Disability or not

With reference to the Twitter storm over Chris Packham's comments 

here    My assessment report said there have to be impairments in social communication, social imagination and social interaction

for an appropriate diagnosis to be made. Is impairment synonymous with disability though?

  • And yes, I felt OK about acknowledging strengths and weaknesses, plus the fact that mine might well not be at all typical.  I just didn't seek a diagnosis because I felt impaired.  I thought it might be illuminating for both myself and my wider family, which has proved to be the case.

  • I think we're basically saying the same thing. My point is I could equally say ND's are impaired because they can't hear everything I can, or they take emotions over fact and reason

  • I don't think it should be seen entirely through the deficit model , but neither should it be seen as something in which those things are completely ignored. It's about acknowledging both strengths and weaknesses.

  • There have been plenty of situations in my life in which I've felt different and, to an extent, disabled as compared to my peer group.  I don't think I ever saw myself as impaired, although this is something I'm now reflecting on.  Perhaps i just don't like the word.  

    However, i sought a formal diagnosis both to confirm my own sense of identity and to give some indication as to what others in my family are facing and why.  Given that, at least in our situation, the issues are longstanding and familial, to me it seems perfectly reasonable for one family member to present for assessment in order to understand the wider issues.  As a parent I felt I could do no other. 

    I decided a long time ago that whether the autism service then views it through the deficit model and calls it a disorder is entirely up to them.  I don't have to accept their terminology.  Plus I'm not a great fan of the DSM but access to services depended upon me going through this process.    

  •  People with Asperger's/ASD/Autism  can be non deficient , even gifted, in some areas while struggling in other areas.  Saying a person has impairments in a few areas is not saying they are impaired in all areas. The ' tangerine' is not an 'orange' ,  but also it's not a perfect piece of fruit and neither is the orange .

  • It's a bit like, most people are oranges but some are tangerines. You can accept you're a tangerine, and want to be formally assessed so that you can prove, for whatever it is you need approval, that you are a tangerine. But it doesn't mean you have to accept that a tangerine is a deficient orange (which is what the oranges say). You're just different, not deficient. Even if the oranges say you're deficient, you don't have to agree. But it doesn't change that you're a tangerine. But you need oranges to accept you are a tangerine and not expect you to be an orange. (Have I stretched the analogy too far? Haha)

  • That isn't what is happening. I've never said I don't believe I'm autistic. I attended an autism assessment as I believed, and had confirmed that I am autistic.

    I see my behaviour as differences to the predominant neurotype but understood the assessor would follow a deficit model and instead of noting my behaviour in this way would write it down as impairments instead. I was ok with that as I understand different people have differing viewpoints and as such will sometimes use language that goes against my preferences. 

  • So essentially it's ok to go to be voluntarily assessed  for something you don't think you have?!

  • Which comes back to the fact that unless you're seen as having impairments  you wouldn't get the diagnosis

    Just because certain parts of society see you as impaired it doesn't mean that you are though. All it means is that those who wrote the criteria and at least the majority of those others who approved it take that view point.

  • This is why I disagree with your comment that those who are autistic and don't feel impaired are in denial.

    Which comes back to the fact that unless you're seen as having impairments  you wouldn't get the diagnosis .

    If a person doesn't think they're impaired , and thus don't believe they fit the criteria,then going to be assessed for it seems very strange to me.

  • A lot of autistic people have the ability to recognise when something is an issue and put in place strategies to overcome e.g the hospital food. This is why I disagree with your comment that those who are autistic and don't feel impaired are in denial. We probably just learnt more effective coping skills than those who have a similar profile and class autism as a disability.

    Your comment about how things have changed over 35 years is interesting. I think a lot of the diagnostic criteria is old fashioned and based on a deficit model, whereas a modern society are moving more towards the social model of disability. Hence fewer autistics seeing themselves as disabled by their neurotype. It'll be interesting to see what the criteria for autism is in the future.

  • It's how you react to a situation where you can not adhere  to your routine, be it food or anything else, that to my mind defines whether it's an impairment or not .

    Things have changed in the 35 years since I was in hospital. Hence,on hindsight,mentioning hospital and how you'd cope was rather redundant .

  • I'm looking into having a c-section so have thought about the hospital food and be making my own to take in as its unlikely I'll want to eat the hospital food.

    My husband's grandma was in hospital recently and as a NT she didn't like the food and wanted meals she was already comfortable with so her relatives brought her food parcels including premade salads/sandwiches and ice-cream. This is a common occurrence amongst the NT I know.

    As such I don't see the need for me to stick to my own preferences during a stay in hospital as an impairment. Do you?

  • I agree with the diagnostic criteria, but whether your situation with food should count as an 'impairment' is another matter. Certainly within your home environment  it's doing you no harm. However how would you be if you went into hospital , and couldn't have those 5 meals in rotation? IMO  the answer to that would show whether it's an impairment or not.

  • My report states one of my 'impairments' is around my need for routine in regards to food, as I have five meals that I eat in rotation. These meals are nutritionally balanced e.g black bean chilli , lentil and chickpea curry, plus cashew nut stir fry. I'm currently pregnant so am having my blood checked regularly and every time they come back that I'm perfectly healthy and do not need any extra support, such as iron tablets. I know many neurotypicals whose eating habits aren't classed as impaired as they fit the general populations yet they were prescribed extra vitamins during pregnancy as they weren't getting the nutrients they need.

    If my diet is providing me with all of the vitamins and minerals I need to live a healthy life I don't see it as an impairment and am instead saddened by NT society as I believe they cause the ND community a lot of harm by trying to wrongly state that the way many of us live is wrong simply because it differs from their preferences.

    I'm interested in your view Firemonkey as whether you'd agree with the diagnostic criteria and feel that I am impaired in regards to this and why?

  • As impairment is required for a diagnosis,and a thorough assessment is done to decide that, I'd venture that some people are in denial/can't see they're impaired.

    Autism and anosognosia

  • I understand what you're saying. I think there's a lot of reasons why people go for diagnosis. I can only speak for myself and that I am not seeking a professional diagnosis. 

  • I sought a diagnosis as I wanted to be able to say authoritatively that I was autistic.

    The world has been created by NTs and sometimes, even if you don't agree with their terminology or view, you have to play their game to get what you want.

  • So basically some people go for an assessment ,  that includes impairment as a criteria for a diagnosis, already denying they are impaired in any way ?!

    Which comes back to the point of-  If you don't see yourself as impaired why seek out an assessment in the first place?

  • Maybe they are of opinion that the impairment is from the NT viewpoint. So it's only seen as an impairment from people who are NT. You could make the comparison the other way, and say various traits of NT behaviour are an impairment of the ND viewpoint (hypersensitivity to senses for example) but the majority of people are NT, so it's ND that are compared to NT, not the other way around.