I'm all for making sure that effective treatments are made available to anyone they might help, but couldn't a lot of this be addressed society just...being tolerant of diversity in people?
Gating everyone through "thrives in American High School" as a measure of normalcy selects for some pretty weird shit, and you can see that in the composition of the leadership today. American high school is about the nastiest thing you could get away with doing at scale in peacetime (go watch Euphoria sometime, no one I know has said it's anything but the uncomfortable truth).
If I need to move a little differently, or not hold eye contact when I speak, the fact that I get made fun of is the problem. If we just accepted, "hey, some people are like that" more, I think we'd have a lot fewer problems.
I am not autistic personally but working in tech and being into field-associated hobbies, I have a much more autism-dense social circle than the average person. This was awkward for me at first because it felt like I was either constantly irritated or being irritating to others by following my standard learned social conventions.
Once I changed my expectations to clarify and verify intent instead of derive and assume intent from others, this immediately stopped. Applying the same changes in social interaction with people who are not on the spectrum has actually felt like it leads to less misunderstandings and hurt feelings as well. I’m left wondering if the parts of human interaction that created these standards that autistic people find so frustrating might not even exist anymore and the rest of us have been upholding conventions that ultimately make life harder for us, just because we were taught to do so.
"Normal" people (whatever that means) tend to forget things quite quickly, and for us it's really hard when states change and contracts change. Meaning that if e.g. in a discussion 3 months ago we casually agreed upon "I do task X and you do task Y" then this will be the assumed state for autistic people until the end of time, because that's what we agreed upon.
When other people at work communicate their feelings, have a bad day and don't want to do those things, or are just lazy about it... Then this is a breach of a social contract. And dealing with those breaches of social contracts without getting very defensive about it is a huge problem for a lot of autistic people I've spoken with. We tend to spiral quickly into a defensive argument that won't help either involved parties and it tends to escalate into a "mudfight" instead of a rational debate.
I just wish that a lot of therapy would help prepare you for these situations of misunderstood (or misagreed upon) situations more. You can compensate for them to a small degree, but they put a lot of stress and burden on us because it's quite a big deal if the state of assumptions changes without having a discussional part in it.
Additionally, talking in conversations about the assumed outcome first before you get into detail helps a lot. Do you need emotional support? Do you want to feel that we are together in this? Do you need a practical solution? Do you need a change in what we agreed upon?
This way we can prepare much easier for what's about to come in the following discussion, and we realize it's not about critique and rather about finding a mutual compromise that both parties are happy with.
Also don't use sayings like "you always do X" or "you never do X" in those conversations when it is not always, because autistic people tend to interpret these as accusations very quickly because to us they sound excessive and are huge trigger points, because they are essentially lies.
If you say instead something like "I feel like you do never X" or even better "I feel like I am alone doing X, can you help me more with it in the future?" we can realize that it's more about the perception and how to improve our contributions, because we can keep the discussion about the actual topic underneath which is "How to balance each party's contributions to the task at hand".
Tangentially, I hate that people express hollow intentions, like “We should definitely hang out some time.” Why would you say that, when it's not your intention? Of course, I understand that people say such things because of social conditioning. But, such language tends to upset people regardless of neurotype. One could simply say “It was nice to see you. Goodbye.” It would be all right.
This is how much of the world works. Johnny doesn't have autism, he's just really into trains. It would be incredibly rude to say much more.
I'd like to draw a parallel with disability. I don't think anyone in their right mind would express that they actively work against people with disabilities, and I'm sure most people would express support if asked directly. But this doesn't translate to actually accessible infrastructure and culture. That takes a lot of special work - and regulation actually, without which the work wouldn't have happened.
All this to say that intentions and expressions are a great first step, but there is much more to acceptance than that.
Of course, what you point out is universal, so there are limits to this perspective. But in more collectivist cultures, I suspect that the burden of adjusting to people who struggle to conform can be more easily shouldered by more than just the nuclear family, or even celebrated more, erm, naturally.
For those who don't know the term "atomized culture": https://en.wikipedia.org/wiki/Atomism_(social)
well off educated people looking to rationalize whatever they think about society, interactions, etc. lotta people here living in a bubble.
great tech discussions sometimes, tho.
As somebody who occasionally struggles to fit in socially, I have come to understand that I might come across in ways that do not reflect my inner feelings and that I need to add a bit more context and explanation, and just be more careful in general. You sort of have to help people to see where you're coming from to help them tune their social barometer somewhat sort of speaking.
At the extreme, you'd just start any conversation with "hey, I'm autistic, so if I appear a bit weird..." to hard-reset people's expectations and sooth their inner alarms. That is assuming they're decent folks acting in good faith.
Then people will criticize you for making autism your whole identity.
Which is a silly point to make but people can be pricks. Not saying you gave bad advice, just saying, it a damned if you do, damned if you don't with some people. I think it is generally good to be open about it, if not just to filter out intolerant people faster.
Many sapiens like to believe they are good people, but they don't like to to think about what that really means. It seems we are talking about a filter that identifies such people very quickly.
This is to say that everyone is slightly different and a healthy dose of tolerance goes a long way. After all, some of your behaviour is probably annoying to others and you do not even realize it.
Also, at extreem low body fat you start to loose the pad of fat behind the eyes, resulting in that sunken look of many supermodels. This of course can reshape the back of the eye and impact vision.
A French actor (Christophe Lambert) has a special expression when he looks at the camera. It is because he is short-sighted and does not look exactly in the typical spot other would look at. He could not use contact lenses so there was no way to change that. The people who fought with him in the Highlander series (with swords) said that it was always an adventure because he was not really sure where he was hitting.
