Autism Spectrum

Thomas Sowell wrote an article last year about the trend of calling autism a spectrum disorder (thanks to commenter Dan for bringing it to my attention). Sowell's argument that placing children with developmental delays on a spectrum rather than clearly defining who's in and who's out dramatically increases the number of children diagnosed with autism. Children who really only have developmental delays or were missed diagnosed end up with the label of autism for good or bad. Sowell likens it to diagnosing people on a blindness spectrum rather than just diagnosing blind or not blind. People who wear corrective lenses would fall on one end of the blindness spectrum while people who are just plain blind would fall at another end.

I've always been unsatisfied with the amount of time it took for Ethan to receive a diagnosis of autism. We went into the appointment having read all of the DSM IV criteria for diagnosis of autism and it's variants. Given the complexity of those criteria I was expecting the appointment to be the first in a series of many before we got a diagnosis (see links below for information on DSM IV diagnostic criteria). Ethan was only with the doctor for about 30 to 45 minutes before the diagnosis was given. More extensive examination didn't come until after that point. It makes far more sense to me to do all of the extensive testing before making a pronouncement that a child has autism. I'd have a lot more confidence in the diagnosis if it hadn't come so easily.

One of the most important things that I have learned thus far in my quest to understand autism is that Ethan is not like other kids on the autism spectrum. He is unique. He does not meet all of the DSM IV requirements for a diagnosis but he clearly meets others and I can see how other problems would develop if he were left to his own devices . This all makes me wonder if it is prudent to lump him in with other children who clearly and undeniably meet the DSM IV criteria?

For example, one hallmark of autism is a lack of eye contact. Ethan has no problem making eye contact with people. His progress report for the end of the summer program he was in noted that he had good eye contact. Despite the fact that we had told his teacher and therapists that he has always made good eye contact with people especially with people he likes. How often will we have to deal with people who want to help Ethan with problems he does not have?

The cynical skepitc in me thinks that there is an emerging autism spectrum disorder industry that seeks to make a profit off of parents trying to help their children and off of the government trying to help it's citizens. My father is a special education teacher in New York City and knows first hand how much money gets poured out of government coffers to provide services to children with special needs. He also knows first hand of the wrangling that goes on by all involved to make sure that they get as much from those coffers as they can.

Parents are left out in the cold. Either having to wade through a sea of theories about childhood development, autism, and methods of intervention or have someone else decide for them which theories and methods to pursue. Most of these theories and methods have little or no research to support them. Parents are left in a buyer beware situation with people trying to sell them all kinds of things and with their children's futures hanging in the balance.

Just between you and me that stinks. I don't know what I'm going to do about it yet but I am not satisfied with business as usual.

DSM-IV Criteria, Pervasive Developmental Disorders


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