With the latest CDC figures out, it appears autism is now appearing in about 1 in 68 children in the United States. The disorder — now officially known as autism spectrum disorder — is being diagnosed at a rate that represents a 30 percent increase from 1 in 88 two years ago.
What’s amazing to me is that I couldn’t find a single media report that floated the idea that this increase represents an overdiagnosis of the disorder. While “overdiagnosis” seems to be the first thing suggested when the topic is attention deficit hyperactivity disorder’s (ADHD) huge jump in diagnoses over the past two decades, it’s not mentioned in any description of autism’s increase.
Why the double-standard?
To be clear, I don’t know the answer to the autism question.
While it may indeed simply reflect better diagnosis of the disorder by health and mental health professionals, it may also reflect the same kind of secondary gains garnered by children who get diagnosed with attention deficit hyperactivity disorder (ADHD). Children who get an autism diagnosis — even in its mildest form, what used to be called Asperger syndrome — can get allowances and special consideration in both the academic resources available to them, as well as their academic performance.
Which isn’t to suggest most children who have an autism spectrum disorder diagnosis don’t actually have it. I suspect the vast majority do, and this jump in diagnostic rates is “real.” Children with severe autism need more resources than most children with severe ADHD. But they can both be equally challenging to families. One diagnosis shouldn’t be demonized by the media.
But I would argue that the jump in diagnostic rates of ADHD is also mostly “real,” while some children remain under-diagnosed or under-treated. So why is the jump in ADHD diagnoses attributed to “overdiagnosis” of the disorder, while that suggestion isn’t made in autism?
I’d guess it’s because autism doesn’t have a drug to treat it. ((At least not yet. Some drug makers are hard at work trying to find one to help treat autism. It’ll be interested to see that, once a drug has been approved to treat autism, if suddenly “overdiagnosis” of autism becomes an issue.))
When journalists can point a finger at “big bad pharma,” it’s easy to raise the specter of “overdiagnosis.” Pharma, it is suggested, is somehow pushing doctors and mental health professionals to diagnose ADHD, just so they can then sell them a drug to help treat it. It’s not entirely clear how pharma is doing this, but that’s the theory.
No such suggestion is being made for autism, and yet the possibility that the increase in autism rates could be partially attributed to overdiagnosis isn’t raised. Overdiagnosis is just as possible with mild forms of autism as it is for mild forms of ADHD, because the presentation relies on subjective symptoms that are present in most children to some degree.
Once a diagnosis is obtained, the child is often then qualified for allowances in their academic performance. Yet I don’t know of any good mainstream media stories that have covered all the secondary (usually academic) benefits children with these kinds of disorders can get.
Autism, like ADHD, remains a serious and often debilitating mental illness that begins in childhood. Both should be treated equally as serious public mental health issues that need to be addressed by policy makers, researchers, clinicians, parents, teachers and advocates. One should not be called-out and demonized for “overdiagnosis” simply because pharmaceutical treatments are available for it.
Read the full article: CDC: 1 in 68 U.S. children has autism
56 comments
I agree, and this issue becomes especially important when looking at the anti-vaccination movemment. Although vaccines have been around for over 50 years, the rates of autism diagnose have only spiked ‘recently” in comparison.
There are multiple factors at play, one being an awareness of autism as a conditon, as well as a percentage of over-diagnosis. Also consider that there are now more doctors/psychologists, etc. who aim to treat or work with children who have been diagnosed. So, is it not possible that a parent who seeks the advice of one of these people because little Jonny or Suzie isn’t hitting every developmental milestone at the exact right time will be told that there child is possibly mildy autistic, because that is what these people have been trained to see?
I agree, that much like ADHD, that is diagnosed based on behaviors displayed by the child, and not by any quantitative or qualitative laboratory test, a mild autism diagnoses can be sought out by the parent who needs a reason for why their child isn’t performed up to the standard that the parent feels is acceptable.
A lot of people tie the movement of antivax/selective-vaccination/vaccination responsibility to autism, but actually most of the people I know who are like that have other reasons beyond—including actual personal experience with a negative vaccine injury/reaction. Most of the people I know who are “anti-vaccine” (as in most or all versus people who do selective vaccination) tend to be extreme pro-life religious zealots.
My grandchild is very high energy and very bright. He has no siblings or children his age around him in his family. Being the youngest person in a family of people in their 50s on up he is sometimes considered to be ornery or hyper. One must consider the environment he is in. His parents are very unmotivated and have bad tempers and no patience. The child doesn’t learn basic social skills because these parents don’t socialize him with other kids. They only want to do adult activities. They sleep in all weekend.The problem with making a diagnosis on a child is that they must ask the parents about the child, and lousy parents blame the child. The parents are looking for an out. Kids in schools for autism rarely have homework. There is far less work for the parents. Doctors are too cowardly to call out the parents on their own habits and behaviors. A pill is the answer. A life altering,brain damaging pill that increases the child’s chance of becoming an addict by over 50 percent. It stigmatizes the child for life. Suicide becomes a high probability due to depression. And the parents are pitied when the real victim is the child. What a travesty!
I would like to talk more about “why” neurodevelopment disorders, vs. whether or not there is a legitimate concern. In my opinion, the significant increase in use of industrial chemicals, along with the impact of use (on human biology) should be in the media spotlight right now.
