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Disability Studies Scholars Critique the “Autism Industrial Complex”
Scholars argue that a business model has developed that exploits autism to sell coercive interventions.
www.madinamerica.com/2021/02/disability-studies-scholars-critique-autism-industrial-complex/
Disability Studies scholars Alicia A. Broderick and Robin Roscigno argue that popular metaphors that portray autism as an enemy, alien, epidemic contagion, or otherwise dangerous serve to create a market for what they term the “Autism Industrial Complex.”
Broderick and Roscigno see these notions of autism as suggesting invasive behavioral techniques as the only plausible response. The researchers describe the business logic and surrounding discourses that legitimize coercive bodily control (and other forms of violence) over those diagnosed with autism.
Autism, Inc.: The Autism Industrial Complex
In: Journal of Disability Studies in Education
Authors: Alicia A. Broderick 1 and Robin Roscigno 2
brill.com/view/journals/jdse/aop/article-10.1163-25888803-bja10008/article-10.1163-25888803-bja10008.xml
Abstract
We contend that, within capitalism, the Autism Industrial Complex (aic) produces both autism as commodity and the normative cultural logic of intervention in relation to it. Comprised of ideological/rhetorical as well as material/economic infrastructure, we argue that the aic is not the myriad businesses and industries that capitalize and profit from it; rather, these constitute its epiphenomenal features. In the production of autism as commodity, the aic also simultaneously produces that commodity’s market, its consumers, and its own monopoly control of that market through production for consumption of need for, consent to, and legitimacy of interventionist logics. Within this apparatus, almost anyone can capitalize on and profit from autism. And within the aic, autistic people—their very bodies—function as the raw materials from which this industrial complex is built, even as autistic people—their very identities and selves—also become unwitting, and often unwilling, products of the aic.
Keywords: autism; capitalism; critical autism studies; neoliberalism; disability studies; applied behavior analysis; autism industrial complex
1 Introduction
Dominant metaphors in popular, media, academic, educational, and policy rhetoric about autism for the last several decades have centered on the constitution of autism as enemy, abductor, epidemic contagion, alien, or otherwise dangerous and “other” (Broderick, 2010; Broderick & Ne’eman, 2008; McGuire, 2016). These metaphors have been explicitly deployed in the service of a broader cultural narrative fueling “intervention” as the only sensible response to autistic people, effectively exploiting ableist hopes and fears in the symbiotic production of the commodities, markets, and consumers of the Autism Industrial Complex (hereafter, aic) (Broderick, 2017; Broderick & Roscigno, 2019). In the U.S., much of the “educational” provision for autistic students is provided by private schools and consulting firms, obviously profiting (mostly through receipt of public dollars) from the dominant cultural metaphors about autism and the interventionist narratives they sustain.
Autism narratives are being exported for global consumption through initiatives endorsed and financially sponsored by the United Nations and the ubiquitous “philanthropic” media behemoth Autism Speaks. State laws in the U.S. are being passed that funnel both private and public health insurance dollars straight into the revenue streams of behavioral consultancies, a business that has boomed in the 20 short years since the institution of the Behavior Analysis Certification Board (bacb) as a body that draws its principal revenue from the certification of multiple levels of behavior analysts. Autistic individuals (including now, very young children) collectively represent a vast market to be tapped and capitalized upon, a market for intervention “technologies” to be levied by certified “behavior technicians.” There is money to be made in the certification of behavior analysts (both for bacb as well as for university-based programs who develop bcba programs and run them as cash-cow tuition-generating certificates, as well as for Pearson, who collects testing fees). There is money to be made in contracts with school districts—a steady stream of mostly public dollars: state, local, and federal ideia funding—to employ aba consultancy firms (whose “technicians” are certified by the bacb) to deploy these interventions in schools (thereby also exonerating districts from responsibility for altering the fundamental structure of their curricula, their pedagogies, their teacher preparation, or the cultures of their schools). And there is money to be made through health insurance reimbursement (also a steady stream of both private and public money, facilitated by the active state-level lobbying that has resulted, as of 2019, in the passage of boilerplate legislation in all 50 U.S. states constituting aba as the “only” “evidence-based” and therefore only health-insurance-fundable, intervention for autism).
In short, autism is currently big business.
Deploying both cultural and media studies and political economy as analytic frameworks, we argue that the multiple intersecting branches of the aic constitute, reproduce, and globally export an effective monopoly not only of intervention services and products, but also (and more importantly) of ideas and information publicly propagated about autism over the past several decades. Ultimately, not everyone consumes autism intervention products and services, but it is difficult to escape the consumption of (a) autism itself as commodified and circulated in media and popular culture, and (b) its corollary interventionist cultural logic. The former market (in which autism intervention products and services are consumed) is somewhat narrow in its scope, but the latter market (in which autism, and the cultural logic of intervention are consumed) is pervasive and ubiquitous. And while the former comprises the autism industry, it is the latter that constitutes the aic.
