Comment by goddesspapa on Autism And Intelligence: Much More Than You Wanted To Know · 2021-03-25T20:46:59.422Z · LW · GW

Here's a few questions that might be interesting:

Is autism (or various ASDs) a scientifically valid definition( as defined in the DSM or ICD 10/11)?

What is the intra-site and inter-site diagnostic reliability for ASDs?

How consistently are ASD diagnostic tools applied? 

Do ASDs have any unique traits?

Are separate, unrelated, etiologies considered ASDs? 

Does "clinical expertise" or opinion having more weight than diagnostic tools impact validity?

Are the definitions of ASDs consistent enough longitudinally for analysis?

Do ASDs vary significantly by culture and socio-economic status?

 

The fundamental problem with most discussions of autism is they very poorly understand how autism is defined and diagnosed.  Before we can build these derivatives, it's important to understand that at it's core autism is diagnosed in a way that prevents it from ever being a scientifically valid concept.

One of the most important smell tests for the validity of any model should be how quickly heterogeneity sets in when you add more data.  Well defined models should be able to tolerate additional data with very low/no increase in heterogeneity.  That autism displays such high heterogeneity from every single data set (whether imaging, genetic, or case note analysis) indicates a very significant issue with how ASDs are being defined.  The variability isn't an indicator of massive complexity in expression, it's an indicator of a massively broken model.

Core to any discussion of ASDs lies the same core issues with all psychiatric/psychological definition, that there is no responsibility to define etiology and the endophenotypes are based on external observation or opinion.  Human cognitive bias examination should indicate why this approach is troublesome, and we see clear indications of this by the large variances in inter-site and intra-site reliability of autism diagnosis, as well as the extremely significant cultural and socio-econonic impacts on diagnosis rates.  That the current DSM V diagnostic criteria allows a pick list of non-specific symptomology backed by clinical opinion being able to override the result of the actual diagnostic tools themselves is on it's face a huge validity problem.

This type of analysis is interesting because it provides a non-specific substrate for a discussion of human variability in general, rather than anything specific to autism.