From a neurotypical's perspective

[Outsider]

My older brother and i are neurotypical, our middle brother is autistic; he was diagnosed at level 2. He is also a savant, he had won several chess tournaments. I know at least 3 person with autism. I would like to learn more about this condition. Is the word "condition" offensive? If I offended anyone I apologize.

 

[thejuice]

You know what the internet is like, someone will be offended. I say disorder but condition seems fine!

 

[WhitewaterWoman]

Welcome to the forum. We do have NT people participating, so you are not alone. I, for one, am happy to have other people interested in hearing about autism from people who are autistic. You will find we are a diverse bunch.

 

[Aspychata]

Welcome to the forum. Great that your brother has a loving home that fosters his interests, and it's a pleasure to make your acquaintance.

 

[Neonatal RRT]

My older brother and i are neurotypical, our middle brother is autistic; he was diagnosed at level 2. He is also a savant, he had won several chess tournaments. I know at least 3 person with autism. I would like to learn more about this condition. Is the word "condition" offensive? If I offended anyone I apologize.

I often use the language "condition". I know it is "softer" than saying "disorder" and know that some people do not consider their autism a "disorder", per se, but use the language "difference". Medical terminology can sometimes be off-putting, when the term "disorder", in this context, means something outside "the norm" or perhaps a certain number of standard deviations off from the mean.

I believe that most of us here are predominantly ASD-1/Asperger's variants. Some are ASD-2 variants with good communication skills on the computer.

To summarize, autism is a prenatal, genetic and/or epigenetic, neurodevelopmental disorder/condition that primarily affects behaviors, socialization, and communication, but can also affect fine motor skills, as well as specific hormonal, neurotransmitter, and immune responses. It is a medical condition, that unfortunately, science is still learning about, and as a result is diagnosed by symptomatology even though there clearly is a brain anatomy, physiology, and genetic component that needs to be studied more, but someday may be, in part, diagnosed by a neurologist and geneticist. Intelligence, per se, has little to do with autism, as some may have genius level, normal, or below normal IQs, and some may have asymmetrical intelligences, such as your brother, that may be "gifted" in a specific area.

Prenatal meaning it starts early in fetal development, as the primary areas that it effects include the thalamus, hypothalamus, and cerebellum that develop during the first and second trimester of pregnancy, and then to the cortex, which develops later in the second and third trimester. Genetics could be directly from the sperm and egg, or epigenetic where DNA and RNA alterations occur due to the intrauterine conditions (hormonal milieu, inflammatory reactions, infections, toxins, etc.). There are cases of identical twins, one with autism, the other not. Epigenetics.

At any rate, we can dig into all sorts of things here, but some things to think about.

 

[kriss72]

My older brother and i are neurotypical, our middle brother is autistic; he was diagnosed at level 2. He is also a savant, he had won several chess tournaments. I know at least 3 person with autism. I would like to learn more about this condition. Is the word "condition" offensive? If I offended anyone I apologize.

You came to a good place to meet autistic people/people with autism, and I'm sure you can learn from being here, and I'm happy you make an effort by coming here to better understand your brother - "condition" is not offensive to my ears...

 

[brandybild]

Indeed, Welcome. Since NTs make up a huge portion of the population, we need to hear from/know them, and, since we "with a condition" are also on Planet Earth, you can learn from us. As someone above pointed out, we are glad to hear that you are accepting of, and sensitive to, your brother. It's really important to us to be accepted for who we are, wherever we are along the spectrum. Ask questions, but of course realize that you will get different answers from different people here. You and your NT brother are not exactly alike, and neither are we! Welcome.

 

[Misty Avich]

My older brother and i are neurotypical, our middle brother is autistic; he was diagnosed at level 2. He is also a savant, he had won several chess tournaments. I know at least 3 person with autism. I would like to learn more about this condition. Is the word "condition" offensive? If I offended anyone I apologize.

No, it shouldn't be offensive.

I wish I were neurotypical. If I was I probably wouldn't be being bullied at work right now.

