April 23, 2012


Filed under: Health, Science — Tags: , , — Nicholas @ 08:41

Sandy Starr refutes the notion that “we are all on the autism spectrum now”:

Is autism a disorder? Is autism an identity? If you had asked me these questions a few years ago, before I became involved with the Autism Ethics Group at King’s College London, then my answer would have been a clear ‘yes’ and ‘no’ respectively. Clearly, autism is most usefully understood as a disorder. And clearly, it is not useful to understand autism as an identity.

If you were to ask me the same two questions today, then I would say exactly the same thing.
[. . .]

The whole concept of autism originates in psychopathology. Hans Asperger (after whom Asperger’s syndrome is named) talked about ‘autistic psychopathy’. Autism is found in the Diagnostic and Statistical Manual of Mental Disorders (DSM). And yet we now seem uneasy about the characterisation of autism as a disorder. Why?

For one thing, a disorder implies a lack of normal or typical function. The increasing numbers of people who are thought to warrant a diagnosis of either ‘classical’ autism, atypical autism or Asperger’s syndrome is now of a scale sufficient to make one ask whether autism is, in fact, exceptional. Only last month, there were newspaper headlines about the fact that about one per cent of schoolchildren in the UK are now recorded as having some kind of autistic spectrum disorder (double the figure from only five years previously). This was followed by the news that according to a new study by the Centres for Disease Control and Prevention, one in 88 children in the USA now have an autistic spectrum disorder (again, almost double the figure from five years previously).

We can speculate about the reasons for this recent upsurge, but, in order to understand it, I think it’s necessary to go back a little further and look at the broadening of autism through the concept of the ‘autism spectrum’, which is what has made it possible for autism to encompass high-functioning individuals such as myself. I think the potential for an unimpeded expansion of the category of autism, of the sort we are now seeing, may have already been there when autism was first conceptualised in the 1940s. It was certainly there once the notion of the ‘spectrum’ was introduced into psychiatry at the end of the 1960s.

I would argue that the category of autism has become less coherent, and consequently less meaningful and less useful, as a result of its expansion. And I think the osmosis into informal discourse and the pop culture of clinical terminology about autism has further undermined the category’s coherence. This has led to a situation where the ‘spectrum’ — once a categorical means of bringing together low- and high-functioning individuals who (arguably) have some features in common — is now routinely used to mean an uninterrupted continuum, ranging all the way from the pathological to the normal.

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