Category Archives: DSM-5

A critical introduction to “The nine degrees of autism, a developmental model” (editors Wylie, Lawson & Beardon, 2015) -1-

dsm-bibleFew may remember, even from amongst the book’s actual readers, that its complete title is “The Nine Degrees of Autism, a Developmental Model for the Alignment and Reconciliation of Hidden Neurological Conditions” (editors Wylie, Lawson & Beardon, 2015)
The necessity of mentioning the book’s complete title is justified by a title’s further reaching implications. With scarce (mediocrity justified) exceptions, the title of a written work carries deeper summarising intentions, oftentimes a book’s legacy, if any.
Since its 2015 publication, the Nine Degrees has become for some autistics -according to some of their Social Media accounts- their “Bible”, however, the book has remained lesser known than some might have hoped considering its authorship of fairly well-known autism and Asperger’s specialists. The reason in my opinion, could be exactly the clear structurally different autism narratives embraced by its many authors through their scientific and academic backgrounds.
Because co-authorship of scientific works carries with itself the ever-present danger of maybe losing its “essence”, often divergent amongst authors; because while “essence” has a grammatical plural, in a scientific endeavour a plurality of essences could be detrimental, even confusing.
Being nearly impossible to comprehensively review a book by so many different authors, this short introduction has been written with an openly acknowledged intent of revealing a conflictual situation caused by the influence on the book, of an extremely poorly considered (un) categorisation of the autism spectrum, by authors of the DSM 5 followed by the WHO’s ICD 10/11. And since from amongst authors Tony Attwood took upon himself the indeed difficult task of writing a pertinent “introduction” to a complex, co-authored book knocking on misty doors still hiding the autism’s complicated secrets, it will be exactly his introduction, the subject of this introductory critique.
My task is greatly facilitated by Prof Attwood’s compact, nevertheless conceptually rich academic style, however, beyond this rather personal style matter, my choice was motivated by indeed the representative content of his summative introduction, reiterated degree by degree, by the book’s many authors.
As most may remember, Attwood has gained a well-earned international reputation as a clinical specialist and academic in the developing field of autism spectrum disorders, especially it’s Asperger’s syndrome subcategory. For many, many years, discussions around autism rarely missed Prof Attwood’s valuable insight in the -mainly- behavioural aspects of autism, emphatically Asperger’s syndrome.
Generations of seekers found answers in the clinically documented accounts of individuals diagnosed with Asperger’s syndrome often aligned side-by-side with aspects of individuals from the general category of “neurotypicals”. However, and rather unfortunately, my notes will not dwell on Prof Attwood’s unquestionable contributions to the field of autism research, but on what I identify as a caveat to the chaos caused by the unwarranted -with devastating consequences- interference in the autism narrative of Judy Singer’s new-age infused “neurodiversity” derailment, followed by Silberman’s brilliantly written gay-rights movement influenced book, which continues nevertheless to undermine not only the desperately needed Autism research, but also the desperate efforts of individuals and families affected in life altering ways by not only autism, but also by disastrous, government dependent social support reduction consequences, for people with very little or no capacity of understanding the world around them, incapable therefor of autonomous/independent living. And instead of having the social support sphere’s efforts channeled towards finding and defining the best ways of supporting in an individually established way all individuals affected by autism, opportunistic sociology and fame seeking journalism are leaving literally millions in the shadows of a limelight hijacked by a militant, identity confused minority. Because until autism and its multi-faceted Dependency Model will be understood, the only “beneficiaries” of this -short lived- “fame” will be those profiting from “teaching” individuals and organisations about how to expect from all these “cool” “neurodiverse” autistics to happily look forward to the golden age when with a few, low-cost “social adjustments” they will be fully accepted as simply another “tribe”, the “neuro-tribe”, by the “happy” community of this newfound tribalism.
It is not however, the short study’s purpose to expose the sad, irresponsible attitude exhibited by individuals having virtually weaponised Singer’s -in her own words- “sacrosanct” neurodiversity concept, against any opposing views and “opponent”, many of whom are hard-tried parents of ASD children. These “neurodiversity vigilantes” have made and are actively making their way as far as government advising bodies, “coincidentally” governments responsible for sadistic reductions of funding for proven, successful therapies such as ABA, simply because the #NDcult decided to demonise something they have no understanding about. And governments have never been shy of loving anything cost-cutting…
