"Impairment" and the Right Planet Fallacy

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Background: There are many in the community who doubt the need for and validity of diagnosis on the autism specturm when there do not appear to be problems that affect the subject living significantly differently to the life they would like to live. The crux of this appears to be the stated diagnostic criterion of "clinically significant impairment". But what is that, exactly?

Let us take the "wrong planet" metaphor for ASDs as read. Now, suppose everyone on the spectrum receives a telepathic transmission that the mothership is about to land in the salt flats of Utah and will soon leave for the "right planet". Everyone boards and is transported to the Right Planet. Now, are they still all autistic, or not? If we say that autism is a neurology, and passed down genetically, how can they not? Stimming is still stimming, tendency to literal language, disordered speech and other individual behaviours "stand alone". The social response is what changes, depending on context. A physics professor with Asperger's, in practice, probably perceives less difficulty in everyday function than their hypothetical identical twin who, for whatever reason, works in retail customer service. Should they be diagnosed differently?

Now let us take a hypothetical person born paraplegic, into a rich family. They cannot walk. But, they have servants to attend to all of their needs, consider physical extertion to be troublesome and have no desire to walk. They can do anything they wish to do and live the life they would wish for. Is this person's impairment in movement (cannot walk or move their lower body) not a "significant impairment" just because they don't wish to move that way?

In my opinion, it is fallacy to say that a person is somehow not "significantly impaired" merely because they have found the Right Planet, or perhaps a more-right planet.

If an autistic person has all her everyday needs taken care of by other people, like the physically disabled person, then she still has significant impairments in functioning, because the other people are needed to help her do everyday things that other people don't other people to help them do.

I agree, this is precisely the point I am making. To have a suitable living situation does not change a person's impairments, it merely changes the effect that those impairments have.

Significant impairments does depend a lot on environment. In college, I didn't think that I had significant impairments, because I went to a school that seemed to be BAP/ASD Central. In grad school, the impairments became very significant. In high school, I didn't think that I had significant impairments, but others might have thought so based on my low social functioning. In grade school, I did, and I had a special education plan to help me with those. So the level of impairment can change a lot during the course of a person's life.

One of the big differences between BAP/ASD Central and other schools was that most exams were take-home and several hours long. As a result, this eliminated the problems of sensory overload taking exams in a classroom. Also, there was much less problem with verbal processing, because taking more time to figure out the test questions is not going to matter much in a five-hour exam, but will matter in a one-hour exam. Also, the test questions were more clear to begin with, because they were designed by and for people who thought a lot like me, at least when it came to academic subjects.

I would like to clarify that in my case, BAP/ASD Central was so automatically accommodating to my needs that I didn't think that I had significant impairments, not that the effects of the impairments were different. I'm not entirely sure what the last phrase means.

Someone looking at me from the outside might have said that I did have significant impairments, however, because I still miscommunicated in very significant ways with people, even though my non-social functioning was very high. For example, I dated people for weeks without knowing that I was dating them, and because I never knew that I was dating them or that I dated them without knowing that I was dating them, I didn't think that I had significant impairments in that aspect of social functioning, even though dating people without knowing that you are dating them would be a significant problem to most people.

So now I am thinking about whether or not I could have been diagnosed with ASD during my time at BAP/ASD Central. First of all, I would have had no reason to get assessed, but supposing that I somehow ended up at a headshrinker place, I think that I still would have been diagnosed with ASD, because even though I was not significantly impaired according to my standards, e.g. doing well in school, having enough friends, not suffering much sensory overload in a place that was like a country club, I was actually more obviously autistic than I am now, because I was an extremely oblivious teenager who was too socially impaired to realize that I was socially impaired in terms of non-verbal communication and speaking coherently and getting social messages. I got none whatsoever back then and knew almost no social scripts either, so I appeared very very very weird in a place where weirdness was the norm. But to normal headshrinkers, I would have been more obviously autistic, and the social functioning impairment would have been met for diagnosis, although that was totally not important by my standards. By impariment in social functioning, I mean not that I had no friends, but that other people would not have seen me as a person who communicated normally or even could. I think that I communicate more normally now, but in the adult world not at BAP/ASD Central, I have impairments in other areas in addition to social.

I saw a video of Nobel laureate Vernon L. Smith discussing the fact that he has ASD. I wonder what his significant impairments were for diagnosis. He has a wife, and he is 80-something, so I wonder when he got diagnosed and why.

I've always thought that someone who doesn't have significant impairments today might have them if the circumstances suddenly change, like the Right Planet blows up and you survive and go on a space ship to another planet, the Wrong Planet, or even if you go there as a planned change, but you don't know that you are autistic, so you don't think that you will have significant impairments at the Wrong Planet until they pop up to bite your head off, almost literally.