Central to our methods is an extensive critical analysis of language and its devices (metaphors, narratives, images, discursive tactics, etc.), ideologies and their power dynamics (claims to legitimacy and authority, and the deployment of “truth”), and the bureaucratic, technocratic, and—crucially—economic institutionalization of these ideas through the intersecting arms of the aic apparatus under global neoliberal capitalism. This project makes a crucial intervention into autism discourse, currently rooted in rhetorics of care and recuperation (Helt et al., 2008), and material practices of bodily control and other forms of violence (McGuire, 2016; Roscigno, 2020). We seek to excavate the specific historical, ideological, and economic circumstances within which the aic evolved, and in so doing, make the familiar—the routine monetization of autism—strange, and additionally, to develop an analytic sufficient to account for the present-day scale, profitability, and ubiquity of the aic.
2 Autism and Capitalism
Relatively little scholarship in the past several decades has addressed the political economy of disability generally. Whole bodies of scholarship have critically explored, for decades and in various ways, the social and cultural production of disability; however, a few pieces distinguish themselves from that larger body of literature by documenting the simultaneous production of disability in a political economy—specifically, in the advanced neoliberal capitalist economy of the United States. A key early analysis of the economy of disability is Gary Albrecht’s (1992) The Disability Business: Rehabilitation in America. In this comprehensive analysis of the rehabilitation industry, Albrecht candidly and explicitly explores the ways that disability became “big business” in the late 20th century. His analysis explores the twin processes at work establishing the disability industry: (a) the “production of disability” as “the construction of a social problem,” and (b) the rehabilitation industry as its “institutional response” (p. 13). Marta Russell’s selected writings (Rosenthal, Ed., 2019), posthumously published though produced largely in the 1990s and early 2000s, offer an explicitly Marxist analysis of the political and economic role of disability in late 20th century American capitalism. Russell’s analytics include incisive discussions of capitalism’s necessity of maintaining a reserve of untapped labor, structural inequality related to housing policy and disaster responses, and the role of incarceration relative to disability in a capitalist economy, among others. More recently, Paul Longmore’s (2016) posthumously published Telethons: Spectacle, Disability, and the Business of Charity is perhaps the most comprehensive example to date of a complex analysis of the inextricably intertwined tendrils of both cultural politics and political economy—in this case, in the particular example of the telethon industry.
However, David T. Mitchell and Sharon L. Snyder (2015) have arguably advanced the most innovative theoretical contributions advancing a complex analysis of disability and neoliberalism, specifically, in their The Biopolitics of Disability: Neoliberalism, Ablenationalism, and Peripheral Embodiment. In developing the concept of ablenationalism, Mitchell and Snyder write that “disabled people are increasingly fashioned as a population that can be put into service on behalf of the nation-state rather than exclusively positioned as parasitic upon its resources and, therefore, somehow outside of its best interests” (p. 17). We will return to this notion of disabled people being put into service on behalf of the nation-state (and more specifically, its economy) as our own analysis develops.
These seminal works collectively offer foundational analyses of the intersections between capitalism and disability, generally. We are interested here in an analysis of the intersections between capitalism and autism, specifically. Both Albrecht (1992) and Longmore (2016) offer analyses of a capitalist political economy of disability that sit in intricate and complex relationship with incisive analyses of the symbiotic production and performance of the cultural politics of disability. In developing the analytic heuristic of the aic, we offer herein an analysis of the co-constitutive production of both the cultural politics and the political economy of autism within capitalism.
The last 15 years have generated a vast and compelling body of critical scholarship exploring the cultural meanings of autism and autistic identity through multiple, intersecting, interdisciplinary lenses. These include feminism, cultural studies, sociology, linguistics, anthropology, rhetoric, queer studies, and others (e.g., Eyal, 2010; Jack, 2014; McGuire, 2016; Murray, 2012; Nadesan, 2005; Osteen, 2010; Rodas, 2018; Runswick-Cole et al., 2016; Silberman, 2015; Silverman, 2013; Yergeau, 2017). Most of these critical social and cultural analyses concur with the indisputable claim that autism is now big business—that much has been obvious for the past several decades. However, relatively little scholarship thus far has involved any analysis of autism in relation to the structures of our political economy, and none of those have yet put forth a comprehensive analysis that attempts to integrate critical social and cultural analyses with and through the overarching lens of political economy. Autistic scholar Michelle Dawson (2004) may have been the first to pinpoint and name the “autism/ABA industry” (n.p.) as such, and for the past 15 years, others have continued to describe and critically analyze what Milton (2012) calls the “vast and exploitative autism industry” (p. 3). Since Dawson’s first articulation of ABA as an “industry,” critical autism scholars have continued to write about the autism industry (Latif, 2016; Milton & Moon, 2012), autism as commodity (Mallett & Runswick-Cole, 2012, 2016), and autism as commodity fetishism (Goodley, 2016; R. Grinker, 2018; Mallett & Runswick-Cole, 2012).