I would totally agree that the presence of industrial chemicals, waste or by products would definitely be an area to look into, also I have noticed that inmsome areas of the population the mothers and fathers are waiting longer to have children which in turn, opens the fetus to all sorts of issues with development, strong healthy dna duplication sites in the body may break down some over the years giving the recipient damaged dna info, or reproductive organs might not work as well as they should , I think you are definitely going I the right direction with your thoughts
I think this is a great article and great point. When I heard the statistics yesterday, while I empathize with all the families I work with who are struggling with a child with Autism, I also have seen so much overdiagnosis or misdiagnosis that I have no doubt contributes to such high rates. People are not talking about how What was previously Aspergers is now just ASD (which you mentioned). But I have also seen so many kids in my experience who have a handful of other deficits (ID, genetic conditions, you name it) and they are often just thrown under the umbrella of ASD,. It’s very frustrating and makes it hard for families to know what to realistically expect for their children. Thanks for writing this article.
My grandson behaves fine when he is at his father’s house but when he is at his mother’s home he can be so bad that he hits her and takes control of the house. He is 9 years old and they want to medicate him, but his father doesn’t want them to, because he does seem capable of good behavior when he is in a disciplined environment. Can you lead us to further information about should he or should he not be medicated if he is controllable in a healthy environment?
Bad behavior does not = autism. This is similar to what was happening in the 1980’s when teachers and therapists stating going crazy prescribing ritalin as a miracle cure for “bad kids” who acted out repeatedly as corporal punishment was well on it’s way out by the 80’s. Most of these kids have no development issues at all. They are not autistic just little punks who never received a good spanking when they needed one. Plus everybody today is trying to one up the other and see who carries the bigger victim-hood title.
100% Agree.
“I’d guess it’s because autism doesn’t have a drug to treat it.”
While it is probably safe to say Big Pharma doesn’t have too much to do directly with a rise in diagnosis of autism, it is wrong to say drugs aren’t used to treat autism. They’re medicating the symptoms, not the condition.
I think no one is suggesting that there is overdiagnosis of autism because our culture is more comfortable considering the symptoms of adhd normal behavior than the symptoms of autism. Also, I think public awareness of autism and its statistics haven’t been around long enough for someone to make this argument. Give it time–if it exists, eventually someone will make an argument for it,
What the cause behind the precipitous rise in autism rates is, I have no idea. However, I do know that it is NOT something that should be taken lying down. Instead of simply speculating, we need to actually put money into research so that these kids get properly treated.
As a mother of a 46 yr old autistic son, when he was born autism was 1 in 200,000. My son was absolutely fine and at 9monts received the 3 in l shot. His arm swelled, red, and he screamed for hours. There was no consoling him. After that he appeared to look through us, he would stare and refused to play with toys, lost all his baby speech. I was a State Chapter President for 12yrs and met many other parents who felt the same thing happened to their children after that 3 in 1 shot.
We are not anti vaccines..thats bull crap. We demand these shots be given one at a time. Also, I live in a State that has chemical companies, polluting the air, water. Many of the parents whose children had autism worked in these vile plants. We believe its a combination…that shot and the chemicals in the environment that destroys their brains.
Same… thank you.
You are mistaken. The MMR vaccine does not cause autism. DR. Wakefield’s findings are totally bogus and were cooked up because he and his attorney’s were looking to file a whole litany of lawsuits against pharmaceuticals back in the late 90’s. There is absolutely no direct correlation between the MMR vaccine and autism.
In general maybe a few kids are diagnosed with autism that may be borderline but I see no reason to ever go to this diagnosis lightly. My son is 19 and when diagnosed it was 1/10,000. I know many families in the Chicago area with severely effected children and adults. Not like the kids they show on the news, doing ABA and looking like they are doing okay. I also believe my son had regressive type of brain assault, he developed completely normally until 16 months also after his shots. NOBODY knows these answers – most likely a combination of several factors but I for one do not think anyone should be forced to inject things into their children. This is America – it should be an easy choice, there is not reason babies need all these shots at such a young age before brain development is more solid and immune systems more mature. Slow it down and do single shots.
You should likely do a better search through the media as I see articles attributing this to better diagnosis almost daily. Obviously, we all missed that one in 32 boys that was autistic when we were kids.
ADHD is a more difficult disability to diagnose and the behaviors of this disability could pertain to other factors of an individual’s life situation (I.e. home environment: little Johnny may act out at school constantly because he is seeing abuse in the home or neglect….) it is uncertain whether his inability to pay attention is caused by a disorder or that of things the person experiences around him/her. ADHD is also not accepted as a disability under the law therefore it is more difficult for a person to obtain special education services for this disability. A student would have to receive a Section 504 plan which is not an IEP. While an individual may exhibit autism like characteristics and not be diagnosed with autism, the likelihood of this increased prevalence of autism is due to the more sufficient testing capabilities and the increased awareness of the disorder.
Unfortunately, your proclamation that ADHD is not a “disability” and is not included under special education is incorrect. I’ve worked as a school psychologist for the past 15 years and as a pediatric neuropsychologist for the past 10, so I’m very familiar with the definitions and criteria for various spec ed categories. ADHD falls under the umbrella of “Other Health Impaired.”
Since I never made such a proclamation in the article, I agree with you.
