Saturday, April 21, 2018

"Comorbid"

 Hot take: The distinction between "autism" and "comorbids" is pointless and arbitrary. The DSM definition of "autism" is based on a fairly arbitrary collection of characteristics determined by external observation that may or may not correspond to autistic people's own inner lives.

Instead of relying on the DSM and neurotypical standards, autistic people can observe ourselves and other people with brains broadly similar to ours to get a sense of what types of characteristics many of us have in common. Not all autistic people have later than average speech development, but later than average speech development is recognized as an autistic trait. Almost all autistic people have above-average levels of anxiety, but anxiety is considered just a "comorbid," not an autistic trait. That doesn't make logical sense, but it allows some "autism acceptance" advocates to say that late speech shouldn't be pathologized because it's "autism," but anxiety should be pathologized because it's "comorbid."
And if you claim "desirable" traits like "creativity" and "giftedness" as autistic traits, but claim that "undesirable" traits like depression and intellectual disabilities are just "comorbids," you're just being ableist.
If your neurodiversity isn't for everybody, it's useless. If your "autism acceptance" is only for autistic people with no learning disabilities, psychiatric disabilities, dyspraxia, seizures, gastrointestinal issues, or autoimmune disorders, who is it even for?
Not all autistic people have all autistic traits. But there are traits that tend to cluster in the 1-2% of the population that is called "autistic" vastly disproportionately to the general population. Later than average speech development, physical hypersensitivity and hyposensitivity and general sensory-input brain weirdness, hyperfocus/ intense special interests, heightened anxiety, learning disabilities, migraines, enhanced pattern recognition, seizure disorders, flat accents, moderate trouble with allistic people's nonverbal communication, dyspraxia, and digestive sensitivity are all autistic traits. Not all autistic people have all of these traits! Not all people with some of these traits are autistic! (But if you have all of these traits... you're probably autistic.) They might be great or they might be terrible or they might be neutral, but they're who we are, so can we stop pretending they're something else?

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