Introduction
Welcome back to my blog! If you thought you missed my October 2021 post... you didn't😓😅 I took a break from making blog post since there was a lot going on in my life😊 Now I've gotten settled and it's time to start writing! This time, I'd like to introduce a discussion topic that arises on occasion which is: Is autism a disability?
From my research (and I use this term pretty loosely here since I just mean watching related YouTube videos and reading reddit/FB discussions LOL) I've seen a variety of opinions:
- Autism IS a disability because there are some struggles that are unique to autistic people on a regular basis (e.g. meltdowns, shutdowns, sensory overload, being misunderstood by people often etc.)
- Autism IS a disability not because autism in itself is a bad thing to have but rather because society disables autistic people by putting limitations on what it means to be "normal"
- Autism IS NOT a disability because autism can have good and bad traits and it is society that dictates what is and what isn't a disability
- Autism IS NOT a disability because as much as we have other types of diversities (hair color, eye color, skin color, height, weight etc.) we also have neurodiversity
- Autism may or may not be a disability depending on the severity
List of definitions
Definition of disability (US and UK)
US (Americans with Disabilities Act (ADA)):
UK (Equality Act 2010):
- substantial - e.g. takes much longer than it would usually would to complete a daily task like getting dressed
- long-term - e.g. 12 months or more
Definition of autism spectrum disorder
Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V)
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history:
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body languages or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining and understanding relationships, ranging for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:
1. Stereotyped or repetitive body movements, use of objects, or speech (e.g. simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases)
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g. extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day.
3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g. strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper- or Hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global cognitive delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected of general developmental level.
Reference: Centers for Disease Control or Prevention (CDC)
International Classification of Diseases 11th revision (ICD-11): Taking into effect starting January 2022
Persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication
Range of restrictive, repetitive, and inflexible patterns of behaviour, interests or activities that are clearly atypical or excessive for the individual's age and sociocultural context.
The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until much later, when social demands exceed limited capacities.
Deficits are sufficiently severe to cause impairment in personal, family, social educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual's functioning observable in all settings, although they may vary according to social, educational, or other context.
Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities.
Reference: ICD-11 for Mortality and Morbidity Statistics (Version: 05/2021)
What do the definitions all mean?
Disability:
- Has some kind of medical condition (can be the mind or body)
- Makes life harder
- Finds it hard to get good grades
- Struggling to get a new job, or sustain a job
- Finds it difficult to talk/make friends/work with people
- Finds it difficult to shop or travel on their own
- Struggles to eat/sleep/go to the toilet/take a bath or shower on their own
- etc...
- Usually long-lasting (months or years)
Autism spectrum disorder
- Difficulties socializing
- Understanding what is considered to be "normal"
- Doing what is considered to be "not normal"
- Doesn't have friends (or a lot of friends)
- Friendships don't last long
- Is not interested in people
- etc...
- Is generally considered to be "different"
- Does the same (or similar) things over and over again
- Says the same words
- Lines up toys/tools etc.
- Paces around and around
- Hand flapping/pacing/spinning/fidgeting etc. often
- Likes things the "same" way
- Same foods
- Same schedules
- Same clothes
- etc.
- Different expression of interests
- Likes things that others aren't interested in
- Likes things a lot more than other people
- Likes very few things compared to other people
- Senses differently
- Finds some lights/sounds/smells etc. a lot more stressful than other people
- Finds some lights/sounds/smells etc. a lot duller than other people
- Starts from when they were small kids
- But might not necessarily struggle until later in life
- Makes life hard(er)
Is autism a disability?
Arguments FOR autism being a disability
- IMPAIRMENT in social interaction and communication
- SUBSTANTIAL LIMITATIONS in life activities
- Present from early developmental period (long-term)
Arguments AGAINST autism being a disability
- Symptoms may not become fully manifest until later when social demands exceed limited capacities - Would the person not be autistic at a time when they may not have been "disabled?"
- Level of functioning may vary depending on the context - If a person struggled greatly in school (e.g. had consistently bad grades), but built a successful career with very few struggles, would the person no longer be considered autistic? Would they no longer become disabled?
- Assessing impairment or level of functioning is up to the interpretation of the assessors and the person themselves - lack of consistency
Conclusion
From a purely literal standpoint it may seem obvious that autism is a disability, but the reality is that there is a lot left to interpretation when defining a "substantially significant impairment" for both an autism diagnosis and disability assessment. It may be safer to assume that autism as a condition is a disability (at least as long as we have the definitions that we have presently) but whether someone identifies as a disabled autistic person is dependent on their situation and the interpretation of the person themselves and the people around them on what it means to be disabled and what it means to be autistic.
Afterthought
- AUTISM AWARENESS (or ACCEPTANCE) MONTH 2021
- Unravelling the mystery of specific learning difficulties
- Story time: Bioinformatics research without a computer science degree
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