The line between neurotypical and autistic and severity

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autiecat
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07 Jul 2021, 5:50 pm

I keep hearing this narrative in certain autistic communities, and it's driving me nuts.

According to this narrative, people are either 100% allistic or 100% autistic and there is nothing in between.
Among autistic people, there's no such thing as more or less autistic. No one can be "a little bit autistic".

Yet, if you look at the distribution of scores on autism questionnaires, they will span a wide range. If 0 means no autistic traits, and 100 means every autistic trait at the greatest intensity, there will be scores in between the two extremes.

Let's say you need a score of 50 to be considered autistic according to this assessment. If people are either 100% allistic or 100% autistic with no degrees of severity, then a score of 50 would have the same meaning as a score of 100. A score of 49 would have the same meaning as a score of 0. Even though in reality, a score of 49 is closer to a score of 50.

Does it really make sense to say someone with a score of 50 is equally autistic as someone who scores 100? Does it really make sense to say someone who scores 49 can't be "a little bit autistic"?

Some autistic people have a few autistic traits with moderate levels of intensity while other autistic people will have many autistic traits that are severe. In this sense, the person with more autistic traits at greater intensities is "more autistic".

And we may hate hearing it, but some neurotypicals who are on the borderline may be a "little bit autistic".

I just have to get this rant out because the idea that being autistic is black & white seems completely illogical to me when clearly people with varying amounts of autistic traits at different intensities exist.

I feel like I might be being pedantic here and I'm being autistic about it all, but this is something that has been frustrating me.

Like I'm significantly impacted by my autism, but I'm also able to acknowledge that people with more severe autism exist.

Do you think people can be more or less autistic or is it just me?!



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07 Jul 2021, 6:11 pm

Who is preaching this "narrative" you cite?  Appropriately-trained and licensed mental-health professionals, or just your ordinary run-in-the-muck YouTubers?


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autiecat
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07 Jul 2021, 6:13 pm

Fnord wrote:
Who is preaching this "narrative" you cite?  Appropriately-trained and licensed mental-health professionals, or just your ordinary run-in-the-muck YouTubers?


The Instagram autism echo chamber, ha.



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07 Jul 2021, 6:14 pm

One thing to consider isn't just severity level, but where the majority of people are scoring. If a person is at 50, they may not be as severe as a person at 100, but if most people are scoring below 20, 50 is heading into noticeable-autistic territory in comparison to most people.

A line has to be drawn somewhere. So even if 50 is midway between 0 and 100, most people are closer to zero, meaning the 50 is noticeable different from the majority.



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07 Jul 2021, 6:18 pm

autiecat wrote:
Fnord wrote:
Who is preaching this "narrative" you cite?  Appropriately-trained and licensed mental-health professionals, or just your ordinary run-in-the-muck YouTubers?
The Instagram autism echo chamber, ha.
Then the "narrative" you cited is both null and void, and can be easily dismissed as irrelevant.


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07 Jul 2021, 6:21 pm

I think the idea of "You can't be a little bit autistic" means that NT / Allistic people can't say they're a little bit autistic if they meet just one or two of the assessment criteria.

Once a person meets an appropriate number of assessment criteria then yes, they're autistic. That's where the yes or no, the all or nothing, applies.

Once a person is "definitely" autistic by meeting the diagnostic criteria their level of support can vary.

Support needs are written into the diagnostic material. They exist.



autiecat
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07 Jul 2021, 6:23 pm

Fnord wrote:
autiecat wrote:
Fnord wrote:
Who is preaching this "narrative" you cite?  Appropriately-trained and licensed mental-health professionals, or just your ordinary run-in-the-muck YouTubers?
The Instagram autism echo chamber, ha.
Then the "narrative" you cited is both null and void, and can be easily dismissed as irrelevant.


I'm glad to see different opinions outside of Instagram. It's interesting to see how autistic communities on here, vs Instagram, vs Facebook differ.



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07 Jul 2021, 6:26 pm

Everybody's autistic. Even the most socially skilled, extroverted neurotypicals you know are autistic, they're just so brilliant at masking their autism that they come across as not autistic on the outside and can trick anybody and be the most life and soul of the party.

