What’s MSSNG in #Autism?
Me, at age 2. Even then, I was #notmssng (c) John Elder Robison |
Yesterday a new hashtag campaign appeared in my Twitter feed
– #MSSNG. It seemed to refer to autism, and a new research project. I had an
immediate reaction, based on my interpretation of the letters in the context of
the autism discussion - I thought, Missing? Certainly not. We may be gifted or we may be disabled but we
are definitely here. And we are complete
humans. I posted that right away,
and it launched a flurry of discussion.
My response seems to mirror the prevailing sentiment with respect to this campaign - autistic people are not missing, and nothing is missing from us. In fact, a counter hashtag had appeared moments after I read it - #NOTMSSNG.
My response seems to mirror the prevailing sentiment with respect to this campaign - autistic people are not missing, and nothing is missing from us. In fact, a counter hashtag had appeared moments after I read it - #NOTMSSNG.
I wondered what the campaign was about, so I went looking. It’s
an initiative by Autism Speaks to sequence the genomes of 10,000 individuals
touched by autism. In my opinion, that
is a worthwhile thing to do. I’ve
written before about the value of genetic research. But it is far from my #1 priority for the
autism community. More on the why of that later.
Their choice of a name turned mssng from an announcement of
a science initiative to a public relations debacle. I think it’s seriously misguided on several
fronts.
First – the community side
As I said in the beginning, autistic people are not missing. We have always been here, and we always will.
Yet I and many other autistics live with the knowledge that we occupy a world
where autism is widely perceived as a disease or defect. I can’t speak for
other autistics, but I don’t much care to be seen as diseased or defective. Nor
do I like being seen as “missing pieces,” which the name mssng implied.
To say that is not to deny the very real ways autism
disables us. Rather, it’s a simple
statement of fact. Autism is a
neurological difference, not a sickness.
As such, it’s here for a reason. Who are we, to second-guess that? Remediate its disability – sure! Wipe it from the world – that’s crazy talk,
and societal suicide.
I’ll bet every autistic kid in America knows how it feels to
be told we were missing some of our marbles growing up, and reminding us of
that in the context of a research initiative is at best insensitive and at
worst seriously offensive.
It’s not a name I’d have chosen. I don’t know who did choose it but I’d bet
they were not autistic.
An organization run by autistic people would not have made
this mistake. An organization run by non-autistics,
autism parents, and autism grandparents DID make this mistake. Or perhaps to
them, it’s not a mistake. It’s just
“Some autism parents speaking.” But that
is not what their organization’s name implies.
If “Autism truly Speaks” it by definition does so through autistics.
That’s the only way it could speak.
“Autism Observed” is what parents and non-autistics do, and
the observers get it wrong a troubling percentage of the time, in the opinion
of many who live autism in the first person.
Those are very different things, and we should get our
terminology right.
Second - the science side.
The idea of researching autism at its most basic makes
sense. But genetic research is fraught
with ethical challenges. However, that
is not its biggest problem here and now.
The biggest problem here and now is very simple: Genetic research is an extremely long term
game. The timeline to start a study like this, make a discovery, translate that
to a possible treatment, and then get that treatment tested and FDA approved is
10 years at a minimum, and more likely 20 years.
So this effort won’t help any of the autistic children
today. Benefits may flow from the
research one day, but the beneficiaries will be tomorrow’s children. Today’s
children will be long grown up, for better of for worse.
What we need right now are therapies to help us be the best
we can be, as we actually are. We need
tools to help us overcome physical limitations.
We need solutions for the medical problems that plague many people on
the autism spectrum. Those are things
autistic people – child and adult alike – want and need right now. The range of therapies, tools, treatments,
and services needed is long and varied – and largely attainable, given the
budget and the focus.
We also want societal change and acceptance. We want sensory friendly workplaces. We want jobs shaped to our different
abilities. We want help navigating the
education and employment mazes. We want
to be productive members of society.
Those too are things we want and need right now. They too are attainable given the resolve,
budget, and legislation to back it up.
If I were running an autistic-centered autism advocacy
organization, I’d be making those things my #1 and #2 priorities. I wouldn’t be talking genetics until I’d made
some really solid progress on my main objectives. Once I showed the community what I was doing
for them today, I’d talk a little about the long term game.
And most of all, I’d be looking around me, at autistic
people leading the organization.
I’m a big believer in science, and I absolutely understand
that genetics may one day solve the riddle of why some people have spontaneous
genetic mutations that lead to severe intellectual disability. It’s led to some important discoveries and it
will surely be key to more. But how many individuals who live with intellectual
disability today will be helped by that?
How many autistic job seekers will get a job, thanks to that work? How many autistic kids who wander dangerously
will suddenly become safe? How many
autistics that suffer from anxiety or gastric distress will suddenly relax in
comfort? Those are a few of the very real issues autistic people are actually
thinking about now, and genetics isn’t one of the answers on tomorrow’s table.
Genetics is important.
But it is not job #1 for this community. Once again, with this effort,
we are spending money in the wrong places.
