A Cure...?

[Fino]

Anxiety and depression are not "part of" autism in my view. Anyone would get anxious and depressed from being treated the way we are treated.

If there were cures then who's going to care about our right to not get abused?

Autism is fine. It's neurotypicals that are hell. Sure, "not all neurotypicals", but when their children bully us it's all "oh, that's what children do", so they do consider that behavior natural. Conformity is too much a part of them for them to consider alternatives, and that's a majority. Maybe we should cure them of that instead.

That's along the line of thinking that I was struggling to articulate.

You also articulated thoughts I had just this morning! Weird! But thanks!

 

[Crossbreed]

Autism is fine.

That means you are not position #1. When it comes to a bona fide co-morbid condition, do you think that a cure/prevention is a worthwhile pursuit, or do you think that they should be embraced as part of one's autism?

 

[Ylva]

That means you are not position #1. When it comes to a bona fide co-morbid condition, do you think that a cure/prevention is a worthwhile pursuit, or do you think that they should be embraced as part of one's autism?

My sensory processing disorder? I don't really want to lose it, because although it causes overwhelm sometimes, it also gives me access to parts of the world that I believe to be closed off to people without it. I certainly have no other explanation as to why they keep denying that it exists.

Alexithymia? …But I literally think that is caused by the gaslighting of the above, so it's not a "good faith" part of my autism as such.

Can't really think of any other common comorbids of autism right now.

More "severe" autism? Maybe if you could turn it into "less severe" autism instead of into neurotypicality. Depends on whether those with it would be willing to experience the world less intensely,or differently than they do.

 

[Crossbreed]

More "severe" autism? Maybe if you could turn it into "less severe" autism instead of into neurotypicality.

The question in this thread isn't about severity levels. It is about whether co-morbid conditions should be considered a fixture of neuro-diversity or an artifact of neuro-psych pathology.

 

[55853]

I'm somewhere between views #1 and #2. I'd need more information to narrow it down further, on which view I'd be closer to. What exactly would this hypothetical cure change and what would it keep the same? Does this hypothetical cure have side effects?

 

[Ylva]

Oh, mutism! I'd get rid of that, I suppose, without side-effects.

 

[Progster]

Firstly, ASD and comorbid condtions like depression, OCD or anxiety are seperate conditions. Secondly, I see no problem with people wanting or seeking a cure to these, or to ASD even if it means that they can function better, are happier and have a better quality of life. After all, I've never come across someone who has said, "I don't want to be cured of my depression. We should embrace it". Most ND people do not want a cure, but if they do want one, then I see no reason why they shouldn't be able to take that option, should they want it. People should be free to make choices about their lives, and that includes whether they accept or pursue a cure or not, but a cure should never be forced upon them unless they are a danger to themselves or to others.

 

[Crossbreed]

I'm somewhere between views #1 and #2. I'd need more information to narrow it down further, on which view I'd be closer to. What exactly would this hypothetical cure change and what would it keep the same?

There are actually two classes of cures/preventatives proposed in this thread.

1. For autism and its attendant co-morbid conditions. No one knows what that might look like.
2. Case-by-case interventions for each co-morbid condition (as in post #4, above). Autism is a neuro-diverse condition, not a form of neuropathy. Quality of life is improved, but the person is still autistic. ASD1 is the cured form of ASD2 & 3.
3. The third view states that co-morbid conditions are integral to one's expression of neuro-diversity, thus it is intrinsic to one's identity. No cure/preventative is even sought.

Using my hypothetical autistic with a co-morbid of Fetal Alcohol Syndrome,

View #1 says if you cure the autism, you will cure the FAC, too (obviously not true).

View #2 says FAC made her ASD2/3. If her mom didn't drink during pregnancy (a preventative), she would have been a healthy ASD1.

View #3 says FAC is just the version of autism that she has. It is part of her autistic identity.

 

[Crossbreed]

Oh, mutism! I'd get rid of that, I suppose, without side-effects.

That's the kind of thing that I am talking about.

 

[55853]

There are actually two classes of cures/preventatives proposed in this thread.

1. For autism and its attendant co-morbid conditions. No one knows what that might look like.
2. Case-by-case interventions for each co-morbid condition (as in post #4, above). Autism is a neuro-diverse condition, not a form of neuropathy. Quality of life is improved, but the person is still autistic. ASD1 is the cured form of ASD2 & 3.
3. The third view states that co-morbid conditions are integral to one's expression of neuro-diversity, thus it is intrinsic to one's identity. No cure/preventative is even sought.

I understand, that's why I'm using the same numbering as you. Use a case like me, someone who has no co-morbid conditions, so view #3 is not being considered.

What are we including in "ASD", and therefore a hypothetical ASD cure?

Is it only the parts that impair functioning (such as difficulty keeping a conversation flowing)?

Is it the above, plus "knock-on" effects (such as difficulty speaking causing strengthened listening ability)?

Is it the above, as well as other parts that meet the criteria, but either do not impair or enhance functioning (such as repetitive interests in my case)?