Returning to the title, the reader has to remember the rather silent mention of what the authors agree to be referred on the cover as a “developmental model”.
When I first saw the book’s title, I was hopefully intrigued, expecting maybe some viable alternative in the unwarranted war between proponents of the medical and the social models. Instead, upon opening at the under-cover page, I was surprisingly informed that this -according to the editors- “ground-breaking” model is a “positive tool” for understanding autism’s “developmental process”, meant to “facilitate the improved mental health and well-being of individuals on the spectrum”, which should “encourage people on the spectrum” to positively “accept themselves by focusing on their gifts”… (emphasis mine)
Unfortunately, my hopes of having maybe found a reconciliatory model, fell sadly apart upon reading the -hidden in plain sight- bias of the editorial team, against what’s mentioned as “negative medical classifications”.
I am not entirely sure that the de facto authors of the book, especially the internationally respected academics of complex -much more than behavioural- medical sciences, were aware that their contributions will have as foreword a clearly subjective bias, basically setting their “negative medical classifications”, and therefore much of their scientific, medical associations with these “classifications”, against the editorial team’s self-proclaimed “positive” approach.
Few are probably aware of what theologians acknowledge as the “principle of the first mention”, which asserts that the conceptual and contextual first mention of a thought/principle within an autonomous writing, letter, scriptural book, et cetera, will set the thought/principle’s definitory influence throughout the writing.
I am therefore obliged by virtue of my interpretative training, to observe that mentioning this bias on the book’s very first page is in fact a declaration of the editorial team’s assumption, about their own model’s “superiority” against other “negative medical” models.
Returning once again to the title, might leave one wondering about its meaning; meaning which stubbornly eludes me to this day, failing at each reading to understand the meaning of a developmental model, “for the alignment and reconciliation of hidden neurological conditions”. My bewilderment isn’t at all helped by the book’s aforementioned trend setting first page, which as previously mentioned, attempts to apply da capo the proposed model, to other “hidden” neurological conditions such as dyslexia, dyspraxia, apraxia, and ADHD, because as the unfortunate recipient of most mentioned disorders, I fail to grasp how am I supposed to see anything positive in often antagonising conditions constantly competing for the last patches of my shrunken sanity, leaving me daydreaming day after day of past “positive experiences” of which I’ve never been part.
If anyone reading my thoughts and deciding to read the book will have arrived at a conclusive understanding of the meaning behind “a developmental model for the alignment and reconciliation of hidden neurological conditions”, let them kindly approach me for a much sought-after enlightenment. Because as much as I am trying to grasp even the syntactic coherence of it, I am constantly thrown back to square one reading that the book’s title and therefore presumed subject, were conceived by one of the editors, “during his identity alignment process while writing a book about very late diagnosis of Asperger’s syndrome”.
Now again, my theological training of connecting metaphysical dots, became useful at proving right a feeling about this “identity alignment” concept, which could be related to the presence amongst co-authors of a “shamanic healer”, whom seems to have transformed the very complex “identity crisis” concept, into an even more unfathomable “identity alignment” concept. As a fairly well read theologian, I am no foreigner in the ever fluid lands of spirituality -shamanism included-, being left baffled nevertheless by the “necessity” of introducing metaphysical concepts into an already abused, autism narrative, where confused and burnt-out autistics and/or parents of severely handicapped autistic children, are forced to battle governments and powers to be, callously insensitive to their plight.
But that again, isn’t at the purpose of my thoughts…
The overall, conclusive purpose of this first part, of a “to be continued” introduction, is my utter failure to understand how authors with a valid, evidence based understanding of both autism and Asperger’s, have engaged in writing -some of them- absolutely valid perspectives of their own scientific fields, “forgetting” to clarify that actually MOST of the book is written about and for the subcategory of autism known as Asperger’s syndrome, and no one, not even the DSM 5 or the ICD 10/11 with their arbitrary removal and attempt to annihilate Asperger’s as a subcategory of autism, can change the fact that basically nothing written in this book could be applied to any other category of autism besides -mostly- Asperger’s syndrome and high functioning autism.
Writing a book about “autism”, when most of it doesn’t apply -as implied by its title- to the entire Autism Spectrum, but only to a segment which far from neutral medical authorities, want for undisclosed reasons to obliviate, is unfair, unscientific and ethically questionable; raising false hopes followed by depths of despair, for many parents of children with severe, High Dependency Kanner’s or Asperger’s autism.

