Uta Frith, women, autism, and what Dr Stock, Helen Lewis etc think...

I absolutely agree. And same with my wider family. However one can’t function without medication, nhs flagged and diagnosed. (More ADD, female.)

I suppose it’s more about if daily living is affected. Frequent tiredness/ exhaustion / burn out is an often over looked symptom. But that could have so many other reasons. Cbt and self understanding / reflection is really helpful.

I found this paper randomly yesterday which describes how it is not necessarily a life long condition and how much external factors affect it https://pubmed.ncbi.nlm.nih.gov/41844271/

Mr P (ict) was diagnosed at school.

I feel i's a wider discussion re. identity, and who gets to decide what autism is, what it is not or how it impacts on people. Not unlike gender discussion in that sense imho. Who decides what neurotypical means? Can neurotypical people be disabled, or autistic - able (as in Attwood's case)?

Perhaps Frith is right in that what we describe as autism now bears little resemblance to what was understood as autism 20 years ago. Apples and oranges.

Also, it's interesting how different individuals and families find support from different people. It suggests that people's needs can vary greatly, supporting the need for greater granularity of diagnosis rather than a broad brush of 'autism'?

That's interesting isn't it, the strength of reaction. It seems to have hit hard on a lot of autistic advocates.

I think partly it's because Frith says some not great things, partly because of the wider political context (SEND reforms, 'overdiagnosis', PIP reforms), and partly because people are worried that her thoughts could lead to a minimising of their challenges, which they already (quite rightly) experience.

I interpreted it more as a defence of those with classic autism, plus a desire to really understand what's going on for people, esp women, with the hope support could be better targetted once diverse needs were better identified and understood.

I though Fisher lends more towards that interpretation than Frith, but there is a tendency in the autism community that no criticism or challenge is allowed, which imo is restrictive and not helping to further understanding.

Andy is a very interesting and capable chap who has set up wide support networks for ND young people. I've never found Fisher's stuff particularly useful in our family whereas Andy has always been spot on. He is generally a very mild mannered figure and this is the most controversial thing I've registered him saying. So I'd be curious to find out more about why he feels let down/surprised? I was certainly surprised by his strength of feeling

As someone who has some of the traits that seem to be considered adhd in an adult these days, I am really not convinced it's useful or even good to see them as a disorder until they are getting more extreme.

There are a lot of people with that personality type in my family, they are very bright in general but they are not typically the kind of people who become academics, for example. This was something that was frustrating for me as a young person who wanted to be an academic for a while, but I eventually reconciled myself to the fact that although the idea of that kind of attention to detail and the study required was appealing, at another level, I really didn't have the type of careful patience required.

However, it is also the case that a lot of my family members with these characteristics have been successful, and sometimes very successful, in other types of work. Particularly things which require a lot of dynamic action, multi-tasking, working with systems, creativity, and quick decision making with complex and/or limited information. Historically they've often gone into the military, but also things like corporate management, journalism, publishing, advertising, and so on. I am these days in public library work which suits me really well.

What strikes me is that people who are good at that stuff are actually very useful in society, you probably really need more of them then you do the kind of people who can go to the very top of an academic disapline. So maybe it's not a disability so much as just a differernt and normal personality type with a lot of adaptive ability.

Once you push things to extremes, yes, you have problems, but there is a lot more identification between that and what is actually very normal than I think is good.

I don't know anything about Andy, but I do know about Naomi Fisher. For him to say that she doesn't understand or spend time with autistic people and their families is inaccurate.

It seemed to me he was angry with Fisher so attacking her, adding to the heat but not offering much to the discussion, other than being an example of why it is hard to say challenging things without the 'autistic community' piling on.

I get why people are defensive about what seem like challenges to their identity, I really do. But it means nuance is lost, and progress in understanding autism and related difficulties is made far harder. The conversation on here has been so interesting and respectful in contrast, with those cross with Frith able to say their piece, but the discussion continues.

Interesting post from Andy at Spectrum Gaming to Dr Naomi Fisher asking why she is platforming Uta Frith's views which haven't changed in 10 years...
https://www.facebook.com/reel/1465295138593987

ADHD is certainly more in line with a linear spectrum, and also one that people can be at a very mild end of but have learnt to adapt to life through chosen professions, sports, the arts etc. I also honestly think that it’s a condition (at the milder end) where background really matters to the child growing up.

In some families there will be all the opportunities to have the BCEs that support a young person to achieve in their way. Sports and the arts are very important here. And parents who are on top of life and emotionally skilled enough to support with organisation and mental health. Environmental adjustments and learning about limits, pacing, self care are really important.

Extreme adhd is relatively rare and extremely debilitating. It also inhibits learning - social and academic. These are the children that need medication and indeed do not progress without it.

I don’t have time sadly to go through the latest posts - all so fascinating and I also think this tread respectfully explores many aspects of all this.

when I went off and explored the highly sensitive person profile, this is a feature.

