
Autism severity can change substantially during early childhood, study suggests - EndXA
https://health.ucdavis.edu/health-news/contenthub/autism-severity-can-change-substantially-during-early-childhood/2020/05
======
kstenerud
> The study also found that IQ had a significant relationship with change in
> symptom severity. Children with higher IQs were more likely to show a
> reduction in ASD symptoms.

This is important information. People of higher intelligence would be more
likely to learn things, such as how to mask effectively. I learned to mask so
well that most people are shocked to learn that I'm autistic. It takes about 6
months of constant exposure for someone to get creeped out and dislike me, to
the point that I wonder if I've done myself a disservice with my masking
habit.

~~~
scandox
Presumably they're creeped out because they believe your emotional responses
are simulated and that your engagement in phatic discourse is inauthentic?

But how they can they tell the difference? And even if they can how do they
know that this isn't also true of everybody else, only that others are
superior fakers?

How can they even know that their own responses are authentic? I ask because
I'm really not sure about this in my own mind.

~~~
kstenerud
In my attempts to discover the secret behind perfect social interaction,
people I've spoken to have been unable to explain exactly how they do it. It
seems reasonable to assume that the brains of social animals are specially
tuned to learn social interaction quickly, as such individuals would more
quickly form a cohesive group with better survival potential (historically
speaking).

The question of authenticity, though interesting philosophically speaking, I
think can be safely downgraded to simply "how it works in practice". Most
people seem to do it out of some sort of instinct, and most people really are
telegraphing their true feelings and intentions to varying degrees.

~~~
surfpel
I have become close to several extremely social people and discussed this
quite a bit. I realized that they approach socializing the same way I approach
engineering and the like. At a party they clearly see the subtle or not so
subtle effects of their actions and gauge the situation on a meta level
without even really realizing that they’re doing it. It’s almost as though
some of my neural circuitry originally intended for socializing was applied to
an awareness of “things” instead.

~~~
amelius
> I realized that they approach socializing the same way I approach
> engineering and the like.

That sounds like a dishonest way of treating people, and might be a reason why
some people prefer to be more introvert.

~~~
surfpel
I don't see it that way. They're not 'social engineering', they just have a
greater understanding as to where interactions will go and the confidence to
carry out said interactions. The only alternative for them is being willfully
blind to social interaction which isn't a real option in my view.

------
JacksonGariety
I have high-functioning autism. Does anyone have some suggestions for making
and keeping friends?

When I meet a friend, things seem to go really well at first, and then my
friend seems to slowly get bored of the interactions we have, and after a
couple months I just don't hear from them again. Not sure what I'm doing
wrong. Is there a scientific way to find out?

~~~
TrinaryWorksToo
The closest I've found to making and keeping friends has been the FBI
interrogation manual, which explains how police officers who would normally
scare a suspect can get them to disclose intimate details of crimes.

[https://www.fbi.gov/file-repository/hig-report-
august-2016.p...](https://www.fbi.gov/file-repository/hig-report-
august-2016.pdf/view)

[https://www.fbi.gov/file-repository/hig-report-
interrogation...](https://www.fbi.gov/file-repository/hig-report-
interrogation-a-review-of-the-science-september-2016.pdf/view)

Obviously you're not entering an interrogation, and you also want to level the
playing field by sharing information yourself.

I think it's an evidence-based guide to how first impressions are formed, and
what people often get out of social interactions.

~~~
Inu
>The closest I've found to making and keeping friends has been the FBI
interrogation manual, which explains how police officers who would normally
scare a suspect can get them to disclose intimate details of crimes.

Sorry, but this is the funniest thing I've read on HN in a while.

~~~
conistonwater
If you're interested in improving your social skills at work, you might also
enjoy the book _How to Talk so Kids Will Listen and Listen so Kids Will Talk_.

