Autism isn’t one disorder, a genetic analysis shows

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The new research reinforces how complex the neurodevelopmental disorder is and that there isn’t a single cause.

This is something many of us have long suspected.

Interesting , but lacks clarity re 'late diagnosed'. There's a difference between being late diagnosed because you were born a long time before the diagnostic criteria were broadened and still being late diagnosed if born after the late 1980s/early 1990s. For those of my age a delay can be lengthened if you develop a SMI beforehand. My attempts to be taken seriously as to there being more going on than SMI were quickly dismissed as 'Whatever symptoms you have are all due to your SMI' . It took moving to a new area, to be near my daughter and her, not me, raising the question of autism for the matter to be taken seriously. It helped that the new pdoc was more open minded and far less prone to diagnostic overshadowing than previous pdocs who saw me. It took nearly 2 decades to be taken seriously , and after being taken seriously- 7 months to get a diagnosis.

Those like me are not the same as those late diagnosed despite being of a very young age when the diagnostic criteria were broadened.

My diagnosis (received days before my 65th birthday!) is:

Autism Spectrum Disorder, Level1 (Mild)
And additionally that I display many of the qualities of what was previously known as Asperger's Syndrome.

I think we can sort of ignore my age when I got my diagnosis, late in life, because Asperger's Syndrome became an available diagnosis for me in 1994 and before that I was just "weird"; I missed the window for an early diagnosis. But I think it is possibly significant that the term "Autism" would not have applied to me until the Autism Spectrum became a possible diagnosis in 2013.

If they start slicing the Spectrum into a large number of genetic differences then it appears to me that Asperger's might be an outlier from the many other "colors" of Autism. Should it still be a variety of Autism or should it be separate...again?

A lot of what this study shows are things I intuitively have believed for a number of years. I wouldn't be surprised if in the future autism will be viewed as a symptom, not a condition or diagnosis - in a similar way as people talk about chestpain.

Yes, I think about autism as a symptom with different neurological grounds, not as a homogenous spectrum.

I think that Asperger syndrome is a kind of autism and even that autism may not present with RRBIs and sensory issues, which is excluded when DSM-V criteria are used.

I would say that there are many unrelated kinds of autism. I think that autism is not always hereditary or genetic. I think that autistic person may present as "normal" in early childhood but develop autistic presentation later.

I wonder if it is possible to have nonverbal learning disorder and social "weirdness" and to not be autistic. I would think that it is rather not possible. Autism with higher full scale intelligence quotient often has VIQ more than one standard deviation higher than PIQ. It does not mean that it is only a learning issue, but may be a function of many kinds of higher-IQ autism.

I do not think that every autistic person has (especially more noticeable) sensory problems, especially related to sounds and lights. Sensory "allergies" are not necessary for being autistic and impaired sensory filtering has not to be present in every case of autism.

I am very interested in links between autism and fetal growth restriction, low birth weight or pre-term birth.

Then ASD stands for Autism Spectrum Door?

Please explain to me precisely with published studies that my autism is not strictly and inextricably genetic.
Because I'm honestly tired of reading studies that claim it's multifactorial.

Please explain this to, like, 60 of my relatives on both sides of my parents' genetic lineage.

Oh! Sorry: it's multifactorial, not genetic.

Of course, more is added, and it's also obvious that it's added or comorbid.
The rest is genetic.
And that's it.
If there are valid opinions to back up that it isn't, it's only because it's only 2025 and we have these studies that suggest it's multifactorial.
I absolutely disagree.
Unfortunately, time will disprove theories of this or that and will lay the foundation for the reality of the facts, which are certainly not multifactorial.

Of course, if you're autistic, you'll have depression, even serious ones, anxiety, interactional stress, and more. PSTD after the age of 16 has been clinically proven to increase due to psychological trauma inflicted by others on many of us. The amygdala volume generally increases by no less than 20%.
How do you explain that?
Are comorbid diagnoses with ADHD causal?

Okay, there are separate diagnoses of ADHD.

Of course, if diagnosed when you're of the age of 18, if not entombed, something confusing happens, and the depression is just as much.
Of course, other forms of autism exist, and they're not just those indexed on the internet, which are worthless.
As for the studies that state these things: I sincerely wonder if it's the discovery of hot water, you know, if it's from Cambridge and published in "Nature," then the discovery of hot water goes viral online.

I really don't think it's worth anything.
*I wouldn't want it to be among the sponsored studies that are supposed to achieve a specific result and that will perhaps then allow states to save a lot of money and have them spend it on other collateral in favor of this or that therapy by instilling that hot water is reality:
It's not.

The tone of the reply corresponds to the calm with which you wrote, only it shows differently, but I never write without thinking it through and calmly.
Also because I always welcome your posts, and it's just that this one makes me feel strange about everything I know.

Cambridge is just a prominent name, just as Naure is a high-sounding name.

