Autism, Accommodation and Treatment: A Rejoinder to Chong‐Ming Lim's Critique

Abstract

We are very grateful to Chong-Ming Lim for his thoughtful reply published in this journal on one of our articles, which motivated us to think more carefully about accommodating autistic individuals and treating autism. However we believe there are some confusions in Lim's argument. Lim uses the accommodation thesis, according to which we should accommodate autistic individuals rather than treat autism, as the starting point for his reasoning. He claims that if the accommodation thesis is right, then we should not treat autistic individuals for their autism, not even low-functioning (i.e. intellectually disabled) ones, because this would be disrespectful to all autistic individuals. We should instead limit ourselves to accommodate all autistic individuals. However, the opposition between accommodation and treatment is not valid in the case of autism, because of ambiguity in the concepts of accommodation and treatment. Moreover there is confusion in Lim's reasoning caused by omitting important facts about the practice of treating autism.

Neurodiversity: An insider’s perspective

“…Conflict between critics and neurodiversity advocates in the debate over support and interventions tends to centre on the end goal of such interventions. Critics often (either explicitly or implicitly) promote reducing or eliminating autistic traits as a key priority of intervention, and despite claims to the contrary (Jaarsma and Welin, 2015), many interventions for autism continue to have the reduction of core autism characteristics as their goal (see French and Kennedy, 2018). In contrast, the autistic community calls for services aimed at improving subjective quality of life and well-being while respecting and preserving autistic ways of being and, importantly, provided at the request and with the consent 2 of the autistic person in question.…”

Neurodiversity in (Not Only) Public Organizations: An Untapped Opportunity?

“…As Jaarsma & Welin writes in the case of people with ASD: “[I]t is unproblematic to advocate accommodation for intellectually able autistic individuals and treatment to counteract the harmful effects of the combination of autism and intellectual disability, for example, social isolation leading to depression. We do not believe that treatment is disrespectful to all autistic individuals” (Jaarsma & Welin, 2015; p. 684). Recruiting neurologically atypical individuals will have to be a compromise between their needs and the needs of public organizations and various dilemmas will be solved by trial and error.…”

Reconciling the seemingly irreconcilable: The WHO's ICF system integrates biological and psychosocial environmental determinants of autism and ADHD

“…[45] While there have been several attempts to reconcile the biomedical and neurodiversity views, with the goal of generating a hybrid or consensus approach, [46][47][48] when distilled down to their essence they appear fundamentally incompatible and irreconcilable. [45,49]…”

“…The neurodiversity paradigm has been criticized, specifically for trivializing or being overly positive towards disability, and for overgeneralization, that is, the assumption that it applies to all individuals living with NDDs, broadly and without exception. [45] While there have been several attempts to reconcile the biomedical and neurodiversity views, with the goal of generating a hybrid or consensus approach, [46][47][48] when distilled down to their essence they appear fundamentally incompatible and irreconcilable. [45,49]…”