walkitout (walkitout) wrote,
walkitout
walkitout

Of quizzes and conformity

Recently, Baron-Cohen and company Got All Digital and put their Autism Quotient questionnaire on Facebook. It has been over at Wired for a while. A variety of my friends took it, so I took it again, trying to be as neurotypical in my answers as was compatible with still being mostly honest. This would be distinct from, giving neurotypical answers that I knew perfectly well weren't accurate, or giving accurate answers that I knew would expose my geekiness in all its glory. There is a spectrum of right answers on these things.

In any event, my score unsurprisingly puts me in the high functioning autism/Asperger's range. However, what may or may not be obvious (this is, after all, a _Facebook_ quiz!), the adult assessment tool for this diagnosis (a term I find much more neutral than "disorder" or "disability") has more to it than the AQ, which is just one of the _screening_ tools. A screen is something you deliver to lots of people, to help you focus on the group of people that you then expend more resources on in order to figure out if they meet the criteria you are using. Think: the quad screen, or a mammogram, or a PSA test. These are tools that are cheap enough to deliver to a large population, but their sensitivity is somewhat lacking.

The other screening tool is the Empathy Quotient, which can be found here:

http://www.guardian.co.uk/life/table/0,,937442,00.html

or here:

http://glennrowe.net/BaronCohen/EmpathyQuotient/EmpathyQuotient.aspx

Again, a _screening_ tool.

According to Tony Attwood in _The Complete Guide to Asperger's Syndrome_ (review, hopefully, will someday appear, but this could take a while -- short form: it is worth reading), the criteria for an adult to have Asperger's includes the criteria in the DSM-IV and some additional criteria. While a person would fill out the AQ and the EQ, the clinician "validates the answers during the diagnostic assessment and makes his or her own opinion on the diagnosis based on the new diagnostic criteria". After explaining the diagnostic criteria, Attwood spends a couple pages on confidence in the diagnosis (does the clinician think the client is being honest, and noting that there "is a difference between knowledge at an intellectual level and actual practice in real life".

Diagnoses in the mental health ordering of the universe almost always include clauses about whether the rest of the criteria are a bad fit for your life. I think this is intellectually appalling: are we _seriously_ expected to believe that we have a disorder just because we're married to the wrong kind of person and/or in the wrong career, but if we had the right kind of job and the right kind of partner, we wouldn't have the disorder even tho _nothing_ else about us had changed? Come on. Attwood is sensible enough to recognize that this isn't about whether it is an aesthetically beautiful abstract structure: it's about what you're going to use this diagnosis for. The "clinician may have to consider whether the person who appears to be coping reasonably well, perhaps with a high-status profession and having a partner, would benefit from receiving a diagnosis of Asperger's syndrome. At the time of the diagnostic assessment, the person may not need treatment from a psychiatrist or services from government agencies (one of the principal justifications for a diagnosis), although he or she may well benefit from relationship or career counselling (sic). However, should the person experience a divorce or unemployment, the signs may become more conspicuous and then warrant a diagnosis. It is perhaps not the severity of expression that is important, but the circumstances, expectations, and coping and support mechanisms."

Yes, dear readers, diagnoses _are_ weapons, er, tools: they are here to get you (or someone you care about) something that will help them.

Nothing in the above should be considered an endorsement on my part of Baron-Cohen's sex-based theory. In the Baron-Cohen world, women empathize and men sympathize. I find him unreadably offensive -- he just isn't reality based.

Here's his Systemizing Quotient screen:

http://glennrowe.net/BaronCohen/SystemizingQuotient/SystemizingQuotient.aspx

FWIW, I score the highly improbable (or improbably high) 51, and that's while giving non-systemizing answers to a variety of questions where my curiosity on a subject has been completely exhausted because I already know the answers I would otherwise be interested in. In fact, that's one of the biggest issues I have with these screens: the people designing them are really sloppy thinkers.
Tags: autism
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