 

[AuroraBorealis]

Hi there. It's great that you want to learn more about autism from autistic people themselves. I believe it shows sensitivity and curiosity.

I'm not a native English speaker - and so are others here, as far as I know - so I believe I have less emotional attachment to the English words. "Condition" is fine to me. I don't particularly like "disorder", but I won't be offended about it, I just wouldn't use it myself. But, as someone pointed out, someone will always be offended on the Internet. Don't worry too much about it. I've found people here to not be prone to holding grudges because of something someone wrote by accident. If someone misunderstands or someone accidentally offends someone, things usually get cleared up quickly and then it's done.

With the limited information about your brother - male, level 2 autism, savant at chess - he sound quite different to, e.g., myself. There will be similar traits, which might show a bit differently. If possible, it might be a good idea to double-check information you get on here from others with your brother, to see how his individual experience is. If he has traits which he finds hard to explain and you find hard to understand - a meltdown, a shutdown or a sensory overload can be examples - people here will be happy to help you out by describing their own experiences. But you will notice that everyone experiences things a bit differently, while some core parts remain the same.

Feel free to ask any questions you have. Glad to have you here.

 

[Crossbreed]

@Outsider, I surmise from your OP, that the brother in question was born before 1974. At that time, ASD2 & 3 was as rare a naturally-occurring triplets, 1:10K. They were so few and far between that no common denominator could be found. I refer to this as Pre-Millennial autism (not counting ASD1).

After 1979, ASD2 & 3 skyrocketed. The blog posts below summarize my findings on Millennial autism (not counting ASD1) which, in turn, seem to shed light on the Pre-Millennial variety.*

• Blog post #1
• Blog post #2

*Namely, that ASD1 is a neurological difference, like giftedness & left-handedness, and ASD2 & 3 are aggravated forms of ASD1, whether rare [<1979] or rampant [>1979].
Competing models, so far, have not accounted for the radical change in 1979 (USA).

 

[Boogs]

I'd personally define autism as a condition because it's defined as a collection of symptoms according to specified criteria. But that can also be seen as a disability depend on it's nature, and its environment.

The actual co-morbidities (to use a poor but common term) that enable person to be classified as autistic are sometimes classed as a disorder, but sometimes that can be a total lack of function in a specific area of brain/mind function, and sometimes just works differently and any disability is only with respect to interactions with others who lack that mode of function.

Often the comparison between being different and being disabled is only according to its context.

 

[Ronald Zeeman]

Some of us have no co morbidities, we are just different. Can be very successful if given a chance.

 

[Outsider]

First of all ,I would like to would like to thank everyone who responded to my post. To be honest, some posts seem too scientific to me, I didn't completely understand them. I have MS in Mechanical Engineering, but physiology is not my thing. I feel that I should read some books on genetics and physiology to broaden my understanding of autism.
My brother was born before 1974, as one of the respondents correctly noted. He was recently re-diagnosed with Level 2; I'm not sure what was his previous diagnosis.
I would like to ask 2 questions: 1. How reliable is autism diagnosis if it is based on MRI ? 2. What are the reasons for a sharp increase in people diagnosed with autism?

 

[TBRS1]

I can tell you why more people are being diagnosed.

It's because more people are looking these days.

Before "autism" was a "spectrum," people like me were just "weird." Then, people started asking us "What is it like?"

Now, we're members of a minority group, with our own opinions about ourselves.

 

[Ronald Zeeman]

To The second question, There Is a lot of use out there most like myself had no idea we were on the spectrum as it was so badly defined, could still be.

 

[AuroraBorealis]

1. How reliable is autism diagnosis if it is based on MRI ? 2. What are the reasons for a sharp increase in people diagnosed with autism?

1. I'm not deep in that research. Maybe someone else can answer better here. To my knowledge, it's not (yet) possible to diagnose someone with autism solely based on an MRI. I don't even know whether there are distinct differences in an MRI between autistic and allistic (non-autistic) people. If someone has scientific facts about that's I'd be interested to hear about them.

