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I respect the letters after your name, but another psychiatrist-blogger (Scott Alexander) has a post on how it's completely meaningless to only prescribe Ritalin to people who "really have" ADHD because the diagnostic is an arbitrary cut-off point on a continuous spectrum.

Does autism separate cleanly into people who truly do/don't have it? Or is there just some continuum of how systematising your brain is, and from some point on it's enough of an impairment to get a name?

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I agree with Scott as far as I understand his position. There aren’t easy cutoff points for many of these things, and it is to some extent arbitrary. But that doesn’t mean there is no difference between obviously not having ADHD or autism and having it. The presence of gray areas doesn’t mean there aren’t any distinctions to be made.

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