Earlier in my career during interviews I'd always tell the interviewer "I'm listening, keep talking, I just need to look at the floor or wall to concentrate or I get too distracted by your animated-ness" and this was in the days before autism entered the zeitgeist. Nobody cared or thought it was particularly odd as far as I could tell. We were accustomed to nerds who sat alone thinking at computers most of the time being quirky, and appreciated the need to concentrate (private offices with doors that close!).
But as I get older it's become more necessary to look at something else while listening to anyone tell me anything I intend to grok. And I'm pretty certain ~everyone now assumes I'm autistic because of it. Never been diagnosed as such.
My interpretation and internal modeling of things is highly visual and genuine visual input is a sort of noise that interferes with my mental reconstruction of what I'm hearing. I have no idea if that overlaps with autism.
I have to make a special effort to make eye contact, and when I do I feel like my “trying to see better” habits and postures make others uncomfortable. I’ve no idea what “normal eye contact” feels like.
I might also have some autism traits (I’m a coder, after all), so that feeds into it.. but even if I wasn’t coder/austistic, I’d be struggling in this domain.
I offer this as anecdata for your “everyone is different” suggestion.
Try making inappropriate eye contact with a human male. You'll probably live to make it to the next experiment, even if you do get punched. Now try it with a gorilla or chimp.
Sexual cues, hunger, aggression/submission postures and responses, whether calls (i.e. communication, speech) engenders trust and connection or mistrust and threat. These things can't be completely overcome, and if they could, our species would have lost the underlying structure and template that allows us to build the greater achievements of self-control and civilization.
The instinct is still there. Of course it is. We can override it in a way other creatures probably can't, but expecting people to not be influenced by instinct and such is a non-starter.
Of course, these individuals are not at all active on social media so you very rarely see them represented.
For example, an allistic (meaning not autistic, but perhaps neurodivergent in some other way) person is more likely to keep their goal unstated and only known through subtle semi-involuntary signs that others evolved to pick up on due to the advantages that come from understanding such semi-involuntarily-shared information. Autistic people who can speak generally just say, with words alone, what they want to communicate, and are less inclined to make such subtle inferences and less likely to perform them in the way that allistic people do. For some people this manifests in an autism accent where the speech is completely well formed in a grammatical sense (not necessarily the same grammar that's in formal writing) but has no tonal information.
This difference is also reflected in conflict resolution: most autistic people will each say what their goals are and then try to find a way to satisfy everyone's goals. Allistic people I have observed are more likely to not want to put that effort in, and will this via the aforementioned subtle communication decide on some particular resolution or will play social status games to get their way.
There is also some scientific research in this area that provides support for this understanding of different modes of communication. For example this¹ provides evidence that there is a different mode of communication, although it doesn't explore what makes up those differences. It filtered for typical IQ scores, but not for support needs.
1: Crompton, C. J., Ropar, D., Evans-Jones, M., Adams, C., Pearson, A., Scott, F., & Fletcher-Watson, S. (2019). Autistic people’s social camouflaging in daily life. Autism, 23(3), 606–613.
People are always looking for plausible deniability and weaponized vagueness in order to get away with things. They don't like it when others don't behave that way because it puts them in situations where they would have to assume the risks of their behaviors.
As far as I'm concerned, it's not the so-called autists that are in the wrong but everyone else that is basically engaged in deceptive behavior. I think this behavior is the most prevalent because of evolutionary pressure, in order to avoid conflict and potentially bad outcomes.
It makes sense in a violent world were looking at someone wrong may get you killed but is very unproductive in a society that is supposed to be orderly and high trust.
That being said it seems like the world is becoming much more low trust and autistic behavior can indeed become risky/problematic.
Autistic are not collaborative - they frequently end up locked in own heads completely ignoring what other people openly directly say.
I think autistic people are better at dropping their egos and working towards goals.
As an autistic person, I fucking LOVE building a plan with a clear set of goals and then accomplishing em. It has nothing to do with me as an individual, it's all about the big picture. I run into problems with people who can't drop their ego and work together because I just don't want to tolerate it.
Give me a STEM team full of autistics folks any day. So much less ego to deal with.
In the case of autism, "social awkwardness" used to fall under aspergers, a diagnosis that was removed over the protestations of many aspergers advocacy organizations in the DSM-V. See, the DSM-V was massively influenced by a lobbying effort or "intelligence" operation. They were hugely focused on things like eradicating any mention of "sub-clinical" autism or recovery criteria. The abolition of aspergers was a concerted effort to essentially force people with aspergers to fight the stigma suffered by "somebody who might have to wear adult diapers and maybe a head-restraining device." As the committee representatives claimed, "it was our belief that the best way to address stigma was to confront it across the spectrum. Why did we deserve protection that other autistic people did not receive?"
"This was... reflective of our commitment to 'cross-spectrum solidarity'." To be clear, this was an effort towards imposed "solidarity", where people with one disorder that often presented mildly enough they could make an attempt at passing for normal were forced to identify as and engage in activism on behalf of said adult-diaper-wearers if they wanted recognition, destigmatization, or access to services. It was an effort I can see only as malign to re-stigmatize or explicitly block "normalization" for those who could enjoy it.
Really, the consolidation of autism into one "spectrum" diagnosis involving a massively diverse constellation of systems was a political mistake not a scientific choice. It's one based fundamentally on presentation, not on etiology, despite dealing with a massively polygenic disease that appears to have many different potential causes. It only served to slow down efforts towards management and a cure (no surprise, given many "advocate" types continue to assert it is simply wrong that the world has norms in a tone similar to those deaf people who oppose cochlear implants.)
You can see this intellectual thread carried forward to recent times. A piece from 2023 reflects very similar sentiments, essentially saying that the consolidation of diagnoses is good because it "[protects] the most vulnerable": https://www.thetransmitter.org/spectrum/weaponized-heterogen...
