Autism is a developmental disorder, and there are indications that it cannot be cured - because the damage is already done. Even if we could resolve the cause in an adult, the effect will stay. The brain had only one chance to develop, and it has developed wrong. This is why autism, unlike many other mental disorders, fails to respond to medication.

Something in the brain development has gone off course - and by the time you see the early symptoms, it has been off course for a while already. Early interventions help considerably, but you might have to intervene extremely early, before any clinical symptoms show, to prevent it. Even if you knew exactly how to spot the risk so early on and what to do to intervene, which, we really don't.

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ridgeguy 6 hours ago | parent | next [-]

It seems you substantially discount neural plasticity: "...cannot be cured".

IMHO, our understanding of autism, specifically, and neural development of the brain, in general, is rudimentary at best. It's too soon to conclude it's incurable.

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ACCount37 6 hours ago | parent [-]

I do indeed. Because developmental windows exist. You can take the cat out of the vertical world, but you can't take the vertical world out of the cat. Trying to train them out of it only helps a little - too much damage is already done. The brain has developed a certain way, and you can't un-develop and re-develop it.

There is no consensus that autism is like this, but a lot of evidence points that way.

We'd need at least a generational leap in neuroscience to be able to pull off something like that. It's not a "laws of physics prevent you" level of impossible - we just don't have a clue of how would we even begin approaching something like that.

	▲	pamplemoose 5 hours ago \| parent [-]
		It's possible that those critical periods can be manipulated or induced. See https://pmc.ncbi.nlm.nih.gov/articles/PMC3848041/

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catigula 8 hours ago | parent | prev | next [-]

Many developmental disorders can be 'cured' through compensatory approaches and probably gene therapies.

	▲	ACCount37 8 hours ago \| parent [-]
		"Compensatory approaches" is what the behavioral interventions for autism are. No silver bullet, but it does help, and it's often well worth the effort. A timely well executed intervention may make the difference between "needs a caretaker" and a mere "struggles in life". But it's not going to negate all of the damage. Gene therapies I have little hope for. Maybe something there may help. But the impression I get is that it's less of a "fix biochemical deficits" issue, and more of an "unwire and rewire existing neural circuits" issue. We have no fucking clue on how to do that. And to sidestep that, you'd have to intervene early - maybe as early as "remove genetic predispositions in an embryo".

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MrDarcy 7 hours ago | parent | prev [-]

Downvoted for “developed wrong” when it’s becoming increasingly clear Autism isn’t so clearly a disorder or wrong as it is different.

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ACCount37 7 hours ago | parent | next [-]

If you think that, then, it's clear that you won the autism lottery.

The ones who weren't so lucky, and got the short straw? They would die without a caretaker to take care of them.

Even among the less severely afflicted: I'm sure there are people who don't mind being autistic, and I'm also sure that there are people who "don't mind being autistic". The difference between the two being: if there somehow was an easy cure, the former wouldn't go for it, but the latter would jump at the possibility. Because their "don't mind" was never anything more than cope. Same as what happened to body positivity in the face of Ozempic.

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MrDarcy 7 hours ago | parent | next [-]

This comment sparked curiosity about the distribution of support needs among autistic people. My hypothesis is those people with high support needs are in the minority and those without are the plurality.

After digging into it, the hypothesis holds. Most autistic people win this lottery you speak of.

Roughly 25–35% of diagnosed autistic people require substantial, ongoing support (e.g., daily assistance, supervised living, or full-time caregiving).

About 30–40% have co-occurring intellectual disability, which strongly correlates with higher support needs.

Roughly 60–75% do not have intellectual disability. Many in this group: Live independently or semi-independently. Work (often underemployed). Mask heavily and are diagnosed late—or never diagnosed.

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ACCount37 7 hours ago | parent | next [-]

Would you have guessed that "1/4 to 1/3 of diagnosed autists need ongoing support" off the top of your head?

Probably not. Because self-selection is doing its work. Out of 10 autistic people you know, ~0 are going to be in the "supervised living" category. They exist - you just don't see them.

