I think we’d all agree with you here. No one (not here, anyway) has said that these aren’t valid medical diagnoses. All that we’ve said is that it’s not clear that the prevalence of these conditions has actually been increasing.
Colophon simply suggested that some of the increase could be due to parents of kids who are borderline on the spectrum, pushing for an official diagnosis, so that their kids would be eligible for services. Based on my experience in real life where I see this kind of stuff happening, I think he’s right: some of it is. So what? No one’s saying that ASD is not a valid diagnosis, or that they shouldn’t get help.
I fail to understand why it’s so hard to understand why a parent might rather have a child labled autistic than mentally retarded. Mental retardation can sound hopeless whereas austistic might have treatments.
Actually, I think the burden of proof is more on those who claim that there are drastic short-term changes in genetic and/or environmental factors causing an alleged upsurge in incidence of autism nowadays.
As Keweenaw’s link upthread noted, the CDC says it’s not determined yet whether there really is a statistically significant increase in autism incidence:
Remember also that we’re not talking about long-established diagnostic criteria here. In the case of smallpox or cholera, for example, we’ve known for more than a century how to identify cases. But ASDs, like most developmental disorders, are complicated phenomena that manifest in a multitude of different ways and are still poorly understood medically.
Fifty years ago, many pediatricians probably hadn’t even heard of autism, and certainly most wouldn’t have known about Asperger’s. Terms like “imbecility” and “mental retardation” and “arrested development” were applied to a wide variety of cognitive, mental and developmental problems. Nowadays children with such problems tend to get more specific diagnoses, but that doesn’t necessarily mean that such problems are commoner than they used to be.
So it seems reasonable to me that the null hypothesis for answering the question “What is causing the current significant increase in autism?” should be “There is no current significant increase in autism, and the increase in autism diagnoses for the most part merely reflects changes in diagnostic terminology and practice.”
By all means, we should continue research on the subject to determine whether that null hypothesis is valid or whether we need to invoke another cause, genetic or environmental or both, to explain the observed data. I’m definitely not advocating just turning a blind eye to the issue.
But IMO we should not be hasty in assuming that there is a cause of that sort driving the upswing in autism diagnoses. The anti-vaxers made one such hasty assumption, and look how well that worked out for everybody.
I understand, but it’s a matter of degree. Some say that 100% of the diagnoses aren’t real. Others say 50% aren’t real. That’s still people saying that diagnoses aren’t real.
He said much more than that, I think. I don’t think it’s just about “borderline” cases.
In typical MR cases (i.e. not what would now be labeled autism), there’s been lots of research and experience on education and behavioral intervention, and even some medical treatments are emerging. Educators and doctors have less experience with autism and what to do with it.
In the long run, you’ll probably be right - autism will be easier to crack. But we’re not there yet.
It’s also interesting that, in a roundabout way, we’ve gone back to blaming the parents for autism, like we used to do decades ago by saying it was caused by cold, distant parents.
lance strongarm, you are doing this kind of thing entirely too often. Your response to Colophon involved a complete misinterpretation of his post, and as a result, a bunch of posters had to take the time to explain something to you that would not have been necessary if you’d read his post more carefully and responded more reasonably by dealing with what he actually said instead of what you felt he was implying (or what someone who takes his views to an extreme might think).
In a roundabout way, as I said, to claim that parents are “pushing” for a diagnosis of autism is kind of like blaming them for it. Not directly, but you get the point.
I went to an interesting lecture on Autism yesterday by a Medical Historian (I did not previously know such a role even existed). Some of the more interesting points:
The definition of Autism was radically changed in 1994. Prior to that only the most severely affected, those with no language and virtually no empathy skills, would have been diagnosed as Autistic.
The ‘Autistic Spectrum’ is a spectrum of disorders, not a spectrum of severity within a single disorder. There are probably many Autistic disorders but currently it is not possible to separate them reliably.
Treatments/therapies appear to be effective in about 50% of cases. It is a crap-shoot whether any given child will respond.
In France Autism is considered a psychological condition caused by some mental trauma in first 18 months, to be treated by psychotherapy. Our views of Autism as a true mental disorder are dismissed as “The Anglo-Saxon interpretation”.
There is some belief amongst the research community that an unusual number of US Senators probably have Autistic grandchildren. This is why Autism research was the only condition explicitly excluded from recent budget cuts.
I seem to have stirred up a hornet’s nest here. I apologise that I haven’t been back to this thread before now.
Yes, you have misinterpreted me; whether that is my fault or yours I can’t say. Almost certainly a bit of both.
I was not trying to belittle or deny the existence of autism. What I am saying is that a combination of factors is (IMHO) at play:
Cases that would previously have been classified differently now get labelled as autism. That’s not to say they aren’t autism; just that half a century or more ago they might have been called something different and, to modern ears, much less kind.
In my experience, some (I did say some!) parents will push for a diagnosis, if they suspect something is wrong. While this can be helpful in getting better support for the child, it can also be counterproductive because the child is labelled and no longer expected to be “normal” or improve, because they have a medical condition.
I was at school with a couple of kids that nowadays would almost certainly be called autistic. To the best of my knowledge that term simply wasn’t used to anything like the same degree that it is now, except in extreme cases. People just thought those kids were a bit odd. I think knowledge and awareness of autism has increased vastly in recent years, in part thanks to the internet. Parents will demand to see specialists whereas before they might not have had the knowledge to do so.
I reacted the way I did for two reasons: the resemblance of this argument to those who would take it further, and the unfortunate dismissive language you chose to use about “little snowflakes” etc. And also your choice to include allergies, etc.
The idea that there are parents out there with kids with real, difficult issues who you dismiss as nothing more than selfish or whatever isn’t really appropriate. It’s insulting to parents who are dealing with very real, serious, issues.
You sound very reasonable and polite now, so I won’t continue to complain about that.
But maybe they SHOULD have been labeled autistic all along.
There are many conditions that we used to not understand, and therefore not treat. We used to dismiss old people with memory problems as just “senile” and say it was normal. Now we call it Alzheimers, and identify it, and try to treat it. That’s good. It doesn’t indicate that everyone who has a “senior moment” is knocking down doctor’s doors to get a diagnosis and drugs for Alzheimer’s though.
No, I don’t. It seems to me that claiming that parental behavior is inadvertently the cause of a real and serious medical condition in children (as earlier autism researchers thought) is not at all like claiming that some parents think their children should be officially diagnosed with that condition.
“Blaming the parents” strikes me as an unfairly harsh and negative way to describe the perfectly reasonable observation that some parents, for various reasons, actively push for a diagnosis of some disorder rather than just waiting for a doctor to bestow it.
We have? In what way? I’m not seeing anybody “blaming the parents” for autism.