The idea that those involved in the lives of autistic individuals should focus on the strengths instead of the deficits of the person with autism, is a well-spread and well-known one. In this post I’m going to challenge that notion, not because I don’t think it’s important to see the strengths of those with autism, but because (I believe) the strengths-based focus is ultimately exclusionary and unhelpful to broader positive goals and to what is in the best interests of autistic individuals. I know many people reading this are going to disagree at the outset; by the end of the post I hope to have made you reconsider your views, even though you may yet continue to hold those views.
The first time I encountered the “think and focus on the positive” approach to autism, was in my own son’s early intervention therapy forms. Every time we filled out a form about where he needed help, we also had to fill out the inevitable section about what was great about him, which I found immensely irritating. I had my hands full with my son on a minute-by-minute basis, and dealing with endless government and medical bureaucracy, yet I was expected to spend time recounting information that was never used in his therapies and which I already knew as his mother: Why my son was great, what he was great at.
Therapies were aimed at helping him overcome his deficits, that is the point of the interventions. All the feel-good stuff didn’t belong on government forms, it was a waste of my time and theirs, and rather belittling to me as his mother – the notion that I wouldn’t appreciate his awesomeness unless someone else made me write it down every time I sought help for his challenges. Figuring out his motivators where relevant for a therapy was always worked out as part of the therapy process anyway, not once did I ever see them utilize the sections of the forms where I had to say why I loved my son despite his autism.
This positive approach to autism – shifting focus from deficits to strengths – is most commonly seen in trying to fix damaging and ignorant public attitudes towards autism. In this particular realm it makes sense, as long as people don’t try to universalize such strengths to every person with autism; that is just as incorrect as the basis of existing negative attitudes. Along the same lines, the positivity-shift is also an approach often used in getting people to understand and treat autistic people as individuals, and not as merely an instance of a diagnosis. Again, this makes sense, autism is, after all, a diagnosis.
The problem is when people – including professionals – try to push this further into the very act and process of diagnosing and treating autism. A prime example is this blog post, by someone who professionally works with autistics and would like to see a strengths-based model at the clinical level. She gives examples of replacement terms in place of deficit-focused language. As I went through her list, the problems with a strength-based model became striking. By the end of the post, I’d shifted from being open-minded about the potential benefits, to being more firmly against such a shift.
First off, such a model is highly exclusionary. A model that looks for and focuses on strengths and gifts, excludes those who function at a lower level or don’t have those gifts. There are a large proportion of autistic individuals who are intellectually disabled and / or struggle daily without some off-setting “gift” from their autism. Any model that excludes the worst affected, is surely of limited use in a clinical context. A deficits based model will capture those across the spectrum, in the way that a strengths-based one will not.
Similarly, the model perpetuates incorrect stereotypes – such as that all autistic people carry savant skills or have high IQs. Claims like this are simply incorrect and have not been shown to be the case. Saying and acting as if it is, denies reality, and further frustrates and confuses desperate parents, and places high expectations on autistics that many cannot and will not be able to live up to. Surely it would make more sense to focus on the individual with autism as an individual, rather than creating yet more difficult and nuanced criteria that they must meet before they can be considered “truly” autistic..?
Furthermore, the point of a diagnosis is to identify where an individual requires help. Shifting to a strengths-based model seems to overlook this central function of diagnosis: If someone is doing just fine and exhibits a wide range of strengths rather than deficits, why does it make sense for governments and insurers to shell out millions to help them and their carers and families? We’re already in a battle to make these governing bodies appreciate the difficulties and be willing to help us address them.
You may reply that the point of such a model is to get a more rounded picture of the entire person. But since when has “capturing the entire person” been the point or function of a diagnosis? It’s meant to identify an aspect of the wider person, the aspect that needs assistance. If we start placing all the strengths and other aspects of a person into a diagnosis, we turn a diagnosis into someone closer to an identity, which is not necessarily (and I would argue, not generally) healthy, helpful, or accurate. In fact it goes towards a notion that needs to be widely fought in my opinion: The notion that autism somehow defines the entire person (see a previous post of mine of the individuality of autistics).
There is a something further than concerns me here, which I think goes little appreciated too: When we redesign language (and criteria) to be more upbeat, positive, and strengths-based, I see the furthering of a very concerning attitude that is already prevalent in wider society; the attitude that mental conditions are not real conditions, they’re just bad personalities, poor choices, or excuses for everything from bad behaviour to poor parenting. If we say that autism is really quite “OK” (or whatever positive term you want), we would seem to be reinforcing the all-too-common view that it’s just a condition in the minds of un-accepting and attention-demanding parents, and of money-hungry psychiatrists who like inventing conditions so they and “Big Pharma” can get their pay check for helping children who have nothing particularly “wrong” with them.
I don’t need autism clinicians to have a positive view of autism, because their job is to help what my son struggles with, not to address his entire personality. They don’t need to know every nuance of what he’s good at, or why he is awesome, that’s my job at his mother, and I know those things so intimately and expansively that no list could ever hope to capture my son, and any list that sets out to do so will always fail.
When it comes to working with one-on-one therapists, it may seem important that they focus on the strengths and not just the deficits since they are dealing with an entire child. But every therapist who has ever worked with my son, has first dealt with him with me right there, and every single time I have seen evidence that they don’t look at him and see “autism,” they look at him and see a person, just like I do. They find things to laugh along with, they enjoy and revel in his triumphs, they are distraught when he is hurt or distressed; they are human, dealing with a human. No more do they than I need someone telling us how awesome this kid is and what he’s good at; we see it everyday. Those who don’t or choose not to, are unlikely to be made better people or better therapists because you changed a few words on a list. (After all, therapists are not the ill-informed and untrained public, with no personal interaction with “real life” autistic people, they know – or should know – that a diagnosis does not define an entire person.)
Do I think language matters? Yes. Do I think people should be more aware of the complexities and variety of autistic individuals? Yes. Do I think these ends are served by changing diagnostic lists and forcing already stressed and exhausted parents to fill out sections in every form about how great their child is? No, I do not. Nor do I think that the outcomes of changing language around autism to a strengths-based one, is always or necessarily helpful, accurate, or beneficial to the individuals affected.
I know I won’t have changed many minds with this post, and believe me when I say that I understand why, I really do (but go ahead and tell me in the comments anyway, that’s fine, I am open to having my own mind changed). I also know that the people promoting this strengths-based approach have their hearts in the right place. I’m just concerned that the down-sides of such an approach don’t get much consideration, and I wanted to put forward some of the very-real concerns. When we make a change for what is perceived to be the better – when we choose different words, different focuses, different attitudes – it makes sense to examine whether they really are a change for the better for the people most affected by the term at issue in the first place.