As Frith says, the criteria for diagnosis of autism have widened (see previous post on ‘The origins of concept of autism’) and there is no agreement it is a biological entity. She lists some drivers of change for increasing diagnosis, including: the desire to have a more inclusive, broader concept, such as autistic spectrum disorder; diagnosis creating a class of people which in a sense did not exist before because having the diagnosis changes their understanding of themselves, which Ian Hacking called a ‘looping effect’; spread of knowledge of the condition by social contagion, including with the increasing use of online communication; uncritical reliance on the perspective of those with lived experience; people wanting the diagnosis to explain aspects of their personality; acceptance that the condition has been masked in females; and, negative aspects of human experience being unnecessarily pathologised.
The concept of neurodiversity is fundamentally about recognising personal differences and the need for society to adapt to those differences (see eg. previous post). A medical diagnosis may liberate people from self-blame but wrongly blaming the brain may impair proper understanding of the reasons for personal differences (see eg. another previous post).
Frith particularly highlights the difference between those diagnosed with autism as young children and those diagnosed later in adolescence and adulthood. Originally autism had to be diagnosed in children before the age of 30 months. As Frith says, “the clinical meaning of ASD [autistic spectrum disorder] has been diluted”. I suspect what this means when the review set up by the government into mental health conditions, autism and ADHD (see previous post) produces its final report is that the diagnoses of autism and ADHD alone will be insufficient for a successful benefit claim.
Neurodivergent diagnoses, such as autism and ADHD, are not the only psychiatric diagnoses in which there has been expansion of the concept, potentially making the diagnosis meaningless. For example, bipolar disorder has been expanded to come to mean essentially mood instability, which is very common (see eg. previous post). Even further back, the use of the term schizophrenia, particularly in USA, became too broad, so that the definition was narrowed by DSM-III (see eg. my article).
Frith was influential in shifting understanding of autism from psychogenic to neurodevelopmental theories. Her questioning of the loss of meaning of autism, with her focus on the need to provide support for those with severe impairments, may well be influential.
