What is the Validity of Autism Diagnoses?

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Nowadays more and more people are being diagnosed with high functioning autism and people who are at all socially awkward or struggle in other areas of their life are looking for answers from these kinds of tests. I also know someone who is mildly autistic - or has been labelled with high functioning autism - and she just uses it as an emotional crutch. We were playing a word association game where everyone has to guess what things could be associated with whatever it is that you are describing within a given time frame, and she was giving long elaborate descriptions and then shouting "stop interrupting me" when people were trying to guess what it was before the time was up. If people get upset with her, she says, "it's not my fault, I can't help it, I'm autistic", she has no life, she doesn't go to the gym and exercise or even shower as much as she ought to, complains that she's never had a boyfriend and whenever I see her she is always finding something to complain about rather than talk about something positive. I want to tell her that the problem is not so much that she is autistic as much as it that she's f*****g boring.

I know that when I was in school I had a very vague (unofficial) diagnosis of language impairments and some possible, mild autistic traits but this was never confirmed officially and I feel that it became a convenient label for teachers to just pidgeonhole me as someone with asperger's if I was ever difficult to manage. It became a self-fulfilling prophecy and I kind of believed that I had to act somewhat obsessively and be slow on exams and that kind of thing just because it was what was expected me. My parents insisted that I had to have an LSA and the school made her sit next to me. I became more problematic as a result, didn't get on with her because of the way it made me look to the other children and couldn't focus on lessons either so my concentration became worse and worse. If I ever brought it up with my mum, her attitude would always be, "stop self-pitying and blaming your problems on everyone else" and "of course you need all of this support, look at how much you struggle". And I would be made to feel guilty because she was doing all of these things to 'help' me and I wasn't being appreciative of the support. She stopped me from going to school for exams because they wouldn't sort out a separate room and extra time for me and the other kids resented me for that and the fact I had a helper. I was a weirdo whether I liked it or not and yeah, of course, I acted in strange, sometimes desperate ways to make friends, as a result but that was because I was made to feel isolated and alienated from everybody. I was at a grammar school where people liked to poke fun at my lack of general knowledge and memory and concentration impairments amongst other things and it's effected the way I interact with people as an adult because now I don't feel like I can even follow basic small talk as a result of constant attacks on my self-esteem throughout my life and feelings that I have all these problems with language and communication and body language.

Everyone on T.V. who had asperger's always stereotypically had really nasal voices; they were obsessed with 'facts', not opinions; their interests were really geeky, obsessional and they would bore you with their technical expertise in these subjects and a host of other things. I was the polar opposite of this, or at least I felt I was, even if I could be a bit aspergic on a bad day or socially awkward because of the things that had happened in my life.

So my question is, do these diagnoses sometimes do more harm than good? Isn't everyone 'autistic' to some smaller degree? People that have been labelled with asperger's as a teenager have learnt to overcome lots of their difficulties and be very social and very successful people. People that you wouldn't believe had asperger's if you met them face to face. Is there some inherent, magical world of communication that people with asperger's are missing out on? I can see when someone is friendly, open and communicative and I can see when someone is closed or doesn't feel like speaking to me. If I overanalyse things it is because I am hyper cautious since in the past I've been told I have difficulties with these things but in truth, I just don't believe it and I don't believe that there is anything particularly different about me to anybody else. I think I'm just a normal guy who's been told he was different and so it became a self-fulfilling prophecy.

No, I don't believe everyone is autistic. What is true is that everyone is a person. If the label is bothering you, drop the labels and see people as people, and let them know this. Even if they use the label, you can respond to them as a person, with respect for them and yourself.

any diagnosis is simply shorthand for a certain constellation of symptoms, usually severe enough to reduce our ability to function to a significant degree. sure, every diagnosable disorder is simply an exaggeration of traits all human beings share, or deficits in certain abilities. but not all share to the degree that it impairs their ability to function past a certain point. that's when a diagnosis comes in handy - not because it is "reality" but because it helps (mainly others) to understand how to treat us / support us. as an Aspie with PTSD I have different needs and respond to different treatments (to a point) from your average introverted NT with PTSD. helps explain why some of my comorbid mental illnesses have been so intractible over the years even though i've been highly motivated in treatment - typically takes me 4-5 times as long to respond, if i do.

however, the problems you pointed out are precisely why many clinicians are schooled to 1) make the minimally severe diagnosis possible and why some clinicians try to avoid diagnosis altogether - because so many people tend to over-identify with the diagnosis. that's why a good clinician is careful to say "a person with autism/Asperger's syndrome" rather than "an autistic person." if the symptoms change or new symptoms are detected, guess what? your diagnosis may very well change completely. Diagnosis can help us try to understand ourselves, help ourselves, and help other people help us. But it is very provisional and should always be taken that way.

So yeah, sometimes people use any diagnosis as an excuse. Or, they may be very unhappy and resentful about having a given issue and be working through that anger and grief. That's the risk of getting a diagnosis. However, if they didn't have an explanation and were still struggling with the issues attendant to, say, Asperger's, would they be better off? What i ended up doing was internalizing all the judgement, criticism, and failure as reflecting on my personal worth and character, which was incredibly demoralizing and damaging. Was I any better off having failed to get a diagnosis early in life? I don't really think so.

I try not to use Asperger's to make excuses but the bottom line is, sometimes it is a *reason* why i behave poorly under certain stressors, and it's not either fair to me to fail to recognize that. I'm trying to use the information to care for myself better, learn my limits, find a way to live my life more functionally by accommodating same more effectively. Everyone has limits; mine are just a little different from some others. Nothing is more frustrating than to have someone tell me it's a choice to be, say, overwhelmed by too many people or loud noises or sudden changes in my schedule. No, it's not.

The hardest part is training the people closest to me to understand it's not always within my ability to control how i react when they continually pressure me to react like an NT and refuse to/can't acknowledge, accept, or understand my differences. Then i am left with the choice to reject the few relationships i have to anchor me, or suffer through the pains of trying. Fortunately at least two people in my life are starting to finally "get" it and give me space when i need it.

Thank you for taking the time to write a reply, Opi. I think I have the opposite problem of people thinking I need time to myself when in actual fact, I would be grateful for the company.

My question is, how would it be known that most people do not have some degree of autistic spectrum disorder? Are there visible neurophysiological differences between the brain structures of individuals with high functioning autism and neurotypical individuals? It should be noted that by no means am I questioning the validity of classic autistic spectrum disorders. However, it seems that neurotypical individuals can have obsessional interests, experience misreading of social cues and possess other traits that could be characterised of mild autism, while individuals with asperger's can also learn to change these traits, should they become a considerable inconvenience.

i suggest you read the diagnostic criteria for each of the diagnoses you mention and decide for yourself.

the difference is a particular constellation of symptoms and the degree to which they impact function.

That was a very helpful and impressive response opi.
I observe here often on WP, a very human resentment
from those more isolated in the spectrum towards
those less so.........suffering is relative.

I do find that people who want an excuse will find one. They don't need a diagnosis, and if they don't have one, they find something or someone else to blame.

I also think sometimes people are quick to take reasons as excuses...when the person stating the reason has no intent of justifying anything and is just trying to explain why they did what they did or reacted that way or whatever.