Sleight of hand, right from the beginning:
The term “neurodiversity” gained popular currency in recent years but was first used by Judy Singer, an Australian social scientist, herself autistic, and first appeared in print in the Atlantic in 1998.
Neurodiversity is related to the more familiar concept of biodiversity, and both are respectful ways of thinking about our planet and our communities. The notion of neurodiversity is very compatible with the civil rights plea for minorities to be accorded dignity and acceptance, and not to be pathologized. And whilst the neurodiversity movement acknowledges that parents or autistic people may choose to try different interventions for specific symptoms that may be causing suffering, it challenges the default assumption that autism itself is a disease or disorder that needs to be eradicated, prevented, treated or cured.
Of course “biodiversity” is Baron-Cohen’s first association with the term. It’s not even wrong that autism is part of human biodiversity. It’s still a misleading way of introducing the subject, because the better analogy is ethnic or cultural diversity. Neurodiversity is political. We are saying that autistic people’s problems are mostly due to historically contingent cultural norms, not biology, much like the problems experienced by ethnic minorities. Lest we forget, back in the 1990s, we started talking about “diversity” because the US Supreme Court ruled that affirmative action programs had to have a “diversity” pre-text to be legal. The neurodiversity movement comes from feminism, not philosophy of biology. By explaining it in terms of biodiversity, he’s depoliticizing it.
Many autistic people—especially those who have intact language and no learning difficulties such that they can self-advocate—have adopted the neurodiversity framework, coining the term “neurotypical” to describe the majority brain and seeing autism as an example of diversity in the set of all possible diverse brains, none of which is “normal” and all of which are simply different.
The standard talking points used against autistic self-advocates are very boring and predictable. Here, Baron-Cohen is using the standard “not like my child” cliche. It’s true that, as originally formulated, neurodiversity was “for” those diagnosed as Aspies instead of classic autistics. It’s not true that nobody dismissed as “nonverbal” or “low-functioning” agrees with the ideas. See this post for examples. The point is that being unable to talk or drive or whatever doesn’t make you less of a person.
He drives the point into the ground for another few paragraphs:
They argue that in highly social and unpredictable environments some of their differences may manifest as disabilities, whilst in more autism-friendly environments the disabilities can be minimized, allowing other differences to blossom as talents. The neurodiversity perspective reminds us that disability and even disorder may be about the person-environment fit. To quote an autistic person: “We are freshwater fish in salt water. Put us in fresh water and we function just fine. Put us in salt water and we struggle to survive.”
There are also those who, while embracing some aspects of the concept of neurodiversity as applied to autism, argue that the severe challenges faced by many autistic people fit better within a more classical medical model. Many of these are parents of autistic children or autistic individuals who struggle substantially in any environment, who may have almost no language, exhibit severe learning difficulties, suffer gastrointestinal pain or epilepsy, appear to be in anguish for no apparent reason or lash out against themselves or others.
Notice that he refers explicitly to the “classical” medical model, but doesn’t mention the social model of disability by name.
Also notice that the language used to describe the social model of disability is vague and metaphorical, in contrast to an ominous list of symptoms. This obfuscates how simple the accommodations can be, like turning the music off or letting us work from home. It obfuscates the fact that everyone, in fact, depends on other people and needs help, but some of us are punished for it.
Autism does NOT create anguish for “no reason.” Sitting in a quiet, comfortable room by yourself, autism doesn’t hurt. Someone might not understand the reason for anguish, but it’s not arbitrary. Because of auditory processing issues, having a TV on in the background can be pretty stressful, and the people around me don’t seem to have any intuition for why. How dismissive to say the anguish has “no reason” just because you don’t understand the cause.
For any given comorbid condition, there are autistic people who don’t have that condition, yet are still autistic. If you want to help us with our seizures or digestive problems, go right ahead. I don’t think anyone is actually objecting to those things. Baron-Cohen is conflating the comorbid conditions with autism when he knows better, to make autism itself sound terrible. Autism is the thing that autistic people have in common. For some people, the cause of the autism and the epilepsy might be the same, but that’s not true for everyone, and the epilepsy would be the reason to treat, not the autism.
Baron-Cohen is the champion of saying stuff a reasonable person would conclude is going to increase stigma. The guy who made a name for himself on “autistic people lack empathy” and “autism is an extreme male brain”, includes “lashing out” as something autistic people do, intrinsic to the autism. No. Lashing out is something distressed people do.
This is also deliberately misleading:
Many of those who adopt the medical model of autism call for prevention and cure of the serious impairments that can be associated with autism. In contrast, those who support neurodiversity see such language as a threat to autistic people’s existence, no different than eugenics.
>See here. The smear is that that we’re hysterical, irrational, calling him Hitler because he wants to settle our stomachs and help us stop hitting ourselves. Nonsense. We can observe that, in Iceland, prenatal screening has actually resulted in the eugenic elimination of people with Down syndrome. They just haven’t gotten to us yet, because the genetics are more complicated than trisomy 21. The diagnosis of autism comes from actual Nazi doctors.
Baron-Cohen thinks we can enjoy peace with our would-be exterminators through semantic hair-splitting:
No wonder this concept is causing such divisions. Yet, I argue that these viewpoints are not mutually exclusive, and that we can integrate both by acknowledging that autism contains huge heterogeneity.
Before we address heterogeneity, a technical aside about terminology: The term “disorder” is used when an individual shows symptoms that are causing dysfunction and where the cause is unknown, whilst the term “disease” is used when a disorder can be ascribed to a specific causal mechanism. The term “disability” is used when an individual is below average on a standardized measure of functioning and when this causes suffering in a particular environment. In contrast, the term “difference” simply refers to variation in a trait, like having blue or brown eyes…
The relevance of this for the neurodiversity debate is that if we dip into the wide range of features that are seen in autism, we will find differences and disabilities (both compatible with the neurodiversity framework), and we will find examples of disorders and even diseases, which are more compatible with a medical than a neurodiversity model.
Yes, everybody understands that. What we’re actually arguing about is whether autistic people suffer because of autism or because of society, because those have very different implications for what we should do about it. Instead of addressing the real point, he gets into the weeds of what exactly is a disorder, disability, or difference, in the results of fMRI studies and blah blah blah, in order to conclude:
What is attractive about the neurodiversity model is that it doesn’t pathologise and focus disproportionately on what the person struggles with, and instead takes a more balanced view, to give equal attention to what the person can do. In addition it recognizes that genetic or other kinds of biological variation are intrinsic to people’s identity, their sense of self and personhood, which should be given equal respect alongside any other form of diversity, such as gender. But to encompass the breadth of the autism spectrum, we need to make space for the medical model too.
He’s just saying the same thing, over and over: neurodiversity advocates are too high-functioning. It’s a patronizing pat on the head. “Nice identity you got there. We’re over here, heroically curing diseases.”
Indeed, the concept of neurodiversity is responsible for “dividing the autism community.”