Anne McGuire appears to be the first to have committed to print the term “autism industrial complex,” a concept articulated in “Buying time: The s/pace of advocacy and the cultural production of autism” (2013), itself an incisive analysis of autism and time with/in the social and economic context of advanced neoliberal capitalism. In the closing paragraph of her analysis of the ways that autistic experience strains and threatens the boundaries of neoliberal concepts of time, McGuire notes that “we must take note of how neoliberal versions of advocacy…already represent a ‘good’ and very profitable ‘return’ on an awareness investment” (p. 121). Further, in pointing to the “sheer breadth of the ‘autism industrial complex,’” she contends that “in one unbroken–and clearly very lucrative–move, our market-driven times, at once, produce and regulate, create and constrain conducts that are beyond the norm” (p. 121). McGuire further develops the idea of the autism industrial complex in her text, War on Autism (2016), though her discussion of the concept remains primarily descriptive rather than analytic. McGuire asserts that the “body of the autistic child has generated a multibillion dollar ‘autism industrial complex’—public and private investment interests that benefit economically from, and indeed whose very fiscal survival is reliant upon, the existence of” autistic bodies (p. 126). Consistent with her stated intent “to provide the reader with a sense of the immensity and diversity of the autism industry,” (p. 127), McGuire points to the industry of jobs and institutions whose purpose centers primarily upon autism intervention. She notes that “whole industries have cropped up around treating and/or curing autism,” while “other industries have discovered it can also be profitable to take the prevention route,” while still “other industries…have honed in on the autism niche market” (p. 127), including products such as software/apps, toys, books, communication aids, etc..
Other critical autism scholars have subsequently drawn upon this concept in analyzing the economics of autism (Broderick, 2017; Grinker, 2018, 2020). Grinker (2020) argues that this “particular diagnosis [autism] became embedded in a financial system that has come to depend on that diagnosis for its sustainability and growth” (p. 7). Further, building upon Ian Hacking (1999), Grinker argues that once a diagnostic label—such as autism—becomes a fulcrum around which institutionalized financial activities coalesce (i.e., once an industrial complex is formed), that very diagnostic category “provides an incentive for manufacturing people with the diagnosis…whose presence and needs support this financial infrastructure” (p. 9), effectively rearticulating Mallett and Runswick-Cole’s (2016) contentention that autism has been successfully commodified. Broderick (2017) argues that autism rhetoric (including deployment of the metaphors of alien, invader, epidemic, enemy, etc.) has been central to that commodification process—the manufacturing of autism, and thereby, through processes of interpellation, autistic people—all in the service of manufacturing a broader cultural narrative or logic of intervention, thus producing the market for, and teleologically justifying and sustaining the profit-generating infrastructure of, the autism intervention industry.
Two edited collections published over the past decade have worked to establish the foundations and contours of the emergent field of critical autism studies (cas), and each of these has engaged somewhat with questions of political economy, but to a limited extent. The first, titled Worlds of Autism: Across the Spectrum of Neurological Difference (Davidson & Orsini, 2013), actually coined the term critical autism studies and developed a loose conceptual framework of what cas comprise. These include: 1) careful attention to the ways that power shapes our understandings and study of autism, 2) the advancing of empowering cultural narratives about autism, and 3) a “commitment to develop new analytical frameworks using inclusive and nonreductive methodological and theoretical approaches to study the nature and culture of autism” (Orsini & Davidson, 2013, p. 12). Thus, the import of studying narrative, culture, and specifically, power is placed front and center in this articulation of the aims of cas as a field of critical scholarship, although economics is not explicitly invoked.
Nevertheless, as economics is a central mechanism through which power circulates, within this edited collection a couple of manuscripts do engage with the economics of autism, albeit in limited ways. For example, Nadesan (Nadesan, 2013) presents an analysis titled “Autism and genetics: Profit, risk, and bare life.” Nadesan, whose earlier (2005) comprehensive sociocultural analysis of autism as a construct appeared to spark the wave of critical scholarship on autism that has been produced over the past 15 years, writes in this piece specifically of the social and political processes of assessing and managing the “economic risks” (p. 117) associated with autism. Through an analysis of the prioritization of funding related to autism (including allocations of public funds toward research, pharmaceuticals, and the quest for genetic markers that may yield either pre- or postnatal tests for autism), Nadesan raises difficult questions about the ratio of public dollars spent on care and support vs. basic research ultimately aimed at prevention of autism. In the context of neoliberal austerity measures, Nadesan warns that “Family members of people with autism will be ‘responsibilized’ for their care without the benefits of supports as states, counties, cities, and school districts shed services” (p. 134). Additionally, Nadesan somewhat ominously predicts that the prioritization and investment of funding in autism susceptibility testing may “have the potential of refiguring risk so that parents of autistic children are made financially responsible for the ‘choice’ to keep (that is, not abort) their autistic children” (p. 134), and that “this prioritization could undermine support for costly educational and therapeutic supports” (p. 137). In this same volume, Bumiller (2013) critically analyzes the politics and economics of the increasing privatization of responsibilities of care in a neoliberal economy, arguing that “it is necessary to reimagine the [financial] responsibilities of the state in the hope of creating a more socially inclusive future for people with autism” (p. 145). Both of these forays into the political economy of autism fundamentally circulate around the costs of intervention, care, and support, and whether those costs should be socialized or privatized, rather than critically examining the intervention industry itself.
