If there is something about the profile which impairs that person's capacity to live a full and satisfying life without significant support, then I think we are entering the realm of pathology.
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Perhaps support becomes significant when the environment has to make modifications to suit an individual that are disproportionate compared to those made for the other members of the community.
This suggests that autism is community dependent - an individual in one culture may not "have" it any more when they move to a different culture that fits them better. That seems a little strange for a "disorder" - I mean, you don't suddenly stop having a sprained ankle because you move from Chicago to Cambodia. Or a brain injury.
Actually, that's my point. Those on the top end of many conditions that we could consider spectrum disorders (e.g., ASD, ADHD) may not be functionally impaired in a setting that is a better fit for them. One could even make the argument that some mildly intellectually-impaired individuals evince minimal functional impairment in certain societies or segments of societies. I am not suggesting that the personal profile is different in different settings, just that the degree of impairment may become more or less significant. Our diagnostic criteria are arbitrary. These are not syndromes for which there are clear physical or biochemical tests. Don't forget that the DSM has historically been a consensus document, with criteria developed by expert opinion, not a deep body of objective quantitative research. Attempts to attach some objectivity have been of fairly recent origin.