(to be continued…)

*Image credits: https://psmag.com/social-justice/dsm-psychiatry-diagnostic-bible-mental-disorders-58075 

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“Autism Spectrum Dependency Classification System v 1.0” -proposal-

[Rev.] Romulus Campan, FDScMH (Forensic), LTh (Hons), CertEd, QTS,
PgCert Religion, Spirituality & Mental Health,
PgCert Special Psychopedagogy,
PgCert Autism & Asperger’s
Chair, Disability & Neurodivergence Staff Network – BSMHFT

Previous attempts to classify the Autism Spectrum (AS), failed to understand the ‘trees’ within the ‘forest’ of unknown dimensions, which has become generally known as Autism Spectrum Disorders.

I am unwilling to concede ‘disorders’ to ‘conditions’ simply because after countless episodes of bullying and harassment from mostly ignorantly unqualified individuals and groups, in this case having found in their “autism activism” a venting platform for complex seemingly psychological issues, I have decided to initiate and maintain liaison only with academically and/or experientially qualified entities, willing to participate in existing efforts to rescue and restore the Autism narrative from the chaos caused by such incompetent “movements” and individuals, the vast majority of whom have spawned from Judy Singer’s disastrous, “NeuroDiversity” brain-child, born as an “idea” explained by the book’s Amazon abstract as follows:

“The word itself was just one of many ideas in this work, her 1998 Honours thesis, a pioneering sociological work that mapped out the emergence of a new category of disability that, till then, had no name.” (italics mine)

Surprisingly, however, as I have detailed in a previous essay, Singer’s careless inference with the medical field mutated into an increasingly conflicted understanding of disability, revealed in a recent article as “The problem with the expression “People with Neurodiversity” is that it turns Neurodiversity into the latest fashionable synonym for Disability.”

The necessity to re-classify the AS should be obvious to all ‘navigators’ of a “system” which could be best depicted as a beach playground where infantile participants more and more aggressively, try to destroy and rebuild their newer and newer sand-castles of a derailed activism, fortunately washed away by oftentimes feeble, but nevertheless professionally and/or experientially much more accurate attempts to defend the Autism narrative from becoming another defunct sociological experiment.

The real reason in my opinion for this constant threat for the wellbeing of millions of autistic individuals and their families worldwide, including my own, is the collapse of observational behaviourism as exclusive instrument in understanding Autism from its ontogenesis throughout its lifetime progression, having left behind a Medi-Social Model identifiable void, where oftentimes hazardous and dangerous psychiatric interventions are being argued against by an equally hazardous reactivist revisionism, frightened apparently that “as long as autism – which is not a mental ill-health condition – remains in the psychiatric diagnostic manuals, there will continue to be those who use this to justify their attempts to find a cure.” (italics mine) (Chown & Leatherland, 2018).

I cannot, in all honesty, understand how and why would 25 autistic individuals, many of whom academics, be afraid that millions of individuals with autism, living themselves, their families and/or care environments under the constant threat of self-harm, wandering and uncontrollable violence, would be offered a treatment, a cure?

I have developed the Autism Spectrum Dependency Classification System, as a response-proposal against the confusions caused by the changes in the past years to the two, main disease categorisation systems, the DSM and the ICD, also the chaos in the less formal use of “functionality-based labels”, the now literally demonised HFA or High-Functioning Autism and LFA or Low-Functioning Autism.

As I have already hinted throughout my social-media presence, I consider dependency the most practical means of conveying the level of functional autonomy of an Autistic -or any other- individual, integrated with a simple, universally applicable sub-categorisation system, by which dependency is in direct proportion with the identified comorbid symptoms, as an individualised, non-numerical quotient of support needed for the maximum achievable autonomy.

By using the concept of “comorbid symptoms” I acknowledge Autism as a monolithic disorder featuring the below explained intellectual/mental, neurodevelopmental, physical and mental-health/psychiatric conditions not as independent co-morbidities (regardless of their also non-autistic existence), but as comorbid symptoms sharing origins simultaneously or developmentally with their Autism root.

The following codes have been used:

ID/MR – Intellectual Disability / Mental Retardation

LD – Learning Disabilities: Dyslexia, Dyspraxia, Dyscalculia, Visual Stress Syndrome, SPD (Sensory Processing Disorders), Tourette’s Syndrome, etc.

PHD – Physical Disabilities (observable and/or non-observable): Motor-functional (Fibromyalgia, CFS, Spinal Disorders, MS, etc), Diabetes, Metabolic Syndrome, etc.

MHD – Mental Health Disabilities: Clinical Anxiety & Depression, B/EUPD, Pathologic Demand Avoidance, etc.

ASD Dependency Cat System

I am publishing this first version of my proposal, relying in all honesty on my personal, academic and professional integrity in regard to having created this system without any deliberate intention to copy or otherwise unethically inspire from anyone else’s previously published thoughts or ideas. Should the reader have any questions or concerns about this, I would respectfully appreciate being informed about it, to address any issue as soon as possible.

