Monday, December 09, 2013
Asperger diagnosis does nothing to solve the mystery of Susan Boyle
The Scottish singer and pop culture legend Susan Boyle was reportedly diagnosed with Asperger syndrome (AS) a year ago. I am no longer convinced that Asperger syndrome is a useful or scientifically valid label, regardless of whether or not it is listed in the latest edition of the DSM, So what am I to make of this latest celebrity AS disclosure? I think we are all open to believing that Boyle is markedly different in some way besides her extraordinary vocal ability and it is clear that there must be some reason why most of her life has been spent on the margins of society.
It is reported that Boyle was deprived of oxygen at birth, was labelled as brain damaged and was bullied as a schoolgirl and was labelled as "simple" by her peers. I'm always skeptical about claims about brain damage as the result of birth trauma. Epidemiological research has debunked the popular idea that cerebral palsy is caused by birth trauma of oxygen deprivation at birth. If this were true then the incidence of this disorder would have dropped with the rise in popularity of caesarian section deliveries, but it hasn't. Genetics are now being considered as a possible cause. I've seen a number of anecdotal cases in which peculiarities in people are blamed on subtle brain damage due to birth complications when in fact the trait explained clearly runs in the family. Some parents apparently can't live with the idea that they have dickey genes and they passed these dickey genes on to a child. I can't rule out the possibility that Boyle has atypical genes, and her weight and slightly odd-looking face would be consistent with some kind of genetic syndrome, I know not which, but it couldn't be pervasively damaging if her IQ is really above average, as was recently claimed.
What kind of disorder impairs a person socially but leaves intelligence not only spared but superior? It must be a selective or specific disorder, or a disorder in their social environment, or some combination of both. The idea that Boyle might be brain damaged appears to be debunked by the recently reported information that her IQ was tested and found to be above average, but there is the definite possibility that she has an inborn or acquired highly selective cognitive disability caused by genes or brain injury, because there are many such conditions. Science is still discovering new varieties of cognitive, perceptual, sensory or learning disabilities, and the list of known conditions is already long: dyslexia (there are at least two different types), dyscalculia, dysgraphia, prosopagnosia, auditory processing disorder, developmental topographical disorientation (DTD), amusia, time perception disorder or time agnosia, and disorders in perception of touch, taste or smell. Many of these conditions are compatible with a genuine high level of intelligence, but many of these conditions could also undermine social functioning enough to make the person with the disability appear to be stupid. I think it is certainly possible that Boyle has one or more of the known or unknown specific disorders (rule out amusia and ADP though), but we will probably never know because I doubt that her assessment for Asperger syndrome tested for many or any of these disorders, and if it did become apparent that she had one of them it is likely that it would have been seen as just one manifestation of the broad and mysterious diagnostic category known as Asperger syndrome.
Susan Boyle has decided that the label of Asperger syndrome will serve her interests, and she has every right to further her own interests after having lived such a difficult and limited life before her rise to fame. An international community and an infrastructure of support can be unlocked with the key of an Asperger syndrome diagnosis, so this must be a very tempting choice. Boyle will be able to claim to be a disabled person while also being able to claim to have normal or high intelligence, because it is almost universally accepted that Asperger syndrome is a social disability that is consistent with normal or even gifted levels of intelligence. It is nice to see in a news report confirmation that Boyle is not mentally impaired, but for any sensible person this should be no surprise at all, because it would be impossible for Boyle to sing with such incredible ability if she was generally cognitively challenged.
There are some important advantages to the Asperger syndrome label and most of us believe that Susan Boyle deserves to have some advantages in life, but I would argue that this label is not much more than the formalization and medicalization of existing beliefs and prejudices that marginalize some people. I would argue that an Asperger syndrome diagnosis is the replacement of informal social marginalization with formal social marginalization that comes with some protections and some advantages. An Asperger syndrome diagnosis might improve a person's quality of life and place in society, but this cannot change the fact that Asperger syndrome is an all-encompassing, vaguely defined and non-specific category with an unknown cause, and is thus virtually meaningless as an explanation or clinical/medical diagnostic category. Susan Boyle could well meet all of the clinical diagnostic criteria for "Asperger's Disease", but this still tells us virtually nothing about Susan Boyle.