 Let's go for this one. This might be an interesting take and I'll kind of pause it and I'll give some experiential things if they get anything a little bit misconstrued. Clinical presentation from Metscape, Osmosis. Even though everyone develops at slightly different paces, almost everyone hits the same general developmental milestones and learns the same sets of skills at about the same time. More or less. These are things like language and communication, socializing, cognitive skills like problem solving, and physical milestones like walking, crawling, and fine motor skills. All of which progress as the brain develops. If one of these doesn't develop as scheduled, depending on the severity, it may be described as a type of neurodevelopmental disorder, neuro referring to the brain. Especially when certain skills related to socializing and communicating don't proceed as normally, it can result in isolation, which is where the name autism originated, since auto means self. So autism refers to a condition where somebody might be removed from social interaction and communication, leaving them alone or isolated. So what if only we got that neurodevelopmental, that is what it is classified as, what's them meaning that you cannot get it from people where you don't have a neuro typical brain and then develop it as you get older, you're born autistic because you develop it when you're in the womb. But definitely as we saw in the video with Paul, some people we develop it quicker and sometimes we develop other things slower. And there is also atypical ways that it can show like in kids like, you know, stimming behaviors and very subtle socializing related things that are not necessarily like completely apparent, unless you know a lot about autism. But yeah, to be by oneself, aughty, ought. So it's an interesting word to have. I mean, it's better than aspergers, I think. Hypothetical I'm always entertaining is that what would the world look like if everyone was on the spectrum? I love that. You know, I did a video on neurotypical syndrome from like a, it's a video that I made like a while ago on like diagnosing neurotypical syndrome in a world where everyone's autistic. I think it was a good one. I don't think I did very good acting on that though. Before 2013, the Diagnostic and Statistical Manual for Mental Disorders, the fourth edition, or the DSM-4, described autism as one of several pervasive developmental disorders, which also includes Asperger's syndrome, Childhood Disintegrative Disorder, and those not otherwise specified or PDD and OS. Asperger's syndrome was used for children that appeared to have characteristics of autism, like difficulties with social interactions or nonverbal communication, but don't generally have significant delays in language or cognitive development. And therefore, Asperger's syndrome was sometimes referred to as a high-functioning form of autism. One thing there, it's actually average or above average intelligence. So we're likely to be slightly more intelligent if you're an Asperger person. But high-functioning, definitely not like a, I think it can be useful in certain settings, like in care and stuff to kind of do do behind the scenes, like address people's needs in a social setting, but like definitely not in a like a conversational setting. Like it's not, I don't think it's very appropriate to be like giving people a high or low-functioning score. High-functioning individuals, it kind of undermines the difficulties that you may have with life being autistic. And if you get classified as low-functioning, like it's just an insult, you know, it very much undermines the skills and stuff that that person may have. But I've heard of that. I know someone who has diagnosed PDD, NOS. Interesting person. I kind of just thought they'd do a bit like me, just an autistic man. But yeah, it's interesting how they split them up. It's now ASD 1, 2 and 3, which is a functioning label scale, which is not the most favorable thing, but I get it. Childhood Disintegrative Disorder was used to describe late onset of developmental delays. So these children develop normally for their age, but then they seem to lose the acquired social and communication skills sometime between age 2 and 10. Pervasive developmental disorder, not otherwise specified, is essentially a catch-all category in which patients meet some, but not all features of autism, Asperger's syndrome, or childhood disintegrative disorder. Researchers found, however, that separate diagnosis of these pervasive developmental disorders weren't consistent across different clinics, since they tend to have very similar signs and symptoms. As of 2013, the DSM-5, a new revised edition, removed these terms and replaced them with Autism Spectrum Disorder, or ASD, which encompasses all the previous pervasive developmental disorders, but uses a scale, or a spectrum, that differentiates based on the severity of two major areas. Jane says that, I find if I say I have autism, people don't believe me. If I say I have Asperger's, they understand it better. Totally. No, I get that. And definitely, if someone wants to be referred to as an ASP or they have Asperger's, it's definitely not something that I'd be like, hey, you can't say that. Some people might within the autistic community. I understand that not everybody who uses it is some, I don't know if I can say the word, World War II stuff. Some people make those links very, very easily for some bizarre reason. But no, completely. If you say that you're autistic, it's like people look at you weird. If you say I have Asperger's, they're like, oh, what does that mean? And you can say, oh, well, I've got average above average IQ. I don't have any speech delays. I don't have as much many care needs, support needs, whatever. It gives you an opportunity to explain it, which I also get. So they're going to talk about the three aspects of what classifies as that. I definitely wouldn't call it a spectrum, because a spectrum is like, I get it that it's like a light spectrum, like it goes in a line. But the traits that people have, they vary very, very widely in a radar diagram. That's the best way of looking at it. What they're talking about in terms of a natural spectrum, like linear one to one, they're talking about support needs, which is not something that a lot of the people that are online that I've seen like. And also the disorder part, you know, some people, they're very kind of positive to neutral about autism. And you have all these ideas of the medical model of disability, it says that the person is disabled by being autistic. But you can also have the social model of disability, which is something that I feel very strongly about, which is all about the things that are around that person at school, in the workplace or in