@autistics I've just started reading Russell #Barkley's "Taking Charge of Adult ADHD" (2nd edition, 2022). Since my #AuDHD self-diagnosis in late 2024, the autism part of the diagnosis has been so rivetingly fascinating that I've been neglecting the #ADHD aspect; I find I actually have to force myself to focus on #ADHD. The reason for focusing on it is that unlike autism, which is more a difference requiring accommodation than a disorder requiring treatment, #ADHD does appear to be a genuine pathology — something that impairs me, that I'd like to have treated, and for which treatment is available. So it's important to understand it, if only in order to seek treatment. But I'm experiencing more than a little culture shock in going from autism literature (C.L. Lynch, Wenn Lawson, Fergus Murray, Morton Ann Gernsbacher) to #Barkley on #ADHD.
Writers on autism understand quite clearly that impairment is a deviation, not from any statistical norm, but from an individual's potential, which may require an accommodating environment to be brought to realization. #Barkley, by contrast, insists on characterizing the impairment that is a defining characteristic of #ADHD strictly as a deviation from a statistical norm, and responds with intensely withering ridicule to any suggestion that it should be made relative to individual potential:
"Impairment is defined relative to the average person in the population, known as the NORM—it is where most "normal", or typical, people are found to be performing in any domain of life. It does not mean how you are functioning compared to incredibly bright or highly educated people even if you are one. To be impaired, you must be functioning significantly below the norm or the average (typical) person. Why? Because the term DISORDER means just that—you are not functioning typically." (p. 30)
In case that wasn't clear (or insulting) enough, he adds:
"To adopt a standard for defining the term IMPAIRMENT other than comparison with the true norm is like something out of Alice in Wonderland, where nothing is as it seems, and words can have whatever meaning one wishes to give them. Saying that a person functioning as well as or even better than the average or typical population can still be considered impaired makes a mockery of the term DISORDER and does a disservice to those struggling with really not being able to function as well as the norm." (p. 39)
Imagine how this diatribe would sound in the context of physical medicine — sports medicine, say. Suppose a powerlifter who can usually deadlift a 600-pound barbell finds one day that they can only manage 300 pounds, brings this issue to a sports physician with a complaint of impairment — and gets #Barkley's diatribe as a response, with the conclusion that the powerlifter can't be impaired because they can still deadlift far more than most people.
#Barkley should have turned his ridicule on himself.
I'm not sure how much of a practical obstacle this issue will be. Judging by my responses to #ADHD questionnaires — including those in this book — I would probably count as impaired even by their "statistical norm" standards. But if this kind of thinking is the best #ADHD professionals have to offer, interacting with them is likely to require some serious tongue-biting on my part.