As readers of this blog will be familiar with, neurodiversity proponents argue that autism is a neuro-minority rather than a mental disorder. In short, they deny neither that categories such as autism indicate disabilities, nor indeed the various forms of distress associated with being disabled. Rather, it is that they locate this disablement and distress in society instead of framing it as stemming from a medical pathology in the individual. So an autistic person may, for example, have heightened sensory sensitivity; but they only become disabled in relation to the senses in a world that is not designed to accommodate for this different way of processing, thus leading them, say, to experience sensory overload.
Nonetheless, critics of the neurodiversity movement like to point to examples of what they (misleadingly, as we shall see) call “severe” or “low-functioning” autism in order to either limit or even dismiss the validity of the movement. Sure, they argue, even if some so-called “high-functioning” individuals seem different rather than disordered, and even if a few people given the “severe” label do advocate for the neurodiversity movement, these are not representative of the many who need 24 hour care, and have (so far) unsuccessfully been able to communicate anything more than very basic needs to those around them. In short, what these critics claim is that the minds of at least some of those deemed “severe” are so deficient that they are not just undeniably bad, but inherently so.
I want to suggest here that these critics of neurodiversity base their view on an increasingly outdated, and indeed unjustified, theory of what a mind is as such. I will call this the ‘atomistic mind theory’, and I take this (at least implicitly) to be the most widely held theory of the nature of the mind among the educated public today. In short, on this view, a mind stems from a brain, and is the psychological functioning that stems from that brain. Looked at this way, you might as well say that you are your brain. Or at the very least, the brain is the seat of the mind, and anything beyond the brain and its thoughts are not part of the mind as such.
This is a fairly widely held view of the nature of the mind, and one I am sure many readers of this blog will hold (including many neurodiversity proponents). But as the philosopher Andy Clark has long argued, this view is neither justified, nor able to accurately capture the phenomena of cognition. In short, he notes, many of our cognitive processes do not just take place within the broader world they are embedded in; rather, many forms of cognition actually wholly or partly rely on this outside world. As a recent commentator summarises, for example: ‘There [are] many kinds of thinking that weren’t possible without a pen and paper, or the digital equivalent—complex mathematical calculations, for instance. Writing prose [is] usually a matter of looping back and forth between screen or paper and mind: writing something down, reading it over, thinking again, writing again. The process of drawing a picture [is] similar.’
What Clark points out here is that, whilst the atomistic mind theory might frame these resources as mere external scaffolding for the mind, this vastly underestimates their importance. In fact, since the cognitive process that arise in light of them could not happen without this scaffolding, then this scaffolding is as integral to cognition as the scaffolding of the brain is.
Hence the superior alternative to the atomistic mind theory is Clark’s (and Chalmer’s) ‘extended mind theory’, which holds that the mind is not situated in the brain, but rather widely embedded in relation to many various resources, from the neural to the technological (for example, even as I type this article, the many tabs open on my browser are constituting my memory as much as my brain is). By contrast, it is a mistake to think that ‘whatever matters about my mind must depend solely on what goes on inside my own biological skin-bag, inside the ancient fortress of skin and skull.’ This belief, although still widely held, rests on unfounded assumptions as to what constitutes cognition – one that unduly discriminates against environmental (and sometimes bodily) resources in favour of just the neural resources.
Return here to the example of the so-called “severely” autistic person who needs a lot of help. Perhaps they need special technology to communicate (we might not even have invented this technology yet), and various technological resources in place to help them organise and plan their day. Perhaps they also need other people there around the clock to help them do things in various respects. And so forth.
On the one hand, according to the atomistic mind view, we should judge mental deficiency in terms of having to rely on external supports more than whatever we consider normal at the given time, since the need for external supports indicates that the mind (and brain) must be lacking. (In turn, if we then look at the neurology and it does indeed seem different to the norm, then this is taken to confirm that the mind was deficient – thus giving the impression of justifying the initial hunch.) Hence, on this view, it is hard to conceive of someone who needs 24 hours support, and so forth, to be anything but mentally disordered, or indeed “low-functioning”.
By contrast, however, without unduly discriminating against the extended aspects of the mind, there is no good reason to think that any given mind is deficient merely for having to rely on the environmental aspect of the mind more than the neural. For if we withhold from such discrimination, then this seem like a matter of different distribution rather than inherent dysfunction. It is just that some minds rely on the neural aspect more heavily, whilst others rely on the environmental aspect more heavily. The case of the so-called “severely” autistic person who needs a lot of help is, then – at least when they do get the help they need – a case of widely distributed cognition, rather than deficient cognition.
Crucially too, then, whether they get this help or not is a matter of social justice, not of medicine. Just as it would be a case of social (in)justice rather than medical pathology if some group (for instance, all those with an IQ between 85 and 90) were needlessly excluded from being given calculators at school due to discrimination. The extended mind theory thus helps us understand how the disablement of the autistic extended mind is a matter of power-structures having excluded this mind in various ways, rather than a simple matter of impaired functioning.
This leaves me with the following two thoughts. On the one hand, for as long as there are autistic people whose extended minds cannot function, then despite initial appearances, it is not the autistics who are sick. Rather, the sickness lies in the society that leads to the disablement of the extended minds of its minority members. On the other hand – and perhaps worse still – society’s need to project this pathology back onto the autistic person, rather than admitting its true societal nature, makes the sickness of that society seem much more insidious that it might initially appear.