Editorial Perspective: Neurodiversity – a revolutionary conc

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Autism is now 73 years old and our clinical and
scientific understanding of it remains largely
disorder-focused, reflected in the name of the diag-
nostic category in DSM-5: Autism Spectrum Disor-
der (ASD). Autism is not alone in DSM-5 in being
called a disorder. Since DSM-1 in 1952, when there
were 106 disorders listed, there has been a steady
increase, and when DSM-5 was published in 2013,
the number had reached 300. It is unlikely that DSM
really ‘carves nature at its joints’, as Plato recom-
mended our best classificatory and explanatory
theories should, if we can keep adding or subtracting
diagnostic categories each time a new edition of DSM
is published. Recall how homosexuality was
classified as a disorder in DSM-I and DSM-II, until
civil rights protests succeeded in having it declassi-
fied from DSM-III in 1980, on the grounds that it is
just a natural example of the diversity of sexual
orientations that exist in any population.
There has been much debate about whether the
DSM-5 characterisation of ASD represented progress
(Lai, Lombardo, Chakrabarti, & Baron-Cohen,
2013), but this editorial focuses on the question of
whether autism is properly characterised as a dis-
order and whether the neurodiversity framework
should be embraced.

http://sci-hub.la/10.1111/jcpp.12703

Thank you very much for posting this article firemonkey.

Over the past year, I have noticed with fascination that Baron-Cohen has been showing signs of having made a very significant personal shift in his attitudes and thinking. I was a bit sceptical of this at first, though having read this latest piece, I think the shift is real, and though he (revisionistically) claims to have been thinking like this for a much longer time, nothing he has said or done supports anything but a much more recent awakening.

I have posted in past years that it seemed to me that Baron-Cohen was very possibly an un-self aware aspie himself, and I continue to see him as on the spectrum, though something has happened (I think) which has led me to think he has had a major self-realising moment. (Many of us have had those!) That moment when you realise that you aren't just looking at the spectrum, you are looking out from your position on the spectrum. And always were...

Though it's only a guess, my guess is that Tony Attwood's transitional aha moment of personal realisation may have very deeply reverberated with Baron-Cohen, and as they are both on the international speaking circuit, it would not be surprising if they have discussed Attwood's transition to aspie awareness. Maybe yes, maybe no.

I recall how astonished I was, a year or so ago, to read comments Baron-Cohen made which seemed out of character with everything he had claimed about AS before, which he presented in all previous years up until then as very much "a disorder", he has been quite a proponent of that, and now he is speaking in a very different voice, and it sounds sincere to me.

Well, there's none so passionate, it is said, as the convert, and it may well be that Baron-Cohen's conversion to more enlightened perception of AS is not only real, but that he may pursue it with the zeal of the ardent convert. I don't think (if he is on the spectrum) that he will "come out", or at least not for a long time.

I take heart though to see someone who has, wittingly or unwittingly, been a force for harm to AS people become a force for good, and I think that is a real potential now for Baron-Cohen.

It's great to be delighted by someone I formerly considered to regard his professional reputation as all that mattered to him, who caused so much pain to the people he built that reputation on. At least in my view, welcome to the spectrum Simon. You may be a game changer after all.

I agree that the autism as disease model has been more hurtful than helpful and the DSM has been part of that problem. The DSM is also the way to obtain benefits and insurance for people who are disordered or disadvantaged enough not to function well in society. I fear we may break out of our DSM chains at the expense of people needing help. People unfairly WILL say you claim there is nothing wrong you, you are just different, why should will help you lazy entitled spoiled brat.

What is the answer? throwing a lot of autistics under the bus as collateral damage because the ends justify the means? Help only the "low functioning?. That is divisive ableism and does not take into account the struggles of the "high functioning". If we leave it as is, we keep the status quo of being kept down by the medical model of Autism. I truly do not know the answer to this catch 22 type situation.

Brilliant article - thanks for sharing!

Love this bit: ‘we are fresh water fish in salt water. Put us in fresh water and we are fine. Put us in salt water and we struggle to survive’.

I am not sure what to make of the disability/disorder distinction. I put this on FB to someone who has studied and worked in behavioural science. They said they were the same with no clear cut distinction just varying degrees of overlap.

I think getting the language right so as not to exclude either high or low functioning individuals is immensely difficult. How do you admit to a difficulty you need help for without saying something is wrong? If there's nothing wrong then everything is ok and you don't need help is what the average person will think. Yet pushing the line of something being wrong can push the recognition of any positive aspects of being on the spectrum far into the background. How do we show that being on the spectrum is a blend of pluses and minuses ? That it's not all good or all bad for most people.

What I make of it is that as disabled you are less able in certain areas and the impetus should be on shifting the environment to mitigate the areas where you are less able (e.g.wheel chair ramps, dyslexic aids etc.) whereas when it comes to disorder the implication feels like that you are disordered no matter what the environmental circumstances. I don't like the D in ASD as it feels to me that autism is relative in the sense of a disability and in some areas it is even an exceptional ability.