Those who have a shot at a "normal" life passing as "normal" are, naturally, not considered. You can see this pretty easily in the basic framing of the issue as "access to services", services which Asperger's patients required and used much less. This was a transparent and explicit effort to lower chances of "normalcy" in an attempt to benefit those who didn't have a shot at it; the "solidarity" framing was, in that sense, completely honest. I see it as nothing less than ascientific and contemptible.
(Much of this information is drawn from a paper the two men who liased with the DSM-V committee wrote some years later and which may be found here: https://www.researchgate.net/publication/337112539_Lobbying_...)
I think a lot of people confuse neurodivergent with autistic as well.
The whole field needs a reorganization anyway. I've talked to dozens of therapists about this and I've received wildly different answers on what autism even is.
And conversely, autistic as a savant was a thing 25 years ago. Long before the social media.
John, 38 yo virgin, spending 50% of his income on Gundam figurines while living with his aging mother and having no IRL friends is supposedly not "autistic enough" for you if he can hold a job, walk and talk normally? What about that one girl you went to high school with who couldn't stop talking about Supernatural and had a full-on meltdown in front of the whole class on more than one occasion, to the point where she had no friends by junior year and got severely depressed?
These characters were seen as "just weird" until actual scientists started figuring out they were autistic, and now they might have a better life with treatment and the necessary disability benefits
Anyway, I suspect "in the past" is further in the past than you think: the distinction between Asperger's and ASD has been officially ditched by the medical community for 12 years now, at least insofar as the DSM represents consensus.
I'm gonna push back on this. There isn't an objective way to diagnose someone with autism like there is with, say, a vitamin B deficiency.
What we do know is the medical community continues to diagnose boys with this condition at a much higher rate than girls.
This would not appear to imply a "false" belief.
Everyone I knew then, even the "cool kids," thought high school was some bleak hell punctuated with moments of extraordinary joy. I have no idea whether that's due to hormones or school or what.
He also says "These weren’t overweight or sedentary individuals" which makes me think he didn't thoroughly read the abstract, which says the main finding is that sedentary people have decreased markers of mitochondrial respiration relative to moderately active people.
People forget that apsergers and autism as a subject were born from the eugenics movement. Asperger’s work on autism was shaped by the Nazi regime’s eugenics and race hygiene policies, which influenced his definitions and categorizations of autistic children.
These classifications serve only to justify atrocities.
There are folks out in the world today being repressed because they don't fit into some cultural ideal set in place by the totalitarian-authoritarian doctrine of eugenics, which has been used for nefarious purposes for over a century now.
Edit: looks like white guy from Norway which explains why you'd think that.
The obsession with skin color and race seems to be a very US-American thing.
Concerning apple pie, I disagree: I know Russians who are similarly obsessed about шарлотка [transcription: sharlotka] (a Russian apple pie). :-)
Gait is not constant in the stride. It all depends on the footwear. The constant for me is being silent while walking. Be the ball of your feet or the heels. Having auditory issues / sensitive to sound, I walk to be silent and unheard.
Walking and scaring wildlife and other humans was a personally taught process. I cannot stand clothing that makes noise while moving nor the sound of my own footsteps. It is also a means to allow for listening of my environment so I am not shocked or surprised.
This also why it is extremely hard to spoke me.
Silence is gold because it allows me filter in the environment. I want to hear the person walking behind me or were I cannot see. I want to walk up to a person and they don't know. This also reduces engagements.
Walking on the ball of your feet is silent up to the point of stretching and cracking your bones. Walking on the heels is also silent when reducing push down with long heel to toe arch. All of course it is defined by the footage and how they squeeze during application to the to the ground dependent on the gait.
The gait and noise it makes also highlights if an aspie has a grander stimulus to sound or not. Those that do not have auditory issues will easily pound their heels into their ground and make the floor shake.
That’s usually not cool.
To that point, I used to wear my keys on a chain, and let the chain dangle to make noise as I walked.
It still didn't work very well, though, so I eventually gave up on that. Now I have no solution for it except that I'm more careful to try to approach people from the side or scuff my feet or something as I approach.
Also...
I was recently diagnosed as having Autism, and I distinctly remember just after high school someone approaching me and tell me that I still "walk funny". They didn't mean anything cruel by it, it was just a fact.
And I realized that I do walk funny, and I can even correct at least some of it if I think about it, but generally, I like how I walk for the advantages it brings, like balance and agility. Which is probably why I taught my self to walk like that in the first place.
Then there are the people who for whatever reason need giant over the ear headphones and also need to walk right in the middle of a bidirectional trail.
I'm asd myself, but i think i show it in speech patterns, not walking.
Anecdata: My paternal side has some kind of innate preference for walking on your toes. I prefer it, my father's mother was well known to have done it, I have a couple cousins like that. While I can't speak for other family, I did go through a massive battery of aptitude and psych tests when I was young as part of the agonizing initiation into the curse of childhood giftedness. No autism.
I've become very concerned in the last few years how our society produces diagnoses that turn into self-inhibiting labels that restrict personal development. Developing ones-self, as much as you are able, is an ancient and treasured tradition. Modernity seems to be leading us to the reverse and to shackle ourselves with the weight of imposed limitations.
Say more. Why do you see these labels as inhibitory rather than liberatory?
I have a complicated relationship with the label given a lack of a formal diagnosis and many years of accusations of ASD, and I haven't identified any positive side of a diagnosis and will likely never pursue one. But this doesn't mean the label hasn't helped me connect with others in my life with ASD, some very hand-wavy, and some non-verbal adults who must have live assisted. Do i actually have it? Does it even matter either way?
A lot of labels put people in boxes or limiting groups. This changes how they think about themselves. Instead of discovering new things people will reject/ignore new things that don't reinforce their labels/boxes.
The one constant in life is change. Putting yourself in self-imposed labels/boxes stifles ones ability to properly interpret change. Their viewpoints change to fit their labels.
Nobody is saying labels are bad. But letting labels define you? Thats often the issue.
