-a-n ... non-59670/

It is often best to have outside perspectives to check your perceptions at this stage.

When I was wondering about this I realized that a former boss had been dropping hints that she believed I was on the spectrum for years, though I had been too obtuse to pick up on that. I called her to verify this impression and she told me many things that she (also diagnosed with Aspergers) had observed. In many cases, they were behaviors that I was quite unaware of.



Last edited by Adamantium on 09 Apr 2014, 10:22 am, edited 1 time in total.

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09 Apr 2014, 10:04 am

Adamantium wrote:
neilson_wheels wrote:
foxfield wrote:
If someone displays all the behaviours related to autism, then they HAVE autism, whatever the reasons behind those behaviours. This is how modern psychiatry works.

You cannot claim that someone who acts in every way like an autistic person actually isn't really autistic because they are behaving like that for the wrong reasons. Such a distinction doesn't exist.


That is not true. For someone to be affected they need to show certain impairments, not everyone with autism displays the same type or levels of behaviour. This is an issue with autism being a spectrum condition, it's not black and white, there is a large grey area between where many people like myself find themselves.


I think that's not quite right because the definition includes the requirement of impairment.

You can't (or should not) be diagnosed if you meet, for example, the DSM 5 A, B and C criteria but not criterion D: "Symptoms together limit and impair everyday functioning." 

If you have the persistent deficits in social communication and social interaction across contexts and the restricted and repetitive patterns of behavior, interests or activities and these limit and impair everyday functioning, and these are not better explained by another cause, then anyone who says you are not autistic is a crackpot.

The grey area would seem to be at the edges of not requiring any support, not actually limiting and impairing everyday functioning.

But seriously, if you can't get on in life without help because of criteria A and B issues not caused by some other condition, it's autism.

This seems helpful in clarifying things: http://depts.washington.edu/dbpeds/Scre ... Guidelines)Feb2013.pdf


Hello Adamantium, I agree with what you are saying. I was trying to reply to the post in response to rocking but may have edited it too much. While I see rocking as a behaviour, and a clinician would also view it that way, it is obviously an impairment to interaction in the "normal" world. I feel there is a lot of confusion between clinical speak and everyday understanding.

I also don't read much into the DSM in regards to this thread. Apart from the fact that DSM is not necessarily effective outside of America, surely the research, highlighted in the programme, ultimately determines diagnosis criteria, not the other way around.

Edited to try and avoid more confusion.



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09 Apr 2014, 10:21 am

neilson_wheels wrote:
Hello Adamantium, I agree with what you are saying. I was trying to reply to the post in response to rocking but may have edited it too much. While I see rocking as a behaviour, and a clinician would also view it that way, it is obviously an impairment to interaction in the "normal" world. I feel there is a lot of confusion between clinical speak and everyday understanding.

I also don't read much into the DSM in regards to this thread. Apart from the fact that DSM is not necessarily effective outside of America, surely the research, highlighted in the programme, ultimately determines diagnosis criteria, not the other way around.


I am sure our views are probably very close on this and I was just getting hung up on a particular issue. Your point on rocking is clear.

Incidentally, I think the thinking behind the DSM 5 is more influential than it might seem, even in places that use the ICD. I believe the idea that Aspergers is best viewed as part of the autism spectrum predates the DSM 5 change and is widely accepted in places where an Aspergers diagnosis is still given, and I think the inclusion of sensory issues (near and dear to me because they have been such a big part of my life and I am somewhat self-centered) is widely accepted as a relevant part of the diagnostic picture, even though that criterion was not included in the DSM IV/ICD 9.

The ICD 9 299.8 diagnosis is roughly the same as the DSM IV 299.80 diagnosis, and the ICD 10 F84.5 contains similar thinking to the DSM 5, although the Aspergers name is retained as a distinct part of the spectrum and the "No childhood delay in language" remains the differentiating criterion.

It is amazing watching the archival footage in the film, how little people understood about any of this in that era.



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09 Apr 2014, 10:31 am

Adamantium wrote:
You can't (or should not) be diagnosed if you meet, for example, the DSM 5 A, B and C criteria but not criterion D: "Symptoms together limit and impair everyday functioning."

If you have the persistent deficits in social communication and social interaction across contexts and the restricted and repetitive patterns of behavior, interests or activities and these limit and impair everyday functioning, and these are not better explained by another cause, then anyone who says you are not autistic is a crackpot.

