Tyler Cowen responds
Tyler Cowen has graciously responded to my recent post in an email. With his permission, I am printing it below. In the interest of accurately representing him, I’m going to post the full email.
“First, I stress that my view is about diversity of outcomes — often extreme diversity — not that things go well for everyone or even most autistics. I feel you are misrepresenting my views on this a bit. I’m not saying it is all “good,” by any means.
Kanner and Asperger recognized varying outcomes as important from the very beginning of this literature, although some of their points often get lost.
You wish to claim that the needs of “high-functioning autistics” are becoming central. Keep in mind that Jenny McCarthy and Autism Speaks are still dominating this debate in the public arena, not the neurodiversity crowd.
In my view we do not know the ratio of “high” vs. “low” functioning; there are probably more “highs” than we think though it is unlikely that they are in the majority. I also have reservations about the term as it is used in that manner.
I very much argue against the idea of autism as personality traits or for that matter autistics as “shy” (many of them are not, or they have non-shy temperaments which they cannot meaningfully express). I view it as a cognitive profile with varying advantages and disadvantages, not a personality profile.
If we look at the history of Down Syndrome, or for that matter issues of race and gender and discrimination, or transgender issues, greater recognition of varying outcomes has gone hand-in-hand with better treatment for those with the less advantaged outcomes. That’s a pretty consistent pattern and I believe it will hold for autism as well. It’s not either/or and it’s not as if the “high-functioning types” are wrecking some kind of current idyllic paradise for the “low-functioning types” or calling for cessation of aid. Quite the contrary. This is perhaps the one point I would wish to stress to you the most.
I would, say, wish to eliminate the often serious motor and coordination problems experienced by autistics. I’ve never met anyone, autistic or not, who wouldn’t agree with that. I would not, however, in general wish to eliminate autistic minds and I believe there is a coherent notion of such a mind without the motor (and other) problems. You might not disagree with that, but I’m not sure you are distinguishing between those concepts with enough clarity.
I worry about creating a separate category of autistics who are in essence labeled as “truly autistic, you are the people who have absolutely no chance.” First, there are some amazing success stories, even if they are a minority. Second, even if they can’t succeed by conventional standards, a large number of these autistics are extremely intelligent and have many other virtues and capabilities.
Also keep in mind that some of these people (and I mean those who can’t talk, bang their heads, have other serious life problems) wake up every day and type “autism” in news.google.com and blogsearch.google.com to read what is new on the topic. I worry about how they should respond to the notion that they are a kind of pure disorder and the possible implication (not necessarily intended by you, I grant) that in essence their minds should not even exist. Why don’t we instead adopt a more sophisticated terminology that recognizes a) cognitive profile as the key feature, b) varying outcomes, c) multidimensional capabilities which render pure definitions of “mild” and “severe” quite complex, and d) the need for aid and assistance in a great number of cases?”
And, in a follow up email
“Note that recent work by Patricia Howlin conservatively estimates that at least 1/3 of autistics have some kind of savant-like ability. So far this paper is being taken very seriously and she is well-established and well-respected in the area.
I do agree, however, that savants as a phenomenon are “over-recognized” in popular culture. My book mentions them only in passing, as I would rather people had a better sense of the non-savant-like intelligence abilities of autistics.
At some deeper level, of course, these abilities, and the possibilities of savant-like skills, may well be related. Most likely autistics have greater access to lower-level forms of information processing (and that involves both costs and benefits).
I should stress that this portrait applies to idiopathic autism but probably not to etiological autism as represented by Fragile X, TS, mouse models, etc., noting that most human autism is idiopathic in nature.”
I am glad that Dr. Cowen has clarified the views expressed in his diavlog. Like Freddie, I haven’t read his book, so my impression of his views were based on his discussion of the topic with Mr. Wilkerson. I took his main point to be that autism should not be viewed as a disorder but as a mismatch between these individual’s personality profiles and the attitudes and opportunities in society as a whole. Neither of these gentlemen mentioned that a greater portion of people with autistic personality profiles engage in repetitive and unproductive or even self-abusive behavior as compared to people without it. Or that they end up in institutions. In a similar vein they applaud the fact (I take their word for it) that people with dyslexia are over-represented among the entrepreneurial class without also mentioning that they also are over-represented in our prisons. I don’t think Freddie misrepresented the views expressed on bloggingheads; perhaps in that context, Dr. Cowen was unable to express the full range of ideas expressed in his book. It seems more accurate to say the discussion misrepresented the views he says are expressed in the book.
I have a lot of sympathy for the notion that people who are at the high-functioning end of a profile/disorder often have abilities that differ from the norm in ways that can allow them to succeed in the right niche. And that public discussion that focuses only on the plights of people at the other end of the spectrum can skew the way society responds to their condition to the detriment of the higher-functioning. I have had a similar experience to the two bloggingheads, except with depression. I believe they pointed out that we often have a more realistic understanding of our abilities, ie. we don’t share the widespread psychological phenomena of being overconfident of our abilities. But this comes at a cost. Other discussions of this phenomena have noted that overconfidence may have important evolutionary implications. While overconfidence does cause difficulties, it also leads individuals to take on new and challenging tasks they wouldn’t otherwise. And often they succeed. Years of seeing everything happening in my life through a foggy gray filter kept me in a job I was not well suited for and a relationship that was not as fulfilling as I would have liked, but I could just not see success following from a major restructuring of my life. I could only see the downsides–like economists, 15 of the 3 downsides. After a couple of years of treatment–not merely being told and even understanding on some level that I had hidden worth as an individual that could be cultivated by changing my life–I moved across the country and took up a radically different lifestyle and have never been nearly as happy.
Would hearing my life-story really be of any use to someone in the midst of an episode of major depression? I doubt it. Perhaps depression is unique in this, but my view is that the style of thinking that I engaged in pre-treatment would have meant that I would have come up with any number of reasons for knowing that such a story was the exception to the rule, that it didn’t apply to me because of my unique circumstances… And hearing that I didn’t have a disorder, but only a different personality profile, would have only confirmed notions I believed and used as reasons to not seek treatment. Being referred to as a depressive would have also been counterproductive. (In his second response, Dr. Cowen twice refers to autistics despite decrying reference to individuals with autism personality profile as “pure disorders”) Being treated as a person with a serious illness, even a disorder, allowed me to focus on what I had in common with others, whereas being called a “depressive” would have set me apart as different.
Perhaps changing economies and technologies will provide enough niche positions for all the people with autism, ADD, and depression who also have above average IQ’s, come from advantaged backgrounds, and somehow are able to come to terms with their true strengths and weakness. And we should all desire and work toward a society that is ordered to maximize these possibilities. But in the case of autism and depression at least, there will still be a need for approaches that acknowledge that many with these conditions will lack the means to pull themselves up by the bootstraps and that without specialized help they will suffer far worse fates than not finding a fulfilling, productive profession. Perhaps how to get there would be a good discussion for another bloggingheads.Report