The Left Hand of Equality

In response to my last post, a reader raised the issue of how autistic people would get needed services if the autism diagnosis were to be removed from the next edition of the DSM.

Here is my pictorial answer to that question:



You're probably wondering why I posted an image of such an ordinary, everyday item as a pair of left-handed scissors. What does that have to do with a complicated issue like autism services?

Well, according to the social model of disability, just about any configuration of the human body can be disadvantageous if the environment is poorly suited to the person's individual needs. Most of our potential disabilities (of which there are many) go unnoticed because our society accommodates our differences adequately. Those of us who happen to be lefties can buy left-handed scissors and other products designed for left-handed use, instead of struggling awkwardly with tools made for right-handers. There's no requirement to be diagnosed with a handedness disorder, or anything of that sort, in order to gain access to lefty products. Vendors have recognized that there is a demand for this merchandise, and anyone can buy it, usually at a reasonable cost (granted, some specialized tools can be scarce or expensive for left-handers).

In a more rational society, products and services designed for autistics and other neurological minorities would be just as easy to obtain. There's no inherent reason why they should be prohibitively expensive. Anne C. of Existence is Wonderful just blogged about buying a portable word processor with text-to-speech capability for 10 dollars. Such products, however, can end up costing thousands because they are purchased by government agencies, insurance companies, school districts, and other bureaucratic disability services providers. Vendors can get away with price-gouging because of the pervasive (and largely groundless) prejudice that "disabled" people cost much more than "normal" people.

Another factor making disability services unnecessarily expensive is society's assumption that certain kinds of people must be closely supervised at all times and cannot make their own decisions or do anything productive. Institutionalization is the classic example of providing costly and unnecessary full-time care, but large institutions are not the only places where this occurs. Quite often in today's society, an autistic teenager who has self-care difficulties will be placed in a group home and treated as if he is incapable of ever working or living independently. Given the opportunity, though, he might do just fine in his own apartment, with a housekeeper coming in once a week to tidy up the place and do his grocery shopping for him. If he could get a decent job without being discriminated against because of his autism, he could pay the housekeeper out of his own wages.

To be clear, I'm not arguing that every autistic adult ought to be self-supporting; after all, there are many non-autistic adults who cannot earn a living wage, for various socioeconomic reasons. But if our society assumed competence and provided equal employment opportunity, there would be more workers contributing to the economy and more disability funds available for those who truly could not work (as determined by individual assessments, not broad labels).

Society also tends to underestimate the cost of providing services to those it classifies as normal. The neurologically normal person is actually nothing more than a figment of society's imagination; as shown in this mathematical proof, a person's chance of being psychometrically normal (that is, within the normal ranges on a set of standard psychological tests) is only 1 in 10,466. Nevertheless, the prevailing assumption is that most people are normal and self-sufficient and can fend for themselves. So there's no attempt made to determine what unmet needs they may have as they go through their lives... and large numbers of "normal" people end up struggling with confusion and anxiety, coping with their problems by drinking themselves into oblivion every Friday night. Because they are "normal," their problems are blamed on their own character flaws, rather than being viewed in terms of a failure to provide services and accommodations for their individual needs.

If we acknowledged that just about everyone could benefit from more services than they're getting, that would go a long way toward reframing the issues associated with disability services. For instance, one of the main areas of conflict in special education is the reluctance of many schools to provide an aide to assist a child in the classroom. Because it's expensive to hire an aide, the autistic child is seen as a burden to the school district. A more accurate way of looking at this situation, though, would be to recognize that today's schools are grossly understaffed and that every classroom ought to have at least one aide.

Many years ago, when children attended one-room schoolhouses, the older children regularly helped to supervise and teach the younger ones. As education became a standardized service provided by large bureaucratic school districts, each teacher was expected to be responsible for a classroom of 25 or 30 students, with no help at all. For a long time, the educational bean-counters managed to get by with this meager level of staffing because there were no laws against disability discrimination. If a child needed more attention than the teacher was able to provide, he could simply be expelled, often with a recommendation that his parents send him away to an institution. More recently, the schools have resorted to drugging large numbers of students with Ritalin and other medications to keep them docile.

Our society does not have millions of defective children—it has a defective educational system that is designed to do everything on the cheap, that treats parents as adversaries instead of customers, and that is incapable of meeting the needs of a diverse student population. Here's my prescription for change: Big hefty vouchers to fund adequately staffed schools and enable families to choose the environment that best suits their child's needs.