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The Problem of Diagnosing Autism: The Medical Model

Olivia Bridges

The medical model for diagnosing autism is problematic for those who have autism. In order for an individual to receive an autism diagnoses their parents have to answer a series of questions. In cases of autism spectrum disorder, the individual may have to opportunity to speak with the diagnostician; however, when a doctor has to assess someone who is non-verbal, the doctor conducts the diagnoses through conversations with family members. As a result, the patient’s story is typically omitted. This can be true of individuals with autism spectrum disorder as well, but tends to be less of the case. The omission of the patient’s story is problematic because it takes away the voice of the autism community. According to Autism, there is no clear definition of autism, so people’s perceptions of autism derives from the medical model and how doctors diagnose autism. Thus, most people view autism in a negative light because doctors use curd language to describe autism, such as inflexible and abnormal. The use of said language leads people to believe autism is a problem that must be cured, but that conclusion is made without the consent and voice of the autism community. When an individual with autism receives an autism diagnoses, their very actions becomes defined by their autism and they lose their agency. The medical model in which doctors use to diagnose autism is problematic because of the association of negative terms and the assumption that autism is a deficiency that must be cured; therefore, resulting in a counterproductive mindset in parents who blame autism on their child’s ever action and only see the autism rather than the person (Murray).

Due to the lack of biological evidence of autism, doctors diagnose autism on assumptions of what they consider to be normal; however, the current diagnostic model typically omits the ‘patient story,’ which portrays autism as a problem. “It remains true, however, that the frequent absence of the ‘patient story’ for the individual with autism the narrative is then supplied by the diagnostic process method itself, which inevitably fills in the gaps with which it finds itself faced (Murray 13).” According to Autism, Murray asserts it is important to understand the concept that autism is deficiency or a problem is built into the diagnosing process itself. When a diagnostician is diagnosing an individual with autism, they do it off of what is considered to be normal. The favoritism towards normality can be seen in the questions asked in the diagnosing process. Developmental psychopathologist, Simon Baron-Cohen outlines a list of questions that is traditionally asked to parents when diagnosing their child. One of the questions is as follows: “Do they show a lack of normal social awareness (Murray 11)?” However, Baron-Cohen does not define what he considers normal social awareness. The term normal is such an ambiguous word and it is set by societal expectations and standards. By establishing the lack of normalcy in an autism diagnoses, individuals with autism are immediately ‘othered,’ which puts them at a disadvantaged because of the already apparent lack of the ‘patient story.’ The assumption of the lack of normalcy takes away their agency and their ability to share their story in the future because their ‘othered’ status discredits them (Murray).

Diagnosticians define autism using harsh language such as deficient and impaired; the use of negative language is problematic because people base their assumptions about autism on the doctor’s descriptions, leading them to believe they need to cure autism. Due to the lack of a clear definition of autism, according to Murray, people base their assumption about autism on the medical model; however, the diagnosing process has flaws and is full of negative connotations. “Looking back on Baron-Cohen’s list, it becomes readily apparent that it is full of descriptions of ‘difficulties,’ ‘limitations’ and assumptions about behavior being ‘wrong’ or deviating from that which is considered ‘normal’ (Murray 13).” By establishing those with autism exhibit behaviors that are wrong or deviant, doctors are setting up people with autism to be treated as lesser. The Diagnosis and Statistical Manual of Mental Disorders or DSM serves as an aid to diagnosticians; however, like Baron-Cohen, the guidelines contains the same negative language. In the DSM-IV, “Autism Disorders” it describes autism using numerous words that establish autistic individuals as lesser. The list of descriptors includes words such as impairment, failure, delay, lack of, inflexible, restricted, and abnormal. Further, organizations that are supposed to advocate for people with autism use the same language as well. The Autism Society claim people with autism may appear deaf and get upset for no apparent reason. They also suggest when interacting with someone who has autism to speak slowly and use simple language. While, the Autism Society is trying to raise awareness, their assumptions about autism stems from the assumption autistic individuals are incapable because their knowledge about autism derives from the diagnostician’s definition of autism. Furthermore, parents also base their assumptions about autism on the same medical model. All of which is problematic. It allows parents to blame their child’s every action on autism while ignoring the cause of their upset and promotes eugenics because it establishes autism as a problem that needs to be cured (Murray).