Actually, this is why I would encourage people who are getting by to get a diagnosis if they could, because many autistic people who have jobs and can support themselves financially and live on their own still have significant impairments in social functioning, and while they have jobs and hopefully health insurance, it would be useful to get a diagnosis, so if they find that they have no jobs and no insurance and no money one day, that diagnosis may help somehow, perhaps with applying for disability without all their problems attributed to disorders that they don't have instead of autism and maybe even open certain doors to getting back to independence. I have a personal story about that, but I don't want to say anything until all is settled. It seems to me that when the world comes crashing down one day or if a person burns out one day from functioning at a level that takes them a lot of effort, then it might be too late to get the diagnosis to get the help or accommodations that one needs.

If I had known about autism back when I didn't think I had any significant impairments, then I would probably have gone to get assessed anyway, but it would have depended on the price. If I had known what kinds of problems I would run into later, on the Wrong Planet, then I would definitely have gone to get assessed, then asked for accommodations using the diagnosis, even if it had cost a lot. I would have emptied my bank account.

To add to this thread my new obsession, just because an autistic person does not think that they have any significant impairments does not mean that clinicians will not see their impairments that they don't see themselves. For example, one thing that I discovered when I saw a therapist was that I sucked a lot at answering any kind of unexpected questions, even ones with obvious answers that I know. I was slow processing the meaning of the questions and slow to generate the obvious answers. All along, I had a feeling that something was wrong in my communications with people, but I didn't know that this was one of the specific issues until I saw a therapist and she noticed this problem that I couldn't see because I can't see myself from the outside.

Thanks for your contrubutions btbnnyr, feel free to add more as it comes to mind.

This strongly illustrates what I've always thought about the topic as well.

The thing is, all people have 'impairments' however you wish to define that, but in a society where NT people share the same 'impairments' those are not regarded as impairments, just 'being human' as the saying goes.

Strengths and weaknesses exist for everyone, and because the weaknesses of many ASD people fall significantly outside the norm as compared to society as a whole, they become regarded as impairments.

To take your inability to walk analogy, if NO ONE could walk, it wouldn't be called an impairment, it'd be just how people are.
We don't call the inability to fly an impairment do we? Because humans can't fly.

So I agree pretty strongly that 'impairment' shouldn't be a diagnostic criteria; it's a useful criteria to determine what sort of help someone needs, but being apie often has little to do with impairments, and as already stated, impairment for many aspies is dependent on the social situations they find themselves in.

I don't know if there is a right planet for me. My doctor is right that I have multiple issues. I don't have confirmation yet on whether or not I have Asperger's. I do know, from being properly diagnosed, that I have fibromyalgia, scoliosis, a heart murmur, and PTSD. Only the fibromyalgia and PTSD are diagnosed conditions that have had an impact on my ability to work or to function at home or in social situations. Only the scoliosis was treated in a way that has had an apparent effect (a brace I wore for five years that kept the three curves in my spine from becoming progressively worse while I was still growing). None of these things are problems that would be immediately apparent to the casual observer. All of them, however, would mean trouble for me if people who think humanity should be "pure" and "free from defect" started to have enough power to round up the folks who "don't belong" and cart them off for experimentation and/or disposal. On the other hand, all of them are worth it to me to know I have, so that I don't feel down about myself for things I can't help (such as not having perfect posture or having debilitating fatigue, so that I might seem lazy because of things I'm too tired to accomplish at any given time).

As I noted in a post I just made on another thread, I've changed my status back, after a brief period, to not knowing if I have Asperger's, rather than having it but being undiagnosed. I simply can't assume I have it, based on whatever amount of reading I've done. I have a belief that I have it, that's all. I could be wrong, and I'd be awfully embarrassed if I kept saying I had it and then got proven wrong by a proper assessment. I don't know if I'll ever succeed in being properly evaluated, but my impatience and frustration are no excuse for making a claim I have no business making, based on the fact that I'd like to have what feels to me like a real answer about things. If Asperger's isn't the answer, I can't simply make it be, by sheer force of my desire for it to be so.

Maybe I've just been too caught up in this recent craze to diagnose people with Asperger's left and right. I'm very disheartened by what I've been reading lately about an Asperger's fad. I don't think I want to be part of a fad. I just want to have information that makes my life make sense and helps me to understand what I might do to make myself able to adapt and function better, if possible. If the things I've learned about Asperger's help me to do that, then I've benefited, even if I don't have it at all. And if I can't do any better than I have, it won't make any difference if I have Asperger's or not. I'll still be just as I am. There's no hiding from that.