Let's not take this type of research at face value because in the end, everything will be oriented based on it.

And future autistic children and children will suffer the consequences.

How strange: they haven't asked themselves why diagnoses are made at a minimum of 6 years of age and much later, when that's what they're supposed to write about, because diagnoses that late cause serious harm.
Imagine diagnoses at two years of age being widespread everywhere.
And very well structured: because I already know the criticisms that things will change later.
Of course they will change: for the worse.
If nothing is done as early intervention and then these researchers discuss hot air, who perhaps will later receive benefits or renewals because they function in the system that has devastated us in 114 years, including 1911-1926, and then translate them from Austrian and poorly into English into autistic psycopathologies that weren't psychopathologies, the translation was, if anything, psychopathological.

Let's keep in mind that the importance of the two institutions will lead to a further, enormous delay in what needs to be done.
To our detriment.

We finally need to think about that, not about non-discoveries or sponsored discoveries (not whether they have any advantages of this kind. Maybe they do, or maybe they're even convinced it has value).

*Let's check what roles these researchers will have in the coming years:
*What the pharmaceutical companies will fund them.
*What benefits, if any, they'll have.

This stuff will be to our detriment anyway, with lots of thanks in the thread and in future diagnoses.

Well, let's forget about the absurdity of research like refrigerator mothers and the like.

If I was born autistic, but I spent my first years in Rwanda and Burundi during the ethnic massacres and the machete attacks, then I'll have some psychological distress if I survive, and I fear it's multifactorial.

In Rwanda, the cycling world championship was held on the body parts of macheted corpses: but money prevails over that, and no one says it's disgusting.

Nor that research is itself worth scrutinizing and carefully evaluating.

Because you can be sure it will be taken and used as a milestone on our mess, which we wouldn't have if someone had done their job well, not in those over 6 years old, adults over 18, and in those over 20, 30, 50, and when it's of no use after 60 unless it's something very minor that has no impact whatsoever on the person who has it or has made unlived lives an ordeal.
I'll answer about sensory problems: yes, I have them, and I'm a disaster.
Many others have them, perhaps in less intense forms, but they have them.
If the diagnosis is well-structured, and often it isn't, even less so.
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Do you know what so many studies are preluding? The intensive use of drugs given to anyone is extended to anyone, and this is still happening today. Even children with ADHD are easily given drugs.

We don't work before the medical damage occurs by saying, "Well, it's getting better, it's not that bad, your son or daughter is perfectly normal... it's a shame they perhaps don't have the same chances as perfectly normal children, if perfectly normal children exist, anyway, Ennetti.
(Neurotypicals) Be careful when they tell you to medicate a genetic condition because you will only suffer enormous disadvantages and ruin your existence if they don't work.

Billions and billions of pills were strangely not needed every day of our lives.

Now they are needed: it's no coincidence that pharmaceutical companies then overflow on the stock market to the point of becoming billionaires, thanks to a system certainly not inclined to non-corruption.

The more drugs are prescribed, the greater the doctors' income and their career advancements will be.

To our detriment, but also to the detriment of the taxpayers of every nation.
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C'est la vie

^
^
Yes, the spectrum is not homogeneous. I agree.
I can't tell you now that Asperger's is a different form of autism, that is, like a cut that separates them into other forms distinct from each other.
Having studied logic for 5 years, the proposition seems illogical to me.
However, it is a variant on the spectrum with identical etiology but with a different functioning (in reality, the functioning is dysfunctional).
The question I ask: if it's not always genetic (hereditary in medicine, which is a passion of mine, means something else, though). If it exists in an individual, it is necessarily genetic: there's no point beating around the bush about this; I'm writing this because they bombard us with non-studies on multifactorial factors that have no logical sequential basis.
Let's imagine if it were devoid of it, that is, not always genetic, then we would always have to logically ask ourselves how the hypothesis that one becomes autistic occurs.
Because: the logic is that one is born autistic.
Not that one becomes autistic. If someone with a background in genetics could explain how it happens, I'd be happy to read it. What he writes will be enlightening. They'd definitely nominate him for the Nobel Prize. He'd have made a sensational discovery: you become autistic without any genetic basis, or how, I don't know.

Without genetics, you're not born autistic, you don't become autistic. That you become autistic over time is perhaps what President Donald Trump, a world-renowned geneticist—don't excuse the democratically elected President of your state—thinks.
"I wonder if it's possible to have a non-verbal learning disorder and social 'oddities' and not be autistic."
Yes. The answer is yes, except that there are other diagnoses. But yes, it's also logical that it could fall under other, non-autistic diagnoses. That is, you're not born autistic, but you are something else, or you have something else, whatever you want to call it.

It's just a learning problem. Let's see. Yes.
But let's ask ourselves why we don't learn something, if anything.