The problematic language and diagnostic definition of autism results in autistic individuals and their actions to be defined by their autism. According to Melanie Yergeau, “Introduction: Involution” from Authoring Autism, upon receiving her autism diagnoses, people—specifically her mother—view her autism as the root of all of her behaviors. “What autism provided was a discursive framework, a lens through which others could story my life….This, my body, this was autism–and suddenly, with the neuropsychologist’s signature on my diagnostic papers, I was no longer my body’s author (Yergeau 1).” In Yergeau’s article, she discusses the matter of autistic poop. She recalls a story her mother tells about how she used to have poop up to her neck as a baby. After Yergeau’s received her autism diagnoses, her mother associated the poop incident with her autism because autistic poop is a common discussion within the autism community; however, it is not exclusive to autism for babies to be covered in poop or even to play with it. It is not an atypical behavior, yet because Yergeau has autism, her mother views it as atypical and a result of her autism (Yergeau). Additionally, in Autism, the International Classification of Diseases provides a description of childhood autism. In the description, ICD associates temper tantrums and phobias with autism. However, like poop, phobias and temper tantrums are not excessive to autism, but as a result of the association when an autistic individual throws a temper tantrum, instead of trying to understand what is wrong, people typically round it up to the individual’s autism. In doing so, people with autism lose their agency and their ability to express themselves (Murray). For example, in William Faulkner’s The Sound and The Fury, while it is not confirmed that Benjy has autism, he experiences the same lack of agency because people define him by his disability. When Benjy burns his fingers, everyone immediately tell him to hush even though his reaction is completely valid. However, due to his disability, his feelings and pain are invalidated and written off as white noise. Any time Benjy attempts to express himself, he is told to hush because his family does not believe he is capable of understanding the world around him; thus, once again, another individual is treated as lesser because of preconceived notions about disability (Faulkner).

The current model for diagnosing autism is flawed and is in dire need of redefining. When an individual is diagnosed with autism, the medical model sets them up for failure. Inevitably stripping them of their agency and voice. As a result of the negative language associated with autism, they are treated as lesser and people view them as impaired and abnormal. When doctors diagnose an individual with autism, they face dehumanization and an invalidation of their feelings. The current model for viewing autism needs to change because it promotes eugenics and devalues autistic individuals and their experiences. Additionally, parents need to stop blaming their child’s every action on autism. Instead they should try to understand why their child is upset or why their child is acting a certain way rather than just blaming it on the autism. However, people with autism will be unable to regain their agency until the negative language in the medical model that promotes said mindsets is eliminated. Change needs to be done at the diagnostic level because it impacts how people base their assumption about autism.

I pledge

Word count: 1,441

Works Cited

Faulkner, William. The Sound and the Fury. Penguin Books, 1964.

Murray, Stuart. Autism. Routledge, 2012.

Yergeau, Melanie. “Introduction: Involution” from Authoring Autism. PDF.

Madness Series Lecture–Last One

Olivia Bridges

I attended the last lecture for the madness series. I cannot remember the name of the speaker but I believe that he is actually the professor of the class. The lecture was called an existentialist approach to madness. While the speaker covered a variety of topics such as Freud and his breakthrough to treat people with mental illnesses as people and get to the root of their trauma rather than treating them like criminals and burdens. The part of the lecture that stood out to me the most was the myth of mental illness. The notion that mental illness is a metaphor and not an actual medical condition, which is why the medical model is incorrect when approaching mental illness. However, I’m not entirely sure how I feel about that idea. As an individual who has struggled with mental illness my entire life this upset me. I have been told my entire life that my anxiety is because of a chemical imbalance in my brain. From what I gather in my notes the speaker is implying that anxiety is caused by those who are aware of their own existence. And while I can see the argument that anxiety worsens when one is not distracted because that is certainly true and part of the reason I struggles so much last semester, my anxiety and depression started long before I was aware of my own existence. It is something I have struggled with my entire life, I was put on medication as young as ten years old and had significant anxiety before then. Probably as early as first grade. It made me feel like my medical condition was being dismissed. The only thing that allowed to me to not be ashamed of my anxiety and depression is because doctors and my parents told me it is a medical condition. One in which I cannot control because it is a chemical imbalance. Yes medication does make me feel better and yes there is not a cure, but mental illness is an illness. I do agree that humans are anxious beings but that shouldn’t take away from others experiences. I have suffered greatly because of my mental illness, sometimes it feels like dying. I understand that mental illness cannot be understood purely on the medical model but it is a medical condition.

