The other issue is self-diagnosis. We get this particularly with frequent internet users. Sitting around bored one night and surfing the net, it's easy to look down some checklist or do some online test and suddenly discover that you have manic depression, aspergers, post-traumatic stress disorder, repressed memories, are at high risk of colorectal cancer, and so on.

Some people, with lives rather mundane, decide to latch onto that and self-diagnose as having serious problems.

It's a bit like the Otherkin. Life's too simple and peaceful for some people, they have to make it complicated for themselves.

Which does not mean that these problems are not real and serious. The fact that some people have Munchausen's by proxy syndrome does not mean that there are not truly sick children of geniunely worried parents; the fact that there are people on Tangency (to take a well-known example) claiming all sorts of obscure troubles does not mean that those troubles don't really exist in others.

Quote from: Ghost Whistler;281704Evidence please.

Leading dudes like Dr. Stephen Camarata of Vanderbuilt University, and Dr. Steven Pinker of Harvard have both expressed these concerns. Yeah, I know, they're not Dr.Phil of Podunk University, nor are they Mary Beth who took an 18-month course in social work, but I guess Vanderbuilt and Harvard will have to do.

Dr. Camarata has been quoted by Thomas Sowell in Crusades vs. Caution as saying that misdiagnosis "has had the unintended consequence of diluting resources, research and services to those children and families who most need the support".

RPGPundit

Quote from: Ghost Whistler;281704Evidence please.

From TIME magazine:

QuoteIs the Autism Epidemic a Myth?

By Claudia Wallis
Friday, Jan. 12, 2007

Epidemic is a powerful word. It generates bold headlines, congressional hearings, research dollars and dramatic, high-stakes hunts for culprits. It's a word that has lately been attached to autism. How else to account for the fact that a disorder that before 1990 was reported to affect just 4.7 out of every 10,000 American children now strikes 60 per 10,000, according to many estimates--the equivalent of 1 in 166 kids?

But what if there is no epidemic? What if the apparent explosion in autism numbers is simply the unforeseen result of shifting definitions, policy changes and increased awareness among parents, educators and doctors? That's what George Washington University anthropologist Roy Richard Grinker persuasively argues in a new book sure to generate controversy. In Unstrange Minds: Remapping the World of Autism, Grinker uses the lens of anthropology to show how shifting cultural conditions change the way medical scientists do their work and how we perceive mental health.

In addition to rising awareness of autism, Grinker points to these factors:

BROADER DEFINITIONS Each successive edition of the Diagnostic and Statistical Manual of Mental Disorders--the bible of mental health--has revised the criteria for identifying autism in ways that tend to include more people. Two conditions on the milder end of the autistic spectrum--Asperger's syndrome and the awkwardly named PDD-NOS (pervasive developmental disorder, not otherwise specified)--were added to the DSM in 1994 and 1987, respectively. Grinker and others say 50% to 75% of the increase in diagnoses is coming in these milder categories.

SCHOOL POLICY U.S. schools are required to report data on kids who receive special-education services, but autism wasn't added as a category until the 1991-92 school year. No wonder the numbers exploded--from 22,445 receiving services for autism in 1995 to 140,254 in 2004. Grinker points out that "traumatic brain injury" also became one of the 13 reportable categories in 1992, and it had a similar spike.

MORE HELP, LESS STIGMA As services have become more available for kids with autism, more parents are seeking a diagnosis they would have shunned 30 years ago, when psychiatrists still blamed autism on chilly "refrigerator" mothers. Doctors are also more willing to apply the diagnosis to help a patient. "I'll call a kid a zebra if it will get him the educational services I think he needs," National Institute of Mental Health psychiatrist Judith Rapoport told Grinker.

FINANCIAL INCENTIVES In some states, parents of children with autism can apply for Medicaid even if they are not near the poverty line. A diagnosis of mental retardation doesn't always offer this advantage.

RELABELING For all the reasons above, many kids previously given other diagnoses are now called autistic. University of Wisconsin researcher Paul Shattuck has found that the number of kids getting special-ed services for retardation and learning disabilities declined in 47 states between 1994 and 2003, just as those getting help for autism was rising. In 44 states, the drop exceeded the rise in autism.

