Autism is like cake

In Autism is like a cupcake I looked at how applicable a cupcake metaphor for autism was, and in what ways it might help us understand autism. Interestingly, I found another cake metaphor to talk about. So are you ready for more delicious insights or frivolous autism-themed cake-talk? It might give some food for thought!

Autism is like cake

Below is an exchange from ASDirect, posted in a Reddit thread.^[1]I was thinking back at this conversation from ASDirect | r/autism | Reddit

I was thinking back at this conversation from ASDirect.
byu/dealingwithgriefhelp inautism

Person 1 says:

Autism is like cake; some people have more slices than others.

And person 2 responds:

I think it’d work more like different people having different flavors of cake;
the kind of cake can vary, but in the end, it’s still cake.

I think both people in the conversation above have a point, but the reality is more nuanced than either of them is describing. But of course, you can only get so far with metaphors anyway. Let’s explore both perspectives.

Different flavors of cake

From the presence of different active genes, different constellations of traits emerge. For example, mutations in the NLGN4 gene have been associated with autism. But there isn’t a single gene that causes autism; instead, it’s governed by hundreds to thousands of genes.^[2]Researchers flag hundreds of new genes that could contribute to autism (Hadhazy, 2016) | Princeton University^[3]Artificial intelligence detects a new class of mutations behind autism (Schultz, 2019) | Princeton University^[4]Genome-wide predictions of autism-associated genes | Princeton University Different combinations of genes form a unique profile of behaviors.

So indeed there are many different “flavors” in the sense that different compositions of genes result in different autistic expressions (i.e. different behaviors commonly seen in and associated with autism). To go back to the cake metaphor, the flavors of cake are the autistic traits or behaviors, while the cake itself is autism.

More or less cake

While it’s true that autism has many different expressions, logically it should also be true that people are autistic to different degrees. Different numbers of genes associated with autism dictate the extent of autistic traits, or autism “severity” as some have awkwardly and unfortunately described it. In the cake metaphor, the slices of cake are the extent of autistic traits or behaviors.

So having more autism genes leads to certain behaviors and abilities that are then perceived to be autistic in greater or lesser degrees—assuming they are perceived as autistic at all. In particular, the perceived level of functioning is inversely correlated with the perceived extent of autism. In other words, the less the ability to function and camouflage autistic traits is in a person, the more autistic they are perceived to be.

What remains unclear—at least to me—is whether there is necessarily a direct correlation between the number of “autism genes” and the perceived extent of autism. Simply put, do more of these “autism genes” lead to more outwardly autistic behaviors, or does it matter more which genes are present?

Cake ingredients

I keep putting ‘autism genes’ in quotes because I don’t think there are autism genes as such. Some or many of the genes implicated in autism also play a role in other conditions or human expressions, and some or many of those genes aren’t necessarily linked to “autistic behavior” specifically.

One good example of this I can think of is the Monoamine oxidase A (MAO-A) gene, also called the warrior gene. MAO-A is present in many autistic people, but is linked to a range of different behaviors, including antisocial behavior, aggression, and impulsivity. While some of those behaviors do feature among autistic people, they are not hallmark behaviors, nor commonly associated with autism. So even having many genes implicated in autism does not necessarily translate to what we might call “autism severity” or the extent of autism.

Which, to be honest, I don’t entirely know what “very autistic” even means. I think what is generally meant by that is outwardly observable behaviors that are stereotypically associated with autism. Many features of autism are not commonly counted among those behaviors. For example, a great ability for pattern-finding might be considered a sign of intelligence rather than an autistic trait. Creativity is also very common among autistics, but I’ve never seen very high creative output being described as “very autistic”.

Perceptions of cake

So how autistic you are perceived to be, probably depends both on the extent of autistic traits, and the visibility of autistic traits. I want to highlight a few different ways in which the perception of autism doesn’t necessarily correspond to how autistic you are on a genetic, biological, and neurological level:

• Subtle behaviors — Some traits are more subtle than others, and thus less likely to be associated with autism. This seems significant to me, because it implies that there isn’t necessarily a straightforward relationship between the traits and genes on the one hand, and perceived behaviors on the other. In principle, I could carry more autism genes than you, yet be perceived as less autistic than you.
• Non-stereotypical behaviors — Not only are some traits more subtle and less likely to be noticed, but some autism genes may lead to behaviors that aren’t necessarily associated with autism in the first place. For example, autism genes can contribute to prodigious memory, which in turn can make a person be perceived as confident. Not to say that autistics can’t be confident—many of us are—but it’s not something commonly associated with autism.
• Camouflaged behaviors — And finally, many autistic traits are camouflaged. If you are intelligent and adaptive, and excel at social interaction and communication, you may not appear autistic to others. What’s interesting about this is that on account of your compensation strategies, you can have a lot of autistic genes and behaviors, yet be perceived as less autistic as someone with fewer autistic genes and behaviors but who expresses their autism more authentically and/or obviously.

I think both of the cake metaphors described in this post make sense, but what constitutes more or less autism is not straightforward to assess. Do you measure the number of genes associated with autism? Do you look at the presence of particular genes? Or do you look at the behaviors of an autistic person? Or does the experience supersede all?

I think what the incongruence between the genetic basis of autism and the perception of autism indicates is that autism is not purely biological, or genetic, or neurological. Autism is also phenomenological, and conceptual. Which is to say, autism is also what the experience dictates rather than what is observed. But at least to a degree, it seems autism is also in the eye of the beholder.