The answer might even be banal: an autistic person doesn't implement them in themselves... Why does this happen? Because it simply can't happen.
Let's say we have a sensible diagnosis, and the diagnosis obviously includes the absence of theory of mind.
Now explain to me on what supernatural grounds an autistic person who can't see (like a socially blind person) suddenly miraculously becomes not blind, as in Franco Zeffirelli's Jesus of Nazareth—but he was the son of God and could perform miracles—suddenly, a few millennia later, his mind is imbued with the opposite: the presence of theory of mind.
Sensational, isn't it? The first documented case in the world, it would be miraculous.

I'm a firm believer in the Catholic religion, sorry for the aside and the examples, but a GOD exists, because otherwise we wouldn't even be able to be born on this exceptional planet in the known universe.

So a GOD exists: I'm not the only one who believes it, but I believe a certain Einstein believed it, and not just him. Too many parameters suggest that we are in an absolutely unique condition in the Universe (which is vast, as you know).
The mathematical possibility is that there are approximately 600,000 perfect solar systems like ours, and planetary systems, therefore, with extremely rare conditions, but they exist on billions of planets, galaxies, and stars that don't form them.
On higher IQs: compared to what?
Because it's always a parameter of comparison, it must be available.
If it's that of a grain of sand: well, I even agree that such a low IQ has reason to be noteworthy.
An IQ of 180 is low; you can brew beer with it, and that's fine, because the machinery to distill it is built very well.
But the IQ of a human being is absolutely ridiculous.
This from an absolute point of view: an IQ makes no sense whatsoever, especially since it is invented entirely from purely logical and mathematical measurements, so trivial.

Autism and fetal growth retardation.
A friend of mine's son was born like this.
But he was born autistic, though.
His father and his offspring are autistic.
Then that problem occurred, and he was born at six months.
A is not the same as B.
Autism and fetal growth retardation didn't affect his autism.

But they did affect the boy's life.

Who would have always been autistic anyway.
Except that his mother helped him by making her way among people who ostracized her with absurd ideas.

Now her son paints at a high level, understands music extremely well, has perfect pitch, and is independent of his mother and brother, but his IQ is incalculable.
The calculable IQ is 102, perfectly in line with the average Italian.
Which is the highest in Europe.
Since IQ is so fundamental: explain to me why a Savant with an IQ of 63 can do extraordinary things that an individual with an IQ of 160 generally can't do. 160 is high, if then with standard deviations it's even higher.

I assure you, it hasn't changed a thing.
If you're autistic like me, it won't change your life.

Perhaps it makes it worse...

My brother is definitely not autistic. My brother had no fetal growth restriction. I do not know if my sister has a kind of autism or not, she was Born with birth weight nearly a 1 kg lower than our brother and I was 0,5 kg lighter than my sister at birth and I received Asperger syndrome diagnosis when I was nearly 17 years old.

The diagnosis of a pervasive developmental disorder helped me a lot. I have comfortable life despite my "weirdness". I have disability pension. I have a bit of diagnoses in addition to Asperger syndrome.

My parents do not appear to be autistic. I may be "the black sheep" in the closer family. I am dysfunctional "weirdo" and I have counter-talent to function at job market.

I think that we should not give autistics (especially adults with above-average or average full scale IQ) more privileges than to adults with nonverbal learning disorder and (or) schizotypal personality disorder? Problems, kind and severity of symptoms matters and they are fundamental in assessing support needs of a person, not the label (like ASD or no ASD), not the cause of it, whether genetic or not.

"I fear that I am not autistic"! !! I have "obsession" about it. I "fear" worsening of my living conditions. I was not diagnosed using ICD-11, but only using ICD-10. I live on Poland, not in aby country in North America. I received substantial support in Poland.

Why ADHD and dyslexia appear to be considered "small" things while ASD (even ASD level 1) appears to be considered a "big" thing?

I hate difficult living conditions. I hate bad living conditions.

I am "not so sensitive" but I hate discomfort and disasters.

My sensitivity to sounds and lights is surprisingly small for a person diagnosed with Asperger syndrome, but I have disability pension despite it (I have also other diagnoses co-existing with AS). I "can't understand" why someone is so profoundly sensitive to trivial sounds or lights - I have no problem with these sounds and lights.

^
Perhaps I didn't explain some parts of my post well.
I meant that if a person is diagnosed as autistic, they are genetically autistic and there are no other causes at all. Otherwise, we fall into the typical error of thinking there's a mix of causes.
I think we'll gradually move toward this univocal definition: 100%, not just 83% as it is today. In the latest research, strangely, that percentage is increasing, and by a lot.
The genetic one is constantly increasing.
My mother had Asperger's, my grandfather, my uncles and aunts, my cousins ​​and their children—I'm just mentioning one branch of the family.
Imagine that out of terror, autistic people were always born (always, not sometimes, but always); families adopted them from the former Soviet Union.
Is it possible that everyone was?
All the cousins?
And their children?
What was concerning was that most of them were low-functioning, some severely autistic in the sense that they were completely dependent on their parents and doctors.