Social media has made this problem much, much worse.
I think a great example is teenagers who are looking for their clique. We all look back on ourselves and laugh at how desperate we were to fit in and the silly things we did/wore/etc. Adults do the same thing but with much more severe consequences and the reflection often never happens.
As kids we always walked on our toes due to material arts + wanting to be ninjas. It also helps if you want to avoid stepping on things outside like pine needles and other prickly boys. To this day I still prefer being on my toes. I have nieces who are on the spectrum and they stomp around...
If I was a teen again, in all that awkward glory, I'd imagine labeling myself to "fit in" better after reading this.
But to be fair, my generation literally cut themselves for attention/help/fitting in so perhaps a little labeling isn't all that bad.
China and Israel use gait surveillance tech because it uniquely identifies people. No amount of face paint, costumes, or slouching can evade this form of detection, but surely the Ministry of Silly Walks can try.
I don't think this says anything about (insert any neurodivergence-ism). Not enough evidence to make this claim.
I'm not sure if it's the differences in gait that might cause people with autism to need less arm swinging for balancing or if swinging less causes them to develop those differences in gait.
- in-toeing, walking with one or both feet turned inwards
- out-toeing, walking with one or both feet turned out.
I thought that toe walking was called out two decades ago when I was in university - I remember it being mentioned in a psych class. Otherwise, that kind of includes everyone who doesn't walk with feet straight, doesn't it?
> Our sources say that Native Americans tended to land on the ball of the foot (a "forefoot strike"), or flat-footed ("midfoot strike"), rather than landing on the heel and rolling forward ("heel strike"). [0: 90]
> Our sources indicate that Native Americans commonly walked with toes pointed straight ahead or turned slightly inward, rather than turned outward. [0: 91]
I've pulled just one article here, but there's a huge trove of racial and ethnic gait stereotypes with all sorts of moral implications. It's important not to repeat that stereotyping when trying to address autism.
[0] Ranalli, B. 2019. "Thoreau's Indian Stride." The Concord Saunterer 27: 89-110. https://www.jstor.org/stable/45271429
We should really consider heel striking to be the unusual non-default behavior here, the same as how prevalence of chairs means many Westerners have shortened Achilles tendons and lost the ability to do a comfortable deep squat which has been a fundamental human posture for longer than we've been a species.
I find walking on concrete is more comfortable when using the whole foot, so just barely tip-toeing rather than my usual heel striking. In general, it's not a good idea to walk on hard surfaces barefoot or in sandals excessively, no matter what the FiveFingers crowd might believe. I discovered plantar fasciitis the hard way [pun not intended].
I think cultures where going barefoot is the norm also tend to have fewer hard concrete and stone floors. We've engineered a whole alien environment for ourselves that then require augmenting our body to deal with.
Incidentally(?) the only person I’ve ever seen do this was clearly neurodivergent.
I’m not of one opinion or the other, I just don’t see why it’s self evident that certain groups of people wouldn’t walk a certain way.
But we don’t often pay attention to other types of physical and behavioural culture being as geographically entrenched as they sometimes seem to be.
Accents hold some special place in being so recognisable but I think there’s no obvious reason we wouldn’t have many other layers of physical culture like this.
The signal is a bit harder to pick up but I’m sure it’s there.
I’m not trying to make any particular point for or against damaging stereotypes here.
Italians talking with their hands, the Indian head-wobble, the East-Asian squat, etc.
https://en.wikipedia.org/wiki/Civil_inattention
So there's a thing which I can't find the name of but it's something like a civil inattention sniff. It's a brief sniff at the moment someone walks past you. I'm not saying this one is cultural or geographical. It's possibly universal, I'm making a reference to the signal vs noise ratio.
If you've never noticed the civil inattention sniff, you may start noticing it now, or noticing yourself do it. I was decades on this earth before I picked up on it. It's a similar amount of signal to feeling the weather change in your knees.
A tiny signal in background noise of input of many physical senses.
I believe and suggest that it's true that there are many of these micro behaviours in many different regional cultures, but I'm not stating as fact or backing that up with science here. This is just an exploratory idea for me that I enjoy speculating on.
— Snow Crash, Neal Stephenson, 1992
I'd be particularly interested in seeing if these gait differences are limited to childhood, or if they persist into adulthood. It might simply be delaying a developmental step.
Running purely on the balls of your feet seems like its more of a sprinting thing
I guess the real "news" is just that it made it into the DSM:
> Having an "odd gait" is now listed in the Diagnostic and Statistical Manual of Mental Disorders as a supporting diagnostic feature of autism.
Roughly speaking, in our brains have to reconcile the internal models of the world with predictions and what we receive through stimuli. Neurotypical people can do this without issues, disregarding either one. Autistic people basically are wired to pay way more attention to external stimuli no matter how small it is.
This sort of explanation makes the most sense, and can contextualize this as well. The gait trait is basically an optimization that comes from a higher sensory sensitivity and low value of "how should I be walking".
What does this really bring to the table as a diagnostic tool for autism?
By the time that you're evaluating gait, you're evaluating a lot of other things, too, since autism usually starts appearing during childhood. Obvious things, like trouble socializing, learning, and processing stimuli.
I'm not a doctor or involved in any sort of diagnosis, treatment, or curing of diseases or conditions, but given that the current head of the US Department of Health and Human Services is a whackjob when it comes to autism and other neurodivergent conditions, I don't see any benefit in offering a way to label people as this or that based on how they walk.
Personally I'm more concerned with the definition of autism itself, which is so incredibly broad that it actually defies most generalisations. For any given symptom or characteristic there may be an autistic cohort in a vastly different part of the spectrum to whom it patently does not apply.
This is just one more tool they can use to help determine that diagnosis. Their tests/questions covered a lot of ground, with a large focus on things from childhood.
You could have just learned to walk weird, as well.