Being very pro social but the needing to detach and hide in bed from exhaustion.

At a more extreme end this is very much an adhd trait. The tiredness especially.

Sorry I see this is all muddled. It wasn’t when I selected! The page is easy to find on fb.

It gets incredibly confusing because even within the same potential groupings people are so different.

Myself and my brother are both autistic (incredibly he is undiagnosed, despite it being more obvious in him, because he has had he way smoothed by the women around him and because it's so obvious people sort of make allowances for him).

Anyway we'd both be in the no LD/"high functioning" type group.

But we think quite differently! We find each other annoying. He tends to be rule-bound, and as if everything we experienced in out childhood is gospel that should always be replicated forever. I tend to question authority if I think it is wrong, analyse experiences and make changes where I think it's better. (Just one example of different thinking.)

Both sets of traits can be argued to relate to autism.

@Jimmyneutronsforehead
It's also difficult because not all autistic people actively choose to withdraw from people either.

Ooh, me! <jumps up and down and waves>

I think I'm actually an autistic extrovert. I feel energised after spending time with (the right) people. I absolutely love a good party with chatty open minded type people. Too much time alone is a drain on my mental energy. But, I also need a certain amount of time alone...

The difficulties I mentioned upthread (where I don't feel like I'm masking, but things take more mental energy) are more to do with demands on me. These don't have to be social, they can be things I need to get done.

It's actually the biggest drain on my life trying to have enough social time and the lack of close likeminded others. Lots of autistic people, perhaps women especially, struggle due to wanting closeness and close relationships but struggling to find them. (The suicide rate of middle aged autistic women is v high, perhaps to do with this.)

This is where it just thinking differently to others comes in. Not playing the same social games. Being a magnet for bullies in school. This is also where, theoretically, it isn't necessarily a disability. If everyone thought like us, was more straightforward and caring about fairness and so on, the world would work better fine!

(Apologies if rambly due to tiredness)

It’s not really a terribly useful term tbh.
If I say ‘DS has autism’ the first question back is ‘what type of autism?’ (And it’s not a straightforward explanation in his case either.)

I certainly think extreme introversion (exhaustion at being with others) and sensitivities to environmental factors can be disabling (especially when thinking about the social model of disability) in our modern societies. They can definitely be career-limiting, lead to feelings of overwhelm, poor self esteem etc. They could therefore be thought of by some as symptomatic of autism? And so we go round in a circle!

This is the age old question of the chicken and the egg in essence.

It's also difficult because not all autistic people actively choose to withdraw from people either. Some actively choose to be with other people, even if they have limited verbal and non-verbal communication, but I do think that withdrawing to the point of disadvantage can be seen in some clinical contexts currently in restrictive and repetitive behaviours and so ticking off one of the triad/dyad of impairment requirements.

As for autism v introversion. I can't remember if I started a thread, or just thought about starting one a couple of years ago on that very same subject!

It's a brave thought, given the strength of feeling about identity within the 'autistic commmunity'. I wonder if the Orchid/Dandelion or Highly Sensitive Person typology could be entertained? Perhaps in a better way than Frith put forward in her interview.

I certainly think extreme introversion (exhaustion at being with others) and sensitivities to environmental factors can be disabling (especially when thinking about the social model of disability) in our modern societies. They can definitely be career-limiting, lead to feelings of overwhelm, poor self esteem etc. They could therefore be thought of by some as symptomatic of autism? And so we go round in a circle!

I saw that too and tend to agree.
I suppose it leaves me questioning though, should all these things be called autism? I get it is a useful term because it is now well know shorthand, but I think we can do better for people who have the diagnosis but who experience life very differently.

I’ve just had fb show me this post which I found particularly insightful

I knew he’d realised his some was whe. His son was an adult and struggling with drink etc.

I didn’t know he was also

Sticking everyone under the ASD umbrella because 'spiky profile' was just stupid. It was just a way to raise the bar on assessment criteria IMO, but many in the autistic community seemed to think it was a wonderful move because they had once self harmed/felt suicidal/had a melt down in a car park. No one seemed to grasp that the difference between classic ASD and Aspergers was simply whether you also had a learning disability or not - and that that differentiation was probably pretty useful/important.

I'd also say that many people with ASD build their life so that it allows them to cope well and this can make it seem feel to them like they are not disabled by having ASD (or ADHD). I don't think it's unusual in higher functioning people. DS had a pretty shit time through secondary school, no friends, but now has a job in his special interest, something he's very good at and is doing really well. He has a lot in common now with his peers, gets on well with them and would consider them friends - although he wouldn't see them outside work. He wouldn't consider himself disabled. No one should be being diagnosed though because they're an introvert, ASD is much more complex than that.