society, things like that. There are definitely some things that I think I would want not to experience. And that would probably be the anxiety and depression. So if they can sort that out, like the crossover with mental health and like, get rid of the traumatic experiences that we might have, that would be great. It's going to come with time though. For the social and communication area, there are four subcategories that clinicians look for deficits. The first is social reciprocity, which refers to how children respond or reciprocate in social interactions. So like how the behavior of one person influences the other, and vice versa. An example impairment in this area might be referring to being alone and not taking a role in social games. A second area. That's a lot to do with cognitive and feel the ability to kind of know how someone's feeling or thinking or like interpret people's indirect methods of communication. I don't know if they're going to include this, but there is definitely four aspects to it. The sensory component is not to be underestimated with autism. It's not always the case for every single autistic person, but for the large majority of autistic people, there is some kind of sensory difference. Which deficit is joint attention, which is the state of wanting to share an interest with someone else. So it's like, hey, check out this awesome thing I found. So an example impairment in this area might be a child not sharing their interests or amusement in an object with their parent. Next, there's nonverbal communication, which refers to difficulties either using nonverbal communication themselves or interpreting nonverbal cues for someone else. So maybe the child won't put their arms out when they want to be picked up. Or maybe they won't be able to tell when a parent's upset, even if the parent's frowning and crossing their arms. The last subcategory of communication deficits is in social you see that's an interesting one because that was I think that was something that happened to me when I was younger. But once I got to a certain age, I started to like, when I when I talk about colleagues of empathy, like people are aware that like facial expressions, tonalities are changing, especially like in adulthood. It's just we don't know exactly why or what that person is feeling based on how they're appearing on the outside. Some people do. And it is definitely a skill that you can learn. It's not like this innate thing that you can never get rid of. But like, it is definitely, you know, you can't I can definitely tell when someone's emotions have shifted. And it was even it went so far as to it went like the opposite way. So like, if I saw any signs that people might be angry, upset, anything like that, I would automatically think like the worst, like they're experiencing the worst emotions at the moment. You know, so I would get very very kind of sensitive to like the changes and people's like demeanors. It could just be like it could just be the case that they were thinking about something that they didn't want to think about like going to work or something like it wasn't actually anything to do with the conversation. But you know, there's that whole thing about like rejects and sensitive dysphoria that I love ADHD autistic people have as well. Relationships. So children have trouble developing and maintaining relationships. So maybe the child has a hard time making friends, or they're able to make friends, but their behavior tends to drive the friends away. Yes. The other major area is called restrictive and repetitive behaviors. And this category is pretty broad and can include a whole bunch of behaviors, some being more well known or characterized than others, like lining up toys in a ritualistic sort of way, or flapping one's hands or imitating words or phrases. The child might be fixed on certain routines like taking the same route every day to school. The flapping hands thing is referring to autistic stimming, which is those repetitive actions that we do to regulate ourselves. That's another like blanket form of sort of regulation, as I was talking about before, which can be quite interesting. And imitating that is echolalia, and also sometimes mirroring behaviors. It's seen more with autistic girls when we when they're younger. It can be autistic boys as well as I was talking about with like the accents and stuff without that Scottish kid. And the routines aspect of it totally. In adulthood, it doesn't necessarily it's comforting for me to have a routine, but I don't always follow it. So the ideal is to follow the same routine every day, perhaps a little bit of variation, like I don't eat the same foods and stuff all the time like like some people do. But definitely with routes, like if I have a route that I walk a lot, like straying from that route is not ideal for me. I get lost very easily. Or they might have restricted patterns of interest, like having a very specific and in depth knowledge of the Titanic or vacuum cleaners. Mm hmm. Children with autism spectrum disorder might exhibit one or more of these deficits and vary in how severe the deficit is. With that in mind, it's important to remember that each child with autism spectrum disorder is going to have a different spectrum of symptoms and deficits. Typically, clinicians will try to observe these behaviors in the child looking for these possible deficits. Since these behaviors are often more well known by the child's caretakers than they are by the clinicians, like their parents or their teachers, a meaningful diagnosis of autism spectrum disorder relies heavily on listening to what others are observing at home or in school. Totally. They might be given severity scores in each area, which can help determine how much support the child's going to need. For example, a severity... There we go. This is the actual scale. It's not a spectrum. This is a functioning scale. Definitely not like to do with the whole radar diagram that we talk a lot about with traits. I think I'm finding this video a bit hard because it is definitely from a scientific medical perspective. It is good in terms of knowledge that is in the medical scientific arenas, but it's definitely not... I think this is what five years ago. It makes sense, but it's definitely not the most favorable language I've found on YouTube. But one would indicate the child needs some support. For social communication, they might speak in full sentences and engage in communication, but normal back and forth conversation with others just doesn't seem to work. For repetitive and restrictive behaviors, they might have difficulty switching between activities. On the other side of the spectrum, a level... Going into a bit further about these things, I know I'm pausing a lot, but there is a lot of things that