But we also should be careful not to over-diagnose neurodivergence based on outward behavior. Not everyone who fidgets is ADHD
They've all mentioned parents shopping around for autism diagnosis for their children who have ADHD.
Apparently ADHD isn't cool, but autism is weirdly seen as "better".
Over diagnosis is already happening. Just like adhd and ocd.
In many places the only help you get with ADHD are amphetamines while autism can give access to a range of resources and accomodations.
Unfortunately it is often difficult to receive help without diagnosis.
Unfortunately, I've found that to be true myself as well.
ADHD is still widely misunderstood by the general population, and it is in fact more difficult to get accommodations vs. autism. People without it just don't understand and can't envision the special hell that having this level of executive dysfunction brings in your day to day life.
For some reason, people view autism as "something they can't help" and yet don't view ADHD in the same way and will turn around say "idk man, you just need to focus and do the thing, it's not hard."
ADHD is also a neurodevelopmental disorder and a lot of work still needs to be done for society to view it as such, and move away from harmful attitudes like "they're just lazy."
> based on outward behavior
Yes, neurodivergence can only be diagnosed based on how you work on the inside. It is not possible to diagnose based on outside behavior as people can show symptoms very differently and can mask their symptoms.
And no, you obviously can not diagnose people based on how they walk. If anything it can only give you hints or be a fun thing to talk about.
> over-diagnose
Both autism are ADHD are vastly under-diagnosed especially in women and adults. The fear of over-diagnosis makes no sense.
There are very hard criteria for an diagnosis and it requires that every other explanation for the behavior is excluded before a diagnosis can be made. The reality it that it is a huge struggle for anyone with autism or ADHD to get any form of help or even diagnosis.
Medication for ADHD works extremely well. Not for everyone but for like 70% and that is insanely good. Still there is so much fearmongering against it. But anti-depressants that can have much more serious side-effects and don't even work that well? Yes, they giving them like they are candy. Insanity.
Struggle mentally in any shape or form? Oh, you must be depressed? What causes the depression? We will not dig deeper. Have your pills and be happy! But stimulants, no those are of the devil!
Not to say that some people don't have just depression but the double standard is infuriating and often undiagnosed neurodivergence causes depression.
Is this standard truly being upheld? Most stories I've heard from people in US & UK go something like "I filled out some forms, hopped on a call/saw a psychiatrist for 30-60 minutes and walked out with a diagnosis and a prescription". Sometimes people even joke about how their psychiatrist talked to them for 10 minutes and concluded that they definitely have ADHD, and while that might be the case, it doesn't seem like many professionals are being particularly thorough about the differential diagnosis and ruling out other causes.
Personally I had to undergo relatively rigorous testing where they went through my entire medical history and administered about a dozen different neuropsychological tests which took about 5 hours total, over 2 months, multiple appointments, and then another month for them to analyze everything and come back to me with the diagnosis.
Of course that doesn't mean that ADHD is overdiagnosed or that those diagnoses are wrong, but it doesn't seem like many places are being as rigorous as they're supposed to be? Am I missing anything?
I had three appointments and lots of questionnaires to fill out at home that were designed to exclude all kind of conditions. And with a diagnosis I was still far away from getting a prescription, that is whole other hurdle.
As for the US, well the CDC says in the section for conditions that must be met:
> The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.
https://www.cdc.gov/adhd/diagnosis/index.html
So it is pretty clear on that.
I know multiple therapists who have had parents try to get their kids an autism diagnosis because they think it'll help on admissions to colleges.
So be aware that what YOU experience is not what is happening elsewhere.
Autism is super cool on social media right now. So while the people who likely should be getting diagnosed likely aren't, many people who don't have autism are happily getting the diagnosis so they can fit in a group or have that label. Be aware that in the US, many people shop around to get the diagnosis they want and many doctors have happy to appease them. That's why antibiotics are massively over rxed in the US. Mental health is no different.
No mentally healthy person is going to pretend to be autistic. There is still a huge stigma against it despite some parts of social media being progressive. I don't think a neurotypical person could even easily "fake" it. If you fit in with neurodivergent people, you probably are yourself.
People have always been gay, trans, neurodivergent, whatever. They just had to hide. Once they are tolerated by society, reactionaries will spread moral panic saying "Everyone is X these days". There were always who they were.
I don't think this is exactly true. We don't involuntarily commit people to psych wards after a long and complicated investigation to understand their mental state. Diagnoses can be made extremely quickly and with little understanding of the interior state of a patient.
> Both autism are ADHD are vastly under-diagnosed especially in women and adults.
I've heard it said that both autism and ADHD are like height, in that it's not clear where the boundary sits. We all agree that some people are tall and some people are short. When someone claims that there are a vast number of undiagnosed tall people, though, to what extent is it because we're not reaching enough people vs because our diagnostic threshold for tallness has lowered?
The threshold for being diagnosed as autistic has increased in recent years. As Asperger is not a separate diagnosis anymore but is part of ASD, some people that might have gotten an Asperger diagnosis would not get an ASD diagnosis today.
Again, a diagnosis requires that you have care needs. If you don't, you will not be diagnosed. There is no slippery slope of lowering standards.
There have always been neurodivergent people. Not long ago, here in Germany autistic children were systematically murdered during the Nazi regime.
The difference is that neurodivergent people don't have to hide anymore as much. We finally have at least a bit of a voice.
I don't understand how a slippery slope of lowering standards and not diagnosing anyone unless they have care needs are mutually exclusive. Our standard of care for basically everything has increased. I think you and I both agree that autistic people in the 1960s were less well cared for than in the 1990s, and that treatment has further improved today.
> There have always been neurodivergent people. Not long ago, here in Germany autistic children were systematically murdered during the Nazi regime...The difference is that neurodivergent people don't have to hide anymore as much. We finally have at least a bit of a voice.
