Volume 1. No. 1 |
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Artwork Lyte |
October 11, 2012 |
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Abstract: This paper critically analyses the use of
normative social scientific principles in the treatment of autistic people
and utilises the concept of psycho-emotional disablement (Reeve, 2002,
2004), to suggest that such a dominant normalising agenda has led to the
silencing of the autistic voice in knowledge production and community
awareness. Reflecting upon the
researchers own insider situated knowledge, and findings from a number of
pilot studies conducted in the course of a doctoral research programme, this
paper examines the insider/outsider positionality of parent and self
advocates within the autistic community, before challenging the legacy of
Lovaas and recent attempts in Britain to modify such techniques. The paper finishes with a reflection upon
how such measures have led to the further disablement of autistic people and
their subjective lifeworld. This paper also includes a contribution
from Lyte, who is an individual who I have met recently in the course of my
studies. As an emerging voice
regarding neurodiversity, Lyte puts their own point of view to some of the
issues that have arisen in the course of my research and are highlighted by
this paper. Key words: Autism, Behaviourism, Normalisation, Psycho-emotional
Disablement, Voice. Positionality, and situated knowledge, or a case study in
psycho-emotional disablement? |
The normalisation agenda and the
psycho-emotional disablement of autistic people.
By Damian Milton and Lyte
For some years now, I had been meaning to write a deconstruction of the
theoretical rationale and practice in the application of Applied Behavioural
Analysis (ABA) as an early intervention for the treatment of autistic
people. Yet, I had then realised that in
order to do so I needed to look deeper into the issue. In order to explore the issue further, a
review of the philosophical underpinnings of the normalisation agenda whether
implicitly or explicitly manifested in the treatment of autistic people was
needed. Followed by the highlighting of
the disabling effects this agenda has had on the invasion and occupation of the
autistic lifeworld.
Before I was diagnosed myself, I had been a budding sociologist. Early in my career I had been interested in
the Sociology of Health particularly mental health, having been misdiagnosed by
several psychologists as a teen. I was
also interested in the classic theorists of the field such as Emile Durkheim,
often cited as the founder of Functionalist sociology. In teaching first-year undergraduates
Durkheims sociological theory of suicide, it occurred to me that Durkheim had
made a fatal mistake. He had assumed, as
had the later Functionalists such as Talcott Parsons, that consensus in society
lay in the stability of social norms and the dominant value system. Deviation from the said norm was deemed
pathological, leading to anomie, and even suicide due to a lack of moral
regulation and also social isolation.
Having known a dear friend (who I now suspect may have also been on the
autism spectrum herself) commit suicide a few years previously, I thought that
it wasnt her inability to fit into society that drove her to suicide so much
as it was societys inability to adapt to fit to her needs as an outlier from
the norm. Indeed, attempts at
normalisation and focusing upon her weaknesses did little to help her.
So what was Durkheims mistake? He
assumed that people were healthiest when normalised, this reification of the
norm was then to become formalised into healthcare practices with the adoption
of models such as Talcott Parsons Sick Role (1951). Parsons was a great believer in equilibrium,
but what if the outliers natural state of equilibrium was something or
somewhere else? What about hermits I
thought, did they really want to be socialised?
What about anarchists? Is their
natural equilibrium to be morally regulated and socially controlled by
outside agencies? Perhaps not I
thought. Indeed, people (like me) who
were outliers occupied diverse positionalities within society, each with their
own dispositional equilibrium. More than
that: attempts to normalise people through behaviourist means or any other, would
send them into disequilibrium and a state of personal anomie and possibly
rather than leading someone away from a state of mental ill-health, be actually
leading someone toward it. It was only
fairly recently following my sons diagnosis and then my own as being on the
autism spectrum, that I discovered that what I had been theorising about all
those years ago, was neurodiversity and the psycho-emotional disablement
(Reeve, 2002, 2004) that autistic people had suffered at the hands of the
normalisation agenda (Arnold, 2010).
What is even clearer to me now, is that my own lack of awareness of the
neurodiversity movement was a form of disablement in itself.
Lyte:
Roughly 6 years ago after a lifetime of not belonging I finally figured
out where to go to get tested in my efforts to discover what had always been
clear to me: that I was not able to learn or even think in the ways everyone around me (including family) seemed to
demand and expect of me. There was initial reluctance to believe the
need for tests because I had scraped by, by doing my best to appear
normal. I knew I was doing this, and
that I had unrealised intellectual and creative potential and it was causing me
indescribable misery but I could see no alternative. I had to survive somehow in a culture I
simply could not make sense of despite what the tests then revealed as a rather
high level of intelligence (much to my amazement). Once the process of my search revealed
triangulated evidence that I was made or had grown in a way that is not
typical, I hunted for support, which came after a great deal of searching,
from a thin thread that became thicker as I sought my way blindly towards the
Neurodiversity (I prefer the term Neurodivergence) movement, where I rapidly
realised I belonged.
