The Diagnostic "Elephant in the Room"

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B19
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30 Oct 2015, 2:34 am

I have long been thinking about the problematic issue of diagnosing any group with mixed characteristics only by its deficits - which ipso facto excludes any positives that exist within that same group. If you want to socially construct difference as deviance, that is the textbook example of how to do it. It is something that tends not to be discussed here (which is a pity IMO).

To illustrate this more clearly, and if the topic interests you, you are invited to construct criteria for an Aspergers diagnosis based on (only) positive characteristics, using the standard positivist approach of only using externally observable behaviours (in the broadest sense of behaviour - this can include mental behaviours, such analytical ability, or auto-didactic characteristics, or...)

You can paraphrase the DSM4 criteria if you like, as a framework, replacing their negatives with your own positives. OR create your own framework, so long as you do the opposite to the DSM and work only within positives are diagnostic signposts.

How people/clinicians conceptualise an issue determines the consequences of how they will see and treat the population that they applying the criteria to; how we see ourselves as people on the spectrum depends to some extent on whether we accept unquestioningly what we are told we are, from a deficit-only perspective or view that conceptualisation as fundamentally biased in a way that reduces autistic reality to a neat set of problems.

If you are really adventurous, try drafting criteria from both of those perspectives, to evaluate the breadth of the distance between them, and the implications of each...



danum
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30 Oct 2015, 3:20 am

These are my thoughts:

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B19
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30 Oct 2015, 3:26 am

Thanks, that's a great start for posts to this thread topic :) Passed with distinction!



iliketrees
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30 Oct 2015, 3:35 am

But it's a disorder, and getting diagnosed entitles you to support. If it was diagnosed on only positives then you'd get most of the population with an Asperger's diagnosis and it'd lose its meaning. If you tried to explain your struggling you'd never get taken seriously. The diagnosis needs to be on the problems we have because it needs to determine who needs help. And there's no positives we all share, but we all share problems with communication, socialisation, and restricted and repetitive behaviour. So why change it?



B19
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30 Oct 2015, 3:55 am

In the NT normative population, support services are always targeted to the people/children who individually need them - for example, reading recovery to otherwise bright NT kids with specific deficits in that area. The fact that some NT children have no deficits doesn't mean that support is withheld from those that do. The fact that the kids with only deficits in reading but strengths in everything else doesn't mean support is withheld from them. Targeted support is required by all kinds of populations, in all sorts of ways, so that's nothing new. On the other hand, isn't treating every member of a specific population as having the exactly the same support need in exactly the same way a one-size-fits-all approach? We aren't carbon copies of one another, on the spectrum or in the normative world.



EnTiTyZ
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30 Oct 2015, 4:11 am

You would have to define "normal" first before you can define any abnormal characteristic.

The positives would be any "normal" attributes what ever normal is, be it cultural or small societal groups, which does not not deduct from quality of life, that would be negative it's abstract conjecture as far as the dsm is concerned.

More work needs to be done on either, genetic or in utero enviromental conditions, to discover what autism actually is or it's just simply a neurodiverse human race and all Psychopathology is just trying to label different functioning brains hence normal is none sequential noone really fits in anywhere, hence there is no normal or abnormal just humans.

Personally just try to turn any weakness, into strengh is always going to be a positive



iliketrees
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30 Oct 2015, 4:13 am

Those are specific learning problems. Autism isn't that specific and doesn't just affect learning. It's called pervasive for a reason.



B19
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30 Oct 2015, 4:24 am

I can see what you are saying, though that isn't what this thread is about. Everyone in every group has potentials, but not everyone's potentials are kept in focus, and tend to be ignored if possessed by members of a group who are defined only in negative terms.

Thanks for the detour, can we get back to the original intention of the thread now?



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30 Oct 2015, 4:31 am

Motivated to learn
Analytical
Good pattern recognition



B19
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30 Oct 2015, 4:54 am

My list!