This is interesting, because I agree with every individual statement, but it's still not supporting evidence for a change in diagnostic threshold.
It feels rational to me, especially coming from a society where everything that's considered a syndrome needs to be treated and washed away with medication.
Back in the 90s, every boy who laughed or had any sort of fun in my school was recommended to be put in ritalin and other ADHD meds. I was a quiet kid, but like any child, had a moment of goofiness here and there. And those moments were far less common than my peers. Despite that, my parents got calls from a teacher saying my 10 year old self needs to be put on meds because I clearly have an issue. I'm glad my parents told them to buzz off. But more than half the other boys in my class were drugged up. Even as a kid, I thought that was strange. Looking back, it's horrifying.
I think the suggestion amongst some groups that everyone must visit psychologists and psychiatrists and must be evaluated and must be diagnosed is kind of bizarre. Some people struggle and it should be easier to get help. But some people are a bit weird, they grow into it as part of their identity, and being labeled as having some sort of neurodivergence and being told they can fix it is surely more damaging than just letting them be a bit strange.
If you've got autism and the biggest thing that stands out is the way you walk... I don't think dragging a kid to a doctor to be told they're not normal is really all that beneficial.
There are very strict criteria on how people are to be diagnosed. More importantly you are NOT getting diagnosed if you are just happy and don't need any help.
You can NOT be diagnosed with autism without any support needs.
Same as you can not be diagnosed ADHD if it causes you not trouble at all.
> being labeled as having some sort of neurodivergence and being told they can fix it is surely more damaging than just letting them be a bit strange.
You want to know what going through life without an diagnosis for your neurodivergence looks like?
People hate you. You don't know why but they just do. You are wrong. Everyone else seems to know when to say the right thing at the right time but you don't. You are some weird alien that does not belong. You try to memorize things to say, copy how other people act, it works but the mask often slips. You must be hyper-vigilant in every social situation to not let the real you slip out. It becomes so automatic that you don't even remember who you are anymore. It is exhausting, so exhausting and alienating. You crash and burn from time to time.
Things that are easy for other people. You can't even fold your laundry. You are lazy. If you would just apply yourself, you could do so much. Achieve so much. But you don't. You lack discipline. Everything you try you just give up after a while. You read a bunch of self-help books, you learn you to organize your time, all the tricks but they never work for you. You are a failure.
Not being diagnosed is absolute hell.
Just being able to know why you struggle, to learn coping strategies that work with your brain, to talk with people with the same struggles, to finally find people that understand you, is absolutely life changing.
And no, it is not about fixing people. You can not fix ADHD, people are born with it and that is how they are. It is about them getting the help they need and embracing that people are different.
> I was a quiet kid
Quiet kids can have ADHD
> my parents got calls from a teacher
Teachers don't diagnose children. They don't decide whether you need to get medicated or not.
Furthermore, yes people where probably very ignorant about ADHD in your childhood, we understand it much better now.
> drugged up
That not how ADHD meds work. They can give you the super power to fold your laundry in a single business day, they don't get you high. Some people hate how they feel but for many they work great. Medication is just one option, you can also learn better coping skills through therapy or coaching.
> It feels rational to me
As someone who was diagnosed late, it seems more like ignorance to me.
This is more of an Autism issue, no? I have ADHD, and this could not be further from the truth for me. I am not well-versed in Autism symptoms nor its various presentations, but I tend to excel in most social situations. I'm in my 30s with golden retriever levels of hyperactivity. Though, difficult to contain at times, I often think people are somewhat attracted to my high-energy presentation. I have no evidence to back up my claim, but I am inclined to believe the more ADHD-PI people suffer from those issues rather than the ADHD-C/-PH folks do.
> They can give you the super power to fold your laundry in a single business day, they don't get you high.
Stimulant medication can and absolutely get many people with ADHD high. Now, I am not saying everyone taking their prescribed medication as directed automatically gets high, but I believe there is a lot more abuse/misuse than doctors and researchers might be able to conclude.
> Medication is just one option, you can also learn better coping skills through therapy or coaching.
Everyone is different, but the data surrounding therapy and coaching for ADHD without medication does not really instill confidence in me. For brevity sake, I'll spare you all my opinions on/experiences with therapy.
I've medicated for a decade, and it's better than nothing, but it ain't far off from nothing, in my experiences. Though, I think I am just a poor-responder to medication, which sucks because I am basically fucked in terms of help.
Yeah, first paragraph was more autism, the other more ADHD.
Personally, ADHD helps me make friends but also makes me not that great at keeping them. People for sure can experience some social difficulty because of ADHD. Pure impulse control and high energy can also be regarded quite negatively.
But in the right context people with ADHD can indeed shine socially.
> Everyone is different, but the data surrounding therapy and coaching for ADHD without medication does not really instill confidence in me.
Yes, good therapists are hard to find so I am not surprised you had bad experiences. I did not really have much luck myself but still generally urge people to give them a shot.
Personally, coaching was a game changer for me. It is not the same as therapy. The main point is you are talking through your problems with someone who has ADHD themselves. They know what it is to have ADHD, they have coached countless people with ADHD. They know what works and what does not.
They help you setting realistic and measurable goals and guide you towards reaching them. It is much more outcome and solution focused which can appeal to people more critical towards traditional therapy. Though coaching is also much less regulated so one also needs to careful to find someone decent.
If you haven't tried, you might want to give it a shot. Anyway, I hope you find something that helps you.
Thank you for sharing.
In other words, ADHD does not really cause me any direct misery, but rather, my ADHD makes others people miserable, and how I am treated because of that is the source of my misery. Honestly, it sometimes feels as if ADHD is just society's way of saying that I am too annoying, unreliable, and unfit to be a part of them, therefore there is something inherently dysfunctional with me.