As convincing as Grinker's analysis seems, arguments about the apparent epidemic will probably continue. It's simply impossible to accurately reconstruct the past incidence of the disorder, given how radically definitions have changed. Those who believe the increase is real often focus on the mysterious paucity of autistic adults. With their conspicuous symptoms like hand flapping and little or no language, "I think we would be recognizing them in institutions," says Dr. Robert Hendren, executive director of the M.I.N.D. Institute at the University of California, Davis.

Grinker's answer is that autistic adults are out there but wearing other labels. "Where are all the adults with fetal alcohol syndrome?" he asks. No one over 40 has the condition, thought to affect up to 1 in 500 kids today, because it was not recognized until the mid-'70s. "But no one would say alcoholism among pregnant women just started," says Grinker.

Grinker, whose 15-year-old daughter is autistic, concedes that there's something reassuring about the idea of an epidemic: "Thinking about any disorder as an epidemic is easier than thinking about it in terms of multiple causes, shifting definitions and a scientific reality we are only just beginning to understand." Besides, if a disease suddenly spikes, it seems more plausible that the increase could be reversed--if only we could find the mysterious environmental trigger. With autism, though, that hopeful scenario seems just too simple.

Claudia Wallis has been writing about autism for years. Here is another interesting article by her ("Inside the Autistic Mind"), written a year before the one I quoted above.

Autism is a description of symptoms. It has to do with the brain not pruning unnecessary connections early in development, but that's not well-understood or easily tested for. So diagnosing it is tricky. Furthermore, having a strict medical diagnosis for autism isn't particularly useful, because it doesn't indicate a strict treatment regimen.

Special education resources are not offered to every student with a medical diagnosis of any kind of disability. The school and the parents and any other advocates meet to determine if a disability has an educational impact on a student and the minimum services required to meet that need are offered to the student. Parents perceive that a medical diagnosis may increase their bargaining position at the table. Autism is a disability that has specific language in special ed law. Therefore, if parents can get a diagnosis of autism--which is vaguely diagnosed--they may be able to more effectively advocate for their child. So diagnoses increase.

Other factors account for the increase. Though we don't understand autism well, we understand it better than we used to, and kids who would otherwise have been diagnosed with a more general disability are now diagnosed with autism. Further--though I have no evidence of this whatsoever and this should be taken with many grains of salt--I think there are environmental factors which may account for an actual increase in the condition. It's not vaccines. People still cling to the idea, but several studies indicate that it's not vaccines. I'm not going to reference them. Google can do that.

The political aspect of the increase in autism bugs me, but I won't blame parents or doctors who are trying to find a means of advocating for their child. If something's wrong with kids and they need extra help in school, they should get it. Why do we have an educational system that requires acts of congress and medical intervention simply to meet students' needs? Frankly--if something's not wrong with kids and they need extra help in school, they should get it. Our system is set up to provide education to attentive, well-mannered children with full bellies and a parent waiting by the phone, just in case. How many kids fit that mold? How many ever have? It would be interesting to me to see what would happen--in some alternate universe--where we just used what resources were available to make sure every kid had the best shot at an eduction, regardless of needs or labels. If we realized that we were all in this together and if it took two people to help a kid with a disability to learn, then the kid who learns fine in the thirty-kid class isn't being ripped off. Would we all be dragged down to the lowest common denominator, or would kids come to understand that school was not a legally-mandated bureaucratic nightmare which they should escape at the earliest opportunity? I don't know.

But I do know that if the educational system doesn't foster the goal of every student being as independent as possible (if if that isn't very independent) regardless of any real or imagined disability, then it's not helping kids with autism or anyone else very much. It's not earning its keep.


edit--I was typing while the other response was going up. I didn't mean simply to summarize it. I don't read Time, but I'm a special ed teacher, and I'm reporting what I've researched and seen myself.

stu: The real problem is that a diagnosis of autism, and starting a kid on the lifelong-track of "government help" and excuses and special ed, if they don't actually NEED it, is basically all but assuring that you'll be ruining his life.  His entire school career will be one of diminished expectations and excuses and being used as a tool to help school administrators get extra cash from the system and help school social workers and psychologists justify their parasitic existence.

