humanist + humorist

So I just read a piece of meta, which I’m going to avoid linking, because I don’t want this to feel like a callout or a slam on the writer. The writer was fine.

The quick summary is, [character] gets interpreted by fandom as autistic, and the writer explained “actually, [character] is intellectually disabled. They might also be autistic — you can be more than one thing at a time! — but they’re definitely intellectually disabled, because of [list of symptoms].”

…And, look, not to be all When I Was Your Age, but: (sits back in rocking chair, takes a long drag on pipe) when I was a young whippersnapper in school, back in the stone ages, all those things were just autism.

When the term “autism spectrum” was canonized in the DSM-5 in 2013, it folded together 4 different previous categories. One was Asperger’s syndrome, which specifically had “doesn’t test as being intellectually disabled” in the diagnostic criteria. The other 3, including the disorder previously known as Just Autism, didn’t have that exclusion.

So here’s some anecdata on how that played out in practice, back when I was in grade school. I knew students who were diagnosed with Asperger’s syndrome — those were the kids who were intellectually able to keep up with standard-to-gifted classes, they just had struggles with other issues. And I knew kids who were diagnosed with Autism Classic, who were mostly in the “special ed” classes.

I can’t swear to the exact diagnosis of every special-ed kid. I was their schoolmate, not their doctor. Possibly some of them had the other two diagnoses (CDD and PDD-NOS) that ended up in the autism spectrum? There’s at least one that I know had Down’s syndrome, which is from a whole separate category.

One thing I can tell you is, in casual conversation, it was pretty standard to use “the autistic kids” to describe the whole group. Which was at least accurate-enough that no teacher or authority figure ever told us not to use it.

In elementary school — maybe third grade? — I remember one particular kid who was in the special ed classes at first, but got “mainstreamed” into my class for a year. The rest of us were specifically told that his diagnosis was autism, and that didn’t change. So, even though the term “autism spectrum” wasn’t official yet, the system did have different approaches available for different autistic people — not just on-paper but in-practice, enough to be understood by random unrelated small children.

(In retrospect, I wish I knew more details. How much support was this kid getting? Was it enough to make the “mainstreaming” work for him? But obviously the adults weren’t gossiping about those aspects to unrelated small children.)

Fast-forward a decade or so, and the DSM-5 merges all the diagnoses. The conversations about it were overwhelmingly positive — as in, I’m not sure I ever heard anyone complaining about it.

Which makes sense, for a lot of good reasons. If multiple “separate” conditions turn out to have the same underlying mechanism, then of course medical science should group them together. If people with the “less severe” condition would benefit from some of the support that the “more severe” condition gets, then of course we should make it accessible to all of them. If there’s not enough recognition that a diagnosis has a range of presentations that need different approaches, then yeah, let’s put the word “spectrum” in The Official Term. (Also: if you have a diagnosis that’s named after a Nazi doctor, it’s never a bad time to rename that.)

…And then I read this post, and I think, oh no. We, as a society, haven’t made a successful conceptual shift from “autism needs all the Classic Autism symptoms, otherwise it’s Asperger’s, which is something else” to “it’s all just autism.” The concept we’re shifting to is “autism is just the Classic Asperger’s symptoms, and if you have the other Classic Autism symptoms, that’s something else.”

Can we actually handle the idea of making a spectrum this broad? Or are we doomed to always fall back on moving it around — that is, only including one new batch of people in the category if we redefine another batch of people out of it?

Ugh.

…again, to be clear, this is all a reaction to one person’s post. I have no idea how widespread this mental framing is. Or if it’s having any negative effects for people IRL, as opposed to just flipping the direction of “[character] isn’t coded as autistic, you can tell because they [do/don’t] have these intellectual-disability symptoms” meta.

But it bothered me enough to vent about, so here we are.