When Society Begins to See

Autism, Prevalence, and Practical Philosophy

There are more people receiving an autism diagnosis. Of that there is little doubt. Much more difficult is the question of whether there are also more people with autism.

The difference between these two statements may seem small. Philosophically, it is significant.

An article published by forskning.no refers to Norwegian figures documenting a sharp increase in diagnosed autism among young children. The increase applies to both boys and girls and is particularly marked in certain social and ethnic groups. The researchers argue that the development can hardly be explained solely by our having become better at identifying autism.

Perhaps they are right.

But before we ask why autism is increasing, we should ask what exactly it is that is increasing.

What We Count

Numbers have a peculiar persuasive power. When prevalence doubles, triples, or quadruples, it can appear as though reality itself has changed. But numbers do not arise without categories. Before something can be counted, someone must decide what is to be counted.

This is an old problem in both philosophy of science and practical philosophy.

Autism must not only exist. Autism must be recognized as autism.

A child must be seen. Someone must respond to the child's language, play, sensory sensitivity, social expression, or development. Parents may begin to wonder. A kindergarten or preschool may become concerned. A general practitioner may refer the child. Specialists may carry out an assessment. The child's behaviour must be understood within certain diagnostic categories.

Only then does the child enter the statistics.

We should therefore be cautious when moving from the statement "more people are being diagnosed with autism" to the statement "autism is becoming more common."

Both may be true at the same time. But they do not mean the same thing.

The Person Before the Diagnosis

Practical philosophy begins somewhere else than statistics. It begins with the human being living a life.

The child exists before the diagnosis.

The child experiences the world through the senses before anyone has decided how that experience should be classified. The child may be overwhelmed by sound before the phrase sensory sensitivity appears in a medical record. The child may withdraw from other children before anyone speaks of social communication. The child may immerse themselves intensely in particular interests before these are described as restricted or repetitive interests.

The diagnosis comes later.

That does not make the diagnosis unimportant. On the contrary, it can be decisive. It may provide access to support, make the child's reactions more understandable, and free both the child and the family from moral explanations of behaviour that was once regarded as disobedience, oddness, lack of interest, or poor upbringing.

But a diagnosis also creates a particular way of seeing a person.

Gadamer taught us that understanding is never a neutral recording of a reality already complete before us. We encounter the world through concepts, experiences, and expectations. We always see something as something.

The same is true of autism.

The Invisible Person

This makes the sharp rise in autism diagnoses philosophically interesting.

It is possible that we are not dealing only with an epidemiological change. We may also be dealing with a change in the way we see.

People who were once described as difficult, eccentric, antisocial, rigid, dreamy, nervous, or maladjusted may today be understood through the autism spectrum.

Girls are a good example. For many years, the image of autism was strongly shaped by how the condition appeared in boys. When our understanding changes, people also become visible who previously fell outside our diagnostic field of vision.

The same applies to adults.

There are people who have lived most of their lives without knowing why the world has been so demanding. They have worked, married, had children, studied, failed, succeeded, and developed strategies for coping with social situations that other people move through almost without thinking.

When such a person receives an autism diagnosis late in life, has the autism then come into existence?

Of course not.

What has come into existence is a new understanding.

And understanding can change a life almost as profoundly as illness can.

When the Explanation Becomes Too Simple

We should therefore be cautious about both extremes in the discussion.

One says:

Autism is increasing only because we diagnose more.

The other says:

The numbers are increasing, therefore autism itself must have become biologically much more common.

Both explanations may be too simple.

There may be real changes in biological or environmental risk factors. Research must examine this. At the same time, our understanding of the autism spectrum has changed. More children are assessed. More groups are recognized. Parents and professionals know more. Health services look for different signs than they once did.

Reality and our way of looking at reality change at the same time.

This is the old problem of hermeneutics in modern medical form.

We try to understand something, but the act of understanding itself influences what we are able to see.

The Moving Boundary of Normality

Behind the discussion lies an even more difficult question:

What do we mean by normal?

Normality is often presented as though it were a biological fact. But normality is also social.

A child who cannot tolerate noise may function very well in a quiet environment and break down in an open classroom. A person who struggles with rapid social shifts may function poorly in a workplace built around meetings, interruptions, and group work, yet excel in an environment characterized by concentration, structure, and predictability.

Where, then, is the disability located?

In the person?

In the environment?

Or in the encounter between them?

Here we approach the heart of practical philosophy. The question is no longer only what autism is. It is how we ought to live together with people who experience the world differently.

That is an ethical question.

The Two Faces of Diagnosis

Diagnoses have two faces.

They can open a door.

And they can close one.

A diagnosis can provide explanation where previously there was only blame. It can lead to support, accommodation, and self-understanding.

But it can also reduce the person to the category.

Suddenly, a person is no longer simply quiet. They are autistic. They are not tired after a social gathering. They are autistic. They prefer routines. They are autistic. They say something inappropriate. They are autistic.

The diagnosis that was meant to make the person more understandable can paradoxically make the person less visible.

We see the diagnosis and stop seeing the person.

Practical philosophy must therefore ask a different question from epidemiology.

Not only:

How many people have autism?

But:

What do we do with a human being once we have given them this name?

From Cause to Responsibility

Science rightly searches for causes.

Genetics. Pregnancy. Environment. Social factors. Diagnostic practice. The organization of health services.

All of this must be investigated.

But even a complete explanation of why autism occurs would not tell us how we ought to meet an autistic person.

Here empirical science reaches a limit: empirical knowledge alone cannot determine what we ought to do.

No MRI scanner can tell a teacher how to meet a child who covers their ears when the class sings "Happy Birthday."

No genetic analysis can tell an employer whether an employee's silence means disinterest, concentration, or overload.

No prevalence study can decide how much a person should have to change in order to fit in among us—and how much the rest of us should change the environment in order to make room.

This requires judgement.

And judgement belongs to practical philosophy.

Perhaps We Are Seeing More

I am therefore uncertain about how we should understand the sharp rise in autism.

Perhaps there are biological changes we do not yet understand.

Perhaps we are diagnosing people who in earlier times would have lived without a diagnosis.

Most likely, both are happening.

But there is also a third possibility that should not be underestimated:

We have begun to see.

We see the child who was once simply regarded as difficult.

We see the girl who learned to imitate the others.

We see the student who manages the examination but not the cafeteria.

We see the employee who masters the task but not the meeting.

We see the adult who has spent an entire lifetime using enormous amounts of energy to behave as the surroundings expect.

It may be that part of the "increase" in autism tells us something important not only about autism, but about the society observing it.

Every diagnosis tells two stories.

It tells us something about the person who is diagnosed.

But it also tells us something about the time that makes the diagnosis.

And perhaps that is why the question of increasing autism should not primarily be:

Why are there more and more of them?

Perhaps we should also ask:

Why has it taken us so long to see them?

Reference:

Jakobsen, S. E., & Dæhlen, M. (2025, September 8). Autisme øker kraftig. Kan ikke bare forklares med at flere oppdages, ifølge forskere [Autism is increasing sharply. According to researchers, this cannot be explained solely by increased detection]. forskning.no.