14/02/2021

Autism: Medical versus Social Approach

There are many discussions in the medical world about the possible causes of autism. I will mention a few: poor bonding with the mother (seriously?), as a result of vaccination (no, is polio preferable?), hereditary burden, fragile X syndrome, tuberous sclerosis, congenital rubella syndrome and untreated phenylketonuria (PKU).

Let's face it, we don't know. 50 years ago we didn't even know about the existence of autism. Autism has now been included in the manual of psychiatry, namely DSM, since May 2013 in the version DSM 5. Since this version, there has been an Austism Spectrum Disorder, a disorder.

Where is the problem, it is in the word "Spectrum". This word indicates that there is a range. On the one hand, it relates to people with a form of autism who cannot or hardly function independently and need a lot of care and, on the other hand, people who only need light guidance to survive in a regular environment. Until DSM 5 this last group was called the group Aspergers and people with PDD-NOS, more generally know as high functioning people with autism.

I do not think it necessary to give the latter the predicate "Syndrome" or even "Disorder" as this is a medical indication and therefore defect-oriented by definition. Disorder refers to a maladaptation to a neuro-typically defined society. That is up for debate as far as I am concerned.

When we place this group of high-functioning people in a social context, we see that the behavior displayed can at most be regarded as socially "different". How many people are different without having a disorder or syndrome? Hmmm, interesting because that would imply that there was an accepted norm against which this can be compared. Are people in Japan different? Yes right? At least from a Western-oriented perspective and standards, this is apparently the norm. Do they all have a disorder?

We do sense what is regarded as normal (neuro-typical) in our Western culture, but here too the bandwidth that is accepted is getting narrower. As a society we are becoming more exclusive, painful but unfortunately true. No, not that we want that, we want to be inclusive, but yes, that takes more resources and investment, and in this time of austerity ..... well, fill it in yourself.

Personally, I think this is rubbish, it is a matter of looking differently and appreciating this group for who they are and what they do and above all, give them a chance, an opportunity they deserve but above all an opportunity that we as a society deserve ... or am I wrong?