I see the renowned simon baron-cohen is at it again with an editorial urging people to embrace the concept of neurodiversity. Many years ago, SBC wrote another article in which he stated that high functioning autism (as opposed to low functioning autism) should not be considered a disability, except when the person is applying for SSI or some other disability benefits in some sort of bizarre Orwellian double think. In the new essay, he's changed his tune a bit, stating that though autism (including high functioning) should be considered a disability, it should not be considered a disorder. He repeats the statement from his first piece that autistic versus non-autistic is no different than left-handedness versus right-handedness.
This is an individual who has espoused the controversial assortative mating theory of autism claiming that autism was only rare until the advent of the IT field when male and female computer nerds starting meeting each other. After having offspring, these nerds managed to populate the world with autistic people at such a fast rate the prevalence went from 1 in 2,500 to 1 in 68 in just one generation.
Even more bizarre is the fact that he claimed in his article about autism, talent and hypersystematizing that among the great superior skills that autistic possess is a visual acuity equal to that of birds of prey. This was based on one study done by someone named Ashwin who worked in Baron-Cohen's lab and SBC himself is one of the secondary authors. It turned out the whole thing was just an error on the researcher's part in using the optometric equipment to assess the visual acuity (assuming it was not outright dishonesty by the researchers). The optometrists who designed the test refuted what SBC's group said by showing they did not use the equipment properly and the group had to concede they were in error.
We also have to judge the good doctor by the company he keeps: The individuals whom he consulted with and gave him the ideas behind his first piece include Temple Grandin, who insults and shames autistics who can't work and insults their parents, David Andrews who is abusive and profane to anyone who does not agree with him and the self-diagnosed Lianne Willy.
For the above reasons, we must take with a grain of salt what this essay may say, but I'd like to dissect it anyway.
He uses genetics stating that though 12% of autistics have de novo mutations that almost 50% of the genetics of autism involve common inherited variants. In at least some of the studies I've read, including those from Jonathan Sebat and Michael Wigler and with personal communication with one Dan Geschwind, the rate of autism involving spontaneous mutations is significantly higher than that, possibly between 20-30%, though a substantial amount of autism does come from common heritable variants. According to Sebat, the number of de novo mutations is likely underestimated due to the fact that the instrumentation to detect them still has limited power and it is likely more cases of autism arise from de novo mutations than have already been found.
SBC cites an article by Huguet et al stating that almost 50% of genetic association with autism comes from common variants and states that these are not disorders but rather natural genetic variation. SBC ignores the part of the article where they state that environmental factors are 38% responsible for autism, so this goes against the idea of natural variation. SBC conveniently ignores the research showing a much higher prevalence of autism in DZ twins than in non twin siblings who have the same genetic makeup. He also does not address the fact that autism has been associated with Thalidomide, acetominophen, pre-eclampsia, cocaine, and other environmental factors. This suggests that autism is not a natural variation.
Baron-Cohen cites a variety of neuroanatomical studies showing that certain brain areas are either larger or smaller in autism and this is not a sign of disorder. Also the fact that there are more neurons in the frontal lobe in some studies on autism.
He neglects to cite work by Bauman and Kemper who have found smaller numbers of neurons in parts of the cerebellum and hippocampus which would point to a neuropathology, i.e. a disorder.
More germane, he does not mention the work of Wegiel who has found heterotopias in post mortem autistic brains as opposed to controls. Heterotopias occur when during fetal development germinal cells which are developing into neurons fail to migrate to their correct spot and are misplaced in the brain. This causes dysfunction and often seizure activities. This is likely why seizure disorders occur in as many of 30% of autistics. Heterotopias in the brain are analogous to an inguinal hernia where the testicle is out of place or an ectopic pregnancy in which the fetus is not in the correct position. There can be no question at all that this is a disorder and not a difference as SBC insists.
SBC and other NDs state that epilepsy is a co-morbid condition along with autism, but is not autism itself. I'm curious how neuroanatomicaly, they can separate the parts of the brain which are just autistic and do not give rise to seizures. The fact that autism is associated with seizures is significant and you cannot separate the two as SBC and other NDs attempt to do.
His next argument that autism is not a disorder is the fact that autistics, as a group, do well, on the block design portion, of the Wechsler IQ test, showing their aptitude for hypersystemitizing and how things work. This is one argument that people use to claim that autistics have the aptitude to do certain jobs such as software testing and all of the BS pieces claiming they make great employees.
While it's true that autistics as a group do well on block design, or at least better than on other portions of the IQ test ,and this is a widely replicated finding, it's not true of all autistics. I'm one of them. I have a scaled score of 4 where 10 is average. So I'd be mentally retarded if I scored this low on all of the subtests.
Though autistics do at least comparatively well on the block design test, they do poorly on the comprehension subtest of the Wechsler. This is where they are asked common sense questions such as what would you do if you found a stamped envelope on the ground or if there was a fire in a movie theater. I also do poorly on this test though better than on the block design. This is very relevant to the problems of autistics on the jobs and in other social areas as it reflects impairments in social judgment where they would say something offensive to a boss on a job and get fired or this would make people not like them if they had a poor social understanding in other areas. Baron Cohen does not go into why a good aptitude for block design means autism is not a disorder, but a poor score on the comprehension subtest does not mean autism is not a disorder.
Lastly he claims that a disability is different than a disorder because a disability can be properly accommodated for, but not a disorder. Though he stated in 2000 that high functioning autism is not a disability, he stated in this second piece that if a person with autism does not show a disability he should not be diagnosed as such. He gives the comparison that if a fish had to climb a tree it would be considered disabled. He claims that autism should not be considered a disorder because they could function well in the correct environment. But does not go into any of the details of how this could be done. I'm still waiting for SBC or any other member of the neurodiversity movement to state how autistic disability can be accommodated for, legally or otherwise, so they could function as well as a non-handicapped person. SBC seems very short on ideas in that area, but if he has any suggestions, I'd be glad to hear them and he should explain how autism can be accommodated for so that it would cease to be disabling.
Though I'm more severely autistic than Temple Grandin, John Robison, Mike Carley, and others, I'd be considered pretty high functioning by most standards. If Baron-Cohen had autism to the extent that I have it, he never would have been able to go to graduate school, become a psychologist and college professor, never been able to write his books and get them published, marry his wife, and have his three children. If that had been the case I can't help wondering whether or not he'd still consider autism as not being a disorder.
No one should take this man seriously. He should not receive research funding or be a licensed clinician if he is one already. I get so tired of hearing SB's BS.