I don’t believe these statements! Autism was almost unheard of 30 years ago and to say it’s better diagnosing that has caused a rise in rates!? All you have to do is spend the day with a child who has been given that diagnosis to see that there is something infecting our beautiful children. And ADHD is a symptom of autism in some cases. The government need to address this issue because kids are the future. I worry so much because who is going to love and care for my girl as much as me after I’m gone
Autism Awareness Everyone
ADHD is not a “symptom” of Autism. Autism is characterized by deficits in social communication, social interaction, and the presence of restricted interests/repetitive behaviors. NONE of the diagnostic criteria for Autism even remotely mention attention, impulsivity, or hyperactivity. I’m not sure where you got this misinformation, but I’d encourage you to stop disseminating it.
I never said or stated that ADHD is a “symptom” of autism. I’m not sure where you read that.
It is not from “better diagnosing”. If that were the case, where are the thousands of I diagnosed 30, 40, & 50 year olds that you see walking around every day? You don’t because they are few and far between. My son is almost 22. Things were much different even back in 1992. I do not believe for a minute that vaccines are the only cause for autism. I believe between genetics, GMO’s, pesticides, other medications, AND vaccines…you can have the right combination to harm many children. I DO believe that the vaccines play a large part in it though…much larger than some would like to admit. I’ve been researching both sides of the controversy for well over 17 years now. I would also like to note that autism is a neurological disorder, not a mental disorder. There is a difference between the two. It stated in the article incorrectly.
Thank you Mindy. Autism is a neurological processing disorder that affects the entire body. It is not a mental disorder. These children perceive, feel and comprehend things the way their brains are wired to do so. I go to church with 200 people. In our special needs class we have 8 children, including my son. Seven of these children are autistic. Clearly autistic, I should mention. They are all boys. This is approximately 1 in 30 people and there are more in this community. I should mention that out of this body of people there is not one single adult on the spectrum, not even possibly. Now, the math is up to you. Whether it is preservatives, chemical, genes, toxic preservatives in vaccine overkill or older parents we cannot deny the increase in autism in our world today. Spend a day with me and my son. It is wildly wonderful and awful scary when I think of how this world will handle these adults when all of us moms and dads are gone. The adults I don’t see very much of now but you absolutely cannot say autism is on the rise because of better diagnoses without diagnosing adults. Now,how’s that for food for thought?
Isn’t interesting though how the large majority of those diagnosed with autism are boys?
Hello Dr. Grohol,
I agree with your opinion on the rising rate in which Autism is being diagnosed. I feel that it would be beneficial for the general public to become aware of what the child, parent, and doctor go through in the process of diagnosing a mental health disorder.
Would you mind reading my blog at http://sites.isucomm.iastate.edu/jbnoble/ ? I would like to have your perspective. In addition, I would love for anyone seeing this comment to follow the link to my blog and give your perspective as well.
Jacqueline Noble
[email protected]
The Green Room at Iowa State University
When you see eccentric adults walking about mainly doing their own thing, those guys are probably on the autistic spectrum.
In the mental health system many adults often in their forties and fifties have been mis-diagnosed with Schizoid Personality Disorders. Many of those people are also thought to be on the spectrum.
Many older people who have suffered with depression and had to give up work never really being able to cope with it. Probably many of those are on the spectrum too.
The problem is that an ASC isn’t just about not fitting in to society or being very shy. It usually affects people in more ways than that as in having great difficulty multi-tasking such as walking and talking at the same time. There are usually many other difficulties which go along with Autism.
Well I know that I was misdiagnosed with autism. After being given the diagnosis they did some research and didn’t really buy into the idea that someone who seemed perfectly normal most of the time, could have the same disorder as someone with severe autism who had no speech and severe retardation. I was taken to Hyper Sensitivity specialist who taught me ways to deal with the anxiety that I feel when I have over stimulation (particularly sound and smell), I am now living out of home on my own and have ways of self soothing when I feel uncomfortable. I think that if I really do have mild autism it is seriously not a big deal it’s just something that you need to work through.
Despite overwhelming anectdotal evidence of a vax / autism connection, drug companies, OWN THEIR OWN RESEARCH DATA and can disclose or not as they choose. Millions of dollars awarded to vaccine damaged children are handled in shadowy settlements managed by the secretive Vaccine Court. Groups like CDC and WHO, which should serve as international watchdogs, instead, have utterly failed in establishing a credible system whereby health care workers would be REQUIRED TO REPORT vaccine side-effects. On the contrary, medical workers are censured, to the point of loss of license, for responsibly blowing the whistle (ie doing their jobs.) A valid data-gathering protocol isn’t likely to appear any time soon as long as these agencies employ scientists who float freely between CDC, WHO, and Big Pharma. Fox / chickencoop, come to mind….
In the past half century, with no longitudinal studies to first prove long-term safety of current vaccine protocol, vaccines for new ailments have been continually added to the roster, as the childhood vaccine schedule becomes ever more bloated (even more in N America than Europe.)
And we run around like addled chickens, squawking: “Oh, my my!! What oh what could possibly be harming our kids at record rates??
Robert F Kennedy, as well as having an impressive family pedigree, is a highly respected environmental lawyer and activist. See his new book (‘Thimerosol’) about the mercury that is STILL being injected into our children with vaccines.
