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DandelionFireworks
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01 Jul 2010, 10:07 pm

Doesn't "impaired" mean nothing? An impairment has to be in your ability to do something you need to do. If you can't carry a tune in a bucket, that's not an impairment if you hate music.

At the time that I was diagnosed, I was not functioning well in my environment. As my environment kept changing, my functioning kept changing. During the time when I was homeschooled and barely left the house and didn't have any friends at all, I didn't need social skills. Hence, I was not impaired. Before that, in public school, I was impaired.

Right now, I have some social skills. They're poor. However, I have very little drive to socialize (essentially no drive to socialize in person, and I'm aware of the huge risks involved in seeing someone in the flesh). That means that in the area of personal relationships, I'm not impaired because although I don't have the ability to socialize very much, I don't need to step beyond my comfort zone, which is socialization in the internet. I have a total of one friendship and one acquaintance (or two people I have some relationship with) from my peer group whom I see regularly in real life, for an average of ten minutes per day total. However, my social needs are not only met but exceeded because I have the internet. I am totally content with my social life. (I am not totally content with my social skills, and would like to be better at presenting myself for, say, job interviews. But in this current situation, I don't need to present myself for job interviews, so that's not a problem.)

My stims and rituals have never been an impairment (very, very rarely a minor annoyance, but overall a positive experience for me). If I lived on in a second-floor apartment, my pacing would be a major problem, and I would be impaired.

Et cetera.


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SuperTrouper
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02 Jul 2010, 8:49 am

It's up to the diagnostician to decide if the impairment is significant enough to warrant diagnosis. Not all diagnosticians are trained well enough in ASDs to do this, but there are many who are.

Anbuend, I understand what you're saying. But the way autism and Asperger's are defined in the DSM, those people would be diagnosed. I know of a little girl who was born at 23 weeks, and as a result, she has many spectrum-like qualities. Its highly likely that it is a result solely of her prematurity, but she is diagnosed, because she meets the criteria. I think the core of this question is the cause of ASDs. If you believe that ASDs are caused by a single thing (yet to be determined), then the blind person would not be diagnosed. If you believe that ASDs can have many causes (blindness, prematurity, in addition to the yet to be determined cause), then the blind person could be diagnosed. I think you could find professionals who would support either side. I'm not saying one is right and one is wrong, just that it's something to consider.



MathGirl
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08 Jul 2010, 5:13 pm

I've posted this a while ago, and finally had a chance to go through it and reply to some of the posts.

jmnixon95 wrote:
I think that communication difficulties are probably one of the biggest (if not the biggest) factors that come into play when it comes to someone being autistic or not. In my opinion, being unable to communicate effectively and being able to, but being reluctant to do so, are two different things. I would classify someone who has the inability to communicate effectively as autistic, while the person reluctant to do so may just be an introverted neurotypical.
I don't believe the sensory problems are mandatory for someone to have autism; they're just commonly found in those who have the other characteristics of autism (communication difficulties, problems with socialization, need for routine, etc.)
It is difficult to determine why someone communicates the way they do. One person I know, who might have AS, is able to articulate himself well and to do so with appropriate eye contact, body language, hand gestures, etc. However, he is overly critical, interrupts a lot, and always assumes that he is right and other people are wrong. He has aversion to certain sounds, as well as obsessive behaviours. While he seems to have no difficulty with conveying information itself, the way he chooses to communicate may or may not be the result of mind-blindness. It can just be extreme stubbornness. That is where it becomes difficult to judge whether one does or does not have AS.

anbuend wrote:
A person with 20/30 vision and a person with 20/600 vision each have myopia, but the first person probably doesn't even need glasses and can function fine, whereas the other person may well be legally blind even with glasses.
That's true, and as you said, autism is not as clear-cut. While vision can be tested in a very concrete way, autism cannot be tested with certainty.

