Autism should not be treated as a single condition

Original Article ↗ Hacker News Discussion ↗

Access and paywalls

  • Several comments focus on difficulty accessing the article and archive sites (CAPTCHAs, DNS/FBI blocking), plus irritation at paywalled content being posted at all.
  • Workarounds (alternative DNS, Tor onion URL) are discussed, but some argue this just highlights unresolved copyright and access issues.

Historical prevalence and “autism epidemic”

  • The RFK Jr. framing of an “epidemic” is strongly questioned.
  • Multiple comments argue autism (and other conditions like asthma, allergies) existed but was:
    • Undiagnosed or mislabeled (“retarded”, “eccentric”, “Larry never leaves the farm”),
    • Hidden away in institutions or segregated education,
    • Or simply died young before modern medicine.
  • Others note diagnostic relabeling (fall of “mental retardation” coinciding with rise of autism diagnoses) and better survival of children with chronic conditions.

Spectrum vs multiple conditions

  • Many say laypeople already see autism as heterogeneous (“on the spectrum”), but others argue this still flattens very different realities.
  • Strong debate over whether ASD should be split into distinct named conditions versus kept as one broad umbrella:
    • Pro-splitting: helps distinguish mild “superpower” narratives from profound disability; may align with different underlying mechanisms and treatments.
    • Anti-splitting: current treatments are largely therapeutic and transferable; broader category eases access to services and research recruitment; subtyping without solid biomarkers risks chaos.

Severity, support needs, and lived experience

  • Repeated tension between:
    • High‑support‑needs cases (nonverbal, self-injury, lifelong full-time care) and
    • Low‑support‑needs/“Asperger-like” cases (can work, marry, but still have serious sensory, social, and executive issues).
  • Some parents of profoundly disabled children feel their kids are overshadowed by “autism is my superpower” and identity‑politics framing.
  • Others stress that masking and burnout make low‑support‑needs autism far more impairing than it appears externally.

Diagnosis, overdiagnosis, and self‑identification

  • Several commenters complain that autism (and ADHD) have become trendy labels, driven by social media, online tests, and sometimes perverse incentives (school supports, disability benefits).
  • Others push back, emphasizing long waitlists, difficulty getting formal diagnosis, and the harm of dismissing people as faking.
  • Debate over casual “we’re all a bit autistic” language: some see it as destigmatizing; others say it trivializes real impairment.

Science, subtypes, and psychiatry

  • Some highlight emerging genetic/phenotypic work suggesting 3–4 autism “cores” or subtypes and welcome more precise subclassification.
  • Others are skeptical of psychiatry’s scientific rigor in general, citing shifting labels, reproducibility issues, and past abuses.
  • Concern appears about future prenatal identification leading to more terminations, versus arguments that severe forms may reasonably prompt such decisions.