In a second edited collection (Runswick-Cole et al., 2016) aiming to contribute to the nascent field of cas, only a couple of pieces refer—and most of those somewhat tangentially—to the import of economics in the critical study of autism. In the introductory chapter, Runswick-Cole (2016) asserts the problematic nature of the commodification of autism (see also Mallett & Runswick-Cole, 2012, 2016): “This thing called autism is everywhere” (p. 25, emphasis in original). She further acknowledges that “Clearly, there is money to be made in autism” and cogently, that “it is not possible to comment on the autism industry without contributing to it” (p. 26). Nevertheless, few of the manuscripts in the collection explicitly analyze this autism industry, though a number concede its profit-generating existence as taken-for-granted background of their analyses. For example, Goodley (2016) refers briefly to multiple forms of “commodity fetishism around autism” (p. 156), and McGuire (2016) parenthetically notes that “the notion of spectrum offers a hopeful (which, from the vantage point of capitalism, most often means lucrative) narrative of the possibility for an incremental recovery of normative life” (p. 103). Further, Timimi and McCabe (2016) rather obliquely, and almost as an aside, quip that “To us, however it seems that the people who have most obviously benefitted from the increase in the use of tools for screening for and diagnosing of asd s have been the professionals themselves” (p. 173).
Latif (2016) engages with these issues somewhat more explicitly. Although his analysis is largely centered on ethical deliberations around autism diagnoses, that discussion is squarely framed within the context of neoliberal austerity policies as a sort of backdrop for the ethical analysis. Latif principally aims to explore how people’s ideas about autism “are modified and influenced by the dominant classification systems, which in a capitalist market has been driving toward a technically based biomedical model of mental wellbeing” (p. 288). Latif further notes that “whilst such a model may be good for expanding markets, problems of feeding disproportionate demand against limited resources arise in universal public health systems such as the United Kingdom National Health Service (nhs)” (p. 288). This primary concern with scarcity of resources in general, and with the impacts of neoliberal economic policies of privatization and austerity in particular, align Latif’s, and most of the analyses of economics in this volume, with those in the Davidson and Orsini (2013) collection.
Mallett and Runswick-Cole (2016) offer the only contribution to this volume to explicitly advance an analysis of autism within capitalism in their piece, “The Commodification of Autism: What’s at Stake?”, wherein they argue that “autism has become a commodity; it is produced, exchanged, traded and consumed” (p. 110). These authors contend “it is the moment when it [autism] becomes a ‘thing’ that it becomes consumable and, therefore, amenable to commodification” (p. 117). They successfully argue and amply demonstrate in this piece that autism has become a hot commodity, illustrated with cogent examples of autism therapies, entertainment and popular culture, and even the rebranding efforts of the neurodiversity movement. However, neither Mallett and Runswick-Cole (2016) nor any other extant analyses yet demonstrates how autism came to be successfully commodified, nor the nature of the intersecting social, historical, cultural, political, and economic infrastructures that both produce and sustain it as a lucrative commodity.
This analysis aims to do just that. Multiple authors have offered useful descriptions of the nature and range of the profit-generating marketplaces operating in the aic—e.g., not only intervention services, but diagnostic and evaluation services, scholarship and research industries, media industries, the special education and related services industries, niche technology industries, etc. (Grinker, 2020; Mallett & Runswick-Cole, 2016; McGuire, 2013, 2016). Almost all extant analyses of autism and neoliberal capitalism focus on the societal and personal implications of privatization and austerity, vis-à-vis access to intervention products and services. Or as Grinker (2020) puts it, exploring the challenges parents face “as they seek to find services and social supports that will enable their diagnosed children to be educated and launched into the neurotypical world” (p. 8). However, to date, no one has yet developed a comprehensive conceptual analytic of the cultural and historical contexts in which the aic emerged, nor how the aic operates in the overlapping spheres of both cultural politics and political economy, manufacturing not only the commodity of autism itself, but also, and crucially, the cultural logic of intervention that undergirds the entirety of the aic’s economic infrastructure.
We develop and deploy the aic as a useful heuristic device that enables us to document and critically analyze the intersecting spheres of both cultural politics and political economy in the simultaneous cultural and economic production of autism and the cultural logic of intervention in relation to it. Our analysis aims to hearken back to Albrecht’s (1992) in that we aim to braid together a complex analysis of (a) the production of autism as a “social problem” with (b) the institutional (interventionist) response to that “problem.” That is, we explore the ways in which the cultural politics of autism and the economy of autism co-constitute one another. In so doing, we draw upon and weave together analyses of the intersecting strands of ideology, rhetoric, and discourse, together with the interlocking strands of social policy, business, education, and medicine, all of which collectively serve to generate and to justify further extraction of profit from autism—and therefore autistic people—in an advanced neoliberal capitalist economy.