This is an adult writing- am middle aged woman with inspiration and hope. I was assumed to have all types conditions: Once was told Cerebral Palsy-no; tested for Fragile X with blood work-negative; tested for cancer-negative; thought I could have had a TIA-stroke-normal; and assumed to be Asperger’s by someone. When someone is looking for something, you show up with the traits. That doesn’t necessarily mean you are that diagnosis.
I think that there is an increase in diagnosis because now it is recognised that autism is on a spectrum whereas previously you had to be at the more severe end of the scale for it to be diagnosed. I do however think that there is overdiagnosis too and some children are put on medications when it is not necessary
Dr Grohol, thank you for publishing this article.
I am a nerd. I have many interests and several areas in which I am a recognized expert in. I have a considerable amount of talent, both as a musician and an artist. I am eccentric, but I know how to tone that down. I have been successful in positions that required me to display tact and good social graces. I am NOT autistic–I’m an emotionally healthy genius.
Even so, I know that there are people who claim that I’m autistic. When I’m under stress for a long period of time, I can become socially awkward. Both my parents were/are severely personality disordered. I was verbally and physically abused as well as neglected by both my parents. Both my parents likely had / have Narcissistic Personality Disorder. At home, they displayed poor social skills–but my mother could clean herself up and look good in public, yet be an abusive nut at home. While I was dealing with a family crisis surrounding the death of my father, I became so stressed out that I became physically ill. There were armchair mental health people who claimed that I was autistic–these were so-called mental health ‘professionals’ who based their opinions on how I behaved when I was severely stressed.
Being an eccentric does not mean that one is autistic. I highly recommend people to read David Weeks, PhD’s New York Times bestseller _Eccentrics: A Study of Sanity and Strangeness_ Dr Weeks is a psychologist in Glasgow, UK. In the UK, eccentric behavior is much more tolerated and, in milder forms, socially acceptable if not expected amongst geniuses and artists. Dr Weeks, through years of study, discovered that eccentrics are, by in large part, happier and both physically and emotionally healthier than those who are not eccentric. T
One of the things Dr Weeks noted is that most very smart people, including eccentrics, avoid coming into contact with the mental health profession–or going into it. For good reason, they fear that mental health professionals will insist that they conform to society’s norms and give up their eccentricities. They are right to be afraid of mental health professionals, because they are provably extremely intolerant of eccentrics and geniuses. The people Dr Weeks studied all noted how so-called mental health professionals are actually extremely prejudiced against well-functioning people whose life / lifestyle does not fit in with society’s norms. We admire the creative output of our eccentrics, yet we are very quick to label them. Aspergers’ Syndrome / Autistic Spectrum Disorder has proven to be a convenient way for the unthinking to put down, those who are geniuses, who are pleasantly eccentric and also functional
I am glad you make the connection from your own experience between ASD symptoms and personality disordered parents. There is a psychologist working for the National Health in the UK named Heather Moran who believes that about 30% of children diagnosed with ASD are actually suffering from attachment disorders induced by their pathogenic upbringings, primarily Narcissistic Personality Disorder (NPD), Borderline and other personality disorders. The symptoms are strikingly similar and usually a differential diagnosis is not applied. She has created what she calls The Coventry Grid for assisting in a differential diagnosis. My theory of this prevalent mis-diagnosis is (1) it is taboo to “blame the parent” and (2) usually the NPD parent presents themselves to the doctors as the perfect parent who does everything right when bringing their child for diagnosis. I have a fifteen year old son who was diagnosed with Aspergers at age 6, shortly after his mother separated from me. It has taken a while for me to figure out that she has NPD but it is abundantly clear to me now. As you know from living with your parents, being the child of an NPD parent is a nightmare. I can assure you that being married (briefly) to an NPD is also a nightmare and does not end well. NPD’s do not take divorce well and this makes the nightmare more severe for the other party. I can only imagine what it is like for the child in this circumstance. If you want to know how the NPD behaves in a divorce and the affect it has on the child and the partner, you should look up Dr. Craig Childress. He has figured it out, and I can tell you from experience that he is spot on, but a lonely voice at this time.
My son was diagnosed with Asperger’s in 1991 at age 5. He is unique, absolutely brilliant with computers, holds down a good job and other than not having a girlfriend or any friends, is happy. He lives in his own apartment and drives a nicer car than mine. He is peculiar, odd and misunderstood by most.
He was literally the first child diagnosed with Asperger’s in this area. He was about 8 years old. He was in treatment due to his language difficulties, severe social difficulties, physical weaknesses, etc. We learned everything we could about Asperger’s. We tried everything we could. It was a long difficult road.
He received a lot of services from the school district after his diagnosis. At the same time, all of the local school districts were doing their best to avoid paying for special education needs wherever possible. There were cutbacks everywhere. But….parents learned if they could get a diagnosis of Asperger’s for their child, it was looked upon as the “magic door” to lots of services. So, suddenly, there were tons of kids around here carrying an Asperger’s diagnosis.
I am not making this up. I heard it from psych professionals in the community, administrators in the schools, a local pediatrician, several special education teachers and some parents.
So, in my little corner of the world, that is why I see such a huge increase in the diagnosis.
I feel that I have a lot of knowledge about raising an Asperger kid. But I acknowledge that I am not an expert at all in the technicalities of diagnosing.
Recently, I saw a locally prepared program specifically about Asperger’s. There was a long segment showing “Asperger’s kids” at a program developed for them. I saw these kids laughing, poking each other, waving at the camera and smiling.