Um, seriously, all effective communication techniques are based on basically
the same principles; there's a book by a former FBI hostage negotiator Chris
Voss ( _Never Split the Difference_ ) where he describes hostage negotiations
with terrorists, and it all works in the workplace too. These two are
significantly better than _How to Win Friends and Influence Friends_ , which
is mostly about sales rather than negotiations.

~~~
james_s_tayler
That guy is legit.

------
EndXA
Study abstract:

> Autism symptom severity change was evaluated during early childhood in 125
> children diagnosed with autism spectrum disorder (ASD). Children were
> assessed at approximately 3 and 6 years of age for autism symptom severity,
> IQ and adaptive functioning. Each child was assigned a change score,
> representing the difference between ADOS Calibrated Severity Scores (CSS) at
> the two ages. A Decreased Severity Group (28.8%) decreased by 2 or more
> points; a Stable Severity Group (54.4%) changed by 1 point or less; and an
> Increased Severity Group (16.8%) increased by 2 or more points. Girls tended
> to decrease in severity more than boys and increase in severity less than
> boys. There was no clear relationship between intervention history and
> membership in the groups.

The study can be found at:
[https://link.springer.com/article/10.1007/s10803-020-04526-z](https://link.springer.com/article/10.1007/s10803-020-04526-z)

------
SubiculumCode
I am part of the research team that collects and analyses this dataset,
although I am not an author on this particular analysis. Feel free to ask me
any questions.

~~~
gwern
I have a question: how do their analyses account for regression to the mean?
The headline sex and IQ differences look exactly like regression to the mean
to me:
[https://www.reddit.com/r/science/comments/gtvoan/around_30_p...](https://www.reddit.com/r/science/comments/gtvoan/around_30_percent_of_young_children_with_autism/fsfm3pu/)

~~~
SubiculumCode
Generally, in longitudinal analysis, three data points are the minimum
required to fit a line while guarding against reversions to the mean. The lead
author is currently assessing data with a third longitudinal timepoint of the
ADOS severity measure. That said, the research article tried to guard against
this problem by defining the minimum amount of change to be considered a
reliable change i.e. a Reliable Change Index statistic (RCI; Jacobson and
Truax 1991), which is, in Latex: RCI_{{Z\,SCORE}} =
\frac{{({\text{ADOS}}\,{\text{CSS}}{\mkern 1mu} {\text{Time}}{\mkern 1mu} 3 -
{\text{ADOS}}\,{\text{CSS}}{\mkern 1mu} {\text{Time}}{\mkern 1mu} 1)}}{{\sqrt
{2\left( {SD\sqrt {1 - r_{{xy}} } } \right)^{2} } }} which takes into account
test-retest reliability correlations.

Roughly speaking, this meant the the change groups ended up changing dX>+2 or
dX<-2 on a 0-10 ADOS severity scale (4 is usually the clinical threshold for
ASD diagnosis), while the no change group was defined roughly as between
-2<dX<+2.

Furthermore, in data I did help analyze which is currently included in a
journal submission, the change groups defined here exhibited altered
longitudinal trajectories of white matter fractional anistropy and
diffusivity, suggesting biological relevance one might not expect with a
statistical reversion to the mean.

~~~
gwern
I see.

> suggesting biological relevance one might not expect with a statistical
> reversion to the mean.

Just going to note here that regression to the mean is not 'just' statistical.
It happens any time two variables are not perfectly correlated. The imperfect
correlation could be due just as easily to 'biological relevance' as it could
be to some sort of more purely statistical random error like rater error, so
pointing out biology is no evidence. (As in the classic example of the flu
patient going to the doctor and recovering afterwards; they really were
biologically sick and really did biologically recover.)

~~~
SubiculumCode
Thanks. I will think upon this.

------
pgt
What if all children start off as autistic and gradually develop situational
and emotional awareness? Some never do.

~~~
wozer
If that is true, it must happen very early. Some two year olds are already
extremely non-autistic.

~~~
pbhjpbhj
Parents in the UK will some times describe a child as "flirty", it has nothing
to do with sexuality - to head that one off. They have learnt, by only a few
months old, to attract attention of adults by using facial expressions, coos,
and such. They certainly seem to be the other end of the spectrum wrt
commanding social interaction.

But I'd suspect it's more that most children have the capacity but a few just
happen upon the formula early. Like we mostly have capacity to walk but some
take 14 months then just get up and walk, whilst others are walking at 8
months when they can barely raise their heads; and others are crawling
backwards, or shuffling on their bums because walking didn't click quite so
quickly.