Take Back The Night Response

Olivia Bridges

Take Back The Night is a tradition long held at Mary Washington; however, for the first time in the University’s history, the Tally Center organized the event with the help of numerous campus clubs. Among those clubs included my own, Where Is The Line? Our club strives to bring awareness about sexual assault and domestic violence. The purpose of the event is to empower survivors so they can heal, but also to bring awareness.

The event began and ended with acapella groups singing as well as a candlelit ceremony once everyone was done speaking. There were several speakers in attendance–I believe it was around five speakers. Two of which I knew. The last speaker was a woman with a physical disability. She previously attended UMW and has poetry published in various publications. While most of the speakers stories narrated their journey to healing, she instead shared her poems. Even though her poems spoke of sexual violence and darkness, it still had an empowering effect because despite what she went though she was strong enough to speak at the Take Back The Night Event. Additionally, at least for me writing is a form of healing. The last poem she shared was actually an activity she recommended everyone do to help them through their trama. I strongly believe that while the poems were melancholy, they were also empowering and eye opening.

Lastly, I thought it was interesting to hear from a woman with a disability because it provided diversity. While I am unsure of the exact statistics I know that 1 in a 5 college women are sexually harassed and 1 and 4 women are as well. However, I am sure the number of people with disabilities that face sexual violence is even worse. So it was important to have a person with a disability speak.

Olivia and Sammie’s Major Project: Beware for I am Fearless and therefore powerful

Our Website:

https://beware-for-i-am-fearless-and-therefore-powerful-com.webnode.com

Rational:

The goal of this project is to look at different Hollywood depictions of Frankenstein and see how it relates to disability. We decided to make this project in order to display the stereotypical Hollywood portrayals of Frankenstein.

Our process involved researching which tv shows and movies included Frankenstein. We had to make sure that there were both older and newer portrayals to see how Frankenstein differed between generations. We then watched the movies and tv shows while we took notes. We made a website and put together some clips to show how Victor Frankenstein and the Creation were depicted in each adaptation. Some of the clips were unavailable to us but we found many other clips that showed the full extent of representation. The process took about two and a half weeks in total.

There are many significant issues in both the tv shows and movies regarding disablity. In several films, there is signs of eugenics at work. Older media tends to portray the Creation as less intelligent and, in some cases, nonverbal. This aligns with the flawed stereotype that people with physical deformities are unintelligent. In most of the adaptations, people are cruel towards the Creation. At many points, the Creation is almost always kept in the background especially in the Addams family adaptation. This is connected to disability because, in some cases, individuals with disabilities are pushed to the side or ignored. By portraying the creation in what could be described as a slave-like state, the film is implying the creation is incapable of independent thought. Additionally, in the novel, the Creation is an intelligent individual who is capable of talking but, in contrast, this specific portrayal of the Creation takes away his voice and leaves him incapable of communicating with others. In doing so, the Creation loses his agency. This also falls in line with the stereotypical assumption that people with physical deformities lack intelligence; however, in the film, the Creation shows an understanding of their situation and experiences emotional responses to those situations. So while he may lack intelligence beyond his piano skills, he still shows signs of emotional intelligence.

While not all people with disabilities do this, there are a good amount of people who will put other people’s needs in front of theirs. Some individuals with disabilities do not want to inconvenience anyone and some may even try to make things harder for themselves in order to keep abled people comfortable. This is seen in the Addams family when Lurch is told to do certain chores and he has to do them without complaint. Another issue regarding disability arises in Once Upon A Time when Rumpelstiltskin reattaches Frankenstein’s arm. The presence of magic essentially makes disability non-existent which is problematic because it is a form of eugenics. Victor Frankenstein is an interesting character to look at under the lens of disability. In all variations of Frankenstein, Victor has obsessions and issues with addiction. Victor is obsessed with creating life and in other adaptations, he is also addicted to morphine and alcohol. As time progresses, these obsessions and addictions begin to affect his ability to function. This is an interesting aspect to look at with thinking about disability.

