LAUSR

Autism has become a deeply contested diagnosis. Whereas family advocacy organizations have long characterized the condition as a disorder in need of effective treatments, a growing number of adults who think of themselves as having high-functioning autism (or Asperger syndrome) insist that autism is an identity deserving of acceptance. The latter use the term “neurodiversity” to contend that autism should be regarded as a profoundly interwoven combination of intellectual gifts and social differences. Some even question the motivations underlying basic scientific research, arguing that genetic markers will be used in prenatal diagnosis to eliminate rather than improve the lives of people with autism.1 The debate over whether to consider autism a disability or identity is surely complicated by its expansion into a spectrum that encompasses a wide range of individuals and functioning. But this controversy is also rooted in a fundamental tension within the core definitions of autism as formulated in the 1940s by the 2 physicians credited for first describing the syndrome. Drs Leo Kanner and Hans Asperger both highlighted the presence of intellectual gifts in many of their patients, alongside social deficits and characteristic behaviors. This emphasis is best understood as … Address correspondence to Jeffrey P. Baker, MD, PhD, Pediatrics, Trent Center for Bioethics, Humanities, and History of Medicine, Duke University School of Medicine, PO Box 3040, Durham, NC 27710. E-mail: jeffrey.baker{at}dm.duke.edu