they are leaving out because it is a short video, but I think it's important to talk about them. The conversation difficulties, we could point to things like processing differences. That back and forth conversation that you get with neurotypicals tends to be very heavily indirect in nature, which can be hard. The nuance around this is that actually, autistic to autistic, it's not an issue in my experience. There tends to be no difficulties with socializing, and they've even done studies into it. They had these groups, group of autistic people, group of neurotypicals, and a mixed group. They had to do a teamwork-based task. Both the autistic and the neurotypical groups performed equally well when you mix them together, not so much. There is definitely differences there, and it's not necessarily something that is always based on deficits, as they're saying. It's a difference. A video about romantic relationships between autistic people might be really interesting. I mean, I've got quite a few of them. Watch one of mine if you want, but there isn't a lot out there, just from my experience. We could look at some clips, maybe from Love on the Spectrum. That might be quite interesting to watch. I watched the first season of it. It was kind of good. The choices in what they did, the production choices, were a bit questionable. It's the mainstream media. What can you do? There isn't also a number of aspects of the repetitive restricting things. They're switching activities. That's a lot to do with transitions. That is something that I struggle with a lot. Some people might interpret that as you have difficulties switching to something that you don't want to do. There might be somewhat of an element of that bias involved, but from experience, it's equal. If I'm in a work mode and I've been going for the entire day and I haven't really taken a break, it's very difficult for me to stop what I'm doing. You get the idea of autistic inertia, that buildup of momentum on what you're doing, and actually halting it and stopping it or being broken out of it. It can actually cause a lot of emotional dysregulation. Sometimes it can take me an hour, just idly sitting by to feel ready to go to the gym after work, just because of that transition time. Kind of means that my schedule needs to be a lot more tailored, I guess, in all of different ways. That's what this talk about with Level 3. Severity means the child needs very substantial support, and on the social communication side, they might display very few words of intelligible speech and rarely initiate an interaction with others. For repetitive behaviors, they might be extremely resistant to change, and their behaviors seriously interfere with their daily life. Well, a lot of the times there is communication there, it's just that they yet to have been taught it. They haven't had the right teaching or the education when they were younger. For some people, it might not be the case, which I get. But a lot of them, they can use sign. I've worked with some individuals who have very high support needs. They're usually great. They're really fun to interact with. You just got to interact with them the way that they interact with you, and everything goes fine. The way that you get around the resistance to change, that's just, you got to make it part of the routine. Interferences with daily life can be hard. I was always a quiet child. I wasn't when I was younger. I was quite happy, go-lucky kind of kid, less so getting into teenager. It's thought that using this scale of symptoms, as opposed to differentiating between pervasive developmental disorders, will help give a more accurate and medically useful way to diagnose individuals. For example, those with what was previously described as Asperger's syndrome would likely fall closer to severity level one than severity level three. Generally speaking, autism spectrum disorders thought to have a genetic cause, which ultimately affects brain development. So that's the thing about this whole thing. It is literally a sliding scale of functionality. And like it's not taking into account all of the different autistic traits that one can display, the sensory things, they don't even mention anything about the sensory thing. And that is such a massive part of it. This is kind of based on this idea of the triad of impairments that was proposed by Lorna Wing. She made some contributions which are quite important for science and also for autistic people. Some of the things, not so much like she didn't believe that we had empathy, which we now know it split up into adaptive and cognitive elements, which are very, very different. The cause is definitely a lot to do genetics. I think I've seen some studies about testosterone in the womb and things like that. The thing is we're talking about causalities of autism is that it's not always because we don't want society to be ableist and have this idea of eugenics, trying to fix people before they're born. It removes the need to look for causes in a way. I understand science is exploring things, but there are definitely a lot of elements to autism that should have more funding put into rather than the causes of it. Find out why we have such bad issues with anxiety and mental health. There's a lot of social factors involved in that, but there is genetic factors with things like epilepsy, anxiety, things like that. That's the area that really needs a lot more scientific research into. Very, very important. Specifically areas that affect social and communication behaviors. Which genes or combination of genes that are affected in autism spectrum disorder, though, is still very much a mystery. In addition, there are a bunch of environmental triggers that have to be explored. But at the moment, there are no clear risk factors that have been identified. With that said, there is also no cure for autism spectrum disorder. And treatment or management has to be specifically and carefully tailored to each child. And this includes things like specialized education programs and behavior therapy that all seek to maximize quality of life and functional independence. Okay, there we go. That is a five-year-old video from Medscape Osmosis. I just want to point out that this is five years ago. And I'm aware that probably there haven't been as much autism advocacy like we do have nowadays. It's progressed quite a lot in a very short space of time. You do find some scientific communities which are diving into using the language that is better and perhaps a little bit less negative deficit focused. Because it's not always the most helpful thing. Talking about the deficits, a lot of these things that are classified as just being deficits of being autistic are a lot to do with the interaction of us with the big wide world that is not designed for us.