Why is autism seen as a disorder?

Within the context of psychology, a disorder is a dysfunction in an individual. This dysfunction is associated with distress and/or impairment, and/or “abnormal responses”, which is to say responses that are not culturally expected.

When considering if something is a symptom of a disorder, consider the three Ds:^[1]What is a Psychological Disorder? (Brogaard, 2015) | PsychologyToday

• Is it psychologically dysfunctional?
• Is it distressing or handicapping to the individual or others?
• Is it associated with a response that is atypical or deviant?

Autistic people tend to tick the boxes of all three Ds.

Terminology

Defining autism as a disorder creates unnecessary stigmatization because the dictionary definition takes precedence over the definition within the context of psychology. When you search Google for ‘disorder’ you get:^[2]Search: Disorder | Google

• noun — a state of confusion.
• verb — disrupt the systematic functioning or neat arrangement of.

This reduces the complexity of autism to a state of confusion, or a disruption in functioning. I protest! I am not perpetually confused or dysfunctional!

Even my aunt Merriam says that I am a “disturbance in normal functioning”,^[3]Definition: Disorder | Merriam-Webster which might be more appropriate but nonetheless stigmatizing. Sure scientists understand a deviation from the norm to mean that we are 1% of the population, but to the average person it still translates that we are not normal.

I still have to wonder why autism is characterized by dysfunction only. Yes, we have our deficits and challenges, but how can society come to an understanding of autism by ignoring our advantages?

If we focus exclusively on our Kryptonites and ignore our amazing Super Powers, even Superman might seem pathological.

Who is this strange bodybuilder that faints when he touches green crystals?

His superhuman strength, his ability to fly, his ability to see through objects, and his ability to shoot lasers with his eyes are certainly more abnormal. In some ways, he is living on the fringes of society, and yet he is still Superman and not Lonerman. He is far more out of the norm than the 70 million autistics worldwide.

It’s interesting how with Superman we focus on the “super”, while his weaknesses are mere character traits and suspense builders; whereas autistics are characterized by their weaknesses, their character is defined by deficits, and the “super” part of us is overlooked.

Maybe we need to be better advocates for our Superpowers.

Neurodiversity

Judy Singer, a sociologist diagnosed with Asperger Syndrome argued for neurodiversity, asserting that:^[4]‘Why can’t you be normal for once in your life?’ From a ‘problem with no name’ to the emergence of a new category of difference (chapter 7) (Singer & French, 1999)

The neurologically different represent a new addition to the familiar political categories of class/gender/race and will augment the insights of the social model of disability.

Just as the postmodern era sees every once too solid belief melt into air, even our most taken-for granted assumptions—that we all more or less see, feel, touch, hear, smell, and sort information, in more or less the same way, (unless visibly disabled)—are being dissolved.

Nowadays there are more and more people who are dissociating themselves from the term ‘disorder’, and urge for the use of the term ‘neurodiversity’—or simply (neurological) difference—instead.

You can read more about neurodiversity here:

The neurodiversity paradigm

Better terminology

I have seen some researchers use the term autism spectrum conditions (ASC), rather than autism spectrum disorders (ASD).^[5]Tunnel Vision: Sharper Gradient of Spatial Attention in Autism (Robertson et al., 2013) The use of such less-established terms might bring confusion to some, but I appreciate their efforts.

The DSM defines autism and other conditions as pathologies, which makes a limited amount of sense if you consider that they describe diagnostic criteria; a diagnosis tends to be necessary in order to get guidance with certain issues, so it makes no sense then to describe the advantages. At the same time, this is not like diagnosing cancer, which is understood only in terms of its harmful effect. An autism diagnosis should rely on an assessment of ALL traits, including the advantageous ones.

Irrespective, researchers ought to remain objective. The fact that even they use negative language to describe the conditions they are researching influences both the perception of professionals as well as the public at large. It’s quite odd to describe your subjects as inherently disordered when you are trying to understand the condition in full—including its advantages. Hence, the use of neutral language such as autism spectrum conditions should be encouraged.

Have a look at our Powers & Kryptonites page for an overview of some of the (potential) advantages of autism.

Disorder or difference

So autism is characterized both by deficits and advantages, making the term ‘disorder’ lacking in descriptive power, or even entirely inappropriate. It’s like ignoring Superman’s powers and referring to him as Faintman on account of his vulnerability to Kryptonite. On the other hand, is ‘Superman’ entirely applicable considering his less than super resistance to Kryptonite? Terminology can be confusing, and we can’t expect it to be fully descriptive of all features.

It should be noted that while the term ‘difference’ is always applicable but non-specific, the term ‘disorder’ is more descriptive but highly contextual.

The term ‘disorder’ may have more descriptive power and applicability when it comes to those on the low end of functioning; more advantages can be seen in autistics with average to high intelligence and low support needs, but even they can face a myriad of challenges, and can at least in part be regarded as disordered.^[6]Autism as a Natural Human Variation: Reflections on the Claims of the Neurodiversity Movement (Jaarsma & Welin, 2011) Perhaps they are not very dysfunctional, and not often distressed, but still have atypical (deviant) responses, and thus adhere to at least one of the three Ds that constitute a disorder.

But note how contextual all three Ds are:

• Dysfunctional — One’s level of functioning largely depends on circumstances and the way society is structured. Of course, autistics are pretty much forced to be part of society, and so dysfunction may be hard to avoid by some, but it’s important to note that we are not inherently dysfunctional; our dysfunction is largely situational, and in principle avoidable.
• Distressed — Our levels of distress depends in part on the environment. If the environment is very accommodating to the individual, there may be no distress. If it’s highly dynamic and loud, it can cause sensory overload and distress.
• Deviant — This one reads more like a judgment than part of disordered behavior. Yes, our responses tend to be different from neurotypicals, but not necessarily subpar. In some cases, our atypical responses are more informed, more specific, and more to the point. Is that deviant?

So put an autistic in an environment that is conducive to autistics, and seemingly dysfunction, distress, and deviant behavior will or can disappear. If a slice of society could be structured in an autistic way,* we may even come to regard neurotypicality as a disorder within that context.

• A lot of major cities in the West have a “Chinatown”. Perhaps it’s time to start “Autismtown” somewhere and consider it a neurological enclave. Interestingly, some “Autismtowns” do start to emerge: Autism-friendly towns

Conclusion

So disorder or difference? I suppose it depends on definitions, context, and personal judgments. As is often the case, not everyone will agree on what we should call autism—even among autistics themselves.

Personally, I would love to be on an autism spectrum that is not defined solely as a disorder. There is a much more positive aspect of the autism spectrum that is often overlooked.

For more on the topic disorder or difference, read our 2-part post:

Autism: disability or difference?