[DEBATE] : Autism: lack of services is the cruel joke

[Russell]

Dr Michael Fitzpatrick
Autism: lack of services is the cruel joke
'Autism' joins the lexicon of lazy political insults. So what?

The description of Labour's heir apparent Gordon Brown as 'slightly 
autistic'
by shadow chancellor George Osborne has provoked protests from
self-appointed defenders of the feelings of families affected by autism (1).
But what is really offensive to us is the lack of appropriate services,
particularly for those most severely affected.
Some years ago I was told off by a social worker for referring to my
autistic son as 'mentally handicapped'. This term, like 'mental retardation'
in the USA, was common parlance among both professionals and the public for
many years, until with the advance of political correctness in the 1990s it
was superseded by 'learning disabilities' (though even more fastidious
authorities prefer 'intellectual disabilities' or 'learning difficulties').
If I had described my son as an 'imbecile', I would probably have been
referred to the child protection authorities. Yet this was the technical
term codified in the 1913 Mental Disability Act for people like him, with
IQs in the range between 20 and 50. Considered unable to earn a living,
imbeciles would now be labelled as having 'moderate' or 'severe' learning
disabilities. They were distinguished from the 'feeble-minded' (dubbed
'morons' in the USA), with IQs between 50 and 70, who were able to work, but
could not compete on equal terms in the labour market and were not capable
of 'managing their affairs with ordinary prudence'. They would now be
described as having 'mild' learning disabilities. Imbeciles were also
distinguished from 'idiots', considered incapable of guarding themselves
against common dangers, now designated as having 'profound' learning
disabilities (IQ below 20). Idiots were sometimes described as 'cretins',
derived from the French for 'Christian', indicating that they were regarded
as 'still Christian', still human beings (this term was also more
specifically applied to those suffering from congenital thyroid deficiency).
All these labels, and others associated with psychiatric illness (from
hysterical to neurotic) and physical disability (spastic, cripple) and
sensory deficits (deaf, dumb, blind) have long provided ammunition for
playground taunts and political polemics. Now that autism has become
fashionable, it seems that the jibe 'autistic' has taken its place alongside
'schizophrenic' in the thesaurus of lazy journalism and parliamentary abuse.
A storm of outrage greeted Osborne's casual slighting reference to Brown.
While he denied the statement, prominent Labour and Liberal Democrat MPs
lined up to condemn this grievous slight on people with autism. A
spokeswoman from the National Autistic Society complained that using the
term 'autistic' in a pejorative way could 'cause deep distress and hurt'.
Novelist Nick Hornby, who has an autistic son, complained about Osborne's
childish use of a 'serious and distressing disability' as a way of taunting
a political rival. Yet it seems that Hornby was not similarly offended by an
article by Robert Harris, entitled '"Autistic" Brown loses the plot'
published in the Sunday Times at the height of the recent eruption of the
struggle for the Labour leadership only a few weeks ago (2). Harris
described Brown as suffering from 'a kind of political Asperger's syndrome',
by which he means that he is 'intellectually brilliant, but socially barely
functional'. He accuses Brown of 'compulsive-obsessional behaviour, epic
rudeness and pathological resentment', of being 'ranting and demented', and
of 'brutal criminal stupidity'. Of course, this was a row within the New
Labour family, in which Harris is a prominent figure, and Hornby's
brother-in-law, so nobody took offence. Given the severity of Brown's
alleged psychopathology (which, as it happens, bears little relation to
autism) it is surprising that nobody has suggested compulsory admission
under a section of the Mental Health Act.
While all this name-calling and posturing was proceeding between Bournemouth
and the Westminster village, my wife was attending a conference on the theme
of 'Commissioning child and adolescent mental health services for children
with learning disabilities in London'. As one of the keynote speakers
indicated, these children are a 'Cinderella group with one of the highest
levels of psychiatric morbidity and lowest level of service'. I am much less
concerned about how my son is labelled than I am about being able to rely
upon gaining access to appropriately qualified staff and specialist
provision when this is required.
If only the provision of resources and services was pursued with the same
rigour as the policing of the terminological minefield of autism then I
would be quite happy for politicians and journalists to abuse one another in
whatever terms they like - though I do not believe that this is likely to
raise their reputation in the eyes of the electorate.
(1) Nick Hornby joins attack on Osborne in autism row, The Times (London), 2
October 2006
(2) 'Autistic' Brown loses the plot, Sunday Times, 10 September 2006
(3) Profile: Robert Harris, Observer, 4 February 2001