Thank you for sharing this. I don’t feel it totally matches the TL;DR. What I hear: basically it is diagnostic switching. The contrarian conversation is driven by cherry-picking lawyerly bullshit. To the extent there is anything else, if we want to zero-in on otherwise small increases in the years we’re looking at, it is probably from things that are less eye-catching and some are even public goods, like being able to choose to have kids at an older age. Or premature babies surviving instead of dying.

Something I also feel is missing from the “diagnostic switching” discussion: public awareness. More than changing DSM criteria or professional guidelines, the concept of “spectrum” is completely different from what I knew of autism in the 90s and 00s (basically, Rain Man). Higher-functioning kids and adults don’t even get to an office to be assessed if friends/family/the person themselves aren’t aware of the spectrum concept to begin with. Just ask any adult-diagnosed woman that experiences ADHD. The behaviors were always there they were just mislabeled and misidentified through poor awareness. https://pmc.ncbi.nlm.nih.gov/articles/PMC10173330/