This initial proposal version wishes to become a collaborative effort with -as previously mentioned-academically and/or experientially qualified peers. Should you be interested in collaborating, please DM me at https://twitter.com/Rev_Rom_ASD, keeping in mind that I reserve myself the right to extend any further collaborative invitations.

 

Neurodiversity, or “The Theory and Practice of Oligarchical Collectivism” -Proposing the “Medi-Social© Model of Disability and Neurodivergence” III-

wpid-picsart_1394741341754.jpg

One of writing’s most complex hurdles is leaving one’s “body” to immerse in the dream within dream of creating a structure for a world somewhat different than the original.

In the dystopian nightmare created by Orwell, Emmanuel Goldstein’s “book” becomes the embodiment of Winston’s hope that his participatory complicity in changing the past to suit a power-dependent, fluid future, will be forgiven, first of all by his own, desperate, depleted, sick, hungry and frightened self…

History has proven over and over again, that “Ignorance is Strength”; that the more “society” needs to ascend to a higher level of “consciousness” the easiest way is through what has become known as “purges”, or the “natural selection through the survival of the fittest”. This is what binds together Thomas Malthus’ theory of passive purge of the weak and vulnerable and Mao Zedong, architect of the murderous “cultural revolution” purge. The “fittest” will decide the means through which the less fortunate may be left, or helped to remain silent…

For some time now, the cult like “neurodiversity movement” has been going through a desperate process of finding any meaning in Singer’s frankensteinian, biodiversity inspired monstrosity. Waves upon waves of more or less well-meaning scientists of mostly non-medical sciences, ridden by more or less derailed individuals and their cohorts, are competing in a sinister race to purge a past they neither understand, nor desire to understand, from anything standing in their way to re-build something for which they have no plans whatsoever…

For some yet cloud shrouded reason, the #NDcult has chosen Autism as their main re-constructionist experiment, probably for the simple, utilitarian reason of being a still unknown disorder, having nevertheless the attention of a spotlight large enough to illuminate their narcissistic egos. And to ensure that ignorance is being further strengthened, they have ever since remembered to pay lip service to other dyslexia, dyspraxia and neurodivergent disorders, relabeling them as evolutionary achievements, “simple variations” of our brains.

As for the “what shall we do with the severe autism part”, the #NDcult has re-branded everything and anything ill-fitting their “geek syndrome”, as comorbidities to be dealt with by the medical professionals ostracised by neurodiversity sociology’s relentless “de-medicalising” and “de-pathologising” purges. Parents and carers of non-geek Autistic individuals have also been targeted for every politically incorrect attempt to express their frustration, pain and desire for finding scientifically valid treatments for their loved ones, being trampled in the mud of the vilest sub-human abuse.

In a recent tweet, @stevesilberman made valiant proof of why neither investigative journalism, nor a career in law should lead the way in shaping the future for millions of people with Autism worldwide. Because if he really meant writing, that “This whole thing is one of the most powerful statements of what ‘neurodiversity’ really means” as an introduction to Tay­lor-Park­er’s following idea, neither of them has any idea of what an IQ 30 means:

“Neu­ro­di­ver­si­ty isn’t an idea whose use­ful­ness is lim­it­ed to peo­ple who are “high func­tion­ing” or “just quirky” because it inher­ent­ly looks at peo­ple who will have exten­sive, expen­sive sup­port needs for the fore­see­able future and asks how we can help these peo­ple build the best pos­si­ble lives for them­selves. Neu­ro­di­ver­si­ty looks to every idea, tool, and prac­ti­cal solu­tion it can lay hands on to answer the ques­tion of how to have a good life with an IQ of 30, exec­u­tive func­tion­ing dif­fi­cul­ties, schiz­o­phre­nia, no ver­bal speech, or all of the above. Where med­i­cine is stumped, and the peo­ple affect­ed may not even want a “cure,” neu­ro­di­ver­si­ty draws heav­i­ly on the social mod­el of dis­abil­i­ty to offer some­thing unique: hope”.

To clarify what an IQ 30 really means, allow me to use as an example the details provided in the former DSM 4 TR:

“318.1 Severe Mental Retardation: IQ level 20-25 to 35-40 (accounts for 3-4% of retarded population). The group with Severe Mental Retardation constitutes 3%-4%of individuals with Mental Retardation. During the early childhood years, they acquire little or no communication speech. During the school-age period, they may learn to talk and can be trained in elementary self-care skills. They profit to only a limited extent from instruction in pre-academic subjects, such as familiarity with the alphabet and simple counting, but can master skills such as learning slight reading of some “survival” words. In their adult years, they may be able to perform simple tasks in closely supervised settings. Most adapt well to life in the community, in group homes or with their families, unless they have an associated handicap that requires specialized nursing or other care. (emphasis mine.)

