Neurodiversity

The actor Jason Alexander, who portrayed George Costanza on Seinfeld, once complained about his character’s motivation in a script to the show’s co-creator Larry David. He felt that no one would behave the way the character was written. David replied: “What are you talking about? This happened to me, and this is exactly what I did.”

I once had a similar experience in a creative writing class. I had crafted a slice-of-life portrait of what I considered a plausible day in the life of a lonely, divorced, middle-aged woman dealing with her social isolation and depression. In hindsight, more than at the time of writing, I realize the character was a stand-in for myself at that time, dealing with much the same issues, including my then-undiagnosed autism.

Some of my peers criticized me for utilizing stereotypes supposedly associated with middle-aged, divorced women. However, what really stood out to me was the claim that it was implausible that someone so lonely would not make more effort to connect with others. This was where my understanding of my own story diverged significantly from that of my classmates.

Defining features of autism include difficulty reading facial expressions, in part because we tend to focus our attention more on the nose and mouth than on the eyes, and generally finding it difficult to catch and respond to social cues. This can make it daunting to seek out social contact, regardless of how much loneliness and isolation may result.

With this in mind, should autism be considered a disability? Some people, inside and outside the autistic community, resist this categorization, perhaps reflecting a kneejerk assumption that disability carries a pejorative undertone. Perhaps more pertinently, there may be objective benefits to neurodiversity. A career advisor once suggested to me that a workforce is like an orange grove, and an autistic employee like an apple tree: we can complain about the apple tree spoiling the homogeneity of the orange grove, or we can be glad that we can also grow some apples.

However, autism can and does represent a palpable source of personal limitations, one which can limit the participation of autistics in objectively beneficial pursuits. I emphasize objectively beneficial pursuits because one can always attribute the benefits of any pursuit to social conditioning: having a broader circle of friends, for instance, or a romantic relationship. There is truth to this perspective, but it is not the whole truth. Many autistic people, like the heroine of my college writing experiment, would probably like to do things from which their condition inhibits them.

My argument can be formulated as follows:

P1: A disability is a condition which makes it unusually difficult for someone to engage in objectively beneficial activities, achieve personal goals, etc.

P2: As a spectrum disorder, autism has a wide range of effects, but it often inhibits individuals from engaging in activities and fulfilling goals which can reasonably be considered objectively beneficial.

Conclusion: Therefore, autism should be recognized as a disability and public policy, medical research, etc. should reflect this categorization.

Defining Disability

The Centers for Disease Control and Prevention (CDC) define disability as “any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participatory limitation).” Limitations in vision, movement, thinking, remembering, learning, communicating, hearing, mental health, and social relationships are all considered disabilities. Disabilities impair the individual’s physical or mental functioning, creating difficulties which would not otherwise be present in fulfilling daily activities and overarching life goals and aspirations. Under certain conditions, autistic people in the United States are eligible for disability benefits if their condition prevents them from working.

Understanding Autism

Applying the above definition of disability to autism spectrum disorder, it is easy to see why it is categorized as a disability by the CDC, the U.S. Department of Labor, and other official sources. According to Millcreek Behavioral Health, autism is frequently characterized by significant impairment of the autistic’s social skills, language skills, and behavioral development.

Examples of how autism can affect individual social skills include poor eye contact, resistance to physical intimacy, failure to establish friendships with peers, lack of interest in sharing in the activities of others, lack of empathy, a preference for solitude, difficulty understanding jokes, and a tendency not to ask for help. Most of these qualities may not be limitations if one does not desire or have a need for normal social contact, but, even allowing for the extraverted orientation of most social conditioning, it seems likely that many of these characteristics would still, overall, be sources of unhappiness. Moreover, some of these social abilities in which autistics are limited, such as empathizing with others and being willing to ask for help, seem like objectively good abilities to have, not to mention the subjective pleasure of being able to understand a joke.

Proceeding to language skills, autistics often exhibit strange speaking patterns and sometimes take an unusually long time to learn to speak (and in some cases never do). Other symptoms can include difficulty understanding simple instructions or directions, repeating words and phrases without understanding how to use them, and an inability to initiate or maintain a conversation. Again, these qualities are not necessarily problematic if one places no inherent value on fitting in with neurotypical society, but it feels too extreme to suggest that the values of neurotypical society are entirely socially constructed. Humans are social animals, and the more extraverted norms of the neurotypical are to a large extent the product of thousands of years of evolutionary biology and evolutionary psychology.

Finally, behavioral symptoms of autism can include physical restlessness, various difficulties in learning, very specific personal rituals and routines, unusual sensitivity to certain stimuli, peculiar food preferences, preoccupation with certain subjects (including intense, sometimes obsessive interests), depression and anxiety (particularly in teenagers), and sleep disturbances. The downsides associated with these characteristics are the most difficult to plausibly define as socially constructed. Few would choose to have trouble learning in school, to find it difficult to get enough sleep, or to be at increased risk of depression and anxiety (with the associated likelihood of attempting suicide and many other consequences).

Any understanding of disability is relative, but acknowledging the reality of the defining effects of autism makes it difficult to define the condition any other way. As a spectrum disorder, there is no unambiguous point where autism ends and neurotypical begins, and perhaps this is why some people find it conceivable to deny that it is a disability.

Conclusion

It can be painful to define oneself, or a loved one, as disabled, especially when the disability only gradually becomes plainly evident or impossible to ignore. Speaking for myself, I initially found it difficult to reconcile my diagnosis with my sense of what I wanted to be. However, I soon found it impossible to deny the simple reality of my condition. Likewise, it can be difficult to accept that one’s condition is a disability (especially since autism affects every autistic differently, in some cases hardly at all), but there is even more cognitive dissonance in denying that the condition is, broadly speaking, a handicap.

A divisive question in the autistic and medical communities is whether autism can and should be cured. Research in this area remains in the exploratory stage, though there is already evidence that some procedures can mitigate autism symptoms. Predictably, given how some deny that autism is a problem, there are those who find it deeply insulting to suggest that we should seek a cure. I once saw a Twitter user suggest that any notion of a cure lends justification to such phenomena as the parents who have tried to treat their autistic children by forcing them to drink bleach.

We should indeed be careful how we talk about autism, and should particularly avoid treating it as a monolithic issue. However, we should also not be ashamed to call a spade a spade. If someone does not feel that their condition represents a source of unwelcome limitations, or otherwise does not feel the need for a cure, they are perfectly entitled to their point of view. By the same token, if one does find it a source of unwanted problems, one is entitled to define it as a disability, to file for disability benefits on that basis, and to seek a cure.

Speaking, again, strictly for myself, I regard my autism as a source of many limitations I would like to be able to live without. I do not find it a source of many corresponding benefits to balance out the disadvantages—not even in the monastic or Nietzschean sense that “great pain is the ultimate liberator of the spirit.” Hence, I find it helpful to define it as a disability. I can also understand why this is a controversial notion. To objectively settle the question, what we really need to understand is what autistic people would like to be able to do with their lives.