The grey area would seem to be at the edges of not requiring any support, not actually limiting and impairing everyday functioning.

But seriously, if you can't get on in life without help because of criteria A and B issues not caused by some other condition, it's autism.


I did not want to derail the thread from the OP to the common discussion on diagnosis and the DSM but I'm going to comment anyway.

I do have an issue with how the cut off between autistic and non-autistic is decided. It seems many people, especially on WP, want to see that boundary defined and I'm not sure that is possible. Maybe this is just a product of my own rigid thinking and not what I perceive as that of others.

I do fall into the grey area, I have no friends and find it hard to support myself financially, I keep living because I do not have a choice but often do not see the point, I manage to sustain a relationship by living somewhere I would prefer not to. In the past I have been homeless due to my "impairments" and unable to resolve the situation easily. IF I received an official diagnosis I would still be determined to be able to live without support and nothing would change for me. Just to be clear, I'm not looking for this support, I'm now too old and still too stubborn to ask for help.

Sorry, derail over, back on track hopefully.



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09 Apr 2014, 10:48 am

Adamantium wrote:
Incidentally, I think the thinking behind the DSM 5 is more influential than it might seem, even in places that use the ICD. I believe the idea that Aspergers is best viewed as part of the autism spectrum predates the DSM 5 change and is widely accepted in places where an Aspergers diagnosis is still given, and I think the inclusion of sensory issues (near and dear to me because they have been such a big part of my life and I am somewhat self-centered) is widely accepted as a relevant part of the diagnostic picture, even though that criterion was not included in the DSM IV/ICD 9.

The ICD 9 299.8 diagnosis is roughly the same as the DSM IV 299.80 diagnosis, and the ICD 10 F84.5 contains similar thinking to the DSM 5, although the Aspergers name is retained as a distinct part of the spectrum and the "No childhood delay in language" remains the differentiating criterion.

It is amazing watching the archival footage in the film, how little people understood about any of this in that era.


I'm also quite self-centered, and as the DSM and ICD are not relevant to me I take little interest in them.

I also agree regarding the footage and it's a very good comparison to what is available now. I jumped into this thread as I feel it is very important to recognise the work that Uta Frith and others have put in on the subject. I feel it is not necessary to agree with all that is said but without this work many more people would have received little or no help.

We are surfing the wave of autistic realisation, some of us have to fall off of their boards, me included. Hopefully some will ride all the way to the beach and feel the full benefit at some point in time.



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09 Apr 2014, 10:52 am

neilson_wheels wrote:
I did not want to derail the thread from the OP to the common discussion on diagnosis and the DSM but I'm going to comment anyway.
Perhaps I misread the OP, but I think that issue, specifically Uta Frith's views on it, IS what the OP was about.

Quote:
I have no friends and find it hard to support myself financially.

I think this is pretty much what it means to require support.
Some people seem to take the extreme view that the idea is that if you are not dead without help, you are fine. But I believe the diagnostic criteria and the medical thinking behind those criteria, take a more nuanced view. If your ability to function socially and work is impaired because of your symptoms, then you have a problem of clinical significance.

Neurotypical people typically do have friends and typically find it relatively easy (within the parameters of the prevailing economy) to support themselves. Autistic people have to work hard to achieve what comes naturally to others, if they have the capacity at all. Perhaps you are doing so well that you are really on the borderline, or all your traits are subclinical. Perhaps you would fit better in the BAP and get into the territory where Simon Baron Cohen and Uta Frith seem not to be wholly in agreement.



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09 Apr 2014, 10:54 am

Acedia wrote:
Rocket123 wrote:
Makes sense to me. Though, I am now wondering how people without autism can skillfully diagnose someone who is high functioning. What obvious signs do they look for (other than conducting neuropsychological testing)?


I don't know really. It's not perfect.

---

As far as I know, they primarily look for a qualitative AND quantitative imairment in metacommunication (body-language, facial expressions, tone of voice, etc.), plus patterns of rigidity in thinking and behavior. Theoretically chilhood history must be covered, but often done loosly. Typical signs of body-movmets are obseved. Social and communication difficulties (qualitative) must be present at the time of dx, but this is soft-knowledge for the diagnosticians.