DM:
There is much current debate regarding the terminology related to
autism. This project will resist people
first phrasing, however in accordance with other autistic voices (Sinclair,
1993; Sainsbury, 2000):
We are not people who
just happen to have autism; it is not an appendage that can be separated from
who we are as people, nor is it something shameful that has to be reduced to a
sub-clause. (Sainsbury, 2000:12).
The descriptors of autistic person/people and autistic spectrum
will be used, and the use of the terms Autistic Spectrum Disorder/Condition
(ASD/ASC) avoided, unless referring to the arguments of other researchers, due
to the medical model connotations associated with these phrases and the
offense that they may cause.
Perceptions of
diversity and the parent/self-advocate divide
The definition of what autism is has gone through a number of changes
since the original formulations of Kanner (1943) both in official diagnostic
criteria and personal narratives, with an ever-increasing number of autistic
narratives joining the public discourse.
The dominant model of definition however, is the medicalised model of
diagnosis based upon the observable behavioural manifestations of the triad of
impairments, leaving those with better strategies at passing as normal as less
likely to receive a diagnosis based on a Galtonian normative deficit model of
pathological difference. A simplistic
yet less deficit based categorisation of autistic types is also given by Wing
(1988): passive, aloof, and active-but-odd.
These loose categorisations are not exclusive though. It is somewhat useful in highlighting to
practitioners that not all educational practice regarding autistic people is
about managing challenging behaviour.
Another popular distinction is that of low and high functioning
autistics. This categorisation is
somewhat of a misnomer given the uneven spiky cognitive skill profiles that
autistic people tend to show, and also leads to the underestimation of the
abilities of the low functioning and an often over-estimation of some of the
abilities of the high functioning, and thus, is somewhat of a disabling
narrative. All differences are subsumed
into the further distinction of the non or pre verbal and the verbal,
placing primacy of ability and categorisation on the formation of functional
communication (as defined by a non-autistic outsider positionality). A similar argument can also be used against
the distinction often made between severe and mild forms of autism. It would seem that the current narrative of
many cognitive psychologists and scientists is to talk of a cognitive
difference and spiky profiles, however there is still a tendency to locate
challenges that autistic people face within individual cognition, while largely
ignoring the social context within which such constructions are made and
practised.
Such concerns inevitably lead one to a discussion regarding the dominant
medical model of disability (and autism) and the social model. Many theorists have questioned the applicability
of either in their respective extreme forms, but much like the nature vs.
nurture debate, narratives tend to arrive at a preference for one or the other
(or some odd contradictory position being taken up). Taking a phenomenological perspective, it is
argued here that identities (including autistic ones) are the reflection of
embodied lived experiences constructed within the confines of historical and
cultural positionality, with the autistic positionality representing an
outlying dispositional personal equilibrium.
Some suggest that people such as myself could not have insight into my
own sons autism, due to my own autism being so qualitatively different to
his (deemed low-functioning), yet I could have an insight into it purely by
being his parent (according to the arguments of some parent advocates, Jager,
2010), however my son and I also share many similarities. Both of us utilise a monotropic
interest/attention system and are detail-focused, both of us have a high
sensitivity to sensory stimuli and are creatures of comfort, and both of us
like open natural spaces. My son and I
love music, gadgets, and are clumsy, we even have a similar taste in
food. What we perhaps share most
strongly however is an autistic dispositional equilibrium of dynamic quality
(Pirsig, 1991, Milton, 2012), a different embodied habitus (Bourdieu, 1977), a
consciousness dominated by a perceptual being in the world (Schutz 1967).
The dynamic quality of the autistic person however, is constructed from
the outside as a pathological deficit, particularly by theorists and
practitioners utilising a Durkheimian/Galtonian idea of positivistic social
science, but also by many parents (particularly those of children deemed
non-verbal), and even some self-advocates, who could be said to have
internalised the negative semantic connotations of this ideological labelling
process in a self-fulfilling prophecy (Becker, 1963). Many parents new to having discovered that
their child has been labelled autistic also seek out any and every treatment
and intervention in an attempt to help their children in a you cant rule
it out approach (Milton, 2011b), whilst others become advocates on dubious
practices such as ABA as it worked with their kid, and they believe in what
works (Maurice, 1993, Jager, 2010).