2. I believe that the most likely explanation for this is a mixture of
- higher awareness in the general population - more parents, teachers, etc. considering autism as a possibility because more people know it "exists", because of more representation in the media, etc.
- the broadening of different representations of autism in the general population - not only the "severe", (non-verbal) forms are noticed, but also other representations
- less stigma of mental illness especially among young people - leading to more teens and younger adults suspecting that they might be autistic, whether that turns out to be correct or not
- better diagnostic options, more questionnaires, more open-minded professionals
- also, to some extent, a recent "trend" around neurodiversity - I'm not saying it's necessarily bad ("trend" may sound like attention-seeking, just with the word), but it has led to more suspected cases of autism especially among young people which seek out an assessment. This can have problematic sides, but at the same time more people get assessed and diagnosed which earlier would just have been seen as shy, introverted, quirky, etc.

 

[Ronald Zeeman]

I wonder how many are getting false positive diagnosed, seems to be the in thing lately. False impression, many of us are high functioning, atypically bright, so many want to emulate us. They do not see the down side. Hearing more frequently its a spectrum we are all on it to some extent. A NMR diagnosis would be great, if there was one.

 

[Misty Avich]

First of all ,I would like to would like to thank everyone who responded to my post. To be honest, some posts seem too scientific to me, I didn't completely understand them.

Yes, I'm not good at understanding scientific logic either. I remember on another forum I was asking about empathy, and someone (with all good intentions) posted a long script of how empathy works in the brain and what neurons connects to what and all that. Um, no, that wasn't quite what I was asking lol.
Autistics don't lack empathy by the way. Well, empathy is subjective, there are many different types of empathy, and what autistics may lack in empathy is what is typical in any humans. It's just that autism seems to be the scapegoat on any imperfect but normal human behaviour.

I have MS in Mechanical Engineering, but physiology is not my thing. I feel that I should read some books on genetics and physiology to broaden my understanding of autism.
My brother was born before 1974, as one of the respondents correctly noted. He was recently re-diagnosed with Level 2; I'm not sure what was his previous diagnosis.
I would like to ask 2 questions: 1. How reliable is autism diagnosis if it is based on MRI ? 2. What are the reasons for a sharp increase in people diagnosed with autism?

Not sure about the first question but to answer the second question, the autism spectrum has gotten so broad that practically everyone might as well be on it. So people who are shy or worrying about things seem to try and seek out a diagnosis of autism, with the answer "I know I seemingly only have one or two autism symptoms but everyone on the spectrum are different, so I could be on it".
But some genius decided that autism should just be called autism with no severity levels or types, which doesn't make sense when we're talking about a spectrum as wide and diverse as autism.

I kind of wish we'd go back to autism being a more specific disorder with developmental delays and obvious behaviours, stereotypical even (I mean, you have to admit, the stereotypical behaviours among autistic folk are common, such as hand-flapping. A lot of autistic people do it. Not me though), something most people get diagnosed with in childhood. It seems weird that the majority of the autistic community weren't diagnosed or even recognised until adulthood - and I'm not just talking about people from the dinosaur era, I'm talking about people who grew up when autism and Asperger's were known of (post 1990 maybe).

As a very mild, sociable and non-stereotypical Aspie female with no developmental delays, I was diagnosed with Asperger's at the tender age of 8, and I feel so alone in this. I just want to be like everyone else (or so it seems) on the spectrum who had that "moment" where they woke up one day and decided they were autistic after seeing an article or something about it, then after getting a diagnosis they feel like they suddenly make sense and feel pleased with their "new identity". I didn't have that. My diagnosis was just traumatic and was too much for an 8-year-old to take it, often finding myself sitting in a room with my parents and other adults discussing my behaviour, with my mum getting emotional and my dad sitting there probably thinking "if my child was normal I wouldn't have to be here". And I don't blame him, as that was exactly what I was thinking too. I just wanted to be a normal kid. I didn't want to be special or labelled. I hated it.

