Interesting new study about the 4 types of autism

[Anonymous]

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

Own of the points of the study is that there is a different condition with different genetic markers that has a later onset. Maybe they will eventually give that a different name but I think that won’t happen until the diagnostic criteria are more advanced. I think in 50 years they will be using a combination of brain scan, genetic test and clinical observations for diagnosis, and by then there might be several different conditions that are recognized as having different causes and potentially different treatments.

Currently we’re at the stage where someone has a stomach ache and we are calling it all one disease — there are some cures that are useful for stomach aches caused by different things, but once you understand that there’s a dofference between an ulcer and stomach cancer and abdominal migraine, you can start to get much more nuanced with treatment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

That was the dividing line between "Asperger's" and "classic" (or Kanner) autism, wasn't it? But they did away with those categories.

My kid either the first category or the third - generally developmentally on track with a history of severe anxiety but doing well now overall with social skills and executive functioning supports outside of school and a 504 plan in school. Still young so may be hard to see all the ways she is impacted but can be considered subtle right now (though it is obvious to me).

Despite it being "subtle" no question she has been autistic since infancy. The severe anxiety became apparent at age 2.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I skimmed through the Nature study very quickly. It divided ASD into 4 groups which were basically Mild, Severe and two in the middle. I'll read it more thoroughly later on.

Which one is caused by 81 shot vaccine regimen plus multiple mRNA shots?

None. According to many, many studies. But not getting vaccines causes death, so there's that.

I only read the shorthand article, but they made it clear that the primary cause is genetic, with many of the parents exhibiting the same traits.

I have a child with AuADHD. After the diagnosis, I looked around my family and found undiagnosed autism on one side and undiagnosed ADHD (rampant) on the other side. I have met other moms of autistics, and many of them clearly have ADHD.

How do you know these mom’s have ADHD? For all you know they might not text you back or tell you a story about misplacing car keys because they are burnt out/exhausted. For all you know this could be the case and they could have OCD, which also has a lot of overlap with autism. Or they could have a ton of sub clinical symptoms and fall into the broad autism phenotype (BAP) category.

[Anonymous]

After my DS was diagnosed with ASD at age 3.
We found out we have 2 ADHDs in my family and 1 Asperger in my husband’s.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why do I still feel like my kid doesn't fit a category? Which one is PDA autism?

NP. I think that PDA is separate or a specific combination of ADHD and ASD (and anxiety) rather than a subset of ASD as some call it now. That's my personal opinion based upon my DC. In this study, I think it would be category 5. Or maybe the first one.

A lot of kids also have some coordination disorder. I think this study is missing some of the key features of autism. I wish they would just diagnose by skill and severity.

Yes! Muscle tone and coordination differences are so prevalent, and this could help with differential dx.

[Anonymous]

Anonymous wrote:When I read about the four sub-types in the summary, it really brings to mind the disorder formerly known as “Aspberger’s,” and then ASD level 1–2-3 in that order. I would like to see the “social and behavioral challenges” group that has at least average IQ, reaches developmental milestones, and struggles with anxiety, OCD, ADHD etc. as a completely separate diagnosis from ASD. I get that they are the largest group in terms of size, but their challenges are soooo much different from kids who use communication devices, have multiple learning disabilities, low IQ, can’t be in regular school classes, and so on. And it’s diluting care and resources from those who most need it. I also think ASD is being over-diagnosed in older kids, teens, young adults, and even adults, because it’s somehow easier to accept an autism diagnosis vs. some combination of OCD-anxiety-depression-ADHD giving you a somewhat “difficult” personality.

Agree with separating diagnosis.

Kind of agree with dilution of resources but in a different way. With autism all “lumped” into one category, misinformed providers mistakenly believe one size fits all.

Help is needed across the spectrum—‘just different kinds of help.

[Anonymous]

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

For real?

Girls are often overlooked because presentation can be different.

We reported to pediatricians differences in behavior we noticed around 8 months. Each visit id take the autism questionnaire but it never felt quite right. I’d then bring up other differences and doctors would always say “it’s just a phase” or “try this activity.”

It was an experienced preschool teacher who said “I’ve been working with 3 and 4 year olds for 25 years. I recommend you get an autism evaluation.”

She was right.

It took observation over a period of time and with a larger group of kids to notice the differences.

[Anonymous]

Anonymous wrote:I am thrilled at this development, as a parent of a child with "mild" autism, because it offers a path for both better understanding the specific challenges my kid faces, and also possibly to make it easier to identify the appropriate supports and therapies.

Here are the categories (my summary from the Princeton Engineering article):

Social and Behavioral Challenges. Show core autism traits (including social challenges and repetitive behaviors), but meet developmental milestones on time. Often co-occurring with ADHD, anxiety, OCD, and other disorders.

Mixed ASD with Developmental Delay. Mixed presentation of autism traits (may have repetitive behaviors but not social challenges, or vice versa). Tends to reach developmental milestones like walking and talking later than is typical.

Moderate Challenges. Show core autism behaviors but but less strongly than other groups. Meet developmental milestones all time. Does not tend to co-occur with other conditions such as ADHD and anxiety.

Broadly Affected. More extreme and wide-ranging presentation of autism behaviors. Includes not only social issues and repetitive behaviors, but also communication issues, and is very likely to co-occur with other psychiatric disorders, including mood disorders.