Such phenomena leave both autistic people and their families at the
mercy of a vast and exploitative autism industry:
...the whole ABA
movement appears increasingly more like a cult than a science: there is a charismatic
leader, a doctrine, a failure to engage with criticisms, inquisition and
denunciation of any who criticise (however mildly), misrepresentation of
critics, and proselytising exercises to gain more converts and spread the
word. (Jordan, 2001, cited in Fitzpatrick, 2009, p. 141).
One of the earliest inklings that I was not alone in my theorising came
from my first reading of the seminal essay Dont mourn for us (Sinclair,
1993). This essay ably depicted the
bereavement process in the becoming of an autistic childs warrior
mum. It would seem to me that the
normalisation agenda of dominant models of autism, not only disable the
autistic person, but also their parents.
The legacy of
Lovaas
How one perceives
autism naturally leads to a perception of what is considered best with regard
to educational practice. One of the most
prevailing trends is that of the notion that the most important educational
period in an autistic persons life is pre-school and the first few years of
school. This discourse has produced an
ever-growing range of early interventions.
It is interesting to note how this emphasis is at a time when the
autistic person themselves has no say in the matter. These methods, although aimed at early
childhood development, have also been used by schools throughout the curriculum
and have also been applied to adult services.
ABA (being the most popular of these methods) developed through the work
of Lovaas (1987), and is supported by many practitioners (TreeHouse, 2010),
theorists (Hewitt, 2005, Brock et al., 2006), and parents (Maurice, 1993), yet
other theorist and practitioner literature either places it on a par with other
approaches (Jones, 2002), or suggests that it is a flawed approach (Jordan,
1999).
Positivist social science
uses a narrow band of criteria to judge the validity of claims to
knowledge. Ontologically speaking, it is
argued by Positivists that there exists regularities in the social world that
can be observed and measured; that researchers can distinguish between value
judgements and factual statements; and so in epistemological terms, knowledge
is seen to be empirically testable.
Positivist research is thus aimed at the nomothetic and universal rather
than the idiographic and particular.
Outhwaite (1987) states how the traditional scientific method employed
by this hitherto dominant paradigm, derived from three generations of
philosophical thinking: 19th century writers such as Comte and
Spencer, Logical Positivism (e.g. Ayer); and Hempels emphasis on value-free
evidence to support policy making.
Deeply entrenched in this position, is the Behaviourist paradigm
employed by Lovaas (1987); who attempts to utilise the theories of Skinner
(1953) and apply them to the education of autistic people. The tenets of Behaviourism suggest that
objective empirical knowledge can be produced from direct observation of human
behaviour, whilst invisible entities are rejected.
Lovaas (1987) defined
autism by first referring to Kanners (1943) original definition, before citing
his own research (Lovaas, Koegel, Simmons & Long, 1973) and suggested this
provided a more complete behavioural definition. Lovaas (1987) argued that a behavioural
definition was the most that science could provide, as the neurology of autism
was not known. The ontology of autism,
for Lovaas (1987), suggested that autism was a chronic disability without a
known cure, defined by pathological behaviours that deviated from the
psychological norm. The aim of the
intervention being to make autistic children indistinguishable from their
peers.
Lovaas (1987)
referenced Lotter (1967) in suggesting that higher scores on IQ tests,
communicative speech, and appropriate play were prognostic of better
outcomes. This notion led Lovaas (1987)
to argue that early behavioural intervention for improving IQ scores would help
the long-term outcomes for autistic people.
Due to the lack of evidence to support medical therapies, Lovaas (1987)
suggested that the most promising treatment for autistic persons is behaviour
modification as derived from modern learning theory, citing DeMyer, et. al.
(1981).
For Lovaas (1987) the
ontology of autism was that of the disordered and damaged other, as having a
retarded IQ and not capable of normal functioning, leading to a poor
prognosis and a dysfunctional individual (possibly with negative associations
of an impact on normal society).
Behaviourist treatment was put forward as the only effective treatment
available to improve the outcomes for this disordered group.
The conceptual basis
of the treatment was reinforcement (operant) theory...Various behavioral
deficiencies were targeted, and separate programs were designed to accelerate
development for each behavior. High rates of aggressive and self-stimulatory
behaviors were reduced by being ignored; by the use of time-out; by the shaping
of alternate, more socially acceptable forms of behavior, and (as a last
resort) by delivery of a loud "no" or a slap on the thigh contingent
upon the presence of the undesirable behavior. (Lovaas, 1987, cited at
neurodiversity.org, 2009).
