Common Misconceptions About Autism Levels – What It Really Means
In this episode and in the accompanying blog post, I discuss three distinct problematic aspects of the medical model and the misunderstanding of “levels”:
1. A general framework that conceptualizes autism as a disease, graded as mild or severe.
2. The eugenic and sexist origins of the “functioning” divide, linked to ideas of “high intelligence,” the “male brain,” and views of disability as a measure of the value of human life. From this emerged the notion of “levels” as two extremes — “high-functioning” and “low-functioning.” These ideas have influenced the medical model throughout its historical continuity and have shaped perceptions and stereotypes that continue to permeate society.
3. Perception of functioning as behavior based on allistic functioning, reflected in ideas about “camouflage”. The erasure and denial of the real difference in functioning. From this emerges the idea of “levels” as, on the one hand, pathologized “autism”, and on the other, the non-recognition of difference (and what that entails), reframed instead as a “personality type”. The behavioralization and psychologization of difference in functioning.
As I reread some older posts, I simply feel the need to clarify a few things regarding the “levels” of the medical model. I try to be clear within the posts themselves about what I mean, but this is a serious issue that requires a great deal of responsibility. I never intended to engage with this topic in the first place. I believe that in the first related post I wrote, I mentioned that others are more suitable than I am to speak about this and that I am conveying personal experience. I ended up addressing it because of the circumstances surrounding RFK Jr. and his reference to an “epidemic”. I had also written at other times, but more generally about the “functioning split” and its eugenic roots. I have also come to understand that this distinction never clearly existed in the DSM as “functioning”, yet it has historically been conveyed informally through medical-model approaches. The DSM is not a manual to which everyone has access. Information is not easily accessible. I convey information through research. I happened to have access to the DSM itself around the year 2000; I read it at the time, but I have not had direct access since. Since then, I too read from others and relay information. Obviously, I do not remember in detail what that edition said about “Autistic Disorder” or “Asperger’s Syndrome”, since it never even crossed my mind that it could apply to me. In any case, whatever it said, I certainly did not identify with it.
What I want to clarify is that I am referring to a framework of perception—not to the flattening or erasure of the support that anyone may need. Within the medical model, “autism” is framed as a disease, with gradations—mild, severe. That is the error from the outset. This must be made clear. If from the beginning one views “autism” as a disease, one is already operating within the wrong framework.
As I say in the video Deconstructing Camouflage – Autistic Journals S2Ep1, the word “autistic” is being redefined today within a different framework. In this framework, we speak of a mode of functioning; there are no gradations or levels within it—levels in relation to what? This does not negate any support that an Autistic person may need. All it tells you is that the person “is Autistic”, they do not “have autism”, because it is not a disease. Let me therefore clarify this point: support is not being flattened or erased.
The problem with the medical model has two main aspects, which reinforce one another and simultaneously perpetuate stereotypes in society. The first is the reference to disease itself—the entire pathological framework of “autism”. The second is the eugenic origins of the concept of “levels". Not the concept of support, but the notion of “high” and “low” functioning, which is linked to ideas such as “high intelligence”, the “male brain”, as well as problematic conceptions of disability as a measure of the value of human life. As long as these perceptions are not clearly addressed, the “levels” of the medical model take on such connotations, and this is a serious problem.
The problem, therefore, lies primarily in dominant perceptions which, formally or informally, have historically been perpetuated through medical-model approaches and their prevalence.
Another point, which I address mainly in the above video on camouflage, is the view of “functioning” as allistic functioning (and whatever approximates it), and behavior based on that. This is not the same as the conception of “high functioning” as “high intelligence”. I also referred to this distinction in the posts Masking is not an indication of “functioning”; it is an indication of greater oppression. It is an indication of suppression,
and Autistics who “mask” are not “high-functioning”; they are supposed to not exist.
This perception relates more to “camouflage” as “functioning”, turns functioning into behavior, and attempts to eliminate it as “behavior”, while denying the real difference between autistic and allistic functioning. Informally, this creates a division between a level of pathologized “autism” and another level that is not recognized and is interpreted as a personality type.
This view is so dominant that it has affected us ourselves. The perceptions that we ourselves often hold about “camouflage” reflect a view of “personality”, or the behavioralization and psychologization of functioning. This denial of difference is also reflected in the idea that “everyone masks”, which I discussed in the post We are not talking about “cost.” “We are able” = “we are able”. They do not care.
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Common Misconceptions About Autism Levels – What It Really Means
Original post (Greek) / Πρωτότυπη ανάρτηση (ελληνικά)
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