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Comment by arkades | Hacker News Reader

Prior to the 18 patient study of rapidly growing teenagers, with subjective rating scales performed by unblinded investigators, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD.

Just adding context.

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How many would have been expected to get cured without any action at all ? (because Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms")

But two years is a very short time. I have a mild form but it still took me decades to get to where I am today. People don't suspect I'm autistic and are surprised when I say it, but I'm absolutely exhausted from a day of masking it at work if there's a lot of meetings with new people.

> Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms"

Having worked with autistic youth before, that's simply not true. First, autism is not a disorder that can be cured but worked with. Second, it doesn't do it by itself, but _can_ get better, with different approaches, and most of them involve hard and persistent education work. Lastly, the part of the spectrum that can look as if they were "normal" is a rather small proportion of the whole ASD.

Ah come on, be fair. Every psychiatric disorder has a pretty high chance of getting resolved without any action from outside. Very few people actually succumb to them.

Furthermore, especially with psychiatric disorders, there is a high percentage of patients that aren't helped, but exactly the opposite, by treatment. That systematically get worse because of treatment.

(I do not claim this is easy or pleasant for the patient, merely that it happens. Furthermore in the more common cases where treatment makes the patient worse it is also incredibly unpleasant, unfair and entirely terrible for the patient)

(and of course you could correctly claim that this is even true for cancer, and it is. However for cancer the percentage of patients that get better without treatment is something like 0.2% up to 4% depending on the cancer, whereas for psychiatric disorders the amount of people that recover without treatment is easily > 90%)

Source for any of this? 90% is a number you should be getting from somewhere, and it sounds unbelievably high.

I would go even further and call it "dismissively" high.

I don’t think what you’re saying is accurate or appropriate for autism.

Originally I posted a longer response, but it's not worth breaking down because the original content is complete, unfounded nonsense. It's the kind of thing you'd read on an anti vax facebook page.

No, the vast majority of those with psychiatric disorders do not recover without treatment

No, there is not a high percentage of patients that get worse because of treatment

Either a source needs to be posted or the comment should be deleted because it is completely false, not adding to the discussion, and incredibly dismissive of those experiencing psychiatric problems or seeking psychiatric treatment

Autism is not a "psychiatric" disorder, it is a developmental disorder with neurological and physiological symptoms.

That is an excellent question.

It depends on how they selected the subject of the study [1] and how accurate is the evaluation at the beginning and the end of the study [2].

That's why they need a control group, that is selected at random, so you hope that the cure rate in the control group is the same than in the main group if they didn't get the treatment.

Also, the groups must be double blind so when the doctors evaluate the results don't know if the patient has been treated or not, and they use the same criteria.

[1] Did they select only the mild case? Did they exclude the mild cases? Average age of the group? How much personalized help they can get to interact with other persons? Did other part of the study affect them? (Something like a minimal medical attention when they visit a nurse each month for minimal checks.) And a few more, that probably nobody know ...

[2] Some symptoms are crystal clear, and some are more fuzzy.

Re double blind etc.. Not for pilot studies where one errs on the side of excluding null results in order to get the required funding to study something properly. Without pilot data, one judt wont get the grant that would play for the clinical trial

Those labeled as "severe" aren't remotely likely to have their autism "resolve itself". Those labeled severe have the types of behaviors that tend to remain through the years. Children who are prone to self-injurious behavior, in my experience (two kids with autism, lots of exposure to other severe cases in the community), don't tend to outgrow it.

Those that you see able to 'mask' their symptoms are generally on the opposite end of the spectrum, sometimes referred to as 'high-functioning'. That requires a level of self-awareness that many of the lower functioning spectrum seem to lack.

One of the major problems with autism diagnoses is that there are lots of people who see the higher-functioning members of the autism community as the norm, whereas there are a fair percentage that are essentially permanently disabled that will likely be unable to contribute to society in a measurable way.

>Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms"

This is absolutely not true for the vast majority of those diagnosed with ASD

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