By the targeting of
behavioural deficiencies, Lovaas (1987) assumed that there was a normal way
to play with toys (following prescribed function of design) and that
self-stimulatory behaviour was in need of modification and was thus framed as
pathological:
it is difficult to
distinguish low levels of toy play (simple and repetitive play associated with
young, normal children) from high levels of self-stimulatory behavior (a
psychotic attribute associated with autistic children). (Lovaas, 1987, cited
at neurodiversity.org, 2009).
The ontological status
of stimming was thus seen as a deeply pathological psychotic behaviour. Stimming (self-stimulation) is a commonly
recognised behavioural feature of children on the autistic spectrum, the
function of which is highly contested (Sainsbury, 2000); yet attempting to
modify a behaviour that provides comfort for autistic people could lead to
upset, confusion, and a breakdown of trust with the therapist. Lovaas (1987) therefore assumed the existence
of social and behavioural norms consensually agreed upon (for example: not
obviously stimming in public), and furthermore, that deviance from these norms
could be classed as pathological and in need of remediation. A worrying ontological issue is that at no
point did Lovaas (1987) identify an ethical dilemma with the use of aversives.
In fact:
In the
within-subjects studies that were reported, contingent aversives were isolated
as one significant variable. It is
therefore unlikely that treatment effects could be replicated without this
component. (Lovaas, 1987, cited at neurodiversity.org, 2009).
Lovaas (1987) suggests
in the above passage that long-term behavioural change is not likely to be
attainable without the use of aversives.
Despite this recommendation, current
Considerable effort
was exercised to mainstream subjects in a normal (average and public) preschool
placement and to avoid initial placement in special education classes with
detrimental effects of exposure to other autistic children. (Lovaas, 1987,
cited at neurodiversity.org, 2009).
In the above passage,
Lovaas (1987) represented autistic people as having a detrimental effect on one
another. One can only presume that what
he meant by this comment, was that if autistic children are not exposed to
normal children, then they will not be able to model behaviour on their
appropriate actions. One could also read
this discourse as suggesting that autistic children could learn pathological
behaviours from modelling behaviour on one another.
IQ and school
placement were seen by Lovaas (1987) as comprehensive, objective, and socially
meaningful measurable variables. Lovaas
(1987) invoked the positivist mantra that objective social / psychological
facts are not only measurable, but the only meaningful data concerning social
science research. Analysis of subjective
narratives was viewed within the Behaviourist paradigm as beyond measurement,
so no data was collected on the views of the children (after follow-up) or the
parents. Also, the reasons why two of
the families involved in the experimental group withdrew from the study were
not explored.
By using a
Behaviourist paradigm, Lovaas (1987) was presuming that the human brain is a tabula rasa (Locke, 1690) that develops
through conditioning of behaviours from reactions to rewards and punishments in
the social environment. By offering
educational interventions as capable of producing normal functioning, Lovaas
(1987) was seriously underestimating the biological conditions that influence
the expression of autistic behaviour patterns and the difficulties that
autistic people with normal IQ measures and educational placements can have
with their impairments and with the social expectations and structures imposed
upon them (Sainsbury, 2000).
Challenging
Behaviourism
Positivism is dead. By now it has gone off and is beginning to
smell. (Byrne, 1998:37).
Despite positivisms many critics, it is still
the dominant ideology informing what is deemed good evidence-based practice in
health and educational policy. The power
embedded in the knowledge produced by research based upon positivistic
ontological and epistemological axioms can profoundly affect the lives of those
being researched, especially when those being researched are a recognised
vulnerable and marginalised group within society with little political voice of
their own. Increasingly, positivist
social science has been led by ideas of falsification and the predictive power
of theory, as standards for judging the production of knowledge. The question should be asked however, can the
practice of ABA reach such lofty intentions?
In order for debates on the education of autistic people to move
forward, a researcher must move beyond the objectifying gaze of the scientific
tradition to be truly participatory with those they seek to produce knowledge
about.
The critics of
Nadesan (2005) argues that ABA has many methodological shortcomings and
practitioners and theorists tend to exaggerate its benefits, yet have much
potential to shape the development of autistic children (for better or worse),
producing certain kinds of subjects requiring professional surveillance and
intervention. She argues that in such an
instance biolooping (Hacking, 1990, 2009) is inevitable, but may be difficult
to identify and predict.
