Neurowars

By: | October 4, 2018

Last week, someone posted a notice for a new meetup on Twitter.

Not really an announcement anyone could take exception to. Until someone did:

“This neurodiversity business is getting a bit out of hand IMHO,” wrote the neuroscientist and writer Mo Costandi, quote-tweeting the announcement.

If you find yourself bracing for impact, you are correct.

Things went pretty much the way you’d expect. A posse was summoned, outrage was ginned up, motives assigned – most participants interpreted Costandi’s tweet as an attack on autistic or queer people. Characters were assassinated, and qualifications impugned: internet sleuths showed up with unsourced oppo research claiming to unmask Costandi as “a high school teacher and a security guard” rather than a credentialled neuroscientist (N.B. he is a neuroscientist). Costandi rolled up his sleeves and responded in kind.

I barely have any business writing about this. My unseemly Twitter rubbernecking stems from the fact that as science writers, Costandi and I travel in adjacent circles. Why was this person, whom I’ve known to be rational in other contexts, choosing this incredibly unreasonable hill to die on? Was he having an Elon-style publicly-traded nervous breakdown?

He wasn’t. In tweet after tweet, Costandi insisted that he was not attacking people who identify as queer, people with autism, or anyone who wanted to attend that meetup. Rather, he was going after its organiser, a proponent of the idea that autism is not a disorder to be cured.

And that’s how I fell down the rabbit hole of an argument that has been raging for years, one that I had no idea existed. At issue is an intriguing question: is it time to rethink “disorders” – including autism, bipolar, and schizophrenia – that have traditionally been dismissed as precluding people from having agency and serving a useful purpose in society? A growing number of people say we should instead redefine these disorders as valid, alternative ways of experiencing the world. Including them could even improve society itself. So, they say, it’s time to adapt society to these differences instead of forcing people with these differences to adapt to society.

For autism in particular, this transition has been under way for several years. A diagnosis that once disqualified you from engaging with civic society – because too many accommodations would have to be made to fit you into a workplace that had been tailored to neurotypicals – is transforming into a highly sought-after qualification in some workplaces.

There are special employment agencies you can consult if you want to hire someone who is autistic. A few years ago at a conference on autism technology in Manchester, I spoke with a woman who runs an outfit that matches people on the spectrum who are seeking jobs with employers. She told me about one particular employer with whom they had placed candidates. He runs a guitar shop in an underrated corner of northwest England called the Wirral. The skills he needed in an employee overlapped with skills people with autism have been known to possess: “A lot of autistic people are good at digesting a lot of information, or learning a lot of information about a certain topic,” Anna Remington – head of the Centre for Research in Autism and Education at University College London – told Clare Wilson in a recent interview with New Scientist. “They are very focused.”

These benefits do require some accommodation. The guitar shop owner got rid of fluorescent lighting (whose hum some with autism can perceive as maddening). He put up detailed schedules and stuck to them punctiliously. He minimised ambient noise. But he said these accommodations were minor compared to the returns. After having worked with people on the autism spectrum, he said he was no longer interested in hiring the people we refer to as neurotypical. Autistic people don’t show up late. They don’t waste time on small talk. They focus on the details. They get the job done.

Those benefits extend far beyond making guitars. “People with autism tend to be really good at identifying mistakes and sensing patterns – a very good match for software testing,” SAP spokeswoman Robin Meyerhoff said in 2013. The company had just reported great success employing people with autism in India as software testers – a pilot program that went so well that SAP immediately set a goal of expanding its autistic workforce to 1 percent of the company’s global workforce.

But I didn’t realise how far “autism as an advantage” had come into the mainstream until earlier this year when I saw Dame Vivian Hunt, a partner at global management consulting behemoth McKinsey & Co, telling the Knowledge Quarter conference that the company’s goal is to get 10 percent of their labour force from the autism community. She pointed out that surrounding yourself with people who have different perspectives – if they are properly respected and integrated – can help to insulate companies against crises borne by heterogeneous workforces. Crises like, for example, the 2008 financial crisis (a large body of research has examined the major role played by “functional stupidity”, the massive blind spots that result when everyone in a team looks at the world from the same perpective, blinkered by the same unchallenged cognitive biases).