	▲	MrDarcy 6 hours ago \| parent [-]
		Not that it's about me but my guess was 20%, 1/5, not far off from 1/4. I know and am close to many autistic people, those with and without high support needs. That estimate is of diagnosed people. Many autistic people are undiagnosed, therefore not in these numbers. There's increasing evidence autism affects all genders equally yet women have been under diagnosed. Anyway, the core assertion holds. The framing and thinking of autism as a disorder of a brain that developed wrong is out-dated and incorrect. We could also frame the neurotypical brain as wrong for modern society because it evolved to ensure the survival of humans. For example, the typical brain evolved sophisticated fight or flight responses, and efficient pattern matching to quickly respond to physical threats. Both are "wrong" for modern society and civilization because they're rarely necessary for survival and they confound reason and thoughtful analysis. It's also a fact human intelligence has evolved significantly faster than human physiology. Those people who win the autism lottery, are successful in life, and ultimately have children will contribute to an increase of the proportion of lottery winners in subsequent generations. Given this new information, better to examine neurological differences rather than focusing on winners and losers, right and wrong.

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bryanrasmussen 5 hours ago | parent | prev [-]

OK well let us then not call it winning a lottery, let's call the negatively affected ones getting run down by a car. That's better! People who did not get run down by cars have it pretty good, no matter if they like to wear certain clothes or have hyperfocus on hobbies it's all pretty good stuff, but the ones who got run down by cars and then the car turned around and went over them a couple extra times, they don't have it that good.

It's not very helpful to say if someone has been run down by a car that they just have different highway experiences than people who were not run down by cars. Their difference is a significant problem, because they have been run down by a car and it hurts.

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MrDarcy 4 hours ago | parent [-]

I agree with you and I’m struggling to see how my reply wasn’t helpful. I’m saying those people who get run over by a car in this analogy shouldn’t be run over by cars on the highway. I look at what’s wrong with the highway. I don’t believe the sole primary reason people get run over in this analogy is because their brain developed wrong.

More that their brain developed differently and our current highway system is incompatible with that difference.

The highway system can and should change just as we individuals can and should try to change our minds in areas where it makes sense to do so.

My preferred analogy is that all neurodivergent people are playing the game of life at least on hard mode. Some are playing on ultra hard mode. Some are playing on impossible mode.

As it relates to treatment, the goal is to help a person live as close to typical difficulty as possible. Same goal for accommodations extended to the person by society.

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bryanrasmussen 3 hours ago | parent [-]

it's fine I guess. but the thing really is that there are two different problem levels, and it seems almost always that any discussion of autism only focuses on one or the other problem level.

So if people discuss the getting run down by car problem level the people who have an "I'm different" problem level feel as if they are being insulted, and if people discuss the "I'm different" problem level the people who care for the people who have been run down by cars feel like... well, insulted would probably be the least of it.

	▲	MrDarcy 2 hours ago \| parent [-]
		For my part I'm obviously at the "I'm different" level and I don't feel insulted discussing the whole spectrum. Hopefully that's true for more people over time. Edit: In retrospect I suppose the “developed wrong” language is insulting to me and the boundary is just beyond the idea of “different” I suppose then the request is for those people caring for autistic people who are so different life is impossible to live without care to view the concept of “different” as a spectrum too. Not wrong.

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kayo_20211030 6 hours ago | parent | prev [-]

> Same as what happened to body positivity in the face of Ozempic.

I have definite feelings about this exchange on autism, which are being hashed out reasonably without my input. But the Ozempic reference is super interesting. I hope some smart person looks into that particular "correction" vs. "coping" dichotomy at some point in the future.

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memonkey 3 hours ago | parent | prev [-]

Agree with you and your responses in the threads elsewhere.

There seems to be a point of contention amongst the terminology for anybody with autism. Someone with autism might not see themselves as having a disorder. But there are certainly very high needs autistic individuals. Apply a whole spectrum of people as being "developed wrong" and you can start to see ableist language.

I appreciated your metaphor about cars on a highway -- and that there's something wrong with the highway, not the car. I thought it was really simple and clear and I think I got the point you were trying to make. And even if it the highway isn't wrong (it was made for cars after all), we should at least extend it to support many types of transportation.