Great enthusiasm for knowledge and understanding of specialist topics
Talent for innovative solutions overlooked by mainstream thinkers
Great focusing ability for detail
Tendency to egalitarianism over hierarchy
Creative originality in diverse fields (science, art, invention, engineering)
Capable of very careful work with high standard of accuracy
Does best work without needing team time and input
Often gifted visual thinkers



EnTiTyZ
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30 Oct 2015, 5:09 am

I often struggle when people say, lack of abstract thinking because in your list you state

" Talent for innovative solutions overlooked by mainstream thinkers"

To be innovative needs strong Logical thinking but also very abstract to come up with unique solutions that others would not think of.

You need fluidity and dynamic/visual thinking to come up with such ideas which would be abstraction surely.



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30 Oct 2015, 5:35 am

B19 wrote:
In the NT normative population, support services are always targeted to the people/children who individually need them - for example, reading recovery to otherwise bright NT kids with specific deficits in that area. The fact that some NT children have no deficits doesn't mean that support is withheld from those that do. The fact that the kids with only deficits in reading but strengths in everything else doesn't mean support is withheld from them. Targeted support is required by all kinds of populations, in all sorts of ways, so that's nothing new. On the other hand, isn't treating every member of a specific population as having the exactly the same support need in exactly the same way a one-size-fits-all approach? We aren't carbon copies of one another, on the spectrum or in the normative world.


I'm with B19. To say autism is a "disorder" is just mouthing a judgement call. It says nothing about the specific features. When you start to look at those features, things get complicated because it's actually on large constellation of features, not all of which show up in every autistic. The science is still out, but it's very likely there's more than one condition lumped under Autism as an umbrella term.

Whether someone has an Autism diagnosis or an NT diagnosis, it only makes sense to treat/intervene with the specific deficits and foster the specific strengths. I think the "disorder" leads to wrong-think. It is better to think in terms of specific deficits had by a given person. I said "better" not perfect. A deficit can be culturally imposed. On the island of little people, someone without dwarfism would have severe access issues to the level of a disability.

To reiterate. The only functional approach is to help a person with their weaknesses, provide societal accommodation where possible, and foster their strengths. Autistics have weaknesses and strength, just like everybody else. The approach doesn't have to change.



Phemto
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30 Oct 2015, 5:52 am

EnTiTyZ wrote:
I often struggle when people say, lack of abstract thinking because in your list you state

" Talent for innovative solutions overlooked by mainstream thinkers"

To be innovative needs strong Logical thinking but also very abstract to come up with unique solutions that others would not think of.

You need fluidity and dynamic/visual thinking to come up with such ideas which would be abstraction surely.


I think you could just as easily come up with a diagnosis for the kind of people who become experimental psychologists. They have certain deficits. If those deficits coincide with strengths had by many autistic people, they won't even think to test for them, or ever be aware that such strengths could exist.

That autistics can lack abstract reasoning was probably "discovered" by someone without a clear understanding of what abstract reasoning can encompass.

Ok. Time to out myself. I'm a member of the triple-nine society. I also frequently have communication deficits. My wife, who's both borne the brunt of those issues and watched me have them with others finally gave me some insight not long ago. If the problem involves abstract and/or visual reasoning to work through, I'll be on step twelve, having almost subconsciously run through steps four through eleven. When I start talking to people who aren't aware this can happen, I just get blank stares. In my experience, many will assume I don't know what I'm talking about and dismiss my input. Then (usually a couple days to a week later) they'll get to step 12 and come tell me the answer they've "discovered," having forgotten what I already told them.

So who has the "disorder?" Them or me?



Phemto
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30 Oct 2015, 6:00 am

Phemto wrote:
I think you could just as easily come up with a diagnosis for the kind of people who become experimental psychologists. They have certain deficits. If those deficits coincide with strengths had by many autistic people, they won't even think to test for them, or ever be aware that such strengths could exist.


I just looked again at the title of this thread remembered an example. We ASD folks are supposed to be really bad at metaphor. "Why are we talking about bringing an elephant in here? How would it even fit? Hurrdur." When you look at the experimental protocol of the original paper that discovered this "deficit," it's clear that what they were really testing was familiarity with colloquial idioms. Now take a bunch of kids with impoverished social interactions (for whatever reason) and how do you think they would do with knowing "what the kids say these days." The researchers didn't know the difference between what they thought they were testing and what they were really testing.



EnTiTyZ
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30 Oct 2015, 6:16 am

Both it's almost asymmetrical thinking, neither person understands the other.