Why do doctors recommend extensive therapies after an autism diagnosis?
Much of the “western” medical system is not neurodiversity affirming
The medical model of disability effects the recommendations given when a person receives an autism diagnosis. Disabled people created a model that better explains their experiences and pushes for inclusion in society. That model is the social model of disability and it is widely accepted by the Autistic Community.
Remember, the medical model sees autism as something to be “cured,” “fixed,” or “treated.” It focusses on changing the person to fit societal standards of “normal” and believes the proper approach involves extensive intervention at the earliest age possible.
This mentality is one of many reasons that I wrote my latest book, No Place for Autism? The medical model does not see a place for us in society. It works towards a time where we no longer exist (the logical extension of the “cure” mindset). It doesn’t consider the many contributions of autistic people towards making the world a better place.
The medical model also has no place for an autistic identity. I am autistic. This is how I identify. Yet, in the medical model, I am a person with autism. The obvious implications of this person-first language is that I can be a person without autism, which is their goal.
As hard as life can be in the “western” capitalist society that I live in, I have no desire to live a neurotypical life. I don’t want to be without my autistic system. I would not be me without it.
Think about all of the “therapies” that are supported by the medical model. One in particular, Speech and Language Therapy, is necessary because the system doesn’t acknowledge the scientific fact that the human brain processes language in differing ways.
Wait? Did you know that humans acquire their primary language in different ways?
The two styles of language acquisition are known as analytic and gestalt. Do you think that it might be helpful for parents and teachers to know which style their child (or student) is using to process language? I do.
Understanding the way a child is building language skills, for example, can help parents understand what their child is trying to communicate. It can help parents learn the best ways to support their child’s growing language skills. Yet the medical model insist that there is only one way humans acquire their primary language. Any deviation from that one way (analytic) is considered disordered. The disordered are then shuffled off to therapy.
But what if your loved one doesn’t need therapy? What if they need an informed and educated team on their side? What if their teachers were trained / educated about the two dominant styles of language acquisition? What if reading programmes acknowledge both styles and offer ways in which learners can grow as readers using their natural language abilities?
A child processing language in an analytic way attends to and learns the meaning of single words. Then, they begin to use that word in different contexts and eventually combine the word with other words to form their own phrases.
Instead of learning the meaning of one word at a time, people like me start developing language by memorizing whole phrases (Gestalt Language Acquisition / Gestalt Language Processing) (GLP). They then work backwards into learning the meaning of the words that make up those phrases.
This often displays itself as delayed echolalia. It’s when a person hears a phrase and then echoes (repeats) it later on. Echolalia is often seen in autistic people. However, some people who are not autistic also use echolalia to communicate. A majority of autistic people are GLPs.
Analytic vs Gestalt Language Processing
Here are some key characteristics of these two methods of language processing:
Analytic Language Processing (ALP)
This is what the system assumes is the “typical” language acquisition in humans.
Child learns single words as units first (ex: “go”).
Progression of language learning moves towards combining words into different phrases and sentences (ex: “I want to go” or “go in”).
Gestalt Language Processing (GLP)
Begins with the child imitating phrases they previously heard (delayed echolalia).
A child then breaks down the phrase as they learn the meaning of the individual words.
The child uses those individual words to build other, novel phrases and sentences to communicate.
You can think of ALP as a progression of acquiring language from parts to whole. Whereas GLP progresses from whole to individual parts.
Again, every single reading program in the western world assumes a learner is an ALP, assigning GLPs to Speech Therapy. This was a major factor in my being functionally illiterate when I graduated high school.
Here’s what to know if your child seems to be a GLP:
A child may start by repeating memorized phrases (echolalia).
They might not understand what the individual words mean or how to sequence them to build a sentence.
As the child starts understanding more about how to arrange words to create sentences (“syntax”), they can start breaking down the phrases into single words.
They can learn how to use those words in a variety of ways and build different types of phrases with them.
All of this assumes a supportive environment. From my experience, this is a very difficult thing to do when those around you aren’t supportive or are abusive.
If you hear your child / student using echolalia, here are some key points to keep in mind:
Remember that the phrases used carry meaning. (For example, if your child says, “are you thirsty?”, that may be their way of saying, “I am thirsty.”)
Echoing a question could be a way to say “yes”. (If you ask, “do you want to play bubbles?” and your child imitates, “want to play bubbles?”, that could mean “yes”).
Help your child break down echolalic phrases to understand what the individual words mean. (use visuals, like pointing or showing your child their shoe as you say, “let’s put on your shoes!”)
All of this is to say that I’m working on my next book project. Just as No Place for Autism? set a framework for understanding the autistic system as designed, my new project will target teacher education programmes, providing teachers with a framework for advancing literacy in GLP populations. Rather than shuffle us off to therapy (available only to a privileged few), I hope that new teachers will use the guidance found in my book to structure their literacy program to include both the ALP and GLP students in their classrooms. Parents and care givers will find a ton of info as well, helping guide their discussions with their child’s instructional staff.
Stay tuned.