I’ve been reading Harold Doherty’s Facing Autism in New Brunswick, a prominent pro-cure blog, where he asks whether the autism diagnosis should be narrowed back to its original DSM-III meaning, thereby removing Asperger’s and most “high-functioning” autism from the DSM. The reason he claims that this move is needed, is that neurodiversity activists are incorrectly comparing ourselves to “low-functioning” autistic children and might be robbing these children off “medically necessary” treatment.
In the comments section, people go even farther, asserting, for example, that intellectual disability, being non-verbal and dyspraxia should all be a mandatory part of autism. People speculate on how soon most Aspies will come back from neurodiversity if their diagnosis is removed from the DSM and they no longer qualify for services. My guess is that those who actually need support services, will no longer say that autistics don’t need help, but then again they aren’t saying that now. Those very few autistics (who generally refer to themselves explicitly as Aspies, so I don’t see why Doherty et al. should be afraid of these), who actually do say that Asperger’s isn’t a disability and Aspies don’t have difficulties, would not be bothered if it were removed from the DSM. In fact, clinically speaking, if they truly don’t have significant impairments in functioning without help, they don’t meet the criteria for a diagnosis at all even under DSM-IV-TR.
However, I think Doherty and his followers are confusing cure with services. “Services” can refer to positive, supportive assistance that will help us live with autism in a mostly NT world. This includes, for example, learning techniques for sensory regulation, learning an alternative communication method, etc. It also may include, once we are adults, help in living in the community, such as assistance with housekeeping, managing paperwork, recreation, etc. Some of us will actually need a carer to take over some of these things. Furthermore, even many “high-functioning” Asperger’s people will at one point in their life need psychotherapy because of depression – which is so common in Asperger’s that Baron-Cohen even considers it a mandatory feature (in which case I would lose my diagnosis, despite all my other difficulties) – or anxiety, and some of these are on medication for these. Some others, like myself, have possibly harmful behaviors, like aggression or self-injury. Behavior modification may help some in preventing someone from getting hurt, but in the long run we need coping strategies to deal with whatever is causing this behavior, such as sensory issues. Some of us will always need help with this, while some eventually learn to manage on our own.
I have yet to meet an autistic, a small number of Aspies on Aspergercentric forums like Wrong Planet, who often make it very explicit that they are NOT like “low-functioning” autistics aside, who claims that autistics don’t need services or don’t have a disability. However, like I said, support services, and actually also some therapy that is aimed at changing our ways of acting and thinking (eg. occupational therapy for sensory issues or cognitive therapy for depression), is not the same as intensive training, for many years, in acting how the NTs act, in an attempt to scratch off every bit of autistic experience (or at least the outward manifestation of that experience) that is in us. It is that which we don’t want, and please stop assuming that we don’t think of ourselves as disabled or we don’t need services until that is what we say.