And by adulthood, that kid that could otherwise have been normal will have it strongly engrained in him by everyone, teachers, parents, administrators, government and other kids of course that he is NOT normal, and never will be, and that he shouldn't expect to have to fend for himself in anything, and that he can fuck up as much as he wants and it all gets excused by his "aspergers".

RPGPundit

Quote from: RPGPundit;281740stu: The real problem is that a diagnosis of autism, and starting a kid on the lifelong-track of "government help" and excuses and special ed, if they don't actually NEED it, is basically all but assuring that you'll be ruining his life.  His entire school career will be one of diminished expectations and excuses and being used as a tool to help school administrators get extra cash from the system and help school social workers and psychologists justify their parasitic existence.

And by adulthood, that kid that could otherwise have been normal will have it strongly engrained in him by everyone, teachers, parents, administrators, government and other kids of course that he is NOT normal, and never will be, and that he shouldn't expect to have to fend for himself in anything, and that he can fuck up as much as he wants and it all gets excused by his "aspergers".

RPGPundit

That can be a problem, but it's just a different kind of laziness on the part of the school. Give a kid what he needs. Including challenge. When the needs diminish, reduce the help. This absolutely works. It pushes the prevalent range of intervention to early ages, when it's more effective.

We have an issue in school--in American schools--of only providing intervention when the kid's education is so screwed up there is no recourse. That's ass-backwards. The need for early intervention is easier to spot, and the means of providing it are generally easier to find.

With early intervention, and an intelligent program of challenge, skill training, reinforcement, and follow-through, we can put kids on fewer tracks, not more. There shouldn't be tracks.

Of course, wherever there's a perceived though, there will be folks looking to feed there, even at the expense of their kids. That's an ugly, unfortunate reality that's much more difficult to address in school. We have to acknowledge it, but we don't have to pander to it.

There is a growing voice of autism "survivors." At their worst, they're the kind of folks Kyle was talking about, but at their best, they're the kind of folks you're talking about who can be perfectly independent in jobs and lives when they're done with school. Listening to them has helped a great deal in fashioning the kind of interventions and prgrams that can be used in schools. Temple Grandin, as one example among many, is an interesting speaker with some unusual insight.

With folks with any kind of disability, reducing expectations is a rotten strategy for education or fostering independence in any way. Targeting expectations is the way to go. And increasing them with success. And as a teacher--keeping track of the process is key. It's a lot of work, but if we're about results, we'll do it. If we're about process, then business as usual is OK.

Quote from: RPGPundit;281727Leading dudes like Dr. Stephen Camarata of Vanderbuilt University, and Dr. Steven Pinker of Harvard have both expressed these concerns. Yeah, I know, they're not Dr.Phil of Podunk University, nor are they Mary Beth who took an 18-month course in social work, but I guess Vanderbuilt and Harvard will have to do.

Dr. Camarata has been quoted by Thomas Sowell in Crusades vs. Caution as saying that misdiagnosis "has had the unintended consequence of diluting resources, research and services to those children and families who most need the support".

RPGPundit

Doctors misdiagnose conditions all the time. It's hardly peculiar to Autism. Is this your excuse for banging on about something you know fuck all about?

This all reminds me of somebody that I was friends with in High School and College. She had Glaucoma and gradually her blindness increased until she was completely blind by her sebior year of high school.

 Her mother NEVER wanted her in special programs or classes. She went to regular school like everyone else.  Got to the point that when friends with her you might start to forget she was blind - 'cuz she got damn determined to make on her own without extra help.

She turned out just fine - she got married , had 2 or 3 kids and she still reads science fiction and is pretty damn opinionated on which authors she thinks are good and which ones are crap.


I think with autism a better definition and diagnosis set of parameters should be created.


- Ed C.

Quote from: Ghost Whistler;281750Doctors misdiagnose conditions all the time. It's hardly peculiar to Autism. Is this your excuse for banging on about something you know fuck all about?

Wait, you asked me to cite doctors who had spoken against the overdiagnosis of autism, I cite two very respected doctors from two top universities (one of whom has been working specifically with autism for over 20 years), and your answer is now... what?

Admit it, you just lost. Now quit being a fucking douchebag trying to derail this thread. I have very little patience for fucktard germans who become obsessed with stalking me along multiple threads.

