The diagnosis story.

Autism as a clinical category is younger than most people assume. The word entered the medical literature in the 1940s. The diagnostic criteria as we now know them are largely products of the late twentieth and early twenty first century. The version of autism that anyone over fifty was working with in their childhood is not the version a teenager would be given today. The frame has moved repeatedly, and it is still moving.

The early descriptions were narrow and skewed. The clinicians doing the describing had access to a specific subset of children, mostly white, mostly boys, mostly from families who could afford to bring them in. The descriptions reflected that subset, and then the diagnostic criteria were built from those descriptions, and then the wider population was assessed against the criteria. The result was decades of underdiagnosis for everyone who did not look like the original sample. Girls. People of colour. Adults. Working class families. First Nations communities. The people the original literature did not see.