DS was breast fed, co slept and didn't go to nursery till he was three. He was diagnosed with Aspergers, it is genetic, no question about it - I have at least 4 ND diagnosed relatives, and several older generation that are IMO undiagnosed. I definitely didn't 'push' for him to be diagnosed with Aspergers because of cachet or to feel better about him getting diagnosed. He was diagnosed with Aspergers because he's autistic and he didn't have a learning disability.

The article is just a load of stupid nonsense IMO. For example 'These days, many people are self-diagnosing before they are assessed.' Well duh, if you don't think you've got something wrong with you then you're not going to seek diagnosis are you? No one goes to the doctor with a mole if they don't think it's skin cancer, no one goes to the doctor with debilitating headaches and doesn't suggest they might be suffering from migraines.

I'd also strongly disagree that teachers somehow 'intuitively' know what children need. Teachers often don't have a clue! IME they know very little about Aspergers. Many kids get all the way through primary school without being noticed, DS did and I know lots of others.

The idea that ASD is a more common male 'disease' just like 'psychopathy' is as fucking offensive as hell. Why the fuck would you link psychopathy and asd in this way. It's also highly misogynistic to suggest that the girls being diagnosed in their teens are just over sensitive. I know several diagnosed this way who have other ND family members, it is clearly genetic and they have been masking the hell out of life until the wheels completely fell off. What proof is there that it's not just less diagnosed due to masking - beyond 'her view'. That's hardly scientific proof is it.

I notice she doesn't really say what these 'wide' criteria are that mean we're now apparently diagnosing too many people under the lovely inclusive ASD 'umbrella' - or is she just talking about the emotionally overwrought teenage girls?

I loathe how people are obsessed with the 'explosion' in numbers. There's also been an explosion in numbers of dyslexic children but for some very strange reason no one ever, ever, ever mentions that - or is at all concerned about it. Why is that? Up to 20% of people are now thought to possibly be dyslexic - pretty similar to stats on ASD and ADHD I believe - but absolutely no concerns about that at all for some reason. Weird huh? Even this woman who specialises in ASD and dyslexia doesn't seem to be wringing her hands over that, just that the ASD spectrum is now too big.

The last thing i would say is that there are a lot of things that can cause ADHD like symptoms, including trauma for example, and we need to be careful that kids are getting the right diagnosis so they can get the right treatment there. When it come to Aspergers though there is no treatment. A poorly photocopied booklist was all we were offered by the NHS.

Yes, this idea of a broad autism phenotype, it's interesting. A lot of the 'autism community' talk about the spectrum rather than a linear scale, but surely at some point there is a cut off for impairment - either experienced by the person or observed by others? And what about those with 'autistic traits' but not diagnosed as autistic? Surely that speaks to being 'a bit' autistic?

So once again we are back at Frith, saying autism is now too broad?

We need some phenotypes surely? Classic autism (associated with LD), what was Aspergers, masked autism, sensory autism? There are likely to be others? Maybe do away with the term autism for the last three and choose a different descriptor?

This way people can be identified and their specific needs met, rather than generic adjustments suggested/made that don't fit and don't help much?

I think that's a very broad term.

I suppose it comes down to why someone would be exhausted from socialising with others.

If you're autistic and socialising tires you out it can often be from sensory overload, overwhelm, communication deficits etc.

In my autism assessment I briefly remember being asked if I like to read books, and I said yes.

I then had to be prompted to say which books and what they were about.

Then my assessor along with the supporting clinician started talking to each other about Vampire Diaries, and I just sat there and observed but they were checking to see if I would join in, ask questions, show an interest, but by this point in the assessment I didn't have the wherewithal to even speak and the exhaustion that came afterwards landed me horizontal for 2 days.

It was reported in my assessment feedback that I lack emotional reciprocity.

When I am with company I have to very consciously remind myself I have to ask these questions because they aren't automatic to me at all, where they seem to flow easily from others mouths. It's really hard especially when it's busy and you're someone like me with auditory processing issues and words just sound like squiggles unless I'm paying extremely close attention and there's no other stimulus in the background.

I don't think I'd describe myself as an introvert, but I definitely find socialising extremely exhausting.

My brother on the other hand can easily socialise but much prefers a good book and his armchair, and I would describe him as an introvert.

I think thats a good question. I would describe myself as an introvert, because my understanding is that its someone who doesnt 'need' people around them to thrive. Whereas an extrovert has that 'need'. Its not necessarily about whether its good for you as such

And then I think about the fact that I do like to be around people, but they equally can exhaust me over long periods. So Im an easily tired extrovert! As a child I was much more social, social butterfly, then as I grew older I think I lost confidence and would have said I was an introvert. Now much much much older I like being out and about with people but within limits or I get tired.

Isn’t the name for people who are exhausted by socialising with large groups of people merely ‘introvert’?

There will be a group which will argue that if there's no impairment, he's not autistic. Previously he may have fitted in under broad autism phenotype.

Cross-post @GreenGoblin09. Yes, I think I’m one of that group.