May I ask anyone for that matter, which part of this DSM quote would offer any incentive for someone to believe that individuals living on this severe end of the Autism Spectrum, could ever “build the best pos­si­ble lives for them­selves”? Because “closely supervised settings” have little do with either autonomy or independence! And why would anyone want a severely disabled, highly dependent individual to build such lives for themselves, when the first call should be the warmth and dedication of their own families to help and assist them, except for when that would be practically impossible? Unfortunately, submitting the article to a simple search for words such as “family/families” returned a disappointing “no results”. However, reading the article I was shocked to find the opposite of what a family should stand for, which is “filicide”, “the deliberate act of a parent killing their own child” …

I am not going to apologise for asking, but what sort of mentality would drive anyone to write an entire article where the only reference to family is a concept on the criminal opposite of what a family should be?

Indeed, as suspected in the beginning, the strength of “neurodiversity” as a “movement”, seems to be its obnoxious ignorance summarised in: “accept the fact that med­i­cine doesn’t have an answer to neu­ro­log­i­cal vari­ety” and most important, “accept­ing that peo­ple are peo­ple, and, love it, hate it, or feel ambiva­lent about it, there is no cure today.”

Is this the “future” of “gold” so fiercely advocated by neurodiversity, the fatalistic view that if “there is no cure today” there won’t be one tomorrow? Is this the reason why neurodiversity is so hell-bent in “de-medicalising” and “de-pathologising” autism, campaigning against vital, life saving medical research about the complex neuro-physiopathology of Autism and its comorbidities, so brazenly called “quackery” by some neurodiversity proponents?

Let me ask in a non-delegated, but implicated way, what shall we do, all clinical professionals from countless fields of medical, health and care sciences? Throw away our passion for being better providers, to the best of our capabilities, of anything and everything could make the lives of people with autism, dyslexia, dyspraxia, Tourette’s, epilepsy, seizures and many other aspects of probably the same, most complex neurodevelopmental disorder, and embrace “neurodiversity” with its utter misunderstanding of the social model of disability? As I have said many times, myself and all clinical professionals I know, work closely together with our dedicated social work colleagues, in multi-disciplinary teams sometimes desperately trying to ensure equitable opportunities to everyone in our care. And we are far from perfect, but I have never heard any of my clinical colleagues talking about “de-socialising” our teams, or our social work colleagues about “de-clinicalising” them?

No, not by any chance…

Returning to my title, I must reiterate my surprise to have realised that the neurodiversity movement is indeed collectivism, with a structure of unquestionable allegiance to its oligarchically maintained “ideology”, which in their own words rests on two major principles. The 1st principle is “Every­one gets the same basic rights”, the 2nd being “There are no excep­tions for label, IQ, or degree of sup­port needs”. By the way, please don’t approach me with diversions such us “why haven’t I read everything in context”! I did, again and again, just to have become unwilling to suffer any longer the inflicted intellectual distress…

I will conclude with another statement which seems to be the essence of what neurodiversity is, and its effects on a society maybe expecting more help instead of even more suffering:

“Neu­ro­di­ver­si­ty is an idea for strong peo­ple, as it bites and claws at every­one who embraces it.”

And I can confirm with my own life and experience, that “neurodiversity” and its cult-like movement has left me with nothing but bite-marks and claw-scars since the day I “embraced” it.

Because if one’s strength is their ignorance, their peace will be a war against themselves and ultimately others.

Remember nevertheless, that ultimately, the real victims of all wars are not the strong, but the vulnerable…

Restructuring the Autism Spectrum Disorder Narrative around the Core Symptomatology of Asperger’s Syndrome and High Functioning Autism

Museo_del_Prado_-_Goya_-_Caprichos_-_No._43_-_El_sueño_de_la_razon_produce_monstruos

[Rev.] Romulus Campan FDScMH, LTh(Hons), CertEd, QTS,
PgCert Religion, Spirituality & Mental Health
PgCert Special Psychopedagogy,
PgCert Autism & Asperger’s

“The theoretical understanding of the world, which is the aim of philosophy, is not a matter of great practical importance to animals, or to savages, or even to most civilised men”.
Bertrand Russell

