Another phenomenal person has joined bluesky! Follow @gertjanvanaken.bsky.social if you want rigorous (philosophically and clinically informed) updates on what it means for a treatment to be "neurodiversity-affirming!" Also, if you haven't, read his paper: www.frontiersin.org/journals/psy... - ThreadSky

quantpsychiatry.bsky.social • 93 days ago

Another phenomenal person has joined bluesky! Follow @gertjanvanaken.bsky.social if you want rigorous (philosophically and clinically informed) updates on what it means for a treatment to be "neurodiversity-affirming!" Also, if you haven't, read his paper:
https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1225152/

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naolimit.bsky.social•90 days ago

📌

unwindoakland.bsky.social•92 days ago

Finally, there are huge issues with ageism in this field where all interventions are focused on individuals under the age of about 22 to 25. However, that is at odds with late diagnosis individuals needs and access to meaningful wrap around support.

quantpsychiatry.bsky.social•92 days ago

Many good points in the replies. I do think some of this is due to the simple lack of data that we have in this area. Often empirical questions in need of head-to-head trials re: "which works best" (especially if we're looking at outcomes like sustaining employment). More innovation is important 1/

quantpsychiatry.bsky.social•92 days ago

The focus on certain age groups is also something that frankly has bothered me for a long time. We don't really have the clinical infrastructure as a field to "collect" or centralize older autistic folx, which means that many adult studies are made of people who "aged out" of pediatrics. 2/

quantpsychiatry.bsky.social•92 days ago

That honestly needs to change in order to do good work that generalizes to the whole adult-diagnosed population (though for perhaps-obvious reasons the child-diagnosed population does tend to need more/higher-intensity services on average, so it may not be the worst to prioritize them). 3/

unwindoakland.bsky.social•92 days ago

I would argue that if we are looking at quality of life outcomes, nobody receiving a late diagnosis is in that clinical diagnostic setting because they are doing a-ok. Average or higher IQ adults over 25, particularly women and people of color, are wildly underserved and unseen.

quantpsychiatry.bsky.social•92 days ago

I'd love to see more established employment and intervention models that apply to middle and older age though. Much is going to have to actually rely on empirical data rather than vibes/anecdote to see what works (and what works better, when, and for whom). 4/4

unwindoakland.bsky.social•92 days ago

I am doubtful about a heterogeneous group being dictated homogenized solutions working well.

unwindoakland.bsky.social•92 days ago

I think what I'm reacting to most is when we start the histories in the 60s, neglecting the eugenics movement in the US that inspired the sequestration, experiments, euthanasia, and dissection of kids like me. Given the incoming administration's attitudes and comments, it's dangerous to exclude this

unwindoakland.bsky.social•92 days ago

I would have more to say, but I was discriminated against in my PhD program. So here we are. I did find it interesting that on a 3-month timeline, CBT actually worsened rumination and depression measures. The idea that what works for a neurotypical group will work for us is one thing I didn't find

unwindoakland.bsky.social•92 days ago

I can certainly say that having three entry level jobs with no hope of advancement and very specific "superpowers" 🤢 needed sequestered from the rest of the company with a social skills interview being conducted in Minecraft was not the answer.

unwindoakland.bsky.social•92 days ago

We need to consider employment models where that exploitation is predominant today. I've seen the unemployment rate for people who are neurodiverse with a four-year degree reported as 25% higher than people who are recently incarcerated. Autism at Work and similar programs replicate the 30s/40s.

unwindoakland.bsky.social•92 days ago

A solid update with some large gaps. I found embodied practices have longer term positive effects on mediating rumination relative to CBT and other similar interventions. Also, it's important to note the eugenics driven experimentation and exploitation of the 30s-70s on kids is coming back in the US

quantpsychiatry.bsky.social•92 days ago

And it looks like his equally-impressive partner-in-crime @themispant.bsky.social is here now too! Another very worthwhile follow.

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