"Oughtism" - Rethinking Autism, Diagnosis, & Systemic Responses in Practice

i suppose i mean if we think about some of the journey of autism so it was around 1943 canna did a study um of of a group of young people and he observed their behaviors observed being a keyword because it was an observational study not you know, not a discussion and understanding experiences from people, more an observation of their behaviours.

And it was Kanner that kind of coined a lot of the terms around autism, but he used words like unique syndrome and talked about autism as a childhood and say the word disorder.

So in that respect, if you were to think about things from a social constructionist perspective, you know, was autism there before Canna named it? It had been referred to as a kind of a behaviour within another diagnostic presentation before, but never a standalone diagnosis.

So did Canna discover autism or did Canna make autism by a naming of behaviours as autism? There's, you know, that's one way of looking at things really.

I think over time, the understanding of autism changed a lot, but Kanner's study was very much around boys.

There were girls within his study, but some of that kind of narrative around autism as a male presentation kind of stemmed from then.

And then a lot of the diagnostic tools and studies around autism were framed on the male understanding of autism.

So then we get very good at observing autism in a way that understands male autism or a certain presentation of autism and assessing it.

And therefore the assessment tool will miss a group of people who don't present in the same way.

And I think quite a lot about observed autism and experienced autism.

So Cassidy, for example, has looked into studies on suicide and apologies for anybody that's listening where this might be a trigger warning, but one of the kind of factors around autism and suicide was the pressure of masking.

So it's an experience of autism, but not unobserved behaviour of autism because it's masking.

But the emotional load of masking is what then adds to the kind of pressure for that individual who then feels suicidal because of the pressure of living not as their true self all the time and feeling that they can't expose their true self.

And that's exhausting, isn't it? If you can't be your true self all the time, really.

But I think that's one of the things that we've got over time is it's about observed and then lived and experienced.

From a social constructionist perspective, it's very difficult, especially if you come from a social constructionist background, to read some of the social constructionist narratives about autism so I mean I've read things like it's nothing more than being socially awkward and that's really harmful as a description because it doesn't understand a lot of the experiences that collectively go together for someone who is described as being autistic so if we think about the sensory processing if we think about the difficulty in masking and fitting in all the time.

And so many of the other things that sort of collectively go together to inform the experience of someone who is described as autistic, there's so much more to it than being socially awkward.

And I suppose, again, there's sort of, if you think about social constructionism, Are we saying that those experiences are only there because we've named autism? Or is it a group of experiences that we've put together and we've called them autism? Doesn't mean those experiences don't exist.

Doesn't mean to say that that, you know, those challenges don't exist.

So I think for those of us who kind of are neurodivergent and also want to sort of support a neurodiverse society, or neuro-inclusive approach, it's difficult to balance social constructionism and that approach at the same time.

But it's possible.

But it's about how you kind of, you do a both-and approach to it, really.

Hmm.

Thank you.

And can you say a bit about its kind of history within the kind of DSM diagnostic, maybe in a kind of formal diagnosis? It's only relatively recent, right? Yeah,