What parts of my personal strengths and weaknesses are and aren't changing in this hypothetical cure? This will change how I feel about it a lot.

 

[Crossbreed]

What are we including in "ASD", and therefore a hypothetical ASD cure?

Having no co-morbids, you are left with

1. ASD1 is a neuropathic condition and I need to press for a cure, or
2. ASD1 is an alternative healthy state and I need to learn how to roll with it.
3. I don't think that you can pick & choose core qualities to "cure."

 

[55853]

Having no co-morbids, you are left with

1. ASD1 is a neuropathic condition and I need to press for a cure, or
2. ASD1 is an alternative healthy state and I need to learn how to roll with it.
3. I don't think that you can pick & choose core qualities to "cure."

I understand, but what are we including in "core qualities"? What specific traits I have mentioned will or won't be "cured"?

 

[Crossbreed]

I understand, but what are we including in "core qualities"? What specific traits I have mentioned will or won't be "cured"?

I don't really know. I am taking a "black box" approach to this problem.

Look at the traits found in your family line. If it is consistently found in your family, it is probably part of your ASD1. If a trait is unique to you, it is likely to be a co-morbid.

 

[55853]

I don't really know. I am taking a "black box" approach to this problem.

Then I'm really not sure how I'm supposed to answer the question. It's too vague for me to give any sort of meaningful attempt. If ASD is not being clearly defined, how am I supposed to know whether I'd agree to it being cured or not?

Look at the traits found in your family line. If it is consistently found in your family, it is probably part of your ASD1. If a trait is unique to you, it is likely to be a co-morbid.

As stated earlier, I have no co-morbid conditions. What I am instead having difficulty with is separating the traits into either part of ASD, or part of being a human being with strengths and weaknesses. Co-morbid conditions do not factor into this.

 

[Autistamatic]

This may be a long one...

As you might have expected I voted option 2. I do not want for one second to be cured of my autism, but I do wish to see society cured of it's ignorance. Co-occurring conditions are not autism and can be treated separately.

To clarify the classifications of ASD 1/2/3. All designations include co-occurring conditions which may be physical or mental conditions. Anxiety and depression are remarkably common amongst ASD1. Less common but still frequent are ADHD, Dyspraxia, Dyslexia, OCD, various GI problems and more. The presence of at least 1 co-occurring condition is expected and looked for in the current diagnostic process.
The current ASD subdivisions are based on care/support needs.

The thing we must keep in mind about co-occurring conditions is although their presence is considered a facet of ASD by science, they are all conditions which are also experienced by NT people.

Our different brain wiring, including our hyper/hypo-sensitivities is autism. Depression, anxiety, GI problems, IDDs, ADHD etc. are not. They are parallel to our being autistic and in some cases we have a higher likelihood of having these side conditions pro-rata, than non autistic people.

Cures or treatments for these conditions will benefit far more NT people than Autistics and in many cases treatments exist. My anxiety and depression has been treated with SSRIs and (attempts at) therapy. My GI problems have been treated with various drugs to control my acid levels and with anti-emetics. BPD and ADHD have established drug treatments that work for a great many people and so on... None of these is prevention or or cure, but they do make the lives of millions of people more comfortable.

There is a separate debate about whether or not drug companies have the incentive to truly seek cures due to the rolling profits generated by symptomatic control, which I don't want us to go into here, but the fact remains that these conditions are often treatable. If they only affected autistic people the numbers would be so low that the treatments wouldn't exist, or the prices would be astronomically high (fancy a £500 bottle of Gaviscon anyone?)

Unfortunately there is no known cure for IDDs (or Learning Disabilities as they used to be called) and the causes of those are manifold. Foetal alcohol syndrome has already been mentioned, and a huge proportion of IDDs can be traced to lifestyle and environment. Epigenetic changes can alter the male gamete before conception. Pollution, alcohol, smoking, diet, obesity and many other factors can affect the foetus in utero. Short of gene scans of sperm prior to fertilisation and complete genetic scans of the early stage foetus, it will be very difficult to practically prevent many IDDs with environmental causes. Amnioscentesis can be used to detect broad chromosomal information such as Downs and gender, but more precise information such as identifying autism or many IDDs is a very long way off.

Consequently, any attempt to prevent autism by selective termination would be a scattergun approach, akin to breaking eggs with a sledgehammer. Many more viable foetuses would be aborted than necessary since there is such an element of doubt. It must also be remembered that the relevant genes so far identified only point to the potential of autism, not a guaranteed autistic birth. There have been occasional cases of identical twins with exactly the same genome, one of whom has been autistic and the other not. There are also uncertainties because the same gene expressions so far found in autism occur frequently within the general population. The present theory suggests that autism is the result of a large number of genetic expressions which, in certain combinations, may lead to the person being autistic.

When we consider what autism is at it's core - an uneven distribution of sensory and cognitive abilities, the question of a cure becomes even more unpalatable for some. I have mentioned before that we, as autistic people, present "spikey profiles" when we are assessed. Our strengths are matched by our weaknesses, whereas NT people have much more even distributions, as shown in the simplified diagram below.