It might as well be like that nowadays, as everybody seems to be getting diagnosed with autism these days because it's that easy to just walk into an office, spout out a few lies about your childhood development, say you get depressed and anxious, and there you go you are automatically qualified for a diagnosis.

Autism is like a leaky pipe and the ground is the population; the leak only covers a small part of the ground at first but as time goes on more and more of the ground gets soaked until the whole area is covered in water.

That's my theory. Maybe we aren't alone after all.


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autiecat
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07 Jul 2021, 6:29 pm

IsabellaLinton wrote:
I think the idea of "You can't be a little bit autistic" means that NT / Allistic people can't say they're a little bit autistic if they meet just one or two of the assessment criteria.

Once a person meets an appropriate number of assessment criteria then yes, they're autistic. That's where the yes or no, the all or nothing, applies.

Once a person is "definitely" autistic by meeting the diagnostic criteria their level of support can vary.

Support needs are written into the diagnostic material. They exist.


I think shades of grey can exist where some people are a few points away from being considered autistic.
Though, I agree with the idea that saying "everyone's a little bit autistic" is rude and invalidating to autistic people who have significant struggles. At the same time, it's technically true in the sense that if everyone took autism assessments, many people would probably tick off some autistic traits so that you would see a distribution of scores from 0 to 100, not only scores on either extremes.



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07 Jul 2021, 6:33 pm

Joe90 wrote:
Everybody's autistic. Even the most socially skilled, extroverted neurotypicals you know are autistic, they're just so brilliant at masking their autism that they come across as not autistic on the outside and can trick anybody and be the most life and soul of the party.

It might as well be like that nowadays, as everybody seems to be getting diagnosed with autism these days because it's that easy to just walk into an office, spout out a few lies about your childhood development, say you get depressed and anxious, and there you go you are automatically qualified for a diagnosis.

Autism is like a leaky pipe and the ground is the population; the leak only covers a small part of the ground at first but as time goes on more and more of the ground gets soaked until the whole area is covered in water.

That's my theory. Maybe we aren't alone after all.


I can't tell if you're being sarcastic, but I don't think everyone's autistic if that's what you think I'm saying. But I do think that neurotypicals can have some autistic traits to varying degrees.

I don't actually know many autistic people outside of the online autistic communities. I still think it's being underdiagnosed rather than overdiagnosed.



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07 Jul 2021, 6:35 pm

autiecat wrote:
Joe90 wrote:
Everybody's autistic. Even the most socially skilled, extroverted neurotypicals you know are autistic, they're just so brilliant at masking their autism that they come across as not autistic on the outside and can trick anybody and be the most life and soul of the party.

It might as well be like that nowadays, as everybody seems to be getting diagnosed with autism these days because it's that easy to just walk into an office, spout out a few lies about your childhood development, say you get depressed and anxious, and there you go you are automatically qualified for a diagnosis.

Autism is like a leaky pipe and the ground is the population; the leak only covers a small part of the ground at first but as time goes on more and more of the ground gets soaked until the whole area is covered in water.

That's my theory. Maybe we aren't alone after all.


I can't tell if you're being sarcastic, but I don't think everyone's autistic if that's what you think I'm saying. But I do think that neurotypicals can have some autistic traits to varying degrees.

I don't actually know many autistic people outside of the online autistic communities. I still think it's being underdiagnosed rather than overdiagnosed.


It's sort of sarcastic but not aimed at you at all.


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07 Jul 2021, 6:56 pm

I think the part of it is that there are people who invalidate people with more "mild" autism and the support they may need. Whenever I've heard someone say you "can't be a little autistic" it's either in the situation Isa described, or where people are acting like higher functioning people are "less" autistic than others and less deserving of support.

Also, you can't really be a "little bit autistic" just because you match one or two criteria. Most NT people don't have the genetic or neurological changes that people with ASD have, and are not "a little" autistic even if they relate with a couple issues that we have. If an "NT" person qualifies as part of the "broader autism phenotype" and just got lucky with not developing full blown ASD then sure, but most aren't like that.


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07 Jul 2021, 7:04 pm

Currently, it is the DSM-5 that defines whether you are autistic or not. This is the cutoff between whether you are or you aren't: Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

And autism needs to be present from birth...