Was it a unique case study in the world?
I mean, was it so large, unique in the world?
Not that such a large number of cases would make the history of autism, but it certainly gives us pause.
The point is that research that mystifies autism, considering it to be one-sixth non-genetic or something else, devastates the person who will be born in the future and who will be genetically as they intend (I'm referring to research, I don't know if it's sponsored by pharmaceutical companies or by government systems that, without results, don't continue and immediately cut funding, for example).


There is a huge amount of research.

The research validated by very important institutions does a lot of damage.

Cambridge and Nature could do more damage with this research than others, and polarize the way we evaluate ourselves into just this and that's it.

Even though genetics is very advanced and will reduce this research to waste paper, digital will shred this research.

On pensions, it also exists in Italy.
But it's very low: consider that it's just over 300 euros, and what do you do with that kind of money?

If the disorder is pervasive, as in my case, it's not as if having, say, an IQ of 170 has any advantages: if so, what are they?

It's not as if there are dividing lines between the worst case and the best case.
Suppose this comparative reasoning is flawed?

I also thought there was a serious gap in my favor and that others were more in need of help: let me be clear, I'm always very critical in my thinking, so if that were the case, I'd certainly agree with whoever said so, but that's not the case.

Then there are mild cases, now level 1: which perhaps may not have a significant impact at all.
However, correspondence with people with confirmed level 1 tells me very differently, and they also have difficulties.
Those who don't have it may have a different diagnosis. §
In my case, again using this as an example, I have diagnoses in five different places.
I generally didn't disclose my previous diagnosis.
Perhaps only in the scientific research I participated in.
But I have an 8-month-long report and precise written assessments.

So I've always had the diagnoses.
From DSM4 to ICD10, DSM5 to ICD11.
My ADHD hasn't changed either.
My comorbidities haven't changed: Major Depression* and Avoidant Personality Disorder.

I can't get away from society for too long.
I've worked immensely to reduce my deficits wherever I could.
I have sensory impairments (genetic, not caused by anything, but always present).
ADHD only changed from childhood to adulthood: but it persists and is a problem.
ADHD can also be present alone, as can other comorbidities.
In my case, it's all in one: it's not that simple.

Paradoxically, if I were evaluated only for depression, I would have a non-reductionist score.

That is, I would have a 100%.
Having comorbidities creates a negative value, and this involves evaluation scales that only reduce the percentages.

All I had to do was appeal, and I would have gotten a 100%.

Except that here you have to wait years just for the approvals and go to countless visits.

I confess that I had asked my doctor to remove me from the evaluation based on percentages, therefore not offer me for a visit.

I couldn't handle the stress anymore.

Instead, I gained the attention of the medical directors, and they wanted to evaluate me.

Then, by giving less than what is due, you pay less than necessary: ​​then you have to appeal, and I no longer had the energy to dedicate to that.

With my certifications and a thorough understanding of the evaluation process, I would have won the case if I had appealed to the court.

Appealing is free here: you pay a minimal fee.

But I didn't.
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Give more privileges?
In Italy, they don't give them at all.

What do you mean by privileges? Maybe I misunderstood this passage and you mean something more complex or different.

To leave the house and reduce sensory and social problems, I have to take an anxiolytic that's 20 times more powerful than Valium, and my dosage is high.
But I tolerate it.
For now.
Also because I've never found a suitable medication or I've had adverse or adverse effects, as several specialists have certified.

And I have Asperger's: do I have fewer disastrous phases than others?
They're just different. But pervasive.


The diagnostic label is useful because it resolves the issue, otherwise we'd be in total diagnostic chaos. Let's not dig into these things because I don't find it coherent.

Diagnostic labels are a word often used to downgrade the diagnoses themselves.
Fortunately, there are diagnostic manuals to help resolve these issues, and they have precise evaluation codes and precise evaluation tests.
Diagnoses are diagnoses, not diagnostic labels.

Type and severity:
I've described the type.
Mine is rated severe.
And I'm not nonverbal.
I learned to speak quickly and read early.
Many of the things I'm diagnosed with are distinctive of Asperger's and not the attribution from the DSM-5, but that's what they use.
Many studies disambiguate Asperger's as a separate form of autism.
See, Simon Baron Cohen published them in 2018, I believe, but other studies are also distinctive in this regard.

My cousin's son is nonverbal with an IQ of 63 on the
Wechsler Adult Intelligence Scale.
His assessment is very serious.
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You write that the help you give is important: okay for a child, but what do you do with an adult?

The distinctive cause, if anything, helps you outline what to do about it.

It's like building a building without a plan, claiming that the plan is a label and the usable material is any old material.
You don't build a building; if you erect it, it collapses after 1 second flat.
It's definitely useful.
We need to distinguish because these reductionist studies are misleading.
You have to know to understand; if you don't know things well, you can't take the necessary steps.