Keeping in mind my Theoretical Philosophy positional disclaimer, I have arrived at the point of my scientific inquiries, where, theories of intersecting dimensional planes aside, I must allow a superfluity eradicating convergence of objectivity in the Autism narrative, which should dethrone impostor monsters, born as painted by Goya, from the minds asleep of scientists, and subsequent masses of dilettantes.
However, in all its simplicity, the Autism narrative’s only problem, is the underlying conflict fuelled by what has become known as Learning ≠ Intellectual Disability (e.g. Dawn, Fragile X syndrome, etc.), formerly Mental Retardation. I have deliberately used the non-equal sign, as a form of silent, dignified and resigned protest, against the frustratingly careless use of Learning Disabilities (rebranded now as Learning Difficulties) which shouldn’t encompass more than reading disabilities, written language disabilities, and mathematical disabilities such as Dyslexia, Dyscalculia, Dysgraphia, also Dyspraxia which has a profound impact on perception, therefore all afore enumerated.
I do respectfully understand and acknowledge why it may be emotionally less intrusive to use Learning Disabilities instead of the Mental Retardation reminiscent Intellectual Disabilities, however, subjective rebranding in the name of political correctness does never change objective inherence. And obviously, this isn’t influenced at all by the fact that Intellectual Disabilities could co-occur with Learning Disabilities, with the former having at the core a genetic or traumatic incapacitation of the brain to process/convey information, while the later are the brain’s non-typical modalities of processing/conveying information, caused by its structural and functional differences.
The Autism narrative therefore, must once and for all, separately consider Intellectual Disabilities, regardless of common identifiables, present at the time being, in what is reluctantly acknowledged as Low Functioning Autism, or more recently, “courtesy” of DSM 5, as Severity Levels 3/2 of ASD.
Now as a tangent thought, I must mention my genuine concern that this ‘reluctance’ has morphed unfortunately in the contemporaneous trend called “Neurodiversity” which has long left its Neurodivergence gathering meaning, home for ASD, Dyslexia, Dyspraxia, Tourette’s etc., having mutated from initially a High Functioning, Asperger’s Autism forum, into a “HF/Asperger’s Autism plus…” stage, for an alarmingly increasing number of “self-ID(Dx) autistic”, more probably narcissistic individuals, unhappy of their probable Personality Disorder traits. These share the stage with the “thinking for myself may hurt + OMG, OMG, you’re so wrong…” vigilante crowd, the “stuck in-there, too proud to admit this is wrong” rather silent minority, and the “more-or-less personal, but good business” opportunists.
Returning briefly to DSM-5, I certainly appreciate the following clarification/condition:
“E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level” (emphasis mine). However, the statement’s last sentence, seems in my opinion to rather seriously muddle the already dark waters of practically understanding what the expected level of general development would be, in case of Intellectual Disability.
On a further thought, comparing symptoms of ID/IDD with symptoms of ASD, the similarities are beyond a reasonable horizon of reassurance that the two conditions wouldn’t be misdiagnosed for each other. Because if anyone is naïve enough to look for repetitive behaviours and/or communication deficits as some sort of failproof sign of ASD, let them be reminded that stereotyped, repetitive behaviours are also typical for passive traumatic experiences such as external stimuli deprivation, just to mention one…
Without even attempting to explain beyond theoretical philosophy the reasons for my suggestion, I propose as a valid and beneficial alternative to the present epistemo-semantic chaos, that the Autism Spectrum should selectively integrate what has been previously known as Asperger’s Syndrome and High Functioning Autism, hoping that Autism research would resume the vital dialogue of identifying specialised diagnostic patterns for the core aspects of both.
Unfortunately, otherwise, the very real and oftentimes devastating, Intellectual Disability or Intellectual-Disability-identical criteria, will continue to overshadow and therefore ignore the maybe less visible but drastically life shortening symptoms of Autism.

Reflections on the Psychopathology of Demand Rejection and Avoidance

1200px-Mud_Volcano_in_Gobustan_01[1]Honouring a long-due promise to Demand Avoidance researcher Richard Woods @Richard_Autism I will attempt to summarise a personal perspective of the psychopathology of Demand Rejection and Avoidance, conscious of the topic’s vast scientific interdisciplinarity, muddled unfortunately by rather recent research derails, causing unnecessary confusion and delays in therapeutically addressing valid psychotherapeutic necessities.

In this short article I will deliberately avoid citing/quoting any post Newson “P/E/DA” researchers, because of what I perceive as bias in their motives to establish a stand-alone diagnostic of “P/E/DA”, separate from the already existent Kanner’s and Asperger’s Autism Spectrum subcategories.

