Autism Is As Autism Does

Autism-Is-As-Autism-Does2While the notion of Everyday Autism Everywhere is still in the air around here (welcome, William Stillman readers), I’d like to further expand some of the ideas Mr. Stillman and I have been floating.  One needn’t be a fan of the Forrest Gump movie to appreciate one of its signature lines, “Stupid is as stupid does.”  In swapping out “autism” for “stupid” though, I do not carry over the insult that sentence often conveys; in fact, the genius of that phrase is that it comments not on those who might be acting stupidly but instead on the nature of human behavior; it simply suggests that we all take a second look at our own actions, however stupid—or autistic—they might be.

All of which is to restate Mr. Stillman’s premise that Everyone Has Autism, that everyone engages in behavior consistent with autism, as well as my reminder that the diagnostic criteria for autism are based entirely on behavior. To the autism clinician too then, including those working right now on the next version of the Diagnostic and Statistical Manual (DSM) of Mental Disorders, autism literally is as autism does.  And actually, an autism diagnosis doesn’t so much answer the question, “Is this person’s behavior autistic?” as it answers the question, “Is this person significantly impaired on a day-to-day basis by a full constellation of behaviors that we have deemed necessary for diagnosis with an autistic spectrum disorder?”

This, while it may not be apparent at first, leaves out a lot.  There is a certain amount of wiggle room, Chinese-menu style, in the diagnostic criteria but most every partial constellation of autistic behaviors which would otherwise be counted toward an autism diagnosis simply does not count as anything, not in the eyes of the DSM.  Behaviors count, they are recognized as “officially” autistic only when they add up within a handful of carefully chosen but ultimately arbitrary categories said to define impairment—these categories being periodically recalibrated, redefined, and re-jiggered with each new version of the DSM.  With all due respect to those involved, the entire undertaking as regards autism seems less like a scientific inquiry than an elaborate, high-stakes role-playing game.

This might yet all be well and good, insofar as the influence of the DSM might be limited to determining who can and cannot benefit from professional attention or other institutional assistance.  You and I and the vast majority of others, for instance, do not live and die every day—as do, say, insurance corporations—according to who can and cannot be deemed eligible for professional attention, or mandated accommodations, or Individual Education Plans, etc.  Or at least … we don’t need to.  To the extent that we do live and die in roles assigned by the DSM (and make no mistake: “not autistic” is a role)—with our vision limited to this black-and-white perspective which serves a corporate agenda rather than a human one—may I suggest (with a smile) that a corporate tool is as a corporate tool does.

The fact is that we do see autism in black-and-white terms that are wholly unsuited to its actual nature and presence, that in fact render it mostly invisible.  These terms are—whether or not we are diagnosably autistic—not in our own best interests, neither as individuals nor as a species.  This is an insight I’ve struggled to communicate, one which came to me as an epiphany, concurrent with the realization that I myself was significantly autistic—and in part because it came to me more or less as a direct, wordless revelation, words have until recently proved singularly unhelpful in getting it across to others. There are no steps to retrace and walk others through; there is no vocabulary for what lies between clinical autism and not-autism.  And yet there is a whole world to be found here—in some respects, the whole world—once we find that vocabulary.

As recently as earlier this year, I had high hopes for “sub-clinical autism” as a first entry in this new vocabulary, a starter phrase that could signify all autistic behavior which escapes the notice of the DSM.  It failed, at least amongst the folks I tried it out with, resoundingly.  Still in search of better words, I had this exchange with Andrew Lehman, whose work I had been reading and commenting on over at Neoteny:

MS: “… my recent and somewhat painful experience is still that without authoritative, plausible, and clear evidence, people will actively reject the notion that [for instance] an affinity for non-verbal media — in otherwise functional, normal-seeming human beings — is at all related to autism … Where is the data to which I can point as evidence of the widespread distribution of sub-clinical autism across the present-day human population? Is there any yet?

AL: Ah, I’m not sure that can be communicated as easily as a data set. We are talking about a measurement of consciousness.

Much as I might still like to see large-scale studies employing the Broad Autistic Phenotype questionnaire and its cousins, that reply helped me recognize the limitations and distortions such studies will carry with them.  A DSM-style scale for sub-clinical autism could only be an extension of the scale for clinical autism, which in practice concerns itself with a single effect of autism (impairment) rather than with autism itself.  Where though would we look to measure the effects—other than impairment—of all autism, clinical and sub-clinical together?  Once again, here are the words of Uta Frith, from her book Autism: Explaining the Enigma:

The term “autistic intelligence” was coined by Asperger. He believed that autistic intelligence had distinct qualities and was the opposite of conventional learning and worldly wise cunning. Indeed he thought of it as a vital ingredient in all great creations in art and science.

Should you still be scratching your head over what was meant by the whole world being hidden between autism and not-autism—those words are one answer.  One place we would look for the effects of all levels of autism across all populations is:  to all great creations in art and science, to their character and to their very existence—and by extension to original creations at all levels.  Perhaps even to the creations of all creatures that are capable of play.

That’s a possibility suggested by Andrew Lehman’s fascinating work, which amply supports what I’m contending here and is available most recently on this site and for some time at Neoteny.  In terms of nailing down correspondences between autism and creativity in the lives of prominent creators, Michael Fitzgerald has done extensive work and so far as I know, to date deserves the lion’s share of credit in that area.  Or the lion’s share of the blame, if you’re that attached to the old paradigm.  This is at any rate, should it all bear out, paradigm-busting stuff.  Not only bigger, in fact, than the challenge of raising a profoundly autistic child, but potentially transformative of that experience as well.

Alarmist ad campaigns spread the news that autism is on the rise, an epidemic decades in the making, and yet what really, on a day-to-day basis, does seem different so far?  Nearly a half-century ago, Edward Abbey quipped from Wolf Hole, Arizona that the sexual revolution had finally come to the West, because now even a cowboy could get laid.  Me, I’ll offer that so far—and as a direct consequence of the kind of societal changes I’ve noted here—what’s really different with the rise of autism is that now even computer geeks can get laid.

No, that doesn’t sound like any sort of impairment to me either—but then autism is, after all, as autism does.

And yippee-ki-yay to that.

on 10/30/09 in featured, Society | No Comments | Read More

Leave a Reply