Scholars argue that a business model has developed that exploits autism to sell coercive interventions.
www.madinamerica.com/2021/02/disability-studies-scholars-critique-autism-industrial-complex/
Disability Studies scholars Alicia A. Broderick and Robin Roscigno argue that popular metaphors that portray autism as an enemy, alien, epidemic contagion, or otherwise dangerous serve to create a market for what they term the “Autism Industrial Complex.”
Broderick and Roscigno see these notions of autism as suggesting invasive behavioral techniques as the only plausible response. The researchers describe the business logic and surrounding discourses that legitimize coercive bodily control (and other forms of violence) over those diagnosed with autism.
Autism, Inc.: The Autism Industrial Complex
In: Journal of Disability Studies in Education
Authors: Alicia A. Broderick 1 and Robin Roscigno 2
brill.com/view/journals/jdse/aop/article-10.1163-25888803-bja10008/article-10.1163-25888803-bja10008.xml
Abstract
We contend that, within capitalism, the Autism Industrial Complex (aic) produces both autism as commodity and the normative cultural logic of intervention in relation to it. Comprised of ideological/rhetorical as well as material/economic infrastructure, we argue that the aic is not the myriad businesses and industries that capitalize and profit from it; rather, these constitute its epiphenomenal features. In the production of autism as commodity, the aic also simultaneously produces that commodity’s market, its consumers, and its own monopoly control of that market through production for consumption of need for, consent to, and legitimacy of interventionist logics. Within this apparatus, almost anyone can capitalize on and profit from autism. And within the aic, autistic people—their very bodies—function as the raw materials from which this industrial complex is built, even as autistic people—their very identities and selves—also become unwitting, and often unwilling, products of the aic.
Keywords: autism; capitalism; critical autism studies; neoliberalism; disability studies; applied behavior analysis; autism industrial complex
1 Introduction
Dominant metaphors in popular, media, academic, educational, and policy rhetoric about autism for the last several decades have centered on the constitution of autism as enemy, abductor, epidemic contagion, alien, or otherwise dangerous and “other” (Broderick, 2010; Broderick & Ne’eman, 2008; McGuire, 2016). These metaphors have been explicitly deployed in the service of a broader cultural narrative fueling “intervention” as the only sensible response to autistic people, effectively exploiting ableist hopes and fears in the symbiotic production of the commodities, markets, and consumers of the Autism Industrial Complex (hereafter, aic) (Broderick, 2017; Broderick & Roscigno, 2019). In the U.S., much of the “educational” provision for autistic students is provided by private schools and consulting firms, obviously profiting (mostly through receipt of public dollars) from the dominant cultural metaphors about autism and the interventionist narratives they sustain.
Autism narratives are being exported for global consumption through initiatives endorsed and financially sponsored by the United Nations and the ubiquitous “philanthropic” media behemoth Autism Speaks. State laws in the U.S. are being passed that funnel both private and public health insurance dollars straight into the revenue streams of behavioral consultancies, a business that has boomed in the 20 short years since the institution of the Behavior Analysis Certification Board (bacb) as a body that draws its principal revenue from the certification of multiple levels of behavior analysts. Autistic individuals (including now, very young children) collectively represent a vast market to be tapped and capitalized upon, a market for intervention “technologies” to be levied by certified “behavior technicians.” There is money to be made in the certification of behavior analysts (both for bacb as well as for university-based programs who develop bcba programs and run them as cash-cow tuition-generating certificates, as well as for Pearson, who collects testing fees). There is money to be made in contracts with school districts—a steady stream of mostly public dollars: state, local, and federal ideia funding—to employ aba consultancy firms (whose “technicians” are certified by the bacb) to deploy these interventions in schools (thereby also exonerating districts from responsibility for altering the fundamental structure of their curricula, their pedagogies, their teacher preparation, or the cultures of their schools). And there is money to be made through health insurance reimbursement (also a steady stream of both private and public money, facilitated by the active state-level lobbying that has resulted, as of 2019, in the passage of boilerplate legislation in all 50 U.S. states constituting aba as the “only” “evidence-based” and therefore only health-insurance-fundable, intervention for autism).
In short, autism is currently big business.
Deploying both cultural and media studies and political economy as analytic frameworks, we argue that the multiple intersecting branches of the aic constitute, reproduce, and globally export an effective monopoly not only of intervention services and products, but also (and more importantly) of ideas and information publicly propagated about autism over the past several decades. Ultimately, not everyone consumes autism intervention products and services, but it is difficult to escape the consumption of (a) autism itself as commodified and circulated in media and popular culture, and (b) its corollary interventionist cultural logic. The former market (in which autism intervention products and services are consumed) is somewhat narrow in its scope, but the latter market (in which autism, and the cultural logic of intervention are consumed) is pervasive and ubiquitous. And while the former comprises the autism industry, it is the latter that constitutes the aic.
