Hello, Friends.
I have a bit of time to kill before a flight, and I've found this thread positively irresistible. I'll tackle the youtube attachment, then respond to the gallery separately. Sorry...this first pass will be quite long.
As a scientist and an Aspie, I find myself frustrated with the lad in the video.
Firstly, as a requirement of my own OCD...I have to point out that the DSM is an
American manual, generally used in other countries only when the ICD is due for updating and a new DSM releases first. The process by which the ICD is compiled is far more thoughtful and evidence-based than the overtly political one that has plagued the last two editions of the DSM.
In another fundamental mistake, the lad confuses the establishment of disorders with their diagnostic application in the clinical setting. The identification and description of a disorder is, in fact, a scientific process, so established disorders are valid enough, at least in the context of current knowledge. [And note that it was advancing understanding, not politics, that finally removed homosexuality from the DSM.]
The first point at which a disorder is interpreted by the broader medical community is the point of inclusion in a diagnostic manual. This is where things can start to go wobbly. A working group for a particular disorder is tasked with prioritising symptoms. They will naturally include only those which are likely to cause the most significant functional impairment, as the end-user of a manual will be a practising doctor whose job is to assess the presence and severity of dysfunction, and from this, develop a treatment plan. In the case of later editions of the DSM in particular, this task has been subject to decidedly unscientific influences...agencies of government, special interest group lobbyists, and others.
Once the manual is released to the field, individual doctors have no choice but to use their own interpretive skills for diagnosis, as there are indeed no biological tests [or at least not many that are cost-effective] to accurately identify most disorders of the mind. At this point, the subjectivity of diagnosis becomes truly problematic.
Any conclusions the lad in the video has drawn from this basic error are, therefore, too flawed to argue convincingly. In his statement that when stripped of symptoms caused by comorbidities, the autism diagnosis becomes “thin air”, he disregards a number of credible studies that demonstrate measurable neurological differences between autistics and NTs.
It’s also pertinent to mention that he apparently doesn’t understand the concept of overlapping symptomology between disorders. For an example relevant to this thread, obsessive-compulsive behaviour is natural to Asperger’s. Specifics and degrees distinguish whether or not a discrete, comorbid disorder is present. Simple enough. I’ll leave this there.
If we are to argue that there is no real science behind any part of the diagnostic process, from identification and description onwards, we must accept that the feeling of rightness we experience when we discover ourselves as autistics is invalid, and that the particular sense of kinship and understanding we find as fellow autistics is so, as well. We don’t all have the same comorbidity, yet still, we recognise our essential similarities, and our differences from the majority population. That, to me, says autism exists as its own entity.
The lad’s one best argument pertains to the folding of all four [not three] autism spectrum disorders under one heading in the DSM-V, but it was underemphasized and poorly articulated, here. A missed opportunity, to be sure.
I see a disturbing trend in our community. It is quite arguable that our neurology is equally “healthy” to that of NTs...a simple variation. I see no problem with that line of thinking, when well-considered and adequately supported. However, rejecting all science, including psychiatry [imperfect as it is], to only embrace how we
want to see ourselves is not only irrational, it’s arrogant. It’s certainly no way to get us better understood. So, I beg of everyone here to think hard before going that route.