This is well and good for people whose experience of autism is comparatively easy to integrate into neurotypical society, for example those who have Asperger’s. But what about people who are considered nonverbal? Well, a ruck of new technologies have been developed to bridge the gap between the limitations of existing society and people whose symptoms prevent them from engaging on society’s terms. iPad apps can help facilitate communication; AI glasses can translate the meaning of the fleeting expressions on neurotypical faces.

Given the increasing availability of such tools, it seems quite reasonable to expect society to accommodate people with neurodivergent perspectives. It also raises the question of whether it’s acceptable anymore to classify autism as a disorder, because in this view, the harm associated with these conditions is caused less by a narrowly defined medical problem than by a society that defines “normal” too narrowly. It’s not much of a leap, then, to wonder: If a bit of accommodation can bring big benefits for both people with autism and the society they inhabit, then why the rush to find a cure?

Indeed, some find darker motives in medicalising the condition. “Neurodiversity advocates often compare such a notion as akin to curing homosexuality, which was considered a psychiatric disorder until the late 80s,” writes the autistic activist Thomas Clements in Quillette. “Some liken the search for a cure to eugenics and even genocide.”

The neurodiversity (ND) movement’s perspective on autism is starting to be applied to schizophrenia and bipolar disorder, too. “Members of the Neurodiversity movement claim that bipolar disorder is the result of normal variability within the human genome,” says the neurologist Manuel Casanova. “They believe that bipolars posses an alternate cognitive style within society that should be preserved and accepted rather than treated. In this regard they cite historical accounts of figures like Wolfgang Amadeus Mozart and Vincent Van Gogh as possible bipolars who greatly contributed to society.”

However, not everyone is convinced. Some of the most vocal opposition to neurodiversity has come from people who are themselves autistic, like Clements.

Clements worries that the neurodiversity movement ignores the real difficulties faced by a vast number of autistic people. “I’ve seen kids and adults who are incontinent and have to wear diapers, who smash their skulls against walls, who have frequent epileptic fits and who have a very poor quality of life despite all the provisions made for them,” he elaborated in Quillette. “In its most disabling forms, autism cannot be viewed merely as benign variation in human neurology. Self-injurious autistic behaviours such as head-banging and arm-scratching which are often associated with severe forms of the condition are evidently pathological.”

However, a central tenet of neurodiversity is the strenuous rejection of the idea that autism can be divided into categories like “severe” and “mild”. As the organiser of the San Francisco meetup puts it:

Finding the line is between autism as an advantage and autism as a condition won’t be easy. Twilah Hiari, a blogger and author, says the task will be made harder by identity politics. “We don’t see this kind of over-identification with other neurological conditions,” she writes. “People with multiple sclerosis, epilepsy, or Alzheimer’s don’t engage in … arguments about identity-first language.” She thinks this conflation of identity and condition has happened because of the assumption that autism is purely genetic, which drives the comparison to sexual orientation and race, other distinctions that shape people’s sense of self.

So is autism genetic? That question is still very much up for grabs. The sheer variety of symptoms and severity that characterise different expressions of autism has made it hard for clinical researchers to come to many solid conclusions.

We’ll need to understand so much more about it before anyone can engage in anything more than speculation. And until then, it’s understandable that discussions quickly become very personal. As for Costandi, he isn’t entirely happy about how quickly things escalated. “I’m a bit embarrassed about my conduct,” he wrote back when I asked him about it. “I wasn’t really aware of this debate either”. But he hopes something good will come of it in the long run. “Hopefully, it’ll open a meaningful dialogue between the advocates and academics.”

 

 

 

 

 

Categorized in: LWON, Mind/Brain, Miscellaneous, Sally

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