Two opposing views have developed regarding autism that affect how autistic persons are treated in medical, legal, and educational circles — the cure viewpoint and the neurodiversity viewpoint.

The Cure View

According to the cure view, autism is a puzzle to be solved (think the widespread image of the puzzle piece as a symbol for autism, popularized by organizations like Autism Speaks). The primary concerns of those who hold this view of autism are determining autism’s cause (and, if possible, assigning liability to those responsible for that cause), developing and implementing treatments to make autistic children appear “normal,” and finding a cure. This view of autism is most often held by parents of autistic children and is supported by advocacy organizations seeking to raise money for research and treatment.

Underpinning the wants of the autistic child from the cure view is the ultimate desire for normalcy.

This viewpoint defines the wants of the autistic child on the child’s behalf, particularly in the case of an autistic child whose verbal ability is limited or non-existent. From this point of view, the impairments that autism imposes on the child make him or her unaware of their own wants and needs at worst, or at best, unable to communicate their wishes accurately.

The cure view defines the needs of an autistic child with a focus on curing the child’s autism, normalizing their behavior, and making them appear “normal” enough to be capable of fitting in with peer groups and society in general. Ideal home and school environments should include the sufficient provision of assistive devices or therapies to help the autistic child adapt to their environment temporarily, with the goal of removing those devices or therapies over time.

Ideal treatments and therapies that have been deemed effective from this point of view include behavioral therapies, such as ABA, aimed at curbing the child’s autistic behaviors and encouraging more normal behaviors. Alternative or “biomedical” therapies with similar goals are often advocated, as well as more conventional pharmaceutical therapy regimens including varying cocktails of probiotics, anti-depressant and anti-anxiety medications, medications intended for children with attention-deficit hyperactivity disorder, and others.

Note, however, the vast majority of the pharmaceutical treatments often recommended are not approved by the FDA for the treatment of autism.

The Neurodiversity View

The neurodiversity movement, conversely, views autism as not a disorder, but a different way of thinking and being. The primary concerns of those who hold this view of autism are preventing discrimination against autistic individuals by “neurotypicals” (i.e., people who do not have autism) and providing autistic individuals with assistance to navigate and function in society. This view of autism is primarily advocated by high-functioning autistic individuals and their families, as well as advocacy groups whose goal is to provide support to autistic individuals.

The neurodiversity view insists, where the child’s communicative abilities allow, that the autistic child should define their own wants and needs. Where the child’s ability to communicate, either verbally or in writing, is limited, a determination of the child’s wants should consider any non-verbal expressions of the same observed by the child’s behavior. The needs of the autistic child from this viewpoint focus on acceptance of the child’s autism by the child and others in his or her life, assisting the child to adapting to and coping with life in a neurotypical world, and encouraging the child’s interests.

The idea that autism is a defect which must be cured is offensive to neurodiversity advocates, who point to the effect that view has on autistic children who are made to feel inferior and unwanted as they are when parents or other caregivers insist they must be cured to be accepted.

Ideally, the home and school environment from the neurodiversity viewpoint should include autism-friendly interior and exterior design features that seek to reduce potential sensory overload and are individualized to accommodate the individual child’s particular symptoms and interests.

Ideal therapeutic interventions according to the neurodiversity view typically include behavioral therapies which focus on helping the autistic child learn to cope with the neurotypical world. The efficacy of many biomedical or alternative treatments often advocated for autistic children is still scientifically questionable, and the efficacy of many treatments may be questionable when considering one particular autistic child versus another due to autism’s extreme variability from person to person.

Treatments which encourage self-advocacy skills are considered most beneficial, while treatments which encourage compliance with the wishes of authority figures above all else are strongly discouraged. Pharmaceutical treatments are not encouraged by this point of view. The long term effects on children of many of the medications advocated by the cure view are largely unknown. Further, the use of medications intended to reduce hyperactivity are discouraged because, in addition to unknown long-term effects, they may also cause children to withdraw from others, which runs counter to the need to encourage social interaction of autistic individuals.

At the core of the divide between these two viewpoints is how each side defines disability, a term which has, historically, carried with it derogatory connotations.

“Although impairments may be inevitable, disability is contingent. Disability is the interaction between a person’s impairment and the person’s environment-it is the negative treatment that a person experiences based on the person’s impairment.” Gray Matters.

The cure viewpoint sees disability as a medically based functional deficit in the person’s ability as a result of their autism. Because of this view, the cure side of the debate advocates dependence on charity, medical intervention, and rehabilitive therapies, and argues for societal accommodations to allow autistic persons full participation in American society. However, this view also carries with it the implication that autistic persons are somehow “less than normal” and results in stigmatization of all autistic people in this fashion, regardless of their level of actual functionality. Gray Matters.

The neurodiversity viewpoint, on the other hand, sees disability as a social construct under which the impairments imposed upon autistic people by their condition are a result of essentially being square pegs in a world full of round holes. Medical, pharmacological, and rehabilitive treatments supported by the cure viewpoint are often regarded “as unethical, stigmatizing, and inconsistent with autistic autonomy” by neurodiversity advocates who support “services and other structural changes that help autistic people better navigate a neurotypical world.” Gray Matters.

Despite the differences between these two viewpoints, both the cure and neurodiversity movements acknowledge that autism, as a disability, places those individuals who have the condition at a disadvantage in society.

Neither viewpoint has advocated strong policy goals beyond those intended to increase availability of and access to services to improve the lives of autistic persons, though the focus of those services is influenced by the viewpoint advocating the same, with the cure viewpoint focusing on adapting the individual autistic person’s behavior to fit society and the neurodiversity viewpoint focusing on adapting society to accommodate autistic people and teaching autistic people to deal with the neurotypical world where such changes are often not feasible.