The last group, what people would think of as classic autism prior to the recent expansion of the category to include a broader range of behaviors, was the smallest group in the kids they studied (just 10% of participants got this classification).

My kid would probably be categorized in the first group. One thing I really like about the categories is that it's not a strict continuum from "mild" to "severe". Rather, they are looking at three metrics (severity of autism behaviors, developmental impacts, and co-occurring diagnoses) to group kids by the types of challenges they may face. This is much more useful than trying to explain my kid has "mild to moderate" autism which doesn't really capture what is going on.

I could also see this being useful in the conversation about when it is appropriate or beneficial to mainstream kids and when they may be better off in a specialized classroom.

This is interesting. My DC has straddled many of the diagnoses as they keep twiddling with them. First he had pragmatic- semantic disorder - with other issues. Then PDD-nos but not Asperger’s. Now it’s Level 1. None were a great fit. However with this description, he looks like he is more in the second group than the first as he sat up late, crawled late, walked at 16 months and was a person of few words (very well articulated however) for a long time. He wasn’t considered “development delay”, but he was edging towards it. As an adult he still has some hypotonia and coordination issues. He was in a social skills class from 3rd grade to HS graduation and credits it with his success in college. We are all math and science geeks in our family and everyone has a smattering of autistic traits, but he ended up with a few more. He did well in college and has a good job now. He is intelligent and is the stereotypical computer engineer so I think his autistic traits are known entities at his workplace. He is within that norm. He moved out a few years ago. He still needs some prodding and I think he should get a cleaning lady, but otherwise he is almost independent now as he heads toward his 30th birthday. Delayed, but getting there.

He still is very rigid on some things and when he hits his limit on socialization, he is done.

Since he was well behaved in school and did well academically, he never had an IEP or 504. However, we did have him move to a different ES in the middle because the grade social interactions were terrible.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

That was the dividing line between "Asperger's" and "classic" (or Kanner) autism, wasn't it? But they did away with those categories.

What was this? If onset was before age 3, it was classic autism but after age 3 it was Asperger’s? That doesn’t work for my daughter. She has “mild” autism but it definitely presented before age 3.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

For real?

Girls are often overlooked because presentation can be different.

We reported to pediatricians differences in behavior we noticed around 8 months. Each visit id take the autism questionnaire but it never felt quite right. I’d then bring up other differences and doctors would always say “it’s just a phase” or “try this activity.”

It was an experienced preschool teacher who said “I’ve been working with 3 and 4 year olds for 25 years. I recommend you get an autism evaluation.”

She was right.

It took observation over a period of time and with a larger group of kids to notice the differences.

Your daughter had onset before age 3. Medical providers just refused to recognize it/didn’t listen to you.

I’m not arguing for onset before age 3 to be a requirement. I’m just saying that your daughter would meet it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

For real?

Girls are often overlooked because presentation can be different.

We reported to pediatricians differences in behavior we noticed around 8 months. Each visit id take the autism questionnaire but it never felt quite right. I’d then bring up other differences and doctors would always say “it’s just a phase” or “try this activity.”

It was an experienced preschool teacher who said “I’ve been working with 3 and 4 year olds for 25 years. I recommend you get an autism evaluation.”

She was right.

It took observation over a period of time and with a larger group of kids to notice the differences.

Your doctor was an idiot.

[Anonymous]

I find the co-occurrence of mental health issues so interesting because I have family members who fall in different groups and that is indeed a huge difference: some are very affected developmentally but don't have the debilitating mental health issues that are characteristic of the first group.

[Anonymous]

These are not new categories of autism. They looked at non-core features of autism as currently diagnosed and grouped them. In the same way you wouldn’t say there are “types of depression” based on non-core criteria. Like, you could take all the people diagnosed with depression and group them based on IQ, extroversion/introversion, height, weight, etc etc. Unless you have a theory about why these grouping criteria are causal or relate to the *core symptoms* of the dx, this is a pretty useless activity.

[Anonymous]

My kid had a major speech delay…..not really talking at all until 2.5 and he’s very much what used to be called Asperger’s in his profile. He’s the type of kid people point to when they discuss overdiagnosis. I even have mixed feelings about the label.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:They need to bring back onset before age 3, that would solve everything.

For real?

Girls are often overlooked because presentation can be different.

We reported to pediatricians differences in behavior we noticed around 8 months. Each visit id take the autism questionnaire but it never felt quite right. I’d then bring up other differences and doctors would always say “it’s just a phase” or “try this activity.”

It was an experienced preschool teacher who said “I’ve been working with 3 and 4 year olds for 25 years. I recommend you get an autism evaluation.”

She was right.

It took observation over a period of time and with a larger group of kids to notice the differences.

Your doctor was an idiot.

DP here

Many pediatricians and even psychologists lack expertise and confidence to even recommend an autism evaluation. Our pediatrician refused to refer us to a developmental pediatrician for evaluation. Thankfully 3 different therapists shared their concerns about autism with us after the issue we went to them for was resolved.

We were very lucky to get the diagnosis at age 5 and not many years later, as her teachers just see a compliant but shy 6 yo girl who is a little slow to finish her activities and needs redirection at times. We had to switch to a more expensive insurance to do it and ignore our previous pediatrician's advice.

It is well known that girls and kids of color are under diagnosed.