Otherwise, we end up with evaluation phases that only involve random clinical attribution.

What do you do with something you know absolutely nothing about?

Primarily, tests.

Diagnostic visits.

Otherwise, we risk the oblivion of "they're useless."
In that oblivion, I'd like to point out to you that there are human beings who suffer terribly.
Not diagnostic labels.

But even if you have a garment to wash, you have to read that label before washing it, otherwise you'll ruin it if you don't know the composition of its fibers.

Genetics: just a matter of time. Notice how the genetic component increases after the studies on this.

It will increase up to 100%.

What will you say then? That it's not etiologically accurate?
Will you go to a conference with the geneticists who expressed it?

Or will you take note?

Now we're just backwards in time; when you reread my post in a few years, you'll radically change your mind on this.
Forgive me: but if you're worried about not being autistic and all the rest, ask for an objective evaluation with tests and doctors.
Poland is an important nation; it has the diagnostics.

ADHD and dyslexia, if this impacts the evaluation phase, are very valid. They are individually evaluated by medical boards to determine whether they qualify for benefits such as attendance allowance or a disability pension, which require a reduction in working capacity of at least 74%.

It depends on whether they're considered disabling.
I don't know about you.
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You write:
"I can't understand" why someone is so deeply sensitive to banal sounds or lights: I have no problem with these sounds and lights.
It's not that everyone is this sensitive: it doesn't happen in your case.
Which doesn't mean you don't have a clear picture of your disability.
You write this:
"I was diagnosed with Asperger's syndrome when I was almost 17."

Do you understand how crucial it is to get it much earlier?
Guidelines for early assessments exist and are well-defined.
I don't understand this delay; I've written about it.
It's serious that this happens.
Because at 17 you can improve on some things, but at 2, you can improve on many things.
My way of looking was crucial for the initial evaluation of the initial 2 hours.
Those who performed it in the primary phase also publish in Nature.
And in other scientific journals.
And he holds the Eye Tracking patent.
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Have you ever wondered why diagnostic work isn't actually done in the early phase?
And are diagnoses made in people of significant age or in the elderly?
An early diagnosis is scientifically possible, and can be continuously evaluated over the course of months.
It's not that just because you have it, it's immutable.
If the conditions are met, it is.

In our country, even permanent and non-revisable disabilities are only so on paper.
That is: you can always be reevaluated.

§

Always. If the state and the relevant agency call you back for a medical examination.
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Sorry, but I'm not sure if yours is a statement or a description of your status.
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If that's the case, I may have written something insensitively about this matter. If you perceive this as an insensitive post, I apologize!

H.F.

Thanks for the post. I was diagnosed when I was nearly 17 years old and it was in 2008. My high school enabled me to being diagnosed for a pervasive developmental disorder for free, my family didn't pat for it. One day I arrived to a centre specialized in pervasive developmental disorders with my mother instead of going to school that day. Diagnostics were "pretty certain" that I have Asperger syndrome, I would say so.

In Poland there are many people, especially women, who receive pervasive developmental disorder diagnosis later than me, after 18th birthday despite the fact that ICD-10 was published in 1994 (but it might become used in Poland some years later - now in Poland ICD-10 is still generally used despite the fact that ICD-11 was published some years ago in the world (in 2022? I am not certain)). There are quite many women who were diagnosed with a pervasive developmental disorder in Poland after 2010 and as adults, so later than me and when they were older than me when they received the diagnosis of a pervasive developmental disorder.

Now I have the disability pension about 1700 PLN in Poland which is larger than about 300 euros mentioned by you that you receive in Italy. If 1 euro is about 4 - 5 PLN (currency in Poland), then 300 euros is only 1200 - 1500 PLN which is less than 1700 PLN. I have also small care allowance (Polish: "zasiłek pielęgnacyjny") thanks to early enough onset of my disability and it is about 215 PLN. So in general I have somewhat more than 1900 PLN netto disability benefits. It is clearly more than 300 euros (when 1 euro is 4 - 5 PLN). 400 euros would be 1600 - 2000 PLN then. Now 1 euro is about 4,25 PLN so 300 euros is about 1275 PLN and 400 euros is about 1700 PLN and my disability pension and care allowance combined are somewhat more than 1900 PLN. But not every one in Poland diagnosed with a pervasive developmental disorder received social pension and care allowance. Some people with a pervasive developmental disorder diagnosis in Poland are (at least initially) considered so slightly impaired on commissions about ruling of disability that they are not considered disabled by law (they do not receive even the mildest of the three levels of disability, at least after first commission, but they can appeal to be evaluated again after which they can be considered disabled by law and having one of the three levels of disability legally). I have (only temporal) ruling of moderate level of disability (Polish: "orzeczenie o umiarkowanym stopniu niepełnosprawności) and (only temporal) ruling of total incapacity of work (Polish: "orzeczenie o całkowitej niezdolności do pracy") - my disability and its cause started early enough to receive disability pension and care allowance and and my disability is in moderate level, not just in mild, so I have substantial benefits which help a lot in adult life. I have to apply for new rulings and re-evaluate when times of my rulings of level of disability and total incapacity of work are close to the end, which can be very stressful because of the concern that new rulings would be not allowing to have financial and other benefits while person's functioning is at the same level or even poorer than earlier, when the person received rulings which give right to the benefits, especially to disability pension. I was not diagnosed only with Asperger syndrome when I applied for rulings about disability and total incapacity of work - I regularly have schizotypal disorder and obsessive-compulsive disorder in addition to Asperger syndrome mentioned in documents for the commissions which evaluate me.