Seriously, if I talk too much, who is more negatively affected, others or myself? If I need more time to complete work than others, then who is more negatively affected, my employer or me? Who is more negatively affected by my fidgeting, others or myself?
I also have an adult friend put on an antipsychotic to treat their moderate depression. They went through horrifying side effects while doctors kept telling them to stick with it. They're going through even more horrifying side effects during the third week of their withdrawal.
There are no strict criteria. Some people need it. A lot of people don't. It's really no different from the opioid crisis America has, where many doctors hand stuff out like candy because, honestly, who cares? Not their problem. But it's a nice paycheck.
And the constant downplaying and dismissiveness of it all, with many people who have personal experience saying things are over-prescribed as well as studies showing such[1][2], while also saying things are massively under-dosed, really does not help the image of the psychiatric drug industry trying to find a solution to any divergence being a pill.
It's fine if you have actual struggles in life and need help and medicine helps you. It's good, actually. But if we're at a point where we're nitpicking and saying, "Your kid walks on their toes. That's bad. Let's get them diagnosed. Then get some meds", yeah, it's horrifying and absolutely indefensible.
And yes. Putting a 10 year old on a prescription drug that makes them sit and fold laundry all day very much fits the definition 99% of people would consider "drugged up." 10 year olds have periods of being little shits. If they're folding laundry all day, and you're giving them medication that makes them do so, you are very much drugging them up. And yes. Teachers did proactively call parents and try to get kids (mostly boys) medicated in the 90s. It was so wild that even South Park had an episode about it. It's unfortunate because people with legitimate issues do get caught up in it and have their issues dismissed. But then children who have no problems are also victimized by being forced to take drugs that make them fold laundry and quit being a kid.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC11107288/
[2] https://www.rutgers.edu/news/risky-combos-psychiatric-drugs-...
Prescribing contraindicated medication is a reason to be cautious and weigh the risks against the benefits. It does not indicate that the combination is unwarranted.
> But if we're at a point where we're nitpicking and saying, "Your kid walks on their toes. That's bad. Let's get them diagnosed. Then get some meds", yeah, it's horrifying and absolutely indefensible.
Nobody is diagnosing anyone with autism based on how they walk, but it might be a sign to seek an evaluation, usually when it's accompanied by other symptoms. Furthermore there's no medication for autism.
I criticized depression being too easily diagnosed myself in the post above.
Autism and ADHD are clearly underdiagnosed. I have posted some sources here: https://news.ycombinator.com/threads?id=cardanome#44586532
Maybe depression meds are given too easily. Not my area of expertise. Might also specific to the US. Getting medication here in Germany seems to be much harder. However, this has NOTHING to do with autism and ADHD diagnosis.
It does not mean that ADHD meds are given too easily. They are a completely different thing.
> But if we're at a point where we're nitpicking and saying, "Your kid walks on their toes. That's bad. Let's get them diagnosed. Then get some meds", yeah, it's horrifying and absolutely indefensible.
That is not what is happening. That is pure fearmongering.
First of all there is no medication for autism. Second of all, no nobody get diagnosed for walking funny. That is not how any of this works.
I repeat, they are not getting medicated because medication for autism does not exist and probably can't even exist.
And even for ADHD, meds are one option. You don't have to take them. They work exceptionally well for some people but not at all for others. Again, there is therapy and coaching.
> hat makes them sit and fold laundry all day
This is not how this works.
The meds help with executive dysfunction. It when you want to do a thing, know how to do a thing, it is important to do it but you can't do it because your brain just doesn't cooperate. Medication helps you do the things you want to do. If you want to play video games all day, you will play video games all day, with or without medication.
Simplified, people with ADHD have lower levels of dopamine. So they are constantly understimulated. Boring tasks hurt to do. Medication helps to get their dopamine level up so they can have the same level of stimulation as a neurotypical person that watches paint dry. They don't get you high, they get you from deficit to base level.
And again
> in the 90s
We were ignorant of many things in the 90s. I don't want to invalidate your experience, surly these problems did exist, I am just saying that you childhood experiences might not be representative for the world in 2025.
Will people 30 years from now say we were enlightened in the 2020s? Or will we look back at 1/6 being on psychiatric medication as being a bit strange?
Doctors also used to give out antibiotics for any illness, now we realize a more targeted approach is much, much better since most illnesses not only don't need antibiotics, but they can make problems worse when improperly prescribed. And I only saw talk of this go mainstream within the past 15 years.
As I read through your entire comment, I see you might agree. And yes, I've seen that woman on Reels before, some of her observations I can confirm, such as "body double" or whatever it's called where you are more productive when interacting with someone else, even if they aren't helping you with something.
Aside: I don't think my PCP is the #1 person to talk to regarding variations in ADHD treatment. I have adderall, which can help sometimes focus me on a task and bypass the anxiety of talking/typing through issues at work. But I loathe using it daily. I wonder if any other medication works differently. Ritalin is different but similar.
How is this known or proven?
https://pmc.ncbi.nlm.nih.gov/articles/PMC8870038/
> As of 2018, 2.94% of 10- to 14-year-olds had a diagnosis (1 in 34), vs. 0.02% aged 70+ (1 in 6000).
https://pmc.ncbi.nlm.nih.gov/articles/PMC8870038/
> The ratio of males to females with ASD is generally quoted as 4:1,[..]The true male-to-female ratio appears to be 3:4. Eighty percent of females remain undiagnosed at age 18, which has serious consequences for the mental health of young women.
sure, people with the common cold do it
but so do people with at least 100 other ailments
(Credit to Doctorow's Little Brother)
> RFK Jr. says autism database will use Medicare and Medicaid info
https://www.npr.org/2025/05/08/nx-s1-5391310/kennedy-autism-...