Given the dangers of [ABA] inappropriate early diagnosis, the lack of
replication, the lack of specificity, the ethically and culturally questionable
nature of the treatment and its impractical and expensive nature, like all
other treatments that have claimed to be specific to autism, it has failed to
establish itself as a definitive treatment. (Timini et al., 2011, p. 204).
Lyte:
Do autistic people
have the status of being human? It is
my view that Behaviourists think I have to do something to be human, or that
I am not intrinsically okay. The idea
of human that they hold has been toxic and limiting to me and my inner
spirit, to the me-ness of me. It dumbs
down all my gifts and renders me disabled.
It cannot be otherwise: that which makes me the gifted, sensitive,
perceptive, creative, original and intelligent being that I am, is, by their
processes of trying to turn me into something I am not, yanked and wrenched as
though my guts are being pulled out of me: and thus suitably disabled, enables
the breaking of my spirit, just as surely as one would do with breaking-in
horses. I became a frightened passive
prisoner in a world I was alienated from by their violent attempts to avoid
seeing who I really was and what I may contribute to humankind. A lifetime spent aping a socialised human
in a despairing attempt to substitute for my lost autonomy and spirit, but now
with little available ability to express my experience of the world and the
gifts of my own humanity. Luckily I
was not subjected to ABA. I expect they
may have broken the very spirit that I have managed by the skin of my teeth to
honour and defend, though there are times when my human need to belong, to be
loved and be respected for who I am was so profoundly and deeply unmet that I almost
caved in - almost making that Faustian deal.
Skinner whose heart I believe was in the right place, seems to have had
little insight into what makes a self, or preferred not to look at these issues
since he was firmly entrenched within a positivist-behavioural paradigm in
terms of theorising only upon measurable function i.e. behaviour.
The re-branding of
behaviourism
DM:
Perhaps the best exemplar of current
What distinguishes
It is argued here however, that what distinguishes ABA is a Galtonian
view of psychological normality and deficit, although Skinner (1953) could be
said to have used a Wundtian methodology, and that the environment and the
causes of behaviour are extremely narrowly defined, although this can vary in
practice due to the practitioner.
Behaviour analysts use principles of learning and laws of behaviour that
have been scientifically demonstrated, and use clearly defined procedures to
specify how to change behaviour. The
primary focus of
The laws of behaviour may well have been demonstrated successfully on
pigeons in controlled experiments (Skinner, 1953), yet they have not been so in
the education of autistic children (Magiati et al., 2007). The continual use of a narrative of support
from a scientifically [proven] evidence-base is confidently stated without
question by ABA advocates, when the evidence for its effectiveness, even by the
measurement standards of its own supporters is virtually nil. The above quote also highlights the primary
focus of behaviourism: behavioural change or modification. Despite protestations that this no longer has
anything to do with normalisation, who exactly is defining what is appropriate
behaviour, or which behaviour enables (or disables) the autistic person? This is not a mutual contract between equal
partners in an exchange, but a power relationship and imposition from an
outsider perspective and positionality.
Lyte:
They judge me on the bit they can see and what they are able to see
sadly will itself be limited by their own conditioning, which appears in
concepts such as that of normal. I
feel and I am in touch with my inner self despite the internalised violence and
applied violence implicit in a conditioning process that is concerned with
trying to pass me off as normal. Thus
I have to question who the beneficiary of such an intervention is. I can affirm that a great part of my life has
had to be concerned, at incalculable personal cost, with the literally vital
need to reclaim my disempowered self. I
recognise the extent of my personal courage and valour in following this
essential quest in the face of a largely uncomprehending social structure and
those who regard normal as equivalent to healthy.
DM:
In the ABA framework (2011), it is stated that the ethical principles and
values of ABA practitioners are in common with other helping professionals,
and that there is the priority not to cause harm, however the definition of
harm can be a contested one, particularly from those of differing social and
neurological positionalities. Like the
behaviourists that came before them, there is also the point made of: being
ambitious of what is possible for someone to learn, without setting limitations
based on someones disability. This is
fine in one context, but not if perceived as ones disability (or rather
neurological diversity) not impacting upon the way someone learns, or how such
a diverse positionality may give someone propensities to succeed in certain
cognitive capacities. One of the best
principles offered by the ABA competencies framework is that of building upon
an individuals interests and preferences in the facilitation of learning,
although one needs to develop strengths in their own right, and not just as a
way of minimising difficulties. Although
the stated principles of the framework also recognise that learning is a
lifelong process, this statement is linked to one concerning skills in all
areas of life. It must be acknowledged
however, that not all learning is the attainment of measurable skills by sets
of criteria.