Way too long, way too hard to follow, and so on.
From my unpublished, unprofessional, non-peer-reviewed insignificant life experiences - if your parent(s) are on the spectrum, then you will most likely be raised in and become acclimated to an on-the-spectrum lifestyle. It gets reinforced.

Thank you!
Thank you for sharing the complete diagnosis.
There shouldn't be any doubts about such highly qualified centers.
Wow: they're excellent.
And they know exactly how to make accurate diagnoses.
Then mine was incredibly long.
The one to be admitted took two hours.
The researcher immediately reached an accurate diagnosis.
He only told me it two hours later, though.
He's brilliant.
He also publishes in Nature about tumor research. He's not a typical researcher, but he has the qualities of genius.
He's collaborated extensively with the US and many states, especially San Diego, and Miami. He's also chosen by another genius who has held very important decision-making roles at the European level and is now in Miami.
Luca Pani, who trained in Chicago, Illinois, then went on to Geogertown University, Washington. In addition to other prestigious positions at the EMA and elsewhere, he was a leader.
By the way, I've never met him in person, even though he's a classmate of a doctor friend of mine.
He's now permanently in the US.
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The level is very high, so
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So you definitely need a clear and unambiguous diagnosis.
It's fairly certain, but it's confusing for you: I'm sorry!

I also believe that comorbidities have affected the overall disability.
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I'll start by saying that I like your writing because it's very straightforward, how you describe it is great!
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You're describing the ICD-10 used in Poland. Know that it can be used very well.
So, okay.
I'll also start by saying that I find both the DSM-5 and ICD-11 alienating.
As a psychiatrist, I honestly wouldn't use them: but this is how it works.
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The ones from 1994 are very good, but they messed up and simplified what isn't simple at all.
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I then wonder what the point was in distorting the DSM4 and ICD-10: none.
The DSM5 and ICD-11 to which it refers are (I don't write it, it's better).
Reducing them to those levels and making the subcategories a cornerstone is mystifying.

It used to be clear, now everything has been trivialized.
And in my opinion, it's wrong too. Those guidelines are flawed, confusing, and flattening.

Anyway, I have the diagnoses from all those manuals.
And they are clear.
Then the post-2013 research openly disavows the DSM5 in the area of ​​helping, but it seems no one cares; it seems like there's a world of inept people at the top.
Asperger's is not a subcategory and not autism at those levels.
And it's not what they make it out to be.
Research confirms this, sir, and it's different and subsequent to 2013. I expect it will be revised and that nonsense about levels and nosographic flattening will be removed.

In the DSM-5, the term "High-Functioning Autism" (HFA) is no longer used as an official diagnosis, but has been replaced by the definition of Autism Spectrum Disorder (ASD), with severity specifiers based on the levels of support needed. In practice, a person who in the past would have been diagnosed with HFA now falls under the definition of ASD with Level 1, indicating the need for mild support.

Mine is Level 2.
With a precise report, however, not just Level 2, which is an extremely generic term.

ASD and Asperger's are different: studies of valid individuals have demonstrated this for a decade.

They are not ASD Level 2, but Asperger's.

They are similar.

It would be like confusing different clusters by saying that I know an anxiety disorder like social phobia is a cluster C equivalent to a personality disorder...

Which is something entirely different.
A cluster C anxiety disorder is treated, cured, and you can reasonably bring it to levels of total symptomatic remission after recovery.
A class C avoidant personality disorder is another matter.
An incompetent person reading the internet won't be able to find any differences.

Because they'll find them identical.

Except they're not identical at all.

How can you equate them? It's crazy.

Especially, an anxiety disorder is either treated and brought to trial.

Let's try to judge a personality disorder!

I mean, the avoidant one: extremely impossible.

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We can only help those who have it. The rest, if it's pure, and it's never pure, may have other connotations that perhaps we can fit into Karnaugh mappings, because the codifications are so many and not free from interactions, nor even dissolvable and univocal.

I could draw 10 different examples of the same disorder, and all would be possible combinations.

But it's very easy to end up in the same mess as social phobia.

They are clearly distinct things, however.

