DSM-V [1] describes criteria / symptoms in two groups (caps from document, sorry):

> A. PERSISTENT DEFICITS IN SOCIAL COMMUNICATION AND SOCIAL INTERACTION ACROSS CONTEXTS, NOT ACCOUNTED FOR BY GENERAL DEVELOPMENTAL DELAYS

> B. RESTRICTED, REPETITIVE PATTERNS OF BEHAVIOR, INTERESTS, OR ACTIVITIES

For criteria A, severity is more or less measured by how much social impairment is observed --- that's a measure of social acceptability in some fashion.

For criteria B, the severity criteria is about "interference with functioning in contexts" as well as observed distress of the patient. Interference with functioning can be related to the patient resisting the desired function, but it can also be because the patient is socially excluded due to their behavior.

Although, I should point out clinical criteria in general and the DSM in specific are a formalization of arbitrary judgements that describe observable characteristics grouped into a diagnostic category; this can be useful, but it's not really an understanding of the underlying condition(s), it's a handbook of things to look for when a patient comes asking for help and what things to try to help them. If someone has the same underlying conditions but manages to pass as socially acceptable, they may not come in for help, and that's fine too. When multiple underlying conditions result in similar observable criteria, the DSM gets pretty confused; there's not much in the way of attaching traces and getting debug logs for mental processes though, especially out in the world, so this is the best society has, I guess.

[1] https://depts.washington.edu/dbpeds/Screening%20Tools/DSM-5(...

ASD is defined by the level of support the individual needs. It says nothing about “fitting in” or by pain or anything else like that

I suspect part of your parent comment's point is that this is an implicit bias in the way the spectrum is defined and thought of, so it wouldn't be clinically defined in those terms explicitly.

In other words, the "spectrum" doesn't exist to capture the variation in the autistic person's own experience - if it did, it would look very different. It's a remnant of a time when autism was seen as just a "problem" for the people around you, and the spectrum measures how much of a problem you are and how weird you are seen by their measure; which does map onto a continuous line in the same way.

That does capture something useful, but only a small part of what autism actually comprises, and is much less useful at capturing the autistic person's own experience of it, and makes it a less useful tool to them than people might assume.

Has social acceptability in any context ever been defined, beyond say, rules of etiquette? It's a free market and everyone is arguably entitled to test to see what it will bear.

The entire nature of the field of psychology and mental health treatment is relative to pain and dysfunction.

If people fit in well and didn’t have issues (either internal pain/suffering or society interaction pain/suffering), they are not applicable to the field.