“Is this Autism?” by Donna Henderson and Sarah Wayland, with Jamell White

Prenotes:

1. The DSM is changing over time
2. Mental health is seeking to be normalized
   • I have a misremembered quote that I heard around the launch of the DSM-5.
     • Statement: “With these changes, almost half the population would have had a mental illness.”
     • Response: “We define physical sickness such that 90% of the population has been affected at some point in their lives, but that does not surprise us.”
3. Autism itself is undergoing some radical transformations as the community grows.

• “Person-first” (“a person with diabetes” vs “a diabetic person”)
• Symptoms must be present in childhood but may mature or change over time
• Lack of reciprocity in conversation
• Struggle with empathic empathy (extrapolating how others feel) but not with affective (feeling deeply for when you see pain)
• Quickly sharing deep, inappropriate information with near acquaintances
• Neural divergent have to use their prefrontal cortex to mask, causing more mental fatigue
• Reading body language is often not consistent and is easy to mask
• “Listen to what we say, not just” what we look like
• “Social motivation” is different from “social energy”
• “Social demands exceed available capacity”
•  Islands of rigidity
• Perhaps it is more about higher/lower reactivity instead of hyper/hypo activity
• Sensors
  • Hearing (including communication and non-communication sounds)
  • Smells
  • Proprioception
  • Vestibular
  • Interoception (“How do you feel?”)
• Autistics tend to have uneven skill distribution
• Autistics tend to meticulously piece together situations instead of using context cues
  • They can focus on the big picture but they default details
  • More intense focus, in general
• Systematizing