Sorry, I'll take up the post again at another time to finish it, and I hope to reply to the next one as soon as possible, because I go on and on with my descriptions, and it bothers some people.
I understand the bother, but if we want to write sensible posts, it can't be reduced to two lines or a yes and a no.

Short explanations are useful for those who are content with things of that nature.

Which involve absolute prejudices and a narrow view of a discussion.

Anyway, I'll answer briefly.
At least as much as possible, otherwise it would be like not writing anything at all.

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Not that you need to write a treatise on psychiatry, but at least something valid. Otherwise, no one will ever write long posts, so as not to read them. However, in short, decisive-type articles, there's no point in writing them short; it's pointless.
I don't outline anything with the short ones.

Let's publish an abstract of a post if possible, which you can then pass on to the actual post.

You tackle a complex topic, but in three and a half words: what's the point?
I understand that struggling to read posts is tiresome.
And what about responding briefly and just writing one idea, as if there were no others?
I'd really like to write three lines; it would mean I wouldn't even be inclined to write them.
Thanks anyway for (I think) having read the whole thing.

Not a single cause??? Did anyone ever seriously doubt that? This idea of being on a spectrum is nuts!

Perhaps the diagnosis, could be thought as a confluence of Environmental Issues. Including genetics . Possibly being a leading trigger,to the very same "environmental circumstances ".
Personal Opinion: People ( including professional)are using their standards for learning to guage disorders , Even Learning disorders.
But allow me to offer the concept of differing methods of learning, can be triggered all the way down to a persons genetic profile . ( just personal observation of others ,that I have managed to maintain longer term relationship/ contacts with)
Consequently , If a individual is guaged by the specific standards of what is considered societal norms . And their entire
method for learning , will very possibly will be considered by those standards to be disabled . Without regards to differing methods of learning ( input).
Perhaps a higher level on the Autism scale , could be reduced to level of ability for adaptation maybe porportionally higher than the average person Aspie or not ,To learn those needed adaptations.Given "genetic and environmental Influences". But obviously this could not be a all encompassing idea,Given the issues of varying savant type characteristics of persons On the spectrum ( possibly leaving a much higher tendency towards Genetic involvement ).
[[[The above is only meant to be a generalization of ideas in this thread.]]]

Apologize for interrupting my response for now, but I'll try to outline some aspects that emerged from your posts.
Jakki: I know your level is very high, so perhaps I'm writing with a different perception than what you responded to.
So if I'm going to reply inconsistently, please let me know.
It's clear that diagnoses are based on clinical observation, tests, and, if made in a very short time, also on the children's parents.
The chances of having a child can also be assessed based on DNA, so one could already understand this in a preventative manner: the percentage is very high.
Of course, if I say something, it's because I've read (studied) about it and not just casually.
I consider the timeframes between 2 and 4 years of age for children to be decent.
The other times I consider them late or extremely late for diagnosis.

Among other things, a diagnosis requires the parents or someone like the grandparents, but someone familiar with the person being diagnosed, and therefore with the child.

But the issue is that research, not the diagnosis. I obviously agree with you on that.
Except for some who make it a mix of genetics and environment, or Pavlovian-style imprinting.

I always write: you are born autistic, you don't become autistic, and even if you don't have autism, not even ADHD, in the specific case, you either have it or you don't.
ADHD can coexist: I don't have the percentages of coexistence at hand right now, but they are higher than other syndromes, disorders, and anything else that can be deduced.
It's clear that any diagnosis can be spurious (sorry for using terminology that has to do with my courses of study: I ​​mean, not just linear autism, but comorbid with something else that can exist with a life of its own). Neurodivergent people aren't just those we normally imagine them to be, but, I'd say, a percentage of 10% include other forms of autism, even non-autistic, but at the same time non-neurotypical. Case studies are complex to diagnose.
There are also discourses that can be assessed with lateral intelligence (Edward De Bono) rather than, as you often do, with vertical intelligence (linear thinking). Lateral intelligence is the ability to solve problems in a creative and unconventional way, looking at situations from different perspectives to generate innovative solutions.
Both can be used together, and they are some (just some) forms of human thought. But there are also unconventional ones, even unclassified intelligences that lead to reasoning that is completely outside of conventional schemes. These are perhaps what fascinates you when you describe savants.

Many of us are also savants. But the percentage of people with Asperger's syndrome is also high, around 50%.
Exceptional Abilities: They may display prodigious talents in areas such as music, art, memory, mental calculation, and spatial skills.
Associated Disabilities: They are characterized by significant disabilities in other areas.
"Islands of Genius": These exceptional abilities are described as "islands of genius."
Medical literature reports numerous famous cases of savants dating back to the late 18th century. These were often highly skilled in calculation, and, in fact, we now know that the abilities manifested in savant syndrome tend to be those based in the right cerebral hemisphere: that is, they are predominantly non-symbolic, artistic, visual, and motor skills. They include music, art, mathematics, calculation skills, as well as mechanical aptitude and spatial skills. The abilities of Savants are always associated with a remarkable memory; this is profound, focused, and based on habitual recitation, but does not involve comprehension of what is said.

