The Problem with the Question​

“Do you think he has Asperger’s Syndrome?” or “In your professional opinion, do you think he is on the spectrum?” or “Do you think it’s ADHD, Asperger’s, OCD, or possibly something else?” 

Shortly after a nationally televised event, my phone began ringing with a flurry of related questions about a young man who was seen on stage alongside his parents. “Do you think he has Asperger’s Syndrome?” or “In your professional opinion, do you think he is on the spectrum?”. Oddly enough, I am asked this type of question frequently. More often than not, when I sit down on a plane or am waiting in an office and begin chatting with someone about what I do, the first question they ask usually involves someone they have always wondered about and what I think they might “have”. “Do you think it’s ADHD, Asperger’s, OCD, or possibly something else?” My response usually frustrates them, but it’s the most honest answer, “it sounds like they are a person.”

Mental health diagnoses have long been controversial, but I’ll let the psychiatrists squabble over them, while the rest of us work with the people they diagnose. Technically, it is generally the classification of a disability and not the diagnosis that causes controversy. Asperger’s and ADHD, for example, are classifications, not diagnoses. A diagnosis is the cause of a problem: influenza virus causes the flu and streptococcus bacteria causes strep throat. A classification is the name we give a cluster of symptoms, not their cause. Classifications are often subjective and rely on observation and opinion. If a psychiatrist checks enough symptoms off the list and rules out others, then they can guess that a person qualifies as “having” something. However, the overlap in classifications cause differing opinions. Anxiety, inattention, and shyness, can look like mild autism (Asperger’s) to one person and ADHD to another. A social communication disorder can become autism if the person is passionate about trains. A room full of clinicians could all come up with a different “diagnosis,” but only one thing stays the same, the person.

Classifications encapsulate the diverse and unique characteristics of humankind into words that give us comfort for difference. The process for grouping these symptoms and assigning them names is a human quality. At the foundation of the process, we simply start with human traits. As we move forward in the process, we begin creating difference. However, the only truth in the process is that as humans, we are all different. By focusing on what someone might “have” we lose sight of all of the beautiful, unique, and creative differences that make them who they are. When we try to treat or even support them by only their label we miss the strengths that make them resilient. When we pathologize differences we overlook the people.

So what does your friend, nephew, cousin, boss, uncle “have?” I don’t know, but my guess is that they have intelligence, drive, and creativity. They have the desire to be a successful and independent. Hopefully, they have family and friends who love them, and celebrate their strengths. Most certainly, they have beautifully diverse and unique characteristics, just like the rest of us.

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