Previous discussion: https://news.ycombinator.com/item?id=43810561 (254 points, 357 comments, 80 days ago)
We recently moved into house with wood floors. I experience my daughter and wife's gaits in new way. Their footfalls have a distinct "thud-thud-thud" with the landing of their heels first, whereas mine are a lot lighter. My daughter definitely didn't inherit my gait, even if she did inherit some of my psychological and mental eccentricities.
Alright, that's enough HN for me today, I'm outie. Have a great evening y'all.
I remember growing up and I always internally joked that my step dad sounded like a cyberdemon from Doom 2 when he walks. It would shake the walls. He wasn't heavy but his feet are really flat so he naturally hits hard on his heels.
I have some type of arch (I don't know if it's high or normal) but for my whole life people have half jokingly said I should stop sneaking up on them because I guess I walk really quiet.
I never measured or tried to gauge how I walk but after doing a few paces around, I would say the balls of my feet and middle of my foot hit the ground right before my heel. I would say in terms of weight distribution it feels like 70% balls of my feet, 5% middle / arch, 25% heel on each step when it hits the ground. I really feel almost nothing near the middle of the arch, maybe ~30% of the outer part hits the ground.
https://theconversation.com/why-do-some-autistic-people-walk...
I am not sure if anyone has ever tried to reproduce this result on a wider scale.
Allegedly some law enforcement uses gait analysis to identify and follow individual people on CCTV recordings. Gait has diagnostic value in some neurological conditions (like multiple sclerosis). Doesn't seem far fetched that a complex disorder like autism would also affect gait.
Shoes are evil. Barefoot all the things.
I think I might be a bit autistic...
https://runrepeat.com/asics-gel-nimbus-27
You can walk, run, stomp around in them all day and your feet will thank you.
They do have some cons though. They are expensive and not very eco-friendly (hard to recycle).
They hurt a lot to get used to (Mostly barefoot for 8 years makes for a hard transition) but now they are good (necessary even) for jogging and distance running.
They still feel like horrible rubber hooves you strap onto your feet.
But you're right, I wasn't introduced to something like these until very recently, when a particularly knowledgeable shoe nerd touched my feet and instantly was like "oh, I know what your problem is, your feet are all weird, you can't be wearing standard sized shoes." Then he went to the back and brought me the above shoes and I had a legit Cinderella moment.
Before I became aware of extra wide, I would typically be caught wearing shoes a size too big, which is why I had so many problems.
when im walking by people facing my direction (past a row of seats at the airport, into a movie theater, etc) i become self aware and try to walk as relaxed and invisibly as possible. probably only makes things worse. i think lots of people, autistic or not, are sensitive and adjust their gait unnaturally all the time. however toe-walking certainly seems difficult and i cant think of a reason id do it intentionally
[1] Autism in the context of joint hypermobility, hypermobility spectrum disorders, and Ehlers–Danlos syndromes: A systematic review and prevalence meta-analyses https://journals.sagepub.com/doi/10.1177/13623613251328059
That said, the reasons for autism are not well understood, and there may be many different root causes that lead to the umbrella diagnosis.
Additionally, experiences vary widely -- some autistic folks do not ever feel hungry and must be reminded to eat (or build support systems for it). Others do not ever feel full and must be reminded to not eat (or build support systems for it). Interoception (the perception of your body's internal signals) is impaired for many autistic folks.
Some of us experience misophonia, and get extreme fight or flight responses to audio signals -- personally, I get extremely agitated if I hear someone eating with their mouth open. (To be clear, it's not annoyance. It's fear/anger/hate/danger sense.)
Right now autism and neurodivergent cover huge swaths of behaviors/traits. This is especially true in the "social arena".
Just like back in the day when every kid that bounced their leg got an ADHD diagnosis. Now we know ADHD presents in a ton of ways and is usually present with other personality traits.
Facts aren't data, but as a counter to the narrative in this article: in my own experience strong calf muscles likely related to autism have allowed me to place at running events as someone with <2 years competitive running experience, and my mother to be the national champion at her age range for a decade.
Long distance though of course would still benefit from stronger calves. However toe walking also might make you tend toward tighter calves and posterior chain (which would leady to injury - especially when doing distance)
In a world with AI systems that can be trained in an unsupervised way against basically all the data we can collect, the amount of information that can be accurately predicted about you is probably proportional to the number of bits of observational data about you available to to the AI, and I would suspect there is a roughly logistic relationship between bits available and the % of information it can reliably guess.
here's a stock photo of a runner:
https://images.stockcake.com/public/7/1/2/7124d219-0531-40c1...
and here's one of volleyball:
https://www.games-eshop.com/wp-content/uploads/2020/07/web.s...
What’s more interesting is looking at people’s reactions. One of the characteristics of ASD, but not applied to everyone with ASD, is exceptionally low social intelligence. People with low social intelligence tend to be extremely easily offended, fragile ego. They also tend to view absolutely everything from a “me first” perspective where everything in their perspective starts from themselves but completely lacks of introspection, like an extreme non-malignant narcissism. I see these conditions in many of the comments, where some people appear to show offense and immediately start talking about themselves.
You might be susceptible to those kinds of unhealthy issues and have more of them without even realising it.
You may look anti-social to your environment.
I'll quote a Bible teacher: "Wanting others to be like us is devilish."
It is especially painful when you are neurodivergend and undiagnosed and spent half your life wondering why people just hate you for being you.
Thankfully people can get over it when they make an effort and educate themselves. So it is good that you admit you feel this way. Maybe you can learn to appreciate people being different or at least tolerate them more.
A lot of people will try to bully you over a weird gait and specifically toe walking. Normies can and do judge people based off this shit. They do it all the time.
Now everyone gonna think I’m autistic. Not that there’s anything wrong with being autistic. It’s the pop science mindset of the aggregate that’s the problem.
There’s a lot of phrenology and humours type pseudoscience within these analysis. Social gossip effort to normalize what we are despite physics we cannot control making all those choices for us.
