To think autism gets worse with each generation

[eastereggg]

Genuine question.

Why does it seem that autism gets worse with each generation?

Example: a mother is a late diagnosed autistic but her child is very clearly autistic and displays much more severe characteristics than she did. The grandmother would probably be diagnosed autistic today as well.

There seems to be a recurring pattern that I'm seeing where autism is getting more severe with each generation. Is there an explanation for this?

Because it's a spectrum. I'm AuDHD, my mum will never be assessed at this point in her life, but she is AuDHD and has suffered immeasurably all throughout her life.

She had no choice but to adapt, but suffer, because she had children to take care of and zero support.

I feel so sorry for her.

It was bad for me growing up too and I've only just been diagnosed. I'm staying to unmask and there is a fair bit of unravelling happening too. I'm done with trying to fit in. It didn't work for me anyhow!! Nor my mum! Who is 82.

No you can’t because categorising involves division. There is no division as you move between support needs and support needs can differ between traits.

Yes I agree @MerryMaker though anecdotally adults with ASD develop into their third decade.

I’m not sure that I understand the model you described but it doesn’t really matter.

Not roasted, reported though. Hopeful for a delete.

No @Dovecare I don’t and can’t imagine why you would think that.

People are (rightly) pointing out that to be diagnosed, autism needs to have a substantial impact on your life.

Yet upthread we had descriptions of people who must have been autistic because of stuff like "they liked trains", "they were quiet" or "they hated the texture of jelly". I see this sort of thing IRL.

It feels as if it's the armchair diagnosing, that seems all the rage, that means people genuinely now don't see it as a (potentially disabling for some, having to live in an NT-geared world) condition that has an impact, just a new way of describing perfectly average variations in taste/personality. So ND people's challenges are then not taken seriously (ironically some of those doing the armchair stuff are ND themselves)

The question is are there more people with very high needsASD and if so why?

People always say you can't get a diagnosis unless it has a substantial impact on your life. I understand the theory. But if someone has a job, married, with kids and with friends, how does ASD have a substantial impact on their life?

@Ohthatsabitshit but that's obvious isn't it. Like all conditions, medical advances means that more people survive premature birth or childhood illnesses, many people with autism have comorbid conditions that in yesteryear would have killed them.

@HPandthelastwish i think the suggestion is a sort of snowball effect is happening.

The DSM and ICD no longer use ‘substantial impairment’. The DSM-5 uses ‘clinically significant impairment’. So, just because the impairment isn’t apparent to the outside world doesn’t mean it isn’t clinically significant. The ICD-11 states “The symptoms result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Some individuals with Autism Spectrum Disorder are able to function adequately in many contexts through exceptional effort, such that their deficits may not be apparent to others. A diagnosis of Autism Spectrum Disorder is still appropriate in such cases.” So, again, may not be apparent to the outside world. You don’t know the toll having a job/family etc. takes and you don’t know the ‘exceptional effort’ involved.

@BrightYellowTrain so it is self reported based on the substantial effort the individual thinks they are making. Without any idea if the substantial effort they are making is just normal.

As we covered earlier in the thread, no, a diagnosis isn’t only based on self reported symptoms.

You could be talking about me. Job, kids, friends etc.

I work about 20h a week, simply cannot cope with more ("cannot cope" looks like total inability to concentrate or complete any task and likely self-harm or extreme anxiety if I push it).

I'm self-employed and do very well, but I crashed out of every employed job I ever had despite giving it my all - in hindsight I think I couldn't cope with the stress of my (simple) commute and the noise of the office.

People who know me would say that I am great with people - at work I lead a lot of volunteers and I am very good at reading people and placing them in the right jobs, engaging with them in a way that puts them at ease. It's because I am very tuned in to people's reactions/expressions and react to them more than most seem to. That's decades of masking for you.

Likewise friendships - I thrive on routine so I happily see the same friends every other Tuesday at 7pm but go to pieces when the holidays or whatever else changes things. I am very rigid in my thinking despite trying my utmost to adapt, be flexible etc.

There's lots more - personal hygiene is a disaster, for example. Significant issues with clothing. Use the same cutlery/crockery daily and can't tolerate others. Can't use loos outside of home. Lots of stims. No one notices any of the above.

Level 2 autism diagnosis by a reputable assessor, plus ADHD.

From the outside I am successful, together etc. I would be the last person anyone would assume had autism.

Since I'm on the thread again I would add - autism isn't a spectrum like the knob on a cooker, it's a spectrum like a light array or circular graph representing various skills and attributes associated with autism. And one autistic person won't be the same as the next. This graphic explains it better than I do: https://ablelight.org/blog/why-the-autism-wheel-is-replacing-the-spectrum/

Now clearly if someone has poor speech and hypersensitivity and tics and and and, they are going to be more obviously autistic and will be much less able to adapt to NT society and function within it, but that doesn't mean that someone with a more moderate profile isn't autistic.