Again, I am no expert, and while these children may have had disabilities, it was not Asperger’s in any possible way according to the Asperger’s I have known in my son and with other kids diagnosed with it back in those days. Perhaps these kids should have had other diagnoses? So, again, it makes me wonder about how it is diagnosed today.
Raising my son was incredibly difficult. My husband and I worked with him every single day. Mostly we loved him all along the way, even when some very dark years came along when he reached Junior High. I am grateful for the services he received from the school district and for the services we had to research and find and pay for ourselves. Mostly we are proud of him and his uniqueness and the young man he has become.
No question that it’s being grossly over diagnosed. I worked in mental health for over 20 years and got out of the field because of nonsense like this. Kids need more services and support in school as the family unit has broken down, the mental health community continues to make excuses to justify single parent homes. This is the same mental health community and the American Psychiatric Association that just recently declared that pedophilia is not a mental health disorder. It’s sad to continue to give everyone labels so that the people who truly live with disorders like this get lost in the shuffle of incompetent mental health workers to try to keep changing to criteria to justify their relevance.
“Mental health professionals” … I hope one day we can look back at that and laugh …
My 2 1/2yr old son was just diagnosed with ASD a few days ago. He has a twin sister who I am 100% sure will also be diagnosed this week, as she is further behind his abilities at this time. You do all the right things in life, to get to where you are, and it feels like it was all for nothing when your children have been handed this label.
There were some things I picked up on from the doctor. I would imagine, many kids would be focused on boxes of (new to them) toys. So my son was so fixated on all this stuff and the doctor would ask me to call his name (not too loud) and he would ignore me, and she would say “See how he’s not paying attention to you?” He does the same thing when the television is on at home. I’ll call his name and sometimes he responds, but when I turn the TV off it’s like I just appeared. He has about half his alphabet learned, gives kisses when asked, grabs my hand to bring me to where he needs help. He repeats structured sentences but I cannot understand what he says. The thinking is there though and that I feel is most important. He’s making pretty decent progress even in just the past couple weeks and I hope that the indicators that doctors look for blend away as time goes by. We will be taking advantage of any help we can get.
When the doctor mentioned him ignoring his surroundings, I made the suggestion to remove the toys from the room so we could focus on him, and he would not be distracted, and that’s when I felt a switch go off with the doctor. She jumped right to “I’m diagnosing him with ASD. He will be able to do simple, repetitive tasks in an employment setting when he is older” She literally made an assumption what his capability would be 16 years from now!
She then went on to recommend some special schooling for him, and referenced a particular one that is opening that she happens to work at. This is where I reel back a bit and try to see the bigger picture of the problem of “over diagnosis”. More children in the program means more money to the school, and more money in her own pocket. I’m not saying this is why the number has increased, I’m saying this is where the line blurs and where the special interests can EASILY take advantage.
My daughter overall is behind his progress, and I’m sure my doctor will want to get her enrolled in the same therapy.
Tough roads ahead no matter the paths we will take. Whatever is going to get them what they need is all I can do.
You are right. You know what .,, I have three late talkers and two of them are extra smart now. I saw that when I jad a son .. my doctor started to make a case for him even though he did not have any signs of autism. He is speech like all my other kids and is very emotional and still the whole world is after me and is trying to prove to me that he is autistic. I have heard other cases too where lkids have turned out to be fine even though their doctors were almost about to declare them to be autistic or adhd. Doctors want you to visit them again and again out of fear. Its all about money and also about a tendency of finding autism in anything.
I had the opposite problem. The teachers were pushing for diagnosis. The clinical psychologist insisted on one (despite saying he was just “2 percent Asperger’s”). I was told the teachers had no influence in the diagnosis – a blatant lie – as I later found the notes from my son’s teacher to the psychologist. She had complained my son was always on his own. He was being bullied poor boy. The dictors said my son was perfectly normal, but I was filled with doubt as to how to do right by my son. We had MRIs, we saw the top pediatric neurologist at a teaching hospital, he had blood tests. They said no way was he autistic.
I deeply regret what my son has been through.
Autism is absolutely over diagnosed. I think it has a lot to do with any issue that is the current “flavor of the month”. 25 years ago, most people never heard of Autism. In the past 10 years, it has been discussed by the news, health programs, documentaries, etc. to death. I have a feeling parents drag their children into the doctors office for not starting to talk “on time” or for being shy, among other things. I was very shy in preschool and somewhat so in kindergarten. As I got older, I naturally adjusted and grew into a normal adolescent, into a normal adult. I was talking to my mother about the autism over diagnosis a few years ago, and we both agree that if I was my five year old self today, I would be “autistic”. (Even though I am in my mid 30s now and I have never been “autistic”… just a shy 5 year old)
As a Developmental therapist working directly with families and their toddlers in early intervention for 15 yrs, ASD is severely over diagnosed. The primary problem from evaluation teams to developmental pediatricians (many reports that I have collected over the years from well respected dev. pediatricians simply proven wrong)is that unfortunately (and tragically) the vast majority do not know how to go down to a child’s level and engage that child where s/he is with respect to deepening meaningful two-way reciprocal engagement around the child’s natural intent or affect. Once we engage a child where s/he is we get a vastly, vastly different picture rather than the “norm”, i.e., administrating a series of mostly if not entirely disembodied checklist questions to child and primary caregivers. At bare minimum the vast majority of what constitutes moderate to severe ASD, if done correctly and over a period of time would be on the mild end of the spectrum. Furthermore, we need to bare in mind the false perception that astoundingly persists of autism as a more or less uniformed diathesis or disorder. At best we are describing not a “disease” but a classification system of symptoms that do NOT necessarily constitute the former and that are constantly shifting (not intractable) as development-and-engagement changes in accord with the great neuroplasticity of the brain in synchronization with the abilities of adults (primary caregivers to dev. pediatricians) knowing how to engage that child developmental, processing and relationship strengths and challenges.
