Asperger Syndrome – Disability vs “Over Pathologising”
Is Asperger Syndrome a Disability?
Some people tell me that I’m disabled. Usually it’s an unstated implication such as referring to Asperger Syndrome as a disability with the assumption that I’ll agree. One time I had someone assume that I had never had a paid job because they knew I’m an Aspie, maybe I should boast more about my career successes.
One interesting take on this is represented by Maco’s bost about Disablism/Ablism where she says “Vocab note: A person has an impairment. Society’s treatment of that impairment is what disables the person” . The same concept is presented by BRAINHE in their Social Model of Disability document .
The Wikipedia page on Ableism says “The ableist worldview holds that disability is an error, a mistake, or a failing, rather than a simple consequence of human diversity, akin to race, ethnicity, sexual orientation or gender” . This is fairly close to the position that Neurodiversity  advocates take on Autism.
Jaarsma P and Welin S wrote an interesting paper titled “Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement”  which considers these issues in depth and comes to the conclusion that High Functioning Autism (for which Asperger Syndrome is generally regarded as a synonym) is a difference while Low Functioning Autism is a disability.
I think that generally we should accept the opinion of the person in question. Someone who is unable to communicate or is too young to make an informed decision could have their disability status determined by carers. But anyone who is capable of making an informed decision and communicating it should have their opinion respected. I am not going to argue with any of the people who claim that they are disabled due to an Autism Spectrum Disorder. But I don’t think that I am disabled and I think that people shouldn’t argue with me about this.
Lynne Soraya wrote an interesting article for Psychology Today about one aspect of the supposed over-diagnosis . She responds to Paul Steinberg, a psychiatrist who made a number of claims about Asperger Syndrome which lack evidence. Paul’s main idea seems to be that anyone who has social problems but who seems to be successful regardless shouldn’t have an Autism Spectrum diagnosis and he claims that such people should be regarded as having a “social disability” instead. His main idea seems to be that having a diagnosis is a bad thing, but his idea of having a “social disability” diagnosis instead doesn’t seem so great.
In many other discussions I’ve seen people claim that a large number of diagnosis of anything is a problem. Their idea seems to be that the vast majority of the population shouldn’t have a diagnosis for anything and that whenever a significant number of people are diagnosed with a psychological condition (and 1% of the population seems to be a significant number) then it’s a problem. I don’t think that having a large portion of the population diagnosed is necessarily a problem, I think that it would be OK if the majority of the population was diagnosed with something. The issue is not whether people are diagnosed but what happens after the diagnosis.
When a child is diagnosed their parents can help them deal with whatever the issues are – this may or may not require further involvement with psychologists or special schools. For the milder cases (of Autism, ADHD, and other conditions) merely knowing what areas will cause difficulty and teaching kids how to deal with them will be enough to solve many problems. When someone is diagnosed as a child but doesn’t have obvious symptoms as an adult that is more likely to be an indication that they were taught good coping mechanisms and protected from bad situations as a child – not that the diagnosis was wrong. There are some serious issues with special schools and psychiatric drugs, but diagnosis doesn’t necessarily imply mistreatment and avoiding a diagnosis is not the correct way to avoid such mistreatment.
When someone is diagnosed as an adult they have to learn to deal with it. The general lack of psychologists (waiting times as long as 6 months are common) and the fact that most psychologists won’t do any good for someone on the Autism Spectrum is a real problem. But merely knowing the source of your problems is a major step towards alleviating or solving them.
One of the arguments that is commonly used against so-called over-diagnosis is that adults don’t show apparent symptoms. The issue here is that with some effort and planning adults on the spectrum can act like NTs. Acting like an NT doesn’t imply being an NT, it usually requires a lot of ongoing effort that could be applied to other things if society didn’t expect us to act like NTs all the time.
I wish people would stop telling me that I’m either disabled or too “high functioning” to be on the Autism Spectrum. I will never think like an NT and I don’t want to, so I’ll always be an Aspie. By most objective measures I’m at least as successful as the general population in all things that require social skills, so unless something like always losing at Poker is considered a disability I don’t think that it’s reasonable to consider me to be disabled.
It would be nice if I could lock the people who claim that Autism is always a disability in a room with the people who think it’s over-diagnosed and let them debate it, no matter which side lost the debate the result would be good!
Update: I removed a broken link to a Youtube video, I published this post from a 3G connection and didn’t test that the Youtube link still worked. For some reason the author had marked it private since the last time I visited it.
-  http://ubuntulinuxtipstricks.blogspot.com.au/2011/05/blogging-against-disablism-day-asl.html
-  http://www.brainhe.com/TheSocialModelofDisabilityText.html
-  http://en.wikipedia.org/wiki/Ableism
-  http://en.wikipedia.org/wiki/Neurodiversity
-  http://www.imh.liu.se/avd_halsa_samhalle/filarkiv1/1.264263/JaarsmaWelin2011Autismasanaturalvariation.pdf
-  http://www.psychologytoday.com/blog/aspergers-diary/201202/is-aspergers-overdiagnosed
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