@MerryMaker

People always say you can't get a diagnosis unless it has a substantial impact on your life. I understand the theory. But if someone has a job, married, with kids and with friends, how does ASD have a substantial impact on their life?

My friendships were toxic. My first marriage was abusive. I did not realise I was vulnerable. I have been sexually assaulted and raped more than once, simply because I did not know how to protect myself. I had jobs over the years but the overwhelming anxiety attached to being able to turn up and do said jobs left me burnt out.

I am happily married now, to an autistic man. I have autistic children, don't bother with friends now and no longer work. All of these things make my life easier but also very very small.

My autism had such a substantial impact on me that it left me with complex PTSD, medicated and addicted. Unable to function as I previously had.

@MerryMaker so what you are hinting at is people getting an autism diagnosis that don't need it or don't have the condition.

Playing devil's advocate here: - What difference does that make?

Even if there was some over diagnosis, there are no drugs to take, no help available on the NHS, you might qualify for questions in advance and extra time in an interview or an extra 15 mins in an exam perhaps but other than that it makes absolutely no difference to anyone else. The vast majority of people who can work (with any condition) want to work as it gives meaning to life and makes you feel like a functioning member of society. To get any sort of disability benefits with autism requires you to hit very high criteria so there isn't even a financial benefit.

What a diagnosis might give someone though is validation tha they find life hard for a reason and have a placebo effect on helping them cope.

It's funny how if you say you've been diagnosed with anything else for which there's no treatment, no one questions why you've got diagnosed. But with autism, it's always "why do you want a label?"

Well in my case if made me more susceptible to work related stress, lots of long periods of sickness or burning myself out because I had told myself I wasn't really sick, it made me more susceptible to being abused because I was told that their reactions were perfectly valid responses to my autistic behaviour by them and their supporters who I had wrongly assumed had my back. It made me more susceptible to financial abuse and being forced to take out loans and lines of credit to stay afloat because I lack the social awareness to risk assess or assess what is "normal" in society.

Being autistic did not stop my reproductive organs from working. Some of my autistic friends thrive off the routine that you implement when you have children so having kids for them hasn't had much of an impact as they have built routines and coping strategies into their lives.

It was highlighted that I had significant social impairment, was at risk of abuse going forward, have accrued over 40k debt in my name to cover for the amount of money the people in my life have cost me.

Working, having a relationship and having kids doesn't mean that I haven't faced any trouble with these areas of my life but more importantly there are many other aspects of my life that being autistic has quite significantly impacted.

So you might look from the outside and think I have these things, and so I don't have any significant impairments but you've not got a clue what happens behind closed doors. Not with me an Internet stranger and not with your friends and family.

Also having been through the diagnostic process I can tell you they're quite thorough at digging into all of the areas in life where you have been at a detriment for the way your brain works. Actual qualified professionals, several of them, and then it's taken to a multidisciplinary hearing where you're cross examined for your deficits.

It's really quite offensive that you keep trotting out this notion that someone who has had relationships, employment or children aren't significantly impaired because you're not in the least bit qualified to make that decision.

Your story mirrors mine almost entirely. Solidarity ❤️

I have two DDs, my oldest I am pretty sure is autistic (no official diagnosis), she has sensory issues such as with the feeling of clothing and with food! Prefers most of her food bland etc.

She also has struggle with anxiety and socialising, however, is learning to mask more and appear more ‘normal’.

My daughter never has melt downs though, she is high functioning and will live an independent life as an adult. I suspect I’m also on the spectrum, but I struggle more with anxiety and with friendships, but I don’t have any issues with food or clothing.

We are all different and the spectrum is so wide. I’m not sure I believe, your children autism will be worse or better…

My youngest DD appears NT so far, no speech delay and hitting all mile stones unlike her older sister. Its just pot luck.

My DH would seem to fit your criteria. But he's working twice as hard and long as peers to progress half as slow - he will probably never have the career he's intellectually capable of. He's on medication for depression, and even then, every couple of years a stressful period at work will get him close to a nervous breakdown. He gets himself into messes at work that other people just... Wouldn't. I'm not sure he'll make staying in his career until retirement. He only functions because I do almost everything at home. I don't think he's aware of how e.g. our bills are paid, kids' school timetables, required house maintenance, etc because he just can't retain all that and work. He is a loving and engaged father but I'm not sure he could survive being a functional working parent without me. He has friendships that are meaningful and long lasting, but social engagements are physically wearying for him.

"Significant impact" doesn't mean you can't do these things and you can't have a happy life - ours is mostly, very happy. But it means that it takes more work and is more of a challenge to do that.

they're quite thorough

This is my experience too. In fact, my NHS assessment, diagnosis and report was more in-depth than my DC’s NHS assessments, diagnoses and reports.

Late diagnosed autism = parent has child with acute needs and as part of the assessment, the parent is also diagnosed.

An artefact of diagnosis, not anything remotely related to eugenics or autism 'getting worse'.