Although they share many talents, including memory, savants vary greatly in their level of skill. Some are obsessed with, and quite skilled at,
memorizing sports statistics and license plate numbers. Talented savants possess far superior musical or artistic abilities. And the very rare savant prodigies possess abilities that would be astonishing even in individuals without deficits. There are probably fewer than 50 savant prodigies worldwide today. Today, specialists are better able to characterize savants' talents, although there is no general theory that can describe exactly how and why they possess these abilities.

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The most appropriate explanation seems to be that a lesion in the left cerebral hemisphere causes the right cerebral hemisphere to compensate for the deficit. In the late 1980s, Norman Geschwind and Albert M. Galaburda of Harvard University proposed a theory that explained some causes of left-hemisphere lesions, as well as the fact that savants are overwhelmingly male. In recent years, further data have emerged supporting the left-hemisphere hypothesis. In 1998, Bruce L. Miller of the University of California, San Francisco, examined five elderly patients with a form of frontotemporal dementia (FTD). They had developed artistic abilities as the disease developed and progressed: they were able to make precise copies of works of art and paint beautifully. Indeed, single-photon emission computed tomography (SCT) showed that their lesions were concentrated mostly in the left cerebral hemisphere. The emergence of savant-like abilities in people with dementia raises questions about the brain's hidden potential. According to some scholars, the next challenge could be to bring to light what has been called "the little Rain Man in each of us", without losing the other prerogatives that accompany normality. A person with "high-functioning autism" can have a level 1 and an "Asperger's" can have a level 2. The situation is different with the ICD-11, in which there are no levels but sub-categories based on language and intellectual level. The definition is therefore broad and includes not only people with very low IQs and exceptional talents, but also people with Asperger's level two who fall within that condition.
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The Importance of Prenatal and Postnatal Development

Autism is highly likely the result of an alteration in the normal course of central nervous system development. Genetic and environmental factors play a role in causing these alterations, acting alone or in conjunction with each other. Different factors can come into play at different times—before, during, or after birth. Although the specific nature of brain damage during development may vary depending on the type, mode, and timing of the etiological factors (genetic and/or environmental), the final outcome will always be the same: the onset of deficits that we collectively define as autism. In the 1980s, psychologist Uta Frith proposed that the symptoms present in people with autism were the manifestation of a psychological deficit, which she called "Weak Central Coherence." According to Frith, "weak central coherence" underlies patients' limited ability to understand the global context of a situation, but at the same time, their marked ability to perceive details or pay attention to the small parts of an object. In other words, to simplify, people with autism prioritize detail to the detriment of perception and an integrated understanding of reality. Subsequent neurophysiological studies have shown that autism is characterized by a lack of communication, or disconnection, between different areas of the cerebral cortex, the same areas that govern higher functions such as social behavior and language. According to Daniel Geschwind, a prominent scientist at the University of California, Los Angeles (UCLA), the origin of this disconnection lies precisely in the embryonic and fetal development of the central nervous system. The term used by Geschwind and others to define altered neuronal connectivity during development is "developmental disconnection." Specifically, a disconnection during development could potentially be caused by a wide range of processes: a lack of synapse formation or the formation of dysfunctional synapses, abnormal neuronal migration, an excess or defect in the number of neurons, impaired formation and growth of axons or dendrites, etc.

The Contribution of Molecular Genetics and the Promises of Genome Research

Identifying the specific cellular or molecular process that has altered development in one or more patients is no easy feat, especially given the impossibility of conducting these studies directly on the patient, fetus, or embryo. Genetics offers us the opportunity to use an alternative approach and overcome, at least in part, these difficulties. It is well known that the scaffolding of basic neuronal connectivity is established in the prenatal period using genetic mechanisms. Therefore, a very interesting working hypothesis would be to clarify which genes are involved in these processes in autistic patients and how mutations in these genes can alter the correct connection between neurons. Furthermore, since the action of (unmutated) genes can also be significantly influenced by the uterine environment (e.g., malnutrition, maternal stress, infections that stimulate the immune system, exposure to toxins, drug abuse, etc.), it would be equally important to understand which environmental factors can alter neuronal connectivity and how. Very advanced research on these topics is underway in various laboratories both in Italy and abroad. Among the most significant results obtained in recent years is the identification of autism susceptibility genes that encode proteins that play a key role in the formation of neuronal connectivity (the so-called "connectivity genes"). Some notable examples include the identification of the genes encoding neuroligins 3 and 4 and neurexins 1 and 3, all involved in the formation and functioning of synapses; the SHANK3 gene, which encodes a protein implicated in dendrite development; reelin, essential for stabilizing the basal laminar organization of the cerebral cortex; and others.