Friday, January 06, 2012

Disorder or diversity?

Whether neurodevelopmental 'disorders' such as autism/Asperger Syndrome, Tourette Syndrome and obsessive compulsive behaviours (e.g in OCD) and ADHD are medical conditions or illnesses in the strictest sense is not easy to discern. It can be argued that they are no more illnesses than the traits of a musician who studies obsessively to perfect their art, a gifted ballet dancer, a brilliant theoretical physicist who works ardently seeking an elusive boson, a highly-driven explorer or political campaigner, a geek, a very shy person, an entomologist, a raconteur, a monk, a pot-holer etc. We are all different and these characteristics certainly cannot be tested for in very early childhood. In the same way there are no effective tests or investigations for ASD, TS or OCD at any age or even any yet credible 'mechanisms' to explain the so-called 'morbidities' which are commonly cited as being characteristic of these disorders. What is apparent is that these are spectrum conditions and that there are no universals, with some individuals being impaired to an extent that their ability to function, in carrying out some of the essential activities of daily living, is disordered. A disorder, clinically, is an affliction that does just that. However a large proportion of individuals will be able to function at a high level or may even have enhanced qualities. Their principle challenge in life comes from intolerance and sometimes downright bullying by their peers. In other words it is not they who have the problem, it is other people. Those who are unable to accept them, see past their 'disorder' and open their eyes to the real person who wants nothing more than inclusion and a chance to show what they can do. 

Some would argue that most 'sufferers' are just part of the diversity of mankind and that it is arrogant or discriminatory to label people as being autistic or Tourettic as it assumes there is such a thing as normal. Those thus labelled often turn the tables by referring to others as 'neurotypicals'. Often the term neurotypical becomes a derogatory response to those who are seen as judgemental or intolerant in much the same way as people may be subject to prejudice and even exclusion for having a different skin pigmentation or hair colour. The clinical approach to these disorders mostly defines by symptoms which are seen as abnormal and the perceived disabilities caused. In contrast many who have been medically-labelled for life with such 'disorders', come to resent the inference that they are, and always will be, restricted, impaired or disabled and stress that there are many positives or that they could effectively compensate for any disadvantages if only permitted tolerance, understanding and given a chance. Some characteristics may actually confer an advantage.