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Autism: Disorder? Deficit? Disability? Impairment?



Disorder, Deficit, Disability, Impairment. These are all words that come up when reading about Autism. It’s no wonder that being newly diagnosed or thinking about getting a diagnosis can hold a lot of misgivings in someone’s mind. Is there something wrong with me? Why can’t I fit in? Why don’t I understand people? These are all questions I have heard from clients throughout my career working with autistic adults.


These thoughts can be generated partly due to societal influences, a pressure to conform, unhelpful stereotypes and family and friends making perhaps well-meaning but nevertheless unhelpful comments such as “we’re all on the spectrum one way or the other”.

That’s like saying to someone in the depths of depression that we all get a little sad sometimes. Yes, people may have autistic traits, but a diagnosis or identifying with being on the spectrum is rooted in how much these traits are affecting and impinging on someone’s life. For example, you may feel a little socially awkward and have a degree of social anxiety. For an autistic individual that anxiety may well affect them being able to access healthcare or go out to work.


A number of my autistic clients suffer from depression and anxiety. In my experience, causes can range from not having had the support needed over their lifetime and years of possible misdiagnosis to closed minded health professionals and denial of its potential existence from family.



The medical model subscribes to the notion there is something wrong with you as an individual. The social model on the other hand, as the name implies, takes a broader wide-angled look at things – how is society disabling you?

The answer to this? In many different ways. For example, Psychometric tests at job interviews with ridiculous scenario-based questions which do not make sense to the logical, analytical way of thinking many autistic individuals have or the notion that autistic individuals need to ‘fit in’ and understand people.


What about what Damien Milton, autistic researcher calls the ‘double empathy problem?’ Many of my autistic clients think the responsibility when communicating with non-autistic people lies upon themselves – that they are somehow to blame for misunderstandings. Why are they being made to feel this way? Sadly, because as a society we still value extroverts and celebrity culture favour a particular ‘type.’ A little bit of understanding and meeting someone who may communicate very differently to how you are used to at least halfway, can go a long way to mutual understanding and harmony. Empathy works both ways. It’s not surprising then that a disproportionate number of autistic people (as many as 2 in 5) experience depression and anxiety – it is a valid response to a perceived unkind and hostile environment where they are made to feel less than equal.


So back to the words at the beginning of this blog. Deficit words. What about strengths I see in my clients? Logical, analytical, empathetic, non-judgemental, detail orientated, honest, dependable, to name but a few.


I am not denying challenges here – Common challenges can include needing guidance in grasping the “big” picture, uneven set of skills (eg may have a PhD but can struggle to follow a recipe), perception of unwritten rules of social interaction, sensory issues, expressing empathy in a way not always understood by others, executive functioning (planning, organising, task initiation). Indeed my work is often based around addressing and helping clients deal with these challenges as well as identifying and challenging barriers which may be getting in the way of them leading a content and fulfilling life.

If you would like to know more about autism support or mental health contact Wings To Fly at contact@wingstoflytherapy.co.uk


We have over 10 years experience working with autistic adults and can help with:


· Autism and mental health

· Workplace support

· Finding and maintaining work

· Relationships and friendships

· Supporting an autistic family member


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