Supporting Autistic Individuals to Thrive

The Medical Model and Autism

Autism research and clinical practice are developing and growing constantly. Nevertheless, the medical model is still the go-to model for most researchers and many clinicians working in the autism domain. And there are many strengths inherent in the medical model.

At the same time, the medical model is deficit-focused, and by and large, it conceptualizes autism as a series of biologically derived functional deficits or deviations from a ‘norm’ or average. This may cover a part of the autism experience; however, it does not seem to capture the whole of autistic experiences accurately. Moreover, it limits us as researchers and clinicians in the questions we ask and the support we offer to and co-create with autistic individuals.

Alternative Models and Autism

Alternative models for conceptualizing autism can be grouped under the umbrella term of neurodiversity approaches. In contrast to the medical model, different neurodiversity models put forward strengths-inclusive approaches that view differences in behaviour and brain functioning as expected variations in a population. Generally, these models aim to identify and build on areas where autistic individuals thrive and where they more often struggle.

In previous posts, I have discussed a four-pronged, strengths-based approach called SBMN. This approach was proposed by Fung and Doyle (2021) to help identify and nurture the strengths of neurodiverse individuals and use this to help us guide future research and support to be less deficit-heavy and more well-rounded.

The Nussbaum Capabilities Approach and Autism

Another model proposed in the neurodiversity space is the Nussbaum Capabilities Approach as applied to autism by Pellicano and colleagues (2022). This capabilities approach, as originally developed by Martha Nussbaum, moves away from a narrowly normative focus on specific life outcomes. Instead, this capabilities approach focuses on ten core elements that contribute to living a thriving life.

Source: Eddie Kopp / Freerange Stock

These ten core elements to consider are:

1) length of life, 2) bodily health, 3) bodily integrity, 4) senses, imagination, and thought, 5) emotions, 6) practical reason, 7) affiliation, 8) other species and nature, 9) play, and 10) control over one’s environment

When we apply this capabilities approach to autism, it allows us to identify domains where autistic individuals thrive and domains where the same individuals may often struggle. For example, research indicates that autistic individuals as a group often show strengths in emotions, affiliation, play, connections to other species and nature, practical reason, and control over one’s environment. At the same time, autistic individuals as a group often are constrained in the length of life, bodily health, and integrity.

This in turn can guide us to issues to which researchers, clinicians, and policymakers should respond and support autistic individuals to thrive and grow. Based on this capabilities approach, the resulting picture is far more complex than conventional, medical, accounts of autism imply.

The Future of Supporting Autistic Individuals

Once autistic individuals, researchers, and clinicians amongst others are equipped with a more accurate understanding of which barriers currently limit autistic individuals from thriving in a particular domain, we should be empowered to start removing those barriers so that growth can be facilitated in that area if desired. At the same time, it is critical to highlight those domains of strength for each individual and autistic individuals as a population.

Overall, though there seems to be a need for more balanced, strengths-inclusive models of autism that are cognizant of internally and externally shaped strengths and disadvantages and ways to work with both.