One can see that ABA theory and practice has moved on from the days of
Lovaas, but as a theory and method for educational practice, it still has just
as many flaws as ever. It was suggested
to me recently by a behavioural therapy specialist (Talakaboutautism.org, 2012)
that maybe what was needed was to re-brand ABA to reflect the changes that it
had gone through. I replied that if one were
serious about investigating the cognitive and social factors of the education
of autistic people and not just their outward behaviour (as a main focus and
priority), then it would no longer be the science of behaviour as proposed by
Skinner (1953) and ABA theorists since, but a model of applied
bio-psycho-social analysis (ABPSA).
This, if it were to acknowledge the value of the autistic voice in
knowledge production regarding autism, would be a model that I could
potentially adhere to, yet this was not an exercise in re-branding but an essential
theoretical and discursive change in focus - ironically from the restrictively
narrow to the broad and eclectic.
The
psycho-emotional disablement of autistic people and the raising of a
revolutionary consciousness
Lyte (in personal communication
with DM):
I can 'get a bit lost' to who I am, when I am in too much contact with
neurotypical people. Im not strong
enough yet to be 'who I am', so I conform and 'act' and then feel horrible
inside and get exhausted and worried because then I get told 'who I am and what
I am or am not capable of. I still have
too much self-doubt, but I do think I have more hope now there are more
like-minded advocates amongst us, or at least, I am more aware of them.
DM:
Reeve (2002, 2004) utilised the Foucaudian concept of technologies of
power to investigate the way society reinforces psycho-emotional dimensions
of disability, and the way in which the medicalised self-surveillance of
ones own body left people feeling worthless and unattractive. Reeve (2002) also states however, that
disabled people were not just the passive victims of a dominant and disabling
discourse, but exercise personal agency and resist. Interestingly, she likened the process of
resistance to negative stereotypes to a process of coming out, mirroring a
term often used within the neurodiversity movement. Reeve (2002) frames disabled identities as
fluid, and representing diversity of phenomenological experience, rather than
situating personal identity within an essentialist paradigm.
Within the dominant discourse of the medical model of autism however, the
autistic person is framed as being incapable of self-surveillance, a
potentially dangerous individual lacking in empathy, and in need of external
and potentially coercive techniques in order to manage and control their
challenging behaviour, albeit with the caveat of attempting to instruct the
autistic person to be able to manage their own behaviour more
appropriately. The autistic person is
thus constructed within this discourse as having no agency and simply the
subject to be worked upon, to be socialised as best one can, so that one can
pass as normal in the adoption of the rehabilitation role
(Safilios-Rothschild, 1970). It is of no
coincidence one fears, that the silencing of autistic voices on such matters,
coinciding with the focus on early intervention before the individual is able
to consent to the intervention, leaves one at the mercy of those who would
financially exploit the situation.
Autistic people are certainly left with an uphill battle regarding their
sense of self-worth, often separated from the one thing that can give them a
more positive perspective: the neurodiversity movement. One cannot come out when ones own culture
is still publicly in the dark. Attempts
at such humanist self-actualisation and combating the damaging effects of
alienation and anomie are thus hampered, often leading to problems in living
and mental ill-health (Milton, 2012).
Reeve (2004) suggested that psycho-emotional dimensions of disability
constitute a form of social oppression, operating at both a public and personal
level, affecting not only what people can do, but what they can be. Reeve (2004) categorises the dimensions of
psycho-emotional disablism into three main areas: responses to the experience
of structural disability, in the social interaction one has with others, and in
internalised oppression. These issues
can be particularly marked in a marginalised group stigmatised by their
differences in social interaction itself (
...emphasis on the barriers out there, has the rather ironic
consequence of leaving aspects of social life and social oppression which are
so keenly felt by many disabled people (to do with self-esteem, interpersonal relationships,
sexuality, family life and so on) open season to psychologists and others who
would not hesitate to apply the individualistic/personal tragedy model to these
issues. (Thomas, 1999, pp.74).
It is this personal tragedy model and resultant normalisation agenda,
supported by some of the worlds largest autism charities, and the resultant
need induced in parents of autistic people to behaviourally modify them, that
has done most to disable autistic people living in society today, many of whom
remain undetected by those who would potentially provide them with support,
i.e. the neurodiversity movement.
Society's played him a terrible trick, and sociologically he's sick
(West Side Story).
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on
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