Identical twins both grew up with autism, but took different paths

Meaning of “spectrum” in autism

• Several commenters object to “opposite ends of the spectrum” as implying a single linear “more vs less autistic” scale.
• Others note that “spectrum” in medicine often means multi-dimensional variation (different traits and severities), not just a line.
• The autism “wheel” metaphor and quotes from NIH/Wikipedia are referenced to emphasize variation in type and severity, not a simple continuum.
• There is pushback that if “autism” covers too many distinct profiles, the label risks losing descriptive power, though others argue broad labels are still pragmatically useful.

Genetics, twins, and non-identical outcomes

• “Identical twins” is clarified as monozygotic (same starting genome), not literally identical people.
• Commenters note somatic mutations, chimerism, and epigenetics can still make monozygotic twins biologically different.
• Hypotheses include random differences in brain development, gene expression, and synaptic pruning leading to divergent outcomes.

Possible medical and environmental factors

• The twin with more severe difficulties had a heart defect, surgery, infection, and a month on IV antibiotics.
• Some propose gut–brain axis and heavy antibiotic exposure as candidate modulators; others argue this is unlikely or overemphasized versus infection, blood flow, or general trauma.
• Early hospitalization and reduced caregiver interaction are suggested by some as potentially exacerbating developmental issues, though others note existing research distinguishes autism from attachment-related conditions.
• Alternative ideas raised: mitochondrial dysfunction, connective tissue disorders, and general developmental insults as correlated with autism; extent and direction of causality are described as unclear.

Communication and the Sesame Street example

• The article’s anecdote about a twin “blurting out a series of words” is criticized: those words appear to be the exact episode title, i.e., a fully correct answer.
• This sparks a long debate about literal vs socially expected answers, neurotypical “hidden” expectations in questions, and the “double empathy problem” (mutual misunderstanding between neurotypes).

Disability framing and lived experience

• Some dislike autism being framed as a disability, preferring “difference” and pointing to societal incompatibility rather than inherent deficit.
• Others note that, legally and practically, autism often is disabling (communication, sensory overload, executive function), and disability status enables protections.
• Multiple parents of autistic or possibly autistic children share experiences of differing severities, hospital stays, and long diagnostic journeys, stressing how little is definitively understood and how support matters more than precise causation.