In the 2015 adaptation, the Creation has a mother-like figure in his life which is unique to this version. The 2015 adaptation is also the most accurate representation of the original novel out of all of the viewed adaptations. What’s interesting to note is most of the adaptations of the Creations portray him as suicidal, especially ones that are nonverbal. This indicates the societal belief that people with disabilities who are unable to communicate verbally are lesser than others and that their lives are pointless. In the 2015 adaptation, the Creation ceremoniously burns his “mother” and burns himself along with her. It isn’t until he is engulfed in flames that he transforms and rids himself of the impurities on his skin and evolves. This is problematic since this ending implies that individuals with physical deformities cannot fit into society unless they change everything about themselves and also encourages the unhealthy notion of “being cured”. This adaptation not only encourages transformations, but it also tries the idea of eugenics. In other words, experimenting with genes until the perfect specimen is born. It can also mean looking for specific genes that cause certain disabilities and figuring out ways to eradicate them or avoid them. Victor experiments with creating the perfect being by making the Creation in his lab; however, he has a backup specimen ready to go in case his first Creation isn’t good enough. In Sharon L. Snyder’s article, she talks about eugenics and says that “Cure-or-kill story endings frequently connect to logics of eugenics where disabled people represent a soon-to-be eradicated group whose promised erasure will better society” (181). In each one of these adaptations, the Creation either wants to kill themselves or has other people that want to kill them. People want to eradicate what they are unfamiliar with and disability is one of those things.

In all the adaptations, there are a few things that they have in common. Nearly every Creation portrayal is suicidal and nearly every one of them is taken advantage of or shown in freak shows. In Mary Shelley’s Frankenstein with Daniel Radcliffe, he is a hunchback and part of the circus. This is due to the cyst in his back. When Victor takes this cyst out, he is left with painful sclerosis but because his pain is now invisible, no one notices his disability. In other adaptations such as The Addams Family movie, the Creation is taken advantage of; the family tells Lurch to do certain chores and is in the background for most of the movie. It is as if he is left out of the family due to the assumption that he isn’t intelligent. Even the other older shows like the Munsters and Struck by Lightning joke about the Creation’s appearance. These adaptations make it seem like people’s differences are a punchline.

In conclusion, these adaptations show the subtleties of how the public views disability.

Olivia Bridges’ Response to Harper Lee’s To Kill A Mockingbird and Alison Kafer’s, “Introduction: Imagined Futures”

In To Kill A Mockingbird, Mr. Underwood equates Tom Robinson’s death to the killing of a songbird; in doing so, he codems the treatment of Tom as cruel, but also depolitizeses disability by ignoring the structural inequality of disability in an ableist society. Alison Kafer argues disability has been removed from realm of politics, which leads to a loss of power that can enact change. As a result, the ablist interpretation of disability is seen as common sense. Thus, rather than striving to understand how the lack of accommodations disabled individuals, people center their attention on the disability itself and what they interpret the person to be losing.

Such attention is vital in a context in which, as Susan Schweik notes, disability-based discrimination and prejudice are often condemned not as a marker of structural inequality but of cruelty or insensitivity; this kind of rhetoric “sidesteps the reality of social injustice, reducing it to a question of compassion and charitable feelings” (Kafer 10).

Said mindset results in feelings of sympathy, which innately dehumanizes people with disabilities because it reduces them to their disability in the eyes of others. For example, the novel describes Mr. Underwood as a bitter man; however, when he hears of Tom’s death he calls it sinful, not because Tom’s only crime is being an African American, but because of his disability. In his mind, killing a person with a disability is the same as killing a songbird. Not only does he attribute Tom’s disability as animalistic, Mrs. Maudie states the reason it is a sin to kill a mockingbird is because they can only sing. “They don’t eat up people’s gardens, don’t nest in corncribs, they don’t do one thing but sing their hearts out for us” (Lee 103). Mrs. Maudie’s emphasis on what songbirds don’t do parallels the ablist focus on the limitations of an individual’s disability; therfourth, when Mr. Underwood alludes to Tom being like a songbird, it has the underlying implication that Tom is only capable of simple tasks such as singing and nothing else due to his physical impairment. Tom is not only discriminated against because of his disability, his mental capacity is brought into question as well and his ability to contribute to the working class. The comparison of Tom to a songbird aligns with the ablist notion that people with physical disabilities or deformities are also mentally incapacitated and incapable of being a productive member of society. Additionally, Mr. Underwood does not acknowledge that if it is not for Tom’s disability, he would have survived. According to Atticus, the guards at the jail believe there is a chance Tom could have escaped the prison. “They said if he’d two good arms he’d make it, he was moving that fast” (Lee 268). The guard’s attributes Tom’s death to his disability; however, Tom’s lack of two arms is only a disability if he is not accommodated. It is not that Tom is incapable of escaping because he has the athletic ability to do so. If the fence is more accessible he could have escaped; of course, it is unrealistic to expect a prison to accommodate a prisoner in their escape. However, it is highly unlikely the prison provides accommodations to Tom while he is in their custody.

Word Count: 544

I pledge: Olivia Bridges