anbuend wrote:
Additionally, a lot of people on this thread seem to think that "impairs functioning" is an objective trait. It's not. It can be highly situational, even for people with things as seemingly objective as spinal cord injuries (some of whom can be totally independent and others of whom can't, even with the same level and type of injury -- but nobody would dream of telling the totally independent ones they're not paraplegic/quadriplegic, even though people seem totally happy doing the same exact thing to autistic people). You can take the same exact autistic person, and have them grow up in two totally different ways, and one way they would not be diagnosable by the standards of people on this thread, and the other way they would be considered fairly severely limited. All these seemingly objective terms that people rattle off, aren't as objective as they look.
True. However, the more significantly a person is impared, the more difficult it would be to find that ideal environment where their impairments do not show. In my case, I used to spend a part of my life in an environment where social ability did not matter much - school. I could pass as a quiet but bright kid until we were assigned group work, where I was suddenly made aware of my social deficiencies. So even though school was a nearly ideal environment for me in terms of social skills, it wasn't entirely so. Besides some sensory processing difficulties and some additional academic difficulties, I felt relatively normal while sitting in class. But I'm illustrating this to show that it is very hard to find a long-term ideal environment for someone who has a relatively moderate degree of impairment in many areas of AS.

azurecrayon wrote:
i believe its up to the individual to decide what they consider a "significant difficulty". thats going to differ for each person. what may be considered a significant difficulty for one person may be acceptable to another. what may be a disability to one may just be personality to another. and you cant see what goes on in someones head and heart. they may feel like dying on the inside when all you see on the outside is a slightly quirky person. thats not even getting into the fact that a persons functioning will change over time where they may be fine during one point of their life and then nonfunctional at another time.
On the other hand, it is fully possible for someone to become fully convinced that they have AS, to convince themselves that they have the traits, and just use the label as a crutch.

What troubles me is that there are people out there who will say that autism spectrum disorder is not something that is important enough to be taken into consideration. I am often scared of disclosing, even though that might be beneficial for me, just because I'm scared of being dismissed. It has never happened to me before, but I'm still afraid that it would. I am very focused on coming across as a mature and intelligent person, so I'm afraid that if I say that I have something that is not taken seriously by many people, it will lower mee in the eyes of other people. I'm trying to find something concrete about it that will absolutely prove that I have it, and I can't settle down because I still haven't found that universal aspect of AS. In other words, I still haven't proven to myself that I have AS, and that leads me to still have a certain level of discomfort with the label. Sometimes I feel like I'm lying to myself, even though I've gotten a diagnosis and I've had other people tell me that they agree that I have it. I've told a guidance counsellor at school about it a while ago, and mentioned several traits, and they said to me, "everyone does this at some point, I don't see how you doing it would necessarily mean that you have a disorder." I know that my life has become much better ever since I've developed coping mechanisms for myself to manage AS traits, but then every once in a while I start thinking whether these coping mechanisms would be beneficial for anyone else who is not on the spectrum, too.


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Ichinin
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09 Jul 2010, 5:39 am

Quote:
What Puts Someone on the Spectrum?


For the time being: AQ, ADOS or RAADS.

AQ being the least precise instrument: It assumes that every quirk a person can have, is contributing in the same amount to the grand total of problems and if you do not have enough quirks then you are normal = Idiotic.

My theory is that Cohen was bored one day and sat down for 5 minutes with Excel...


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StuartN
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09 Jul 2010, 6:13 am

DandelionFireworks wrote:
Doesn't "impaired" mean nothing?


The International Classification of Functioning, Disability and Health http://www.who.int/classifications/icf/en/ is the usual definition of "impaired". Impairment is a measurable deficit from the normal range of one of the defined ICF domains. A person is additionally disabled if that impairment causes a deficit in interaction with the environment, and additionally handicapped if that impairment / disability causes a deficit in social interaction. All of these are defined with reference to the normal range of function.

I can see academic and social value in appreciating that a person with significant impairment / disability / handicap is on the lower end of a spectrum of normal human dysfunction. I can not see much value in a huge spectrum of "mild autistics" who have no measurable disability and / or handicap.

Like someone said earlier, there are (for example) some "painfully shy" people who don't realize yet just how affected they are, who would benefit from formal recognition of their disabilities.



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09 Jul 2010, 6:24 am

I think that as far as WP is concerned, I'd be the perfect example, of what puts a person, on the spectrum.


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