Is Autism a Disorder?

In recent months there has been a resurgence of an old debate on social media (or maybe not so much a resurgence as an ongoing debate that has become more fervent in its intensity) about whether or not autism is a disorder.

In the neurodiversity movement, a lot of low support needs autistic people insist that autism is simply a neurotype and should not be pathologized. Capitalism and society make it a disorder.

This is where the social model of disability is tossed around as the be-all and end-all of disability studies (it isn’t actually).

Conversely, people with higher support needs have been challenging this belief in the last several months, and for once, lower support needs autistics have been paying attention to their pushback.

Citing their particular experiences with autism as being more debilitating for them, the higher support needs autistics on various social media apps propose that those of us with lower support needs are fooling ourselves and hurting them in the process.

By refusing to admit that autism is a disorder, we are effectively leaving them out of the conversation and talking over them once again.

They say that if we would simply better scrutinize the reality of how autism affects us, we might see that it is fundamentally debilitating for us as well and that even if we were idyllically accommodated in every way, it would still disable us.

In other words, the social model of disability, so favored by the neurodiversity movement, has us lower support needs autistics in denial about the reality of our day-to-day existence.

For the better part of a year, I’ve found the concept of anyone calling my brain disordered to be quite reductive and offensive. I didn’t want anyone to think that my way of thinking, socializing, or communicating is disordered. I even wrote about it here.

I still maintain that my way of thinking is a natural cognitive variance that came about for a reason. But do I think that autism is also a disorder?

I will admit that I don’t know. For me, the answer is not straightforward. It involves complexity and nuance.

I believe that my intelligence and my abilities with hyperfocus, problem-solving, pattern recognition, above-average visual recall, creativity, and similar talents to other autistic individuals are all cool assets for humanity and society and are not disordered.

However, on the other hand, my sensory experiences are intense and disabling.

Some days the sun is too bright for me and the birdsong and cicadas making noises in the summer are too loud.

I have autistic inertia, where getting motivated and up off the sofa is difficult for me because I am mentally frozen. The desire to get up is there, but the ability to do so is not. It’s an internal struggle.

My executive dysfunction is also pronounced. Is it my autism? Is it ADHD? It’s hard to say as one can have executive dysfunction with both conditions.

In addition, no amount of accommodations within our capitalistic society is going to remove my inability to remember to drink water or to recognize when I have to pee. I wet myself a few times a month because I do not know if I need to urinate until it is urgent.

I have dehydrated myself to the point that I develop UTIs because I don’t remember to drink. It is poor interception that is to blame; it’s a sensory issue. I don’t get a very good thirst signal or my brain doesn’t recognize the thirst signal very well. Is this disordered? I would tend to say yes.

There are also days when I have autistic aphasia so badly that speaking is challenging and I give up and go selectively mute until it passes. Some days just simply getting words out verbally is difficult.

And I can’t forget to mention that I have high levels of anxiety. Many autistic people online insist that anxiety is not a trait of autism. I disagree and I strongly argue that it can be for some of us.

I do have anxiety from trauma, but anxiety has been a part of my life since I was a very small child, and this anxiety is not entirely based on my traumatic experiences.

As a small child, I would often become anxious about seemingly innocuous situations that were happening in life or on television and I would get very dysregulated and upset over what I thought I had seen on the TV. So much so that I would stay home from school with terrible stomach aches caused by my distress.

Even if nothing scary or weird was happening at the time, my brain would register it as being a threat. I don’t think it was PTSD fueling that, but my autistic brain.

I had anxieties about going to sleep. I had anxieties about people having scars on their faces because I couldn’t understand why god would do that to them. I had anxieties that had nothing to do with trauma. For me, anxiety is definitely about being autistic.

These issues seem disordered.

People in the neurodiversity movement may argue that autism isn’t a disorder until allistics make it a disorder.

It is a reality that we have to be declared disordered and have most of our traits (even those that cause us no distress) pathologized so that we can get the accommodations and supports that we need within capitalism.

I believe I was born anxious. Did this anxiety develop because of being chronically overstimulated and not being accommodated in an allistic world? There could be an argument for that. But again my autistic condition created that scenario, so the argument for it being a disorder could still stand.

Some autistic folks are saying that the neurodiversity movement has gone too far in trying to de-pathologize autism and as a result of their activism, support for the disabling issues that come with autism is being threatened for high support needs autistics. Really for all autistics.

Autism researchers are now spearheading a disconcerting pursuit to outline and define a theory about what they call the “broader autism phenotype”.

In essence, they are saying that there exist people who have a lot of traits of autism, but they are subclinical and pose no impediment to functioning for these individuals and therefore they cannot be diagnosed as having autism spectrum disorder.

They believe it is an inherent thing, but some of us believe they are trying to make it a thing to deny some autistic people their diagnosis and thus deny them support and accommodations.

What they are doing in their research is assessing siblings of people with autism and determining that they have traits that do not qualify them to be considered as being autistic.

What this study of a “broader autism phenotype” does is fail to take into consideration the various presentations of autism that have been acknowledged and identified in research done in the last five years.

They are denying the existence of masked autism where autistic individuals learn skills and adapt well enough that their struggles are not as apparent to others and sometimes they don’t even know the depth of their struggles themselves. Denial and brainwashing are powerful things.

If you would have asked me a year ago, “Do you think you qualify as being autistic?”, I would have told you no because masking autistic traits was not something on my radar.

I would have told you that I didn’t take things literally, that I understood humor all the time and sarcasm in all instances, and that my sensory issue weren’t severe enough. All of which is wrong.

I would have told you that I knew what was going on socially and that I didn’t have communication differences. I was wrong on all accounts.

Just because a person who doesn’t fit the autistic stereotypes has someone in their family who is autistic does not mean that they have intimate knowledge of how autism can present outside of the stereotypical image society has of autism. Some of them might, some may not.

The fear right now is that establishing a broader autism phenotype is a thing that is now going to create a situation where masking autistic people (usually BIPOC folks and those assigned female at birth) with low support needs are going to be denied a diagnosis they need to get accommodations and services because those in power in our society are feeling threatened by the rising rates of autism diagnoses.

Is this some nefarious plan to keep autistic people in their place and keep us marginalized and unaccommodated? It’s hard to say.

Do I believe that autism is a disorder?

Can we have a disorder, not just a disability, and still be a neurotype that emerged during the Ice Age as a complement to allistic existence? Maybe so. Dialectics, where seemingly opposing views coexist, are real.

I think the neurodiversity movement is absolutely necessary to work toward normalizing autism and promoting acceptance, but I think it lacks nuance and the ability to admit that some of us find our autism to be disabling beyond the social model of disability.

I don’t have the answers and I don’t think other autistic folks do either just yet.

And so the debate rages on.