I hate to be the one to bring this up but with ADHD there was this little secret that nobody seems to know or talk about; a lot of it goes back to testing. Back in the 90’s school districts found out that if a child was diagnosed with ADHD they could throw out their scores in student testing. So, as a result, it was highly pushed to get unruly, hyper, or disruptive kids diagnosed and they could eliminate potentially bad scores from the average. It was manipulation to benefit the teacher – get the “bad scoring” kids diagnosed rather than teach them to get the average up. I get the same feeling from autism. If a kids seems to have any kind of symptom that they might be different or learn a different way they are pushing for diagnosis so it doesn’t impact school testing down the road and the schools get their funding. Yes, many diagnoses are real but such an increase makes me suspect. It always goes back to money.
I do believe there is a high rate of “misdiagnosis”. My son has a form of epilepsy that is said to be “very rare”, and it has robbed him of his ability to understand spoken language as well as his ability to speak. What he has is called Landau-Kleffner Syndrome, it is usually seen around the ages of 3-8. A normally developing child suddenly starts regressing in behavior and verbal skills. This regression is caused by absence seizures, my son was very advanced and then started to decline around 4 years of age. It was a slow regression at first and then about 4 months into his regression it became extremely bad. We took him to many specialists and we got the same thing over and over, he seemed autistic but he was already 4 1/2 so they had no idea what was going on. So we took it into our own hands and did so much research and got him into a neurologist and he was given an EEG. The next day we were told he was having to many seizures to count, he never convulsed not once. He was having absence seizures every time he got tired, fell asleep, or didn’t sleep enough. If a child is having seizures around the clock it will give them brain damage. I personally believe LKS is being misdiagnosed as Autism.
I have to agree with this article as I am a parent with a child who was misdiagnosed with autism. My son did have flags but he was two when he was diagnosed. He was a late talker, fussy, had sensory issues, not a typical child but we always sort of disagreed with the diagnosis. Now at age 5 1/2, you wouldn’t even be able to tell that my son is any different from any other 5 year old. He is social, talks at a 5 year old level, has great eye contact and his sensory issues are gone. He excels at his regular school without any more behavioral therapy. My conclusion is that they are diagnosing some of these children too young. I am going to get my son a new evaluation and I know we will lose that diagnosis.
I have some ideas about the cause of Asperger’s. I’ve observed that all of the people I know that had Asperger’s were babysat for the first 4 years of their life mainly by one adult, or one adult at a time. Even if a child went to daycare. It wasn’t some very constant experience. I suspect that for a healthy social development, children learn their socialization mainly from other children, mainly playing with other children. Just like many of us did as children. Parents tend to busy to much themselves with other things, and tend to ignore kids for most of the time. However, other children will show more interest in interacting, unless like in the modern times, kids are plug to the high tech, like Nintendo or cell phones, etc.
The one constant dramatic change has been society. In the 50’s children interact with lots of other children. Now days even at school children don’t have time allowed for real playing, many times the cause being a fear triggered by lawsuits, things, children playing physical interactive games, will be more surely hurt physically.
In societies where there are more children, and families with more children, Asperger’s seem less common.
I agree with you .., nowadays kids are getting abnormal environment . They need that happy free playing with the other kids.
Notice the hhard the majority of children diagnosed with autism are boys. Must be a coincidence.
Yes, I do think that mild autism can be misdiagnosed, and often is. Mild autism shares many features with other problems, and not just ADHD.
One major problem is that personality characteristics associated with being highly gifted (IQ 150+) are shared with mild autism. Here is a link to a table that compares and contrasts features of mild autism with features of giftedness. link: https://mumsinthewoodeducation.com/teach-them/special-needs/gifted-and-talentedaspergers-syndrome/ Please be aware that many gifted children who don’t have mild autism will have some traits listed in the right hand column.
Many lay people (and that includes teachers) use a child’s lack of social skills as a strong marker for autism. Furthermore, research into highly gifted individuals shows that 40% of highly gifted students also have a learning disability–commonly (but not always) dyslexia. One of the problems that someone who is dyslexic and highly gifted face is that they might not be identified by the school as highly gifted. These learning disabled but highly gifted students fly beneath the radar, because they still get good enough grades even though they are, in fact, underperforming and bored. Thus, they are not receiving the services they need–both accommodations for their learning disability and gifted / talented services, in order to develop to their potential. I think, the most important thing that Gifted / Talented programs offer students is that they get to meet and get to know others who have similar interests–commonality of interests is necessary for friendships to grow. According to Barbara Klein, Phd, “Social quirkiness in bright kids is normal and is more a sign of difficulties with peer relationships. The difference in intellectual abilities between gifted kids and kids who are more normally average is the root of this social problem.” (link:http://drbarbaraklein.squarespace.com/your-gifted-child-is-not-on-th/)
What about a child who is being raised by a caregiver with a Cluster B personality disorder and who is being abused or neglected (especially emotionally abused)? There is a good chance a child in this situation will not learn appropriate social skills, or may even be taught bizarre social skills by their severely personality disordered caregiver. Again, if one looks at the Gifted versus Gifted and Autistic chart I referred to, a child in this situation might display many of the behaviors of mild autism, but actually have Complex Post-Traumatic Stress Disorder (C-PTSD). Treatment for C-PTSD is very different when compared to the management of mild autism. (example: a professional would not think of referring a family to Child Protective Services if the child is mildly autistic, but would be obliged to make this referral if he or she diagnosed the child with C-PTSD and had reason to suspect that one (or more) caregivers had a Cluster B Personality Disorder and were abusing the child).