Central to our methods is an extensive critical analysis of language and its devices (metaphors, narratives, images, discursive tactics, etc.), ideologies and their power dynamics (claims to legitimacy and authority, and the deployment of “truth”), and the bureaucratic, technocratic, and—crucially—economic institutionalization of these ideas through the intersecting arms of the aic apparatus under global neoliberal capitalism. This project makes a crucial intervention into autism discourse, currently rooted in rhetorics of care and recuperation (Helt et al., 2008), and material practices of bodily control and other forms of violence (McGuire, 2016; Roscigno, 2020). We seek to excavate the specific historical, ideological, and economic circumstances within which the aic evolved, and in so doing, make the familiar—the routine monetization of autism—strange, and additionally, to develop an analytic sufficient to account for the present-day scale, profitability, and ubiquity of the aic.
2 Autism and Capitalism
Relatively little scholarship in the past several decades has addressed the political economy of disability generally. Whole bodies of scholarship have critically explored, for decades and in various ways, the social and cultural production of disability; however, a few pieces distinguish themselves from that larger body of literature by documenting the simultaneous production of disability in a political economy—specifically, in the advanced neoliberal capitalist economy of the United States. A key early analysis of the economy of disability is Gary Albrecht’s (1992) The Disability Business: Rehabilitation in America. In this comprehensive analysis of the rehabilitation industry, Albrecht candidly and explicitly explores the ways that disability became “big business” in the late 20th century. His analysis explores the twin processes at work establishing the disability industry: (a) the “production of disability” as “the construction of a social problem,” and (b) the rehabilitation industry as its “institutional response” (p. 13). Marta Russell’s selected writings (Rosenthal, Ed., 2019), posthumously published though produced largely in the 1990s and early 2000s, offer an explicitly Marxist analysis of the political and economic role of disability in late 20th century American capitalism. Russell’s analytics include incisive discussions of capitalism’s necessity of maintaining a reserve of untapped labor, structural inequality related to housing policy and disaster responses, and the role of incarceration relative to disability in a capitalist economy, among others. More recently, Paul Longmore’s (2016) posthumously published Telethons: Spectacle, Disability, and the Business of Charity is perhaps the most comprehensive example to date of a complex analysis of the inextricably intertwined tendrils of both cultural politics and political economy—in this case, in the particular example of the telethon industry.
However, David T. Mitchell and Sharon L. Snyder (2015) have arguably advanced the most innovative theoretical contributions advancing a complex analysis of disability and neoliberalism, specifically, in their The Biopolitics of Disability: Neoliberalism, Ablenationalism, and Peripheral Embodiment. In developing the concept of ablenationalism, Mitchell and Snyder write that “disabled people are increasingly fashioned as a population that can be put into service on behalf of the nation-state rather than exclusively positioned as parasitic upon its resources and, therefore, somehow outside of its best interests” (p. 17). We will return to this notion of disabled people being put into service on behalf of the nation-state (and more specifically, its economy) as our own analysis develops.
These seminal works collectively offer foundational analyses of the intersections between capitalism and disability, generally. We are interested here in an analysis of the intersections between capitalism and autism, specifically. Both Albrecht (1992) and Longmore (2016) offer analyses of a capitalist political economy of disability that sit in intricate and complex relationship with incisive analyses of the symbiotic production and performance of the cultural politics of disability. In developing the analytic heuristic of the aic, we offer herein an analysis of the co-constitutive production of both the cultural politics and the political economy of autism within capitalism.
The last 15 years have generated a vast and compelling body of critical scholarship exploring the cultural meanings of autism and autistic identity through multiple, intersecting, interdisciplinary lenses. These include feminism, cultural studies, sociology, linguistics, anthropology, rhetoric, queer studies, and others (e.g., Eyal, 2010; Jack, 2014; McGuire, 2016; Murray, 2012; Nadesan, 2005; Osteen, 2010; Rodas, 2018; Runswick-Cole et al., 2016; Silberman, 2015; Silverman, 2013; Yergeau, 2017). Most of these critical social and cultural analyses concur with the indisputable claim that autism is now big business—that much has been obvious for the past several decades. However, relatively little scholarship thus far has involved any analysis of autism in relation to the structures of our political economy, and none of those have yet put forth a comprehensive analysis that attempts to integrate critical social and cultural analyses with and through the overarching lens of political economy. Autistic scholar Michelle Dawson (2004) may have been the first to pinpoint and name the “autism/ABA industry” (n.p.) as such, and for the past 15 years, others have continued to describe and critically analyze what Milton (2012) calls the “vast and exploitative autism industry” (p. 3). Since Dawson’s first articulation of ABA as an “industry,” critical autism scholars have continued to write about the autism industry (Latif, 2016; Milton & Moon, 2012), autism as commodity (Mallett & Runswick-Cole, 2012, 2016), and autism as commodity fetishism (Goodley, 2016; R. Grinker, 2018; Mallett & Runswick-Cole, 2012).
