Comment by formerly_proven
1 day ago
The criteria for diagnosing ASD today are vastly different from those that would’ve resulted in an autism diagnosis shortly after the abolishment of lobotomy, it is hardly surprising the rate keeps going up as you widen the net.
> shortly after the abolishment of lobotomy
That's an important bit of context whenever RFK Jr. talks about how conditions like Autism and ADHD weren't a thing when he was growing up - his own aunt, who may well have had one of those conditions, was dealt with by giving her a lobotomy and then hiding her away. Those are the supposedly better times he's harkening back to.
https://en.wikipedia.org/wiki/Rosemary_Kennedy
Lobotomy was not given to young children even when it was a thing...
In this case lobotomy was put on a non consenting 23 year old. So much better?
> who was one of the youngest survivors of the transorbital lobotomy, a procedure performed on him when he was 12 years old.
https://en.wikipedia.org/wiki/Howard_Dully
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This is a huge factor, in ASD and in mental/behavioral issues in general. Not saying it's a bad thing but it makes comparison over time to be apples to oranges.
Also... the picture of left-handed people would fit in here.
https://slowrevealgraphs.com/2021/11/08/rate-of-left-handedn...
The very much same applies here I think.
> The criteria for diagnosing ASD today are vastly different
Not that much.
The difference between now and 50 years ago is that a) we don't just throw them into asylums, b) we actually have accessibility of getting diagnosed, c) employment opportunities suitable for many people with mental disabilities (such as factory line assembly) have gone down the drain.
None of those points are related to diagnostic criteria.
No, they are related to the pool of people being diagnosed.
You're only getting a diagnosis if a) you have access to a psychiatrist and b) you are running into enough issues in your daily life to warrant having it looked into.
Life has gotten a lot more complex over the past few decades, so people run into issues more often - and earlier in life. Someone who would've just been "a bit of a weird guy" 50 years ago is getting an autism diagnosis today, simply because these days they run into issues as a child and are being put in front of a psychiatrist.
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> Not that much.
Very much so. What we now call Autism Spectrum Disorder was referred to as "childhood schizophrenia" in the DSM-2 [1], things only started moving in the right direction with the DSM-3 [2] when it was finally sort-of recognized as an independent disorder of "infantile autism", but some core elements of ASD like sensory processing differences were only recognized in the DSM-5.
There's a good overview at [3]. It's good that criteria are different today, the criteria from decades ago failed to include majority of ways that autism expresses itself, many of which benefit from support and accommodations even though they're not obviously debilitating.
[1] https://www.madinamerica.com/wp-content/uploads/2015/08/DSM-...
[2] https://aditpsiquiatriaypsicologia.es/images/CLASIFICACION%2...
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/
And let’s not forget that until the DSM-V, a child could not be diagnosed with both autism and ADHD (see section E at the bottom of this table [0] showing changes from the DSM-IV to DSM-V):
> The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorders and is not better accounted for by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, or a personality disorder).
The DSM-V states that they can exist together. In fact something like 28-44% of people with Autism exhibit some form of ADHD. [1]
It just goes to show that we’re still evolving in how we understand things. And then we can get into things like twice exceptionality and Asperger’s…and yeah. Lots to learn.
[0]: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/
[1]: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
Yes, but is that a feature or a bug? Certainly those who define these things understand the need and value of historic tracking. And yet the target keeps moving.
If expanding the definition is the feature required action should be taken to mitigate the bug. True?
What's the link between ASD and lobotomies?
Progress of understanding.
Sorry, still not that clear to me.
Are you saying that there is no direct link but rather understanding of various areas increased due to the stopping of this practice?
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I think he's just trying to choose a point in time when mental healthcare was more primitive to go along with saying the diagnosis is more sophisticated now.
A main thing is that people with autism would just be classified as generally mentally disabled and the rise in autism is highly tied a drop in that general diagnosis. I don't think that covers 100% of the rise but does seem to make up the big majority.
U.S. special-education autism classification was created in 1994 and tied to a big rise in diagnosis.
https://news.wisc.edu/data-provides-misleading-picture-of-au...
Thanks. That helps.