Early ‘Autism’ Diagnosis: As I Suspected …..
Confirmation usually doesn’t come this quickly, but in case of the autism-related item at this morning’s “Couldn’t Help But Notice” post, it has.
At that post earlier this morning, I wrote:
Excuse me if I detect the distinct aroma of a victim-creating, society-blaming industry. If it takes a bunch of false diagnoses and lifetime stigmas to create a hysteria, too bad, so sad.
In “Crusades Versus Caution: Part II,” Thomas Sowell flags the victim-creating industry (bolds are mine, and prove the point):
….. the dangers of false diagnoses of toddlers and preschoolers have been pointed out by Professor Stephen Camarata of Vanderbilt University, who has tested and treated children with autism for more than 20 years and has encountered many cases of inaccurate diagnoses.
A prudent trade-off, as distinguished from a crusade, would weigh the dangers of false diagnoses against the benefits of “early intervention.”
There is already considerable evidence of false diagnoses of preschool children as autistic, and the treatments inflicted on them can be abusive, with incalculable negative effects on their development.
….. Much has been made of statistics showing a sharp increase in diagnoses of autism in recent years.
What has gotten much less attention is the changing definition of autism, which raises the question whether there has been an actual change in the real world or simply a change in the way words are used when collecting statistics.
People today are often spoken of as being “on the autistic spectrum,” rather than as having autism.
While there are some conditions which are much like autism, there are other conditions, such as having a very high IQ or simply being late in talking, which often include characteristics listed on checklists for autism. These are open invitations to false diagnoses.
We would see the dangers immediately if people who wear glasses were included on “the blindness spectrum” or people with harmless moles were included on “the cancer spectrum.”
Blindness, cancer and autism are all too serious — indeed, catastrophic — to use loose definitions that fudge the difference between accurate and inaccurate diagnoses.
Loose definitions of autism produce bigger and more newsworthy statistics, which in turn can attract more children into existing programs and attract more money from the government, foundations and other sources to support those programs.
Many parents have told me that they have been urged to let their children be labeled autistic, or on the autistic spectrum, in order to get money for speech therapy or other conditions from grants that are available to deal with autism.
Professor Camarata points out that the “less precise ‘autism spectrum’” label “has had the unintended consequence of diluting resources, research and services to those children and families who most need the support” — that is, families whose children suffer from genuine autism.
I’m less sure than Prof. Camarata that what he cites is “unintended.”
Here’s an example of press coverage that plays right into Sowell’s point. Note the breezy jump from “autism” to the “spectrum”:
The alarming rise in autism rates in the U.S. and some other developed nations is one of the most anguishing mysteries of modern medicine — and the source of much desperate speculation by parents. In 1970, its incidence was thought to be just 1 in 2,500; today about 1 in 170 kids born in the U.S. fall somewhere on the autism spectrum (which includes Asperger’s Syndrome), according to the Centers for Disease Control and Prevention.
As to the “society-blaming” part, that same Time article engages in that too:
Still, there’s a nagging sense among many experts that some mysterious X-factor or factors in the environment tip genetically susceptible kids into autism …..
Enter Michael Waldman, of Cornell’s Johnson Graduate School of Management. He got to thinking that TV watching — already vaguely associated with ADHD — just might be factor X. That there was no medical research to support the idea didn’t faze him.
….. Lo and behold, Waldman and colleagues found that reported autism cases within certain counties in California and Pennsylvania rose at rates that closely tracked cable subscriptions, rising fastest in counties with fastest-growing cable. The same was true of autism and rainfall patterns in California, Pennsylvania and Washington State. Their oddly definitive conclusions: “Approximately 17% of the growth in autism in California and Pennsylvania during the 1970s and 1980s was due to the growth of cable television,” and “just under 40% of autism diagnoses in the three states studied is the result of television watching due to precipitation.”
If you think this stuff doesn’t pass the laugh test and has no chance of having public-policy implications (e.g., higher taxes on cable bills to feed the autism industry, regulation of how long TVs are on, perhaps even universal day care to control exposure to those autism-inducing TV sets), you’re forgetting that globaloney and globalarmism make similar leaps to indict mankind as THE cause of alleged global warming and climate change — and that those who are pushing it on us are prescribing draconian standard of living cuts and/or outrageous taxes and fees. The “anti-autism” measures I just described would be (excuse the pun) baby steps.
So young and so cynical!
Best wishes
Comment by Maddy — November 14, 2007 @ 11:52 am
When I saw VH1 Classic’s Rock Autism ads I realized I was watching the marketing of the next “victim industry”. I wonder who’s behind it? Pharma companies?
Comment by Steve — November 14, 2007 @ 1:05 pm
I don’t know exactly where to jump on the bandwagon but I agree with your line of thinking about the woe is me factor comes into play WAY TO OFTEN. Is it a cycle we can stop or are we going down the drain? Really…is there any way to stop it? I’m more of a pendulum thinking person, with time it will adjust itself.
As for getting services for my child, you better believe I’d “label” him anything if he needed the service (dare I say most parents would). When he wasn’t talking at the age of three and needed speech therapy, I let them call it whatever it took to get the help he needed. After four years of therapy and lots of hard work he is doing well.
If autism awareness is the lesson for the day then I’m waving the flag. Early intervention can help thousands lead productive, independent lives and that helps no matter where the pendulum happens to be.
Comment by Canvas Grey — November 15, 2007 @ 7:19 pm
#3, whether the child needs the service is the key. It appears that parents are sometimes being convinced or duped into thinking their kids are autistic, when in reality they’re not at all, or are somewhere in the mystical “spectrum.”