Another thing people should be aware of: an adult or child who is undergoing a stressful situation can behave in ways that make it appear that they might be mildly autistic. In the chart referred to above, a child or adult can experience nearly all the signs and symptoms in the mild autistic side of the chart under the headings ‘Speech and Language Therapy’, ‘Social and Emotional’, ‘Behavioral’ and ‘Memory and Attention’ if placed under prolonged and severe stress (especially stress caused by the behavior of other human beings). So, it’s important NOT to make a diagnosis of mild autism to someone who is currently going through a series of stressful events. Wait for the person’s life to calm down and only then consider making a diagnosis.
Why do I care about this? I am a high IQ individual who is also learning disabled (mild dyslexia). I have been ‘accused’ of being mildly autistic. I’m not. Both my parents were severely personality disordered (father: C-PTSD and probability more, mother: Narcissistic Personality Disorder and probably more. My brother is a functioning psychopath and has a history of alcohol dependency–the Golden Child. I was the scapegoat. I have nothing to do with my family of origin–they are truly wicked, evil people. Both parents were physically and emotionally abusive as well as neglectful. I have the behavior characteristics of a high IQ person (and so did my grandfather on my father’s side). Like most highly gifted children, I had problems relating to my peers, because I didn’t have much in common with them. My friends were usually the smartest people in the room. The first time I got to interact with people who were as smart as me, who had similar interests to me and who were my age, on a consistent basis was in college. I had many friends and was the leader of a peer group of about 15 students. Most of my friends did go to schools with gifted and talented programs and they were more advanced socially than me.
The upshot is this: Mild Autism has become a ‘disease du jour’. The problem with all ‘diseases du jour’ is that they are often over diagnosed, especially by lay people and way too many professionals (who should know better). Mild Autism has many, many signs and symptoms in common with other problems and with giftedness. It takes a skilled and knowledgable professional to make the diagnosis (and not necessarily a run-of-the-mill educational psychologist or clinical psychologist). A diagnosis of mild autism can have major life changing affects–and can close doors that would have otherwise open to the individual (such as military scholarships).
Profound autism is always accompanied by intellectual impairment. Even for high functioning autism, the average IQ level is below the average level of normal people, it is merely within, or just below, the normal range.
It is a complete myth that autism is associated with high intelligence.
There are claims from the “aspie” community for instance, that film producers have autism. This is completely ludicrous.
The diagnosis of autism is now so out of control I think it must now be simply removed.
More effective treatment for _real_ autistic patients would be applied if the profoundly autistic were termed “intellectually impaired” and the others diagnosed with a schizotypal disorder or simple schizophrenia.
As the mother of two premature boys, I have felt pressured by teachers into diagnosing my sons with autism. They show characteristics, yes, but at the most are quirky, interesting boys. I argued I should have my oldest checked by a pediatrician first but the teachers were adamant we see a psychologist first. My boys have a healthy appetites, they have friends, they do not have meltdowns. My oldest was extremely knowledgeable and teachers said he didn’t really understand what he was talking about. As his mother I can say this was absolutely not the case and I had several conversations with teaching staff insinuating I was ignorant. A clinical psychologist said he was 2 percent autistic and it was best for him, against my wishes, to be slapped with the label, plus mental retardation deferred. I later found my son had a physical problem with his neck and spine which had led to a bunch of issues developmentally including sensory problems. He had private sensory integration and vision therapy and is fine now. I did not do the therapy as part of the autism label as I never considered my boy autistic. I always knew there was something else. Now no teachers can believe he ever had a learning disability, and he is considered educationally gifted. Frankly nothing good came from the diagnosis. My son was bullied and teachers never took it seriously. I really struggled to be heard. Bullies are bullies. End of.
I am now being pressurised to have my youngest diagnosed by “well meaning teachers” and am wise to this. He’s a charismatic and popular boy, but being nine weeks premature I would not discount some mild sensory issues. I just think this is so wrong as there are many children who deserve the diagnosis.
Even then are diagnosed children actually getting the help they need? My friend’s son was diagnosed with Asperger’s age 4 and has had no help at all with his SPD despite being in the public healthcare system.
It’s over diagnosed because physicians spend 5 minutes with a child in an office and say they have autism. There is no consistent use of assessment for accurately determining a diagnosis of autism. With as much money that’s pumped into Autism Speaks, establishing standard and required assessments to make a diagnosis. Additionally, children are diagnosed despite a having a diagnosis that should exclude them from receiving an autism diagnosis.
