1: What is Autism?

lecture 1 of autism: research, theory and culture

neurodiversity

diversity of human brains and mind

intrinsic equality

there is no one “normal” or “healthy” type of brain or mind or type of neurocognitive functioning

neurodiverse

a group of people, where multiple neurocognitive styles are present

medical model of disability

laing (1971)— views disability as something that should be fixed or changed

laing

leader of movement for critical psychiatry

implications of medical model of disability

suggests that health difficulties and differences are the result of biological/physical mechanisms that can be diagnosed and treated

methods of medical model of disability

uses classification to aid diagnosis and treatment

examples of methods of medical model of disability

clinical assessment, communication, research, benefits (e.g. via insurance or other policies)

model of social disability

oliver (1984)— the notion that disability is created by society

social barriers that make a person disabled include

physical barriers, social barriers and attitudinal barriers

the neurodiversity paradigm

neurodiversity is a natural and valuable form of human diversity

dsm-v autism deficit criteria

in social communication and interaction: social-emotional reciprocity, nonverbal communicative behaviours, developing, maintaining and understanding relationships

dsm-v restricted/repetitive behaviour criteria

stereotyped or repetitive motor behaviour, insistence on sameness, restricted interests, hyper/hypo reactivity to sensory input

problems with dsm-v criteria

focuses on deficits and pathologises autism, based on observed behaviour isntead of inner experience

neurodiversity paradigm description of autism includes

patterns of neurodevelopment that lead to differences in cognitive, emotional, social, sensory and motor processing

neurodiversity paradigm difference criteria

differences with social interaction, executive function, and in identifying and describing feelings, increased attention to detail, and sensory activity (heightened or lessened, or sensory seeking)

benefits of using neurodiversity paradigm description

autism described by autistic people

global prevalence of autism

1 in 100 children are diagnosed

MFR

male to female ratio

median MFR for autism

1:4.2

co-occurrence with intellectual disability

33%

factors likely attributed to the differences in rates

sociodemographic factors, community awareness and service capacity

potential barriers to diagnosis

referral waiting times are long, age, ethnicity, and geographical location

norwegian patient registry child MFR

1:3.67

norwegian patient registry adult MFR

1:2.57

russell et al. (2022) incidence of autism dx between 1998-2018

787% increase

russell et al. (2022) sex/gender incidence differences between 1998-2018

greater increase for females

russell et al. (2022) age incidence differences between 1998-2018

greatest increase in adults

reasons for self-identification

more understanding and acceptance of neurodiversity, doesn’t require validation or need for support, systemic barriers that prevent formal diagnosis

why might autistic people feel they don’t want or need support?

they feel supported by their environment due to more understanding and acceptance of neurodiversity being more commonplace 9though this is a position of privilege

benefits of formal diagnosis

clinical validation of being “truly autistic, gaining support and access to services

disadvantages of formal dx

diagnostic process is often deficit-focused, stigma arises when disclosing identity

why might an autistic person feel misunderstood

unhelpful stereotypes in the media and previous misdiagnosis

what are some post-dx issues

barriers to support services such as waiting times or “functioning” requirements

aims of neurodiversity-affirming language

to be more respectful, inclusive and to to be less likely to reinforce stereotypes

person-first terminology

“person with autism”

aims of person-first terminology

to prevent people from being defined by their “conditions”

criticisms of person-first terminology

implies that autism is inherently negative, resulting in increased stigma

value-neutral differences

acknowledging differences without bias