Absolute Nonsense

Over in England, Mary is working to get her son assessed for ADHD, Tourette’s Syndrome and Asperger’s. I would think that the TS would be a fairly easy diagnosis for their specialist to make, especially if various people at home and school have documented lists of various motor & vocal tics. The ADHD diagnosis can sometimes be trickier, if only because the more noticeable tics tend to overshadow things, but given the frequency with which these syndromes are co-occurring (I hate the term “comorbid”), no one should be surprised. Likewise, AS also tends to come in these “package deals”.

But the reason I mention all this is to comment about one of the aspects of the interview process that she mentioned:

They did not think, for various reasons, that he has Asperger’s, mainly because he is highly creative and also has a sense of humour (doesn’t take everything literally as most asperger people do).

Boy, talk about literal-mindedness! There’s nothing like absolutes to mess up diagnostics. When people start throwing around concepts like “always” and “never”, I get the impression that their experiences with different students (or clients, or adults, or children) is limited to memorising narrow diagnostic criteria and the obligatory (brief) psych rotation during training, rather than with numbers of rather diverse, real people.

Asperger’s or autistic kids do not:

  • always take things literally;
  • never have a sense of humor;
  • always have flat affect;
  • never make eye contact;
  • always drone on incessantly about their special interests;
  • never have friends;
  • are always computer or math whizzes;
  • always demonstrate stereotypical flapping, rocking, or stimming;
  • or lack imagination — as the man himself said:

“It seems that for success in science and art, a dash of autism is essential.”
~Hans Asperger

After all, everything is relative — we’re comparing how the person is compared relative to their peers. Likewise, if the family has members with TS, AD/HD, AS or any other co-occurring conditions, well, it shouldn’t be too hard a diagnostic stretch to consider that the person of enquiry may well have similar issues!

As a pal of mine used to jest, “There are absolutely no absolutes.”