I will use instead as a lose structural frame, citations and my own personal interpretation of these citations on the topic of PDA from the National Autistic Society’s (NAS) webpage which under the “What is pathological demand avoidance?” subtitle, lists the following:

-“(PDA) is increasingly, but not universally, accepted as a behaviour profile that is seen in some individuals on the autism spectrum. (emphasis mine)

 -“This demand avoidant behaviour is rooted in an anxiety-based need to be in control.(emphasis mine)

-“the demand avoidant profile has been found to be relatively uncommon“. (emphasis mine)

-“People with a demand avoidant profile can appear to have better social understanding and communication skills than others on the autism spectrum and are often able to use this to their advantage.(emphasis mine)

-“uses social strategies as part of avoidance, eg distracting, giving excuses” (emphasis mine)

-“appears comfortable in role play and pretence” (emphasis mine)

-“Parents very often use the term ‘manipulative’ to describe this aspect of their child’s behaviour and will comment on how it seems to be their greatest skill(emphasis mine)

It doesn’t require an exceedingly vast (necessary however) mental health experience to understand and notice that nearly everything mentioned in the citations above, and also much of the source material, seems to extrapolate into a rather clear anamnesis showing similarities with subcategories of Personality Disorders.

There is a generally recognised divide between the Neurodevelopmental Autistic Spectrum Conditions which have a Genetic background, and the Psychopathological Personality Disorders which seem to have a Traumatic background, each with very much different approaches to what’s best in providing support to individuals diagnosed with these conditions.

Further, the NAS material states under “Guidelines for parents” that “tried and tested strategies used with children who have other autism profiles are not effective for their child with a demand avoidant profile. This is because people with this profile need a less directive and more flexible approach than others on the autism spectrum” which seems to me fairly similar to the approach of the Dialectical Behaviour Therapy, designed to help individuals with Personality Disorders. This in my opinion seems to be also supported in the advice by the same source that the “use of structured teaching methods, which can be useful for people with other autistic profiles if individual needs have been considered, are often much less helpful for people with a demand avoidant profile and need considerable adaptation. People with this profile don’t usually respond to structure and routine. An indirect style of negotiation is more likely to lead to them feeling the control over their learning that they need.” (emphasis mine) Again, in my opinion this appears to be in direct contradiction with what the NAS seems to be emphasising that “a person with PDA does not make a deliberate choice to not comply and they can’t overcome their need to be in control”, because “feeling the control”, negotiating and responding in an expected manner to this, does to a significant extent imply the repeated use of “deliberate” choices, not to mention the sharp contrast of this behavioural profile with the clinically proven stability provided to autistic individuals by “structure and routine”.

In conclusion, I am very much concerned that exactly at a time when the future of both Kanner’s and Asperger’s Autism research have been jeopardised by historical blunders caused by arbitrary decisions made by the respective APA and the WHO to dismiss decades of research into the differences between the two major Autism subgroups in their DSM-5 and ICD-11, scientifically questionable research is being used to include -in my opinion- primarily mental health conditions into a neurodevelopmental category.

Finally, I am genuinely surprised and deeply disappointed by the @Autism NAS’s indulgent participation in this far from clarified and at the moment highly controversial subject. Their carelessness in making unclear statements such as “PDA (pathological demand avoidance) is a behaviour profile within the autism spectrum” have already given grounds to some groups such as “The Jigsaw Tree” to claim that “Pathological Demand Avoidance (PDA) is now recognised as an Autism Spectrum Condition by the National Autistic Society.” I’m curious if the NAS @Autism would confirm this conclusion…

Maybe researchers should consider another path as suggested by Rebecca McElroy whom has noticed that “PDA describes a child who is primarily led by a need to avoid demands and control situations, struggles with social communication and relationships. However, these exact same characteristics could equally be used to describe a child with disordered attachment (NICE, 2015).”

Because in my opinion, the major difference between the Autism Spectrum and the Pathologic Demand Avoidance is that while the first is Neurodevelopmental the second is Pathological.

Ref: NICE (2015). Children’s attachment: Attachment in children and young people who are adopted from care, in care or at high risk of going into care. Clinical guideline, first draft.

Disclaimer: The interpretations and re-contextualised use of the citations from the indicated NAS website are entirely my own, and therefore do not represent in any form the official position of the NAS concerning PDA.