~~~
nicoburns
Myers-Briggs type theory suggests that there are 8 modes of cognition, and
that we all develop one first and only later begin to develop the others. Even
if you don't like the Myers-Briggs stuff, I think the idea that children all
develop a specific way of thinking first, but that the one that develops first
isn't the same for all children is insightful.

------
DyslexicAtheist
my son had a couple of very annoying years between 4-7 where he would seem
behind compared to other kids on certain things such as motor skills and
physical (hand/leg) coordination. he was also huge for his age, like trapped
in a larger child's body.

when it was time to send him to school our neighbors who knew him (because he
hung out with their kid) suggested to send him to an IQ test because they
figured he might be highly intelligent ("same as their kid").

they believed that their own son was very bright too but I thought it's only
because both parents were closer to 50 than to 20. their child also had no
real children friends and mixed mostly with adults - hence also talked like an
adult (and seemed smarter than average for that reason alone - he was total
sh1t with being a kid though but he knew how to recite grown up books and
read/write long before school ...)

anyway - bear with me, I promise to connect these things

eventually we sent our son to do an IQ test and it came back inconclusive. we
were told to test him again in a years time. (he was a mixed kids growing up
with 3 languages which might also have altered how he performed on the test).
Long story short he had a difficult first year in school with the teachers
telling us that either a) he is too smart and should be moved forward a class,
or b) he needs to go to a special school because he is dumb, or c) he should
probably be tested for both autism and ADD. We decided to do none of the above
and give it another 2 years to see how it play out. Eventually he settled into
his surrounding and turned out one of the best students in class.

another case: my best friend's kid is diagnosed with autism ("somewhere on the
spectrum" they say). He is incredibly active for his age and more than other
kids. His parents who are both very ill (ALS and MS) are used to seeing a
doctor every few weeks to get injections, ... they have more exposure to
doctors than to any other grown ups in their life, and meanwhile their friends
are also all people who have "sick" kids. Whenever I play with the kid I think
he is pretty normal, except for that he is a lot smarter than anyone else.
Like a smart boy stuck in a smaller childs body.

Another example: my gf is a nurse and occupational therapist. she literally
works with disabled kids who are on the spectrum, have down-syndrome, cerebral
palsy (to name the most common problems). She says if somebody has autism you
can sure as hell tell. There is no "maybe", or "somewhere on the spectrum"\-
yes some cases are milder but she thinks that some doctors just diagnose and
presribe solutions for things they don't fully understand themselves.

could it be that a lot of these kids simply go through stages in their
childhood at different speeds? like not every kid fits into our "systems-
thinking" model and maybe totally grows out of it a year later? The horrid
thing here is that the moment way start treating their behavior as a disease
it has good potential to actually become one, ... which brings me to the last
example.

I worked with a US company remote. we were all on Jitsi every day even we
weren't meeting so the mgmt could keep tabs (this was the rule for some
reason). The assistant to the CEO a mid 30ies lady insisted that her child had
autism. She constants forgot to switch her mic to mute and I could see how she
talked to that child. He would get regular slaps in the face and get screamed
at - then he would be told to take his meds. Also I think they might have been
on some deal where they get benefits because their kids was "disabled".

idk what to make of this but the whole medical profession seems like a racket
to me. especially in the US (where this disease seems more of a fashion than
anything) ... I hope these kids don't wake up one day and realize the crimes
that have been committed against them.

I'm glad I put my foot down and not put my child on pills (just to put money
in some idiotic Dr. med. pocket). I would have destroyed my child! (and I see
what it's like whenever I look at my best friends kid!

~~~
sm_sohan
I think you're lucky with your son. The meds and interventions are essential
for some. End even then the progress isn't always visible. Speaking from a
different experience than yours.

------
stretchwithme
I've read recently that supplementing zinc and sulforaphane can help autism.

Is there any truth to that? Anyone have personal experience trying either?

~~~
chownie
n=1 obviously

I take a multivitamin with 15mg zinc in it, as far as I can tell none of the
autism specific symptoms are affected. The biggest difference is that I feel
sleepy in the afternoons when I take zinc, when I don't take it I feel more
awake but less rested.

------
conistonwater
How do studies like this take regression to the mean into account? Seems like
a hard problem.