Anne McGuire appears to be the first to have committed to print the term “autism industrial complex,” a concept articulated in “Buying time: The s/pace of advocacy and the cultural production of autism” (2013), itself an incisive analysis of autism and time with/in the social and economic context of advanced neoliberal capitalism. In the closing paragraph of her analysis of the ways that autistic experience strains and threatens the boundaries of neoliberal concepts of time, McGuire notes that “we must take note of how neoliberal versions of advocacy…already represent a ‘good’ and very profitable ‘return’ on an awareness investment” (p. 121). Further, in pointing to the “sheer breadth of the ‘autism industrial complex,’” she contends that “in one unbroken–and clearly very lucrative–move, our market-driven times, at once, produce and regulate, create and constrain conducts that are beyond the norm” (p. 121). McGuire further develops the idea of the autism industrial complex in her text, War on Autism (2016), though her discussion of the concept remains primarily descriptive rather than analytic. McGuire asserts that the “body of the autistic child has generated a multibillion dollar ‘autism industrial complex’—public and private investment interests that benefit economically from, and indeed whose very fiscal survival is reliant upon, the existence of” autistic bodies (p. 126). Consistent with her stated intent “to provide the reader with a sense of the immensity and diversity of the autism industry,” (p. 127), McGuire points to the industry of jobs and institutions whose purpose centers primarily upon autism intervention. She notes that “whole industries have cropped up around treating and/or curing autism,” while “other industries have discovered it can also be profitable to take the prevention route,” while still “other industries…have honed in on the autism niche market” (p. 127), including products such as software/apps, toys, books, communication aids, etc..
Other critical autism scholars have subsequently drawn upon this concept in analyzing the economics of autism (Broderick, 2017; Grinker, 2018, 2020). Grinker (2020) argues that this “particular diagnosis [autism] became embedded in a financial system that has come to depend on that diagnosis for its sustainability and growth” (p. 7). Further, building upon Ian Hacking (1999), Grinker argues that once a diagnostic label—such as autism—becomes a fulcrum around which institutionalized financial activities coalesce (i.e., once an industrial complex is formed), that very diagnostic category “provides an incentive for manufacturing people with the diagnosis…whose presence and needs support this financial infrastructure” (p. 9), effectively rearticulating Mallett and Runswick-Cole’s (2016) contentention that autism has been successfully commodified. Broderick (2017) argues that autism rhetoric (including deployment of the metaphors of alien, invader, epidemic, enemy, etc.) has been central to that commodification process—the manufacturing of autism, and thereby, through processes of interpellation, autistic people—all in the service of manufacturing a broader cultural narrative or logic of intervention, thus producing the market for, and teleologically justifying and sustaining the profit-generating infrastructure of, the autism intervention industry.
Two edited collections published over the past decade have worked to establish the foundations and contours of the emergent field of critical autism studies (cas), and each of these has engaged somewhat with questions of political economy, but to a limited extent. The first, titled Worlds of Autism: Across the Spectrum of Neurological Difference (Davidson & Orsini, 2013), actually coined the term critical autism studies and developed a loose conceptual framework of what cas comprise. These include: 1) careful attention to the ways that power shapes our understandings and study of autism, 2) the advancing of empowering cultural narratives about autism, and 3) a “commitment to develop new analytical frameworks using inclusive and nonreductive methodological and theoretical approaches to study the nature and culture of autism” (Orsini & Davidson, 2013, p. 12). Thus, the import of studying narrative, culture, and specifically, power is placed front and center in this articulation of the aims of cas as a field of critical scholarship, although economics is not explicitly invoked.
Nevertheless, as economics is a central mechanism through which power circulates, within this edited collection a couple of manuscripts do engage with the economics of autism, albeit in limited ways. For example, Nadesan (Nadesan, 2013) presents an analysis titled “Autism and genetics: Profit, risk, and bare life.” Nadesan, whose earlier (2005) comprehensive sociocultural analysis of autism as a construct appeared to spark the wave of critical scholarship on autism that has been produced over the past 15 years, writes in this piece specifically of the social and political processes of assessing and managing the “economic risks” (p. 117) associated with autism. Through an analysis of the prioritization of funding related to autism (including allocations of public funds toward research, pharmaceuticals, and the quest for genetic markers that may yield either pre- or postnatal tests for autism), Nadesan raises difficult questions about the ratio of public dollars spent on care and support vs. basic research ultimately aimed at prevention of autism. In the context of neoliberal austerity measures, Nadesan warns that “Family members of people with autism will be ‘responsibilized’ for their care without the benefits of supports as states, counties, cities, and school districts shed services” (p. 134). Additionally, Nadesan somewhat ominously predicts that the prioritization and investment of funding in autism susceptibility testing may “have the potential of refiguring risk so that parents of autistic children are made financially responsible for the ‘choice’ to keep (that is, not abort) their autistic children” (p. 134), and that “this prioritization could undermine support for costly educational and therapeutic supports” (p. 137). In this same volume, Bumiller (2013) critically analyzes the politics and economics of the increasing privatization of responsibilities of care in a neoliberal economy, arguing that “it is necessary to reimagine the [financial] responsibilities of the state in the hope of creating a more socially inclusive future for people with autism” (p. 145). Both of these forays into the political economy of autism fundamentally circulate around the costs of intervention, care, and support, and whether those costs should be socialized or privatized, rather than critically examining the intervention industry itself.