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07 Jul 2021, 7:07 pm

HeroOfHyrule wrote:
I think the part of it is that there are people who invalidate people with more "mild" autism and the support they may need. Whenever I've heard someone say you "can't be a little autistic" it's either in the situation Isa described, or where people are acting like higher functioning people are "less" autistic than others and less deserving of support.

Also, you can't really be a "little bit autistic" just because you match one or two criteria. Most NT people don't have the genetic or neurological changes that people with ASD have, and are not "a little" autistic even if they relate with a couple issues that we have. If an "NT" person qualifies as part of the "broader autism phenotype" and just got lucky with not developing full blown ASD then sure, but most aren't like that.


I'm thinking that there could be variations in brains that are in between the NT brain and ASD brain. Of course people with just a few traits won't meet the diagnostic criteria and are not technically classified as autistic. So they're not a "little bit autistic" in that they would be diagnosed as autistic - just in the sense that they have some autistic traits. When both neurotypicals and autistic people take autism assessments, there are always scores along the borderline.

I'm not talking about the implications of using the terms - just the fact that there is a distribution of scores that fall in the middle. In this sense, those toward to extreme end are "more autistic" as they have more autistic traits at greater severities. I completely understand why some people don't like the distinctions between different levels of autism. Some people feel that their struggles are invalidated if they're classified as "mildly" autistic or think that this means they are less deserving of supports.



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07 Jul 2021, 7:14 pm

autiecat wrote:
HeroOfHyrule wrote:
I think the part of it is that there are people who invalidate people with more "mild" autism and the support they may need. Whenever I've heard someone say you "can't be a little autistic" it's either in the situation Isa described, or where people are acting like higher functioning people are "less" autistic than others and less deserving of support.

Also, you can't really be a "little bit autistic" just because you match one or two criteria. Most NT people don't have the genetic or neurological changes that people with ASD have, and are not "a little" autistic even if they relate with a couple issues that we have. If an "NT" person qualifies as part of the "broader autism phenotype" and just got lucky with not developing full blown ASD then sure, but most aren't like that.


I'm thinking that there could be variations in brains that are in between the NT brain and ASD brain. Of course people with just a few traits won't meet the diagnostic criteria and are not technically classified as autistic. So they're not a "little bit autistic" in that they would be diagnosed as autistic - just in the sense that they have some autistic traits. When both neurotypicals and autistic people take autism assessments, there are always scores along the borderline.

I'm not talking about the implications of using the terms - just the fact that there is a distribution of scores that fall in the middle. In this sense, those toward to extreme end are "more autistic" as they have more autistic traits at greater severities. I completely understand why some people don't like the distinctions between different levels of autism. Some people feel that their struggles are invalidated if they're classified as "mildly" autistic or think that this means they are less deserving of supports.


None of these tests are diagnostic. Having the traits of autism does not mean you are autistic. Autism is a condition from birth and the test does not account for that. Other conditions have similar traits as well.

Also, there is no "mild" autism. Autism is classified by support levels from 1 to 3. You are categorized by the amount of support you need, not how you might appear to others.



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07 Jul 2021, 7:35 pm

I remember Baron-Cohen saying that if you think you've got a bit of Aspergers, you probably haven't got it. I didn't agree with him and still don't. His view is that it's OK for him to draw a rather arbitrary line and say that anybody who doesn't quite score above that should have the diagnosis withheld from them. Me, I just see AS as a continuum, and I recognise that somebody who just scores enough for the DX is almost no different from somebody who doesn't quite score enough. I just can't do that reductionist thing that would conclude one is simply positive and the other simply negative. It's bad enough reducing AS to a single number, let alone trying to reduce it to yes or no. And the 3 levels of severity isn't much better. I suppose it's necessary for them to simplify it so they can calculate how much to spend on a given person or whatever they do, but I don't have that to worry about so I can just look at the individual and figure out what they're good at and what they're bad at, to assign a multi-faceted profile to them if you like. I don't know many people well enough to have that much information about them, but in principle that's what I always set out to do. It's probably not surprising that if you try to hammer real people into neat pigeon holes, it doesn't work very well.