I feel my son was just wrongly diagnosed with autism this week and I’m furious! If he has it – okay, not the end of the world; I love him just as he is and a diagnosis doesn’t change that. I’m also not saying autism is the worst thing that could happen; I’m also not saying there’s anything wrong with autistic people… I’m just pissed at how the whole evaluation went down. This psychologist knew she was diagnosing him before she even evaluated him; she twisted my words, asked questions over and over til she could walk me into the answers she needed, she coersed me to say things. She was pressing issues that are not there.. She was suggesting my son does things he doesn’t do and she was claiming he lacks certain things that he does not. Some of the things “wrong” about him are completely normal 2 year old little boy things and if those characteristics make him autistic, then fine, i don’t want to fix it! Ex – he was playing with a magic wand, pretending to cast spells and as he danced around with it he did a twirl – she tried to say he spins to regulate himself… He was literally dancing and he has a 4 year old sister who twirls around with wands everyday. Another ex. During our talk, my husband brought our daughter and our other son (the diagnosed child’s twin) into the room and they played fairly rough together. (They’re 2, 2, and 4). She said his energy is too high and they played with toys inappropriately (as in – when the boys want something the other twin has, they throw what they’re holding) 🤦 Yet she’ll also try to suggest he doesn’t play well with other kids (because that’s a strong autistic symptom)… I don’t know how many times I had to tell her he plays perfectly fine with others… So of course she turned his play into a negative in the other direction.
The entire evaluation was a joke.
I’m pissed because we scheduled this months ago when my son was having temper tantrums; I wanted to know what was going on in his head (he has a speech delay). Since then, his speech has improved A LOT and so the tantrums have calmed down a lot; he’s now able to tell me what he wants instead of screaming. I’m also able to explain things as he’s understanding more words. So we went into this meeting expecting to discuss his behavior, yet she led it with “we’re going to discuss if we see autism or not.” I was caught so off guard! And also – why are we seeing if he’s autistic or not? Why can’t he have something else if he has to have something?
I texted his therapists who we’ve worked with for a long time (due to him being a preemie twin, speech delay, free services.. Never anything major).. And one therapist said – off the record; sorry i don’t see it, you need to have him re-evaluated. (She’s been coming to my house weekly for a year and a half).
The therapist kept pushing that we have the other twin evaluated also before he turns 3… Absolutely not now!
So I’ve been googling like crazy to find information on over diagnosing or wrongly diagnosing, etc. I CAN’T FIND ANYTHING!! How is the internet protecting this phenomenon?!?!
Hi there, you and your situation remind me of me! I posted a response to this article about 3 1/2 years ago. And so I want to help put your mind at ease since no one seemed to be able to help us while we were going through this. Our son was diagnosed with moderate autism at 2 1/2. I totally disagreed with the diagnosis. The evaluator also twisted all my son’s actions to make it geared more towards a diagnosis. Maybe I was in denial, but here is what happened. I had my son re-evaluated at 5 with the ADOS test. He wasn’t even close to being on the spectrum. The new psychologist was actually baffled by how he even qualified (and it was moderate diagnosis, not mild) He scored a 17 on the ADOS at 2 1/2 and I think he got 2 points on the ADOS test done at 5 which (I believe anything under 7 is neuro-typical?). My son is 8 1/2 now. No signs of Autism at all. He gets good grades, is focused, no tantrums, is social, has friends. I don’t know what to say. Maybe the early intervention therapy worked…maybe his brain rewired itself. My son hasn’t had any therapy since he was 4 1/2 and is thriving. He plays basketball & swims and loves his third grade class. Anyway, take the early intervention and see how he is doing at 4/5 and re-evaluate. I was told at one point my son may never talk and I just roll my eyes now when I think back. Doctors and psychologists can’t predict everything. I hope this helps you 🙂
The problem is a lot of autistic behaviors cross into other disorders—including trauma-caused behaviors and personal quirks. I have met a number of adults who disturbingly label themselves as autistic (not in an ironic way), but they are often people who have survived child abuse and/or are profoundly gifted people.
I myself used to believe I was autistic after hearing an NPR interview with Temple Grandin when I was a young teen. At that point, I had survived years of child abuse at that point and was still undergoing it by multiple adults in my family. There were times I thought I might actually be killed by my father, and other times I felt the world may be better off without me (after severe verbal abuse from my father and stepfather).
As I was able to break away from my parents and get therapy during adulthood, a lot of my so-called “autistic” behaviors started to melt away. I have emotional scars and will probably always be a bit of an oddball. I also have a high IQ, some sensory processing disorders (which I find go away if I gradually immerse myself in noisy situations) and had spent some of my childhood years in the woods away from other kids. I cringe terribly when I meet other people (usually other women) who label themselves (and even their own kids) autistic without seeking outside professional help.
The single and sole reason for the dramatic increase in the bogus “diagnosis” of autistic features and traits is simple: FUNDING. Public schools and parents rapidly want to identify students with whatever they can get away with in order to get double funding for their special needs child…..even if it’s primarily a behavioral problem due to poor parenting, which is not as popular to talk about so they overpathologize children/adolescents and teens to get more money, and to not have to look in the mirror as to how poorly prepared they were to be parents. End of story.
Hannah Gadsby, a _stand up comedian_ (!!!) , has been diagnosed with autism by what is clearly a fraudulent psychiatrist.
The term is now completely meaningless.