 

[Neonatal RRT]

I would like to ask 2 questions: 1. How reliable is autism diagnosis if it is based on MRI ? 2. What are the reasons for a sharp increase in people diagnosed with autism?

1. Without getting into all the details, an MRI can be performed several ways, and this will be able to look at the gross anatomy with some detail, and there may be specific structures within the brain's anatomy that would be consistent with some forms of autism, but not all. There are at least 3 known brain morphologies that autistics may have. However, MRI might not be the best way to do this neuroimaging, but rather PET scans which can be useful for showing conductivity and connectivity (the voltages and wires), and this is where autistic brains typically differ from neurotypicals, and it can be quite different. Most of what we know about the autistic brain, within the context of anatomy, is from postmortem studies where researchers can study the brain at the cellular level. It's there that we see the cellular anatomy of the neurons can have too little connections (looking more like a stick) and areas where there might be too many connections (looking like a bush), neither is normal. The densities and layering of neurons are different. The cerebellum structures of autistics are quite telling, as the internal anatomy is markedly different from neurotypicals. Concentrations of glial cells are higher in autistics. The bottom line here is that we need to look at the brain at more the cellular level versus gross anatomy, and currently we are unable to image the brain in that way and say, "Oh, that's an autistic brain." Google Scholar will have multiple studies on this topic. We are not there yet with diagnosing autism with neuroimaging alone, although it is logical that it will, someday, have its place.

The same thing with genetics, if we can get to a point where we can do an "autism profile" using DNA, this could be helpful, but right now, there are over 100 known DNA markers for autism, another 1000 or so epigenetic markers for autism, and over 2000 RNA markers for autism. So, this gives you an idea of what a daunting task a potential "autism profile" might include and the work that goes into it. Maybe if it can be done quickly with a supercomputer, then maybe, but right now, it can take years to get results back.

2. As others have suggested, awareness of the condition and better screening have contributed to an increase. However, epigenetic risk factors include, (1) more people having children in their 30's and 40's, and less in their 20's (old sperm and egg), (2) older mothers also mean a population with elevated estrogen levels, higher insulin levels, lower thyroid hormone, and longer exposures to environmental toxins, all of which, independently, increase risks. The intrauterine environment appears to have a significant impact. Keep in mind, from an obstetric perspective a pregnant woman who is 35+ is considered "geriatric" and is associated with increased health risks to her and her baby. I know people these days are just starting families in their 30s, but this is NOT how we were designed, as a species. (3) The US is in the midst of an obesity and diabetes epidemic, again, elevated insulin, estrogen, and inflammatory mediators playing key roles here. (4) We, in neonatology, are saving more and more extremely premature infants, currently down to 22-23 weeks' gestation. 20 years ago, this would have never happened. These are basically fetuses. When a pregnancy is interrupted, the babies are exposed to all sorts of environmental insults and stimuli that they never would be in the womb. Inflammation, infections, pain, sensory issues, hormonal alterations, blood flow alterations, and all of this is happening as the brain is developing, and this can lead to abnormal neural pathways and ultimately the whole brain development. Autism in this population is disproportionately high. Within this context, the premature infant model may be considered an "injury model" of autism etiology.

 

[Crossbreed]

What are the reasons for a sharp increase in people diagnosed with autism?

That is the $24K question, but remember, most of the statistics given are for ASD2 & 3 (not including ASD1 cases).
At the risk of oversimplification, ASD1s are just nerds, geeks & eccentrics;* you know, engineers...!

I can tell you why more people are being diagnosed.

It's because more people are looking these days.

The tighter criteria has only given us more ASD1s, who do not require special education in school. The epidemic of ASD2s & 3s is real** and unprecedented (before 1979). That changepoint is slightly different in countries outside of the US, like Japan & the UK.

Further (unlike more general giftedness), savantism is almost always evidence of a (specific) brain injury, albeit a beneficial one.

*With or without high IQs.
**They still would have been recognized under the old criteria due to their extended infantilism.