The theory goes along the lines of each individual being born with a number of individual "skillpoints" (as some RPG players will be familiar with). The typical NT profile is that of a generalist, with the points relatively evenly distributed between dozens of different skill traits. Autistic people have Spikey profiles because their skillpoints are distributed unevenly. Very high in some areas and equally low in others. Most commonly social skills are quite low, but logic, reason, linguistic or artistic skill could be much higher than the average. The extreme case is the savant, who may be quite low across the board but spike extremely highly in a narrow area.

This where the "cure for autism" hits it's biggest problem. If you find a cure or preventative measure, those peaks will drop as the troughs are raised. If you "cure" poor social skills, something else has to give. To answer the question from @55853 above, if you cure our autism, you also cure the attributes so many of us hold dear. Speaking for myself, I may gain social confidence, improve my Theory of Mind and lose my auditory sensitivities, but I would lose my linguistic skill, my sharp hearing and my creativity to pay for it. It is not a price I am willing to pay since it essentially would make me into a different person.

Another thing to consider with the most common co-occurring conditions of anxiety and depression. It has been posited that both conditions are an inevitable result of the pressures we face living in a society that we often have limited understanding of. Many of us face discrimination, hostility and marginalisation. The majority of us are out of work and short of money. Our living conditions may be poor as a result. Those are conditions which would lead anybody, including NTs into such unwanted mental states. It has been observed that autistic people living in better conditions with understanding and accepting people around them suffer less anxiety and depression than those who don't. It stands to reason then, that improved outcomes for integration and employment lead to less co-occurring mental health problems.

 

[55853]

This where the "cure for autism" hits it's biggest problem. If you find a cure or preventative measure, those peaks will drop as the troughs are raised. If you "cure" poor social skills, something else has to give. To answer the question from @55853 above, if you cure our autism, you also cure the attributes so many of us hold dear. Speaking for myself, I may gain social confidence, improve my Theory of Mind and lose my auditory sensitivities, but I would lose my linguistic skill, my sharp hearing and my creativity to pay for it. It is not a price I am willing to pay since it essentially would make me into a different person.

Thank you for answering my question. If that's the case, I agree with you, for myself personally. I can see why someone would still want a cure, however, if they have more difficulty with their weaknesses then I do.

The current ASD subdivisions are based on care/support needs.

This is off topic, but I keep seeing this, and keep wondering. I was diagnosed under the ICD 10 with Asperger Syndrome (and nothing else), which I understand would be ASD1 in the USA? The "social communication" description is a match to me, but the "restricted, repetitive behaviours" is not. I have checked the DSM 5 criteria, and it is very similar to the ICD 10, so it is not surprising I also meet it. But none of the "severity levels" are met for "restricted, repetitive behaviours", as my "restricted, repetitive behaviours" do not impair my functioning (instead, organisation is a big strength of mine). What do they do with cases like me in countries that use the DSM 5 and its levels? Would I still be ASD1, even though I only am half of it?

 

[Pats]

Thank you for answering my question. If that's the case, I agree with you, for myself personally. I can see why someone would still want a cure, however, if they have more difficulty with their weaknesses then I do.


This is off topic, but I keep seeing this, and keep wondering. I was diagnosed under the ICD 10 with Asperger Syndrome (and nothing else), which I understand would be ASD1 in the USA? The "social communication" description is a match to me, but the "restricted, repetitive behaviours" is not. I have checked the DSM 5 criteria, and it is very similar to the ICD 10, so it is not surprising I also meet it. But none of the "severity levels" are met for "restricted, repetitive behaviours", as my "restricted, repetitive behaviours" do not impair my functioning (instead, organisation is a big strength of mine). What do they do with cases like me in countries that use the DSM 5 and its levels? Would I still be ASD1, even though I only am half of it?

You don't have to meet all requirements - it's in one ore more of the criteria.

 

[Sarah S]

EDITED disregard i managed to mix both DSM 5 & ICD - 10 check my latest reply in this thread for clarification as well as misread the question sorry for the mixup

 

[55853]

To be diagnosed ASD with said DSM 5 you need to have in total Minimum 8 (usely Min 2 in each criteria in most but some only 1 is required of the so called symptoms) . NOONE can be expected to have al of them dear (btw i have 16 of 22 possible )

Right, but I'm not asking about the criteria. I meet that, as I know which of the ICD 10 criteria I meet, and it translates almost directly into the DSM 5. What we do not have where I come from is the "severity levels", which is why I ask.

You don't have to meet all requirements - it's in one ore more of the criteria.

To clarify, you are speaking of the levels of autism severity, correct?

 

[Pats]

To be diagnosed ASD with said DSM 5 you need to have in total Minimum 8 (usely Min 2 in each criteria in most but some only 1 is required of the so called symptoms) . NOONE can be expected to have al of them dear (btw i have 16 of 22 possible )

Yes DSM 5, I was reading the level list that Autistamatic posted and 55853 asked about dear. (and BTW I've met all requirements I've read on DSM 5 for autism).