There’s not a darn thing wrong with awareness. There’s a lot wrong with premature diagnosis. Sowell is unimpressed with what “early intervention can accomplish. Where’s the crisis in waiting until age 3 or 4 in a lot of these cases to make a definitive determination?
Comment by TBlumer — November 15, 2007 @ 7:50 pm
Thanks for an opportunity for more awareness!!!
The characteristics of autism:
1. difficulty with social interaction or speech
2. problems with verbal and nonverbal communication
3. repetitive behaviors or narrow, obsessive interests
#4 “Where’s the crisis in waiting until age 3 or 4 in a lot of these cases to make a definitive determination?”
I could speak volumes to the crisis of waiting…waiting for what? Waiting until the child in complete frustration resorts to aggressive behaviors for lack of connecting and communicating with others? Two or three years of that pattern in development and later they might be saying, “Book ‘em Dano” or mourning another suicide.
Only qualified doctors can make a diagnosis. Will there be some premature, incorrect diagnosis? Absolutely. Doctors are in “practice.” However, a diagnosis can be changed and services removed. In the meantime we are talking about two or three years of HUGE developmental stages in shaping lives, personalities, habits and understanding the world.
Comment by Canvas Grey — November 15, 2007 @ 9:57 pm
#5, if you could read Sowell’s whole piece I’d appreciate it.
What are your responses to his claim that little can be done if it’s serious autism, but lots of harm can be done with the premature autism stigma?
Comment by TBlumer — November 15, 2007 @ 10:31 pm
It sounds like you’re also objecting to children who have Aspergers getting therapy under the name of ASD. Who the heck cares what they call it? If my child is diagnosed with ASD (but actually has something not as severe as Autism) and gets therapy at age 2, which changes his life, why would that by a bad thing?
I understand and appreciate the premise of your complaint. As a mother of a child who has been diagnosed with ASD, I have spent countless hours questioning how problematic are his disabilities and am I doing too much or not enough to focus on these problems, etc. However, if the testing he received had been for Autism and only Autism, not ASD, it is likely he would not be getting servies, which he very clearly needs. Perhaps these labels could be more specific to avoid catching so many in their net, but I sure am glad they caught us. Otherwise, I might still be crying myself to sleep at night, wondering what in the world is wrong with my son.
Comment by Deb — November 16, 2007 @ 12:41 am
#6, I read his piece and all the upset and humor in the thread.
I truly think Mr. Sowell has made deductions on too few resources to comment about autism and diagnosis. I still can understand where he is coming from and respect his opinion (and yours too).
However, if the concerns are based on diagnosis and the wallet, then he needs more information. The only type of therapy that would come from his/our wallet would be ABA (I’m not a fan of that for the most part) which is already in some public school systems. Mainstreaming of high functioning autistics is in the public school systems and has been since we entered the world seven years ago. Of course indirectly we all pay for any type of therapy via insurance. However anything out of the mainstream for autism isn’t covered under insurance and the cost comes directly from the parent.
There are so many “therapies†running around out there it reminds one of the snake oil offered for dieters during late night TV. In desperation perfectly intelligent people will try anything to help their child become “normal†instead of patience and acceptance with room for growth over time. Autism isn’t something you can pop a pill for and you’re done. So in answer to those concerns from a monetary point of view, the burden is on the parent because insurance won’t pay for those types of “therapies.â€
Can some therapies be harmful to a child? Absolutely! So can a vast number of things in this world. Mainstream therapy for a child misdiagnosed at 3 would include teaching the child sign language or physical therapy to improve motor skills. But I’m not the one to ask, the professionals are the ones to ask. If autism is suspected then the child is referred to a certified doctor of neurology or a neurological developmentalist to determine further diagnosis. These are the experts, not the family doctor or my friend Flicka or me or anyone so highly unqualified.
Here is the last paragraph of Mr. Sowell’s article (II):
“Parents whose children are late in talking or have other troubling problems would do well to seek diagnoses from the most highly qualified professionals they can find — but not rely on the facile checklists being promoted in the current crusade for universal diagnosis of infants and toddlers for autism, without facing the question whether or not there are enough people qualified to make such diagnoses.”
I’m all for sharing and debate; after all we need each other. We need people at each end pulling and tugging at one another so that we all can make sound decisions about our own, unique circumstances after learning the facts. Awareness and education is the key! The “checklist†is a place to start, just like developmental charts have been used to gauge developmental problems for years.
Thanks again for allowing me to share information!
Comment by Canvas Grey — November 16, 2007 @ 1:01 pm
#5, thanks for your thoughts.
I had a discussion on the topic with someone else today who thinks early intervention is fine when handled properly …. I guess those three words are the key. I thought it was odd when this person referred to it being schizophrenia if a person is diagnosed too late. I don’t get that.
I still worry that the govt. and others might have a predisposition to diagnose autism in borderline cases.
Comment by TBlumer — November 16, 2007 @ 2:29 pm
Ya know who I worry about…pharm. companies and their drugs to “cure” or “enhance” and the society that so readily takes them. We have no real studies on long term effects of MOST DRUGS, except aspirin. Drugs can surely help, my dad would have been dead long ago without them. But he took all of them AFTER reproducing children.
The schizophrenia diagnosis and autism have been lumped together and unlumped together since the beginning. We are still infants when trying to untangle how things work and are wired in our brains. Whether a person actually becomes a different person if not taught to communicate, or function in this world…I think that answer is clear.
Comment by Canvas Grey — November 17, 2007 @ 10:12 am