 

The Cognitive-Behavioural Interpretative Isolationism of Intellectually Proficient Kanner’s & Asperger’s Autism (IPKAA)© Part 3 – The Myth of “Weak Central Coherence”

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Part 3 – The Myth of “Weak Central Coherence”

(Rev.) Romulus Campan
FdScMH, LTh (Hons), CertEd, QTS,
PgCert Special Psychopedagogy, PgCert Autism & Asperger’s

‘Frith (1989) attempted to sketch out the preliminary theory that one deep underlying cognitive deficit in autism has to do with a lack of coherence. In other words, autistic people lack the drive to pull information together into overall meaning.’ Hill (2004)

Hill seems to continue Frith’s rather hidden mentioning of the fact that while she proposes her theory as a ‘deep underlying deficit’, a door has been left open to a ‘lack of drive’ which implies a selective-volitional aspect, with what she proposes as an ‘information processing style, rather than a deficit’.
The coherence theory postulates that incoming information is usually processed in its context. Now, while acknowledging that oftentimes communicated information is meant to be processed in some context, I don’t believe that noticing ‘needles in the haystack’ while paying no interest whatsoever to the haystack’s any aspect, should be considered a deficit, but rather a valuable control asset, through which the flow of information can be monitored for systemic accuracy. And the fact that autistics may decide to ignore the context in order to gain through focus, a deeper understanding of the detail which flagged their attention, does not substantiate that contextual coherence is the required norm, but as Hill suggests, a ‘cognitive style’, which no autistic should be expected to justify, an even less to change.
I am also a theologian. This means that I was trained, and apparently excelled in interpreting textual and contextual details way beyond the newspaper reading level. And since theology should be first of all philosophy, I was given the chance to observe and contemplate, also judge and analyse thoughts hidden away, sometimes even to their writers.
Now if I would take Hill’s above quoted text, and gaze upon it just superficially, but with a rather merciless analytical rigor, I should note the following about “autism”:
-Autistic people suffer from a deep underlying (basic/fundamental) cognitive deficiency, which is lack of coherence, leaving them without the “drive” (ability/willingness/capacity?) to see/understand meaning in scattered fragments of information.
Unfortunately, “thanks” to the unmandated vigilantism of a way too noisy herd of dilettantes, whom mostly out of genuine, however misplaced concern have come to oftentimes falsely represent the entire intellectually proficient Kanner’s and Asperger’s autism (IPKAA) community, autistics without cognitively impairing intellectual deficiencies/disabilities have been left stranded at the mercies of a mercilessly mercantile “healthcare industry”, for whom the daily torture of having ALL our senses tortured, our personal space assaulted, our meticulousness abused, our silence raped and our solitude violated, means nothing because we have degrees and jobs…
So, here we are, probably the most vulnerable and exposed of us, trying to convince an already biased world that there’s no such “thing” as “simply autism”, that the Autistic Spectrum has two, fundamental categories, the Intellectually Proficient and the Intellectually Deficient, fact which shouldn’t be tampered with by semantic militias resembling more and more to editors of 1984’s Newspeak. Proficiency and Deficiency are existential opposites present everywhere from our vitamin D synthesising capabilities to our intellectual capabilities and shouldn’t be subject to any thoughtless political correctness. As most of the well-meaning, dedicated and yes, oftentimes heroic carers of intellectually deficient autistic individuals expect that those they love and care for will be given assistance as required by their specific needs, we, intellectually proficient autistic individuals expect to be listened to and assisted as required by our specific needs.
I hope to be mistaken when I speculate that the reason why the profiteering “healthcare” industry has successfully manoeuvred the not so neutral DSM and ICD into practically grinding to a halt decades of extremely promising research into High-Functioning and Asperger’s Autism by obnoxiously dropping Asperger’s as a subcategory, is the fear of having to listen to the scientifically and experientially valid opinion of a new generation of extremely capable autistic academics, diametrically opposed to the reductionist and generalising, clinically flawed stereotypes by which it’s cheaper to provide helmets to intellectually deficient, self-harming autistics, than answers to intellectually proficient, self-harming autistics.

-Frith, U. (1989). Autism: explaining the enigma. Oxford: Blackwell
-Hill, E. L. (2004). Executive dysfunction in autism. TRENDS in Cognitive Sciences Vol.8 No.1, January 2004, 26 http://www.ucd.ie/artspgs/langimp/autismexecdysf.pdf

(to be continued…)

Per aspera ad astra…

Yes, I reverted my Twitter handle back to @Aspergreatness

I was diagnosed with ASD/Asperger’s Syndrome according to DSM5/ICD-10.

What Hans Asperger shouldn’t have done in history’s darkest hours, I can’t change.

The legacy of his research into understanding my neurobiology, saved my life.

I became an Asper 😡♿✡

Proudly 🐉

Asper Latin DefPer_aspera_ad_astra,_1894