We should not be trying to “solve the autism riddle.” We should not be “looking for missing pieces
of the autism puzzle.” We should be Helping Autistic People – Right Now. When we consider a piece of research - and much is needed - we should never lose sight of the fact that people need help today, not in ten years. Basic science is good, but applied engineering gets the roads and dams built. That is a very apt analogy for our situation.
The misjudgments about priorities and the marketing mis-steps have overshadowed the science for now. That's unfortunate, because the concept behind this latest effort seems to have a lot of merit. And I'm sure it could have been enthusiastically embraced, had it been presented in the right context, with autistic oversight, and as part of a larger effort whose main thrust was directed more toward deliverable benefits.
So what can we do, to avoid more public relations debacles like this, which hurt us all? We can bring autistic people into positions of authority in all the agencies who speak for and about the autism community, and who fund research into autism. If the organizations are guided by autistic thinkers we might all be surprised at where that could lead us. And believe me, we need answers. The challenges we face are all too real, and very diverse.
That is my opinion, and my hope and wish for this holiday
season.
John Elder Robison is an autistic adult and advocate for people
with neurological differences. He's the author of Look Me in the
Eye, Be Different, Raising Cubby, and the forthcoming Switched On. He serves on
the Interagency Autism Coordinating Committee of the US Dept of Health and Human Services
and many other autism-related boards. He's co-founder of the TCS Auto
Program (A school for teens with developmental challenges) and he’s the Neurodiversity
Scholar in Residence at the College of William & Mary in Williamsburg,
Virginia. The opinions expressed here are his own. There is no warranty expressed or
implied. While reading this essay may
give you food for thought, actually printing and eating it may make you sick.
Comments
I agree that the other areas need attention too. I am sure the frustration is more that these areas seem to take a backseat to Autism Speaks "finding a cure". We should be doing all right now, not just the genetic portion.
I am absolutely supportive of this. I just think there are more important issues ahead of it.
Thanks for your thoughts
But I also made the point that we (the autism community) have a very diverse range of problems most of which will not be addressed through genetics. We need behavioral therapies, technology to help communicate, and a host of other things.
So genetics is valuable. But it's not the centerpiece of a well thought through strategy to serve the community who lives with autism now.
Thanks for your thoughts
John
So what can we do, to avoid more public relations debacles like this, which hurt us all? We can bring autistic people into positions of authority in all the agencies who speak for and about the autism community, and who fund research into autism. If those organizations are guided by autistic thinkers we might all be surprised at where that could lead us. And believe me, we need answers. The challenges we face all all to real, and very diverse.
Thanks for your thoughts
Yes we need the studies, but it's terribly out of balance with real time resources for families.
I've also said and written, that I hate hearing about the missing piece. I'm not missing a damn thing. It's not ever been my goal to find the piece to make him fit, into a school, a club, a society. My goal has always been to help him know how to advocate for himself, and teach the people around him, who he is, how he learns. I know I'm lucky in that he isn't as challenged as some, but I wouldn't ever want him to be anything other than what he is. He's taught me tolerance and patience.
Thank you for this piece. I'm grateful for you.
In my community, we have a great need for advocacy. Many families do not know what therapies are available to them or how to go about obtaining support. Many supports can also be lacking. Is this a void that AutismSpeaks can fill? Is this one of their tenets of operation? Somehow, yes families and individuals need to be connected with proper supports, therapies and community programs. People need to know their rights.
All our social communication programs include equal numbers of socially challenged and socially skilled peers. Why? Because growth in understanding and skill is needed on both sides--those who have autism and those who don't.
You are a consultant to our board. We look forward to your continued support. Our non-profit will be on GuideStar in January and we hope to make our model available across the country through a trainer of trainers program.
We welcome people with autism to participate in the development of our organization. Find the Social Communication Foundation on FB and the internet :)))
(child, mother and wife of fellow humans with autism)
By remediating the folate deficiency, you remediate many of your autistic difficulties. In your case those difficulties have a fixable medical basis. But are you "cured of autism?" I don't think so.
Out brains wire and rewire themselves from birth through the process of plasticity. It is that wiring that shapes our thoughts. You can fix a chemical imbalance in your brain overnight, but the non-standard wiring that is a consequence of growing up different will remain.
Could you rewire yourself to be less autistic over time? Sure. That is what you see in me and many other autistic adults. But it's a lifetime process, not a quick fix.
And as you note, you still have a number of medical challenges remaining. We must work one by one to remediate those precisely because there is no systemic cure.
Another thing your post illustrates is that there are many different paths into autism, and they can affect us very differently even though we are diagnosed with one condition - ASD - based on a broad set of behavioral observations. There may not be not much in common between the core of your autism and mine, even though we both acted in similar ways such that doctors gave us the same diagnosis.
That of course shows the great value of biomarker testing when it becomes available, because the treatment for you would be different from anything for me.
Thanks for your thoughts
We need acceptance and understanding. The idea of autism being pathologized and reduced to the point of Down Syndrome, where 90% of children are aborted, is terrifying to me. We can help ameliorate the truly disabling aspects of autism without erasing us. I refuse to countenance eugenics.
Maybe that is what should be the focus of research.