In a second edited collection (Runswick-Cole et al., 2016) aiming to contribute to the nascent field of cas, only a couple of pieces refer—and most of those somewhat tangentially—to the import of economics in the critical study of autism. In the introductory chapter, Runswick-Cole (2016) asserts the problematic nature of the commodification of autism (see also Mallett & Runswick-Cole, 2012, 2016): “This thing called autism is everywhere” (p. 25, emphasis in original). She further acknowledges that “Clearly, there is money to be made in autism” and cogently, that “it is not possible to comment on the autism industry without contributing to it” (p. 26). Nevertheless, few of the manuscripts in the collection explicitly analyze this autism industry, though a number concede its profit-generating existence as taken-for-granted background of their analyses. For example, Goodley (2016) refers briefly to multiple forms of “commodity fetishism around autism” (p. 156), and McGuire (2016) parenthetically notes that “the notion of spectrum offers a hopeful (which, from the vantage point of capitalism, most often means lucrative) narrative of the possibility for an incremental recovery of normative life” (p. 103). Further, Timimi and McCabe (2016) rather obliquely, and almost as an aside, quip that “To us, however it seems that the people who have most obviously benefitted from the increase in the use of tools for screening for and diagnosing of asd s have been the professionals themselves” (p. 173).
Latif (2016) engages with these issues somewhat more explicitly. Although his analysis is largely centered on ethical deliberations around autism diagnoses, that discussion is squarely framed within the context of neoliberal austerity policies as a sort of backdrop for the ethical analysis. Latif principally aims to explore how people’s ideas about autism “are modified and influenced by the dominant classification systems, which in a capitalist market has been driving toward a technically based biomedical model of mental wellbeing” (p. 288). Latif further notes that “whilst such a model may be good for expanding markets, problems of feeding disproportionate demand against limited resources arise in universal public health systems such as the United Kingdom National Health Service (nhs)” (p. 288). This primary concern with scarcity of resources in general, and with the impacts of neoliberal economic policies of privatization and austerity in particular, align Latif’s, and most of the analyses of economics in this volume, with those in the Davidson and Orsini (2013) collection.
Mallett and Runswick-Cole (2016) offer the only contribution to this volume to explicitly advance an analysis of autism within capitalism in their piece, “The Commodification of Autism: What’s at Stake?”, wherein they argue that “autism has become a commodity; it is produced, exchanged, traded and consumed” (p. 110). These authors contend “it is the moment when it [autism] becomes a ‘thing’ that it becomes consumable and, therefore, amenable to commodification” (p. 117). They successfully argue and amply demonstrate in this piece that autism has become a hot commodity, illustrated with cogent examples of autism therapies, entertainment and popular culture, and even the rebranding efforts of the neurodiversity movement. However, neither Mallett and Runswick-Cole (2016) nor any other extant analyses yet demonstrates how autism came to be successfully commodified, nor the nature of the intersecting social, historical, cultural, political, and economic infrastructures that both produce and sustain it as a lucrative commodity.
This analysis aims to do just that. Multiple authors have offered useful descriptions of the nature and range of the profit-generating marketplaces operating in the aic—e.g., not only intervention services, but diagnostic and evaluation services, scholarship and research industries, media industries, the special education and related services industries, niche technology industries, etc. (Grinker, 2020; Mallett & Runswick-Cole, 2016; McGuire, 2013, 2016). Almost all extant analyses of autism and neoliberal capitalism focus on the societal and personal implications of privatization and austerity, vis-à-vis access to intervention products and services. Or as Grinker (2020) puts it, exploring the challenges parents face “as they seek to find services and social supports that will enable their diagnosed children to be educated and launched into the neurotypical world” (p. 8). However, to date, no one has yet developed a comprehensive conceptual analytic of the cultural and historical contexts in which the aic emerged, nor how the aic operates in the overlapping spheres of both cultural politics and political economy, manufacturing not only the commodity of autism itself, but also, and crucially, the cultural logic of intervention that undergirds the entirety of the aic’s economic infrastructure.
We develop and deploy the aic as a useful heuristic device that enables us to document and critically analyze the intersecting spheres of both cultural politics and political economy in the simultaneous cultural and economic production of autism and the cultural logic of intervention in relation to it. Our analysis aims to hearken back to Albrecht’s (1992) in that we aim to braid together a complex analysis of (a) the production of autism as a “social problem” with (b) the institutional (interventionist) response to that “problem.” That is, we explore the ways in which the cultural politics of autism and the economy of autism co-constitute one another. In so doing, we draw upon and weave together analyses of the intersecting strands of ideology, rhetoric, and discourse, together with the interlocking strands of social policy, business, education, and medicine, all of which collectively serve to generate and to justify further extraction of profit from autism—and therefore autistic people—in an advanced neoliberal capitalist economy.