RPGPundit

Many of the people I've known who picked up a label of ADHD or Aspergers had 1 major life challenge in common -- they lack confidence because of their "conditions" and this was a major road-block to their careers and social lives.  I'm always telling them that there are TONS of people working in IT who are just as quirky as they are... but they have good jobs, families, happy (normal) social lives, etc.  The only difference is they don't think they *can't* succeed or have those things because someone slapped a label on them.

I don't particularly know about Stephen Camarata or Steven Pinker - the links were to stuff about their credentials rather than their own thoughts on autism.  I don't think either of their credentials make them more authoritative than the CDC, and in particular, Pinker's being an advocate of evolutionary psychology makes him suspect to me.  

As for the Time article, it is simply arguing what everyone is basically agreed on -- that the changing rates of diagnosis are at least partially caused by changing diagnoses and definitions.  Similarly, I don't think anyone disagrees that there are problems today caused by medical mishandling of kids -- such as overdiagnosis of ADHD or ASD, and overmedication.  

The sticking point is the idea that the handling twenty years ago was much better than today.  

In general, the issue with autism is similar to the general trend of mental health.  We used to think of there was a relatively sharp line between insane and normal -- and we would tend to lock away forever those we deemed insane, from a peak around 1950.  These days, we tend to acknowledge more that there are spectrums of behavior.  We have vastly fewer people locked away in mental hospitals, but we have many more who are in the population but still noted as having problems.  

I think the modern view is generally more accurate.  The trend is a problem to me in that more people are exposed to psychiatry, which as a field may be getting better but is still full of crap.  On the other hand, the problem of a few people's egos being hurt by being told they have a problem seems vastly less significant than the problem of forcibly locking someone up in an institution for life.

The problem isn't with people's feelings being "hurt" by a labelling of a psychiatric disorder (or Autism), the problem is with the creation of a bloated nanny-state culture of dependency and excuses.

Look, the country in the world with the most psychologists per capita in the population? Argentina.
The country which also has the biggest ratio of mental illness? Argentina.

Is it that Argentina is just such a miserably fucked up country? I mean sure, it has had its share of problems but isn't very different than any other country in south america. In fact, it ranks among the most economically prosperous south american countries, is politically stable (at least for the last 25 years), the culture isn't different from that of europe's, I can think of lots of countries that are worse in terms of either stability, security, or culture.  

If you ask me, the obvious answer as to why there is such a high rate of mental illness there compared to other countries is because there are so many psychologists.  There needs to be high rates to justify their continued existence. And in the process they've created a society of therapy-seekers and therapy-pushers.

In the states, similar things are happening with the "childhood syndrome" lobbyists. They need to justify their existence and get government money, so OF COURSE they're going to see autistic "spectrum" children everywhere they look.

Its like if you start to pay a guy to be the Witch Hunter. You can bet he's going to end up finding witches, torpedoes be damned. And if you end up paying millions for thousands of witch-hunters, you can bet there'll be an epidemic of witchcraft going down in old salem town.
That's what these social workers and school psychologists and aspergers-lobbyists are doing.

No one (regardless of what jhkim is claiming) is suggesting that the HANDLING of the genuinely autistic was better 20 years ago than it is today. That defies reason.
What is being said is that there's a shitload of people being handled today, at the "diagnostic" end of things and in the therapy-business, who have NO FUCKING BUSINESS being labeled as Autistic.

What you've created, Kim, is a false dichotomy; we could continue to provide humane treatment for REAL autistics without having to expand the definition of "autism" to include toothaches and ear wax as a justification for turning otherwise potentially functional human beings into permanent dependents of nanny-state welfare.

RPGPundit

Quote from: RPGPundit;281783What you've created, Kim, is a false dichotomy; we could continue to provide humane treatment for REAL autistics without having to expand the definition of "autism" to include toothaches and ear wax as a justification for turning otherwise potentially functional human beings into permanent dependents of nanny-state welfare.

When attempting to portray someone's response as a logical fallacy, introducing your own strawmen is somewhat ironic, yes? I don't see anyone advocating broadening the definition of autism to include "toothaches and ear wax" in this thread.

Quote from: CavScout;281794When attempting to portray someone’s response as a logical fallacy, introducing your own strawmen is somewhat ironic, yes? I don’t see anyone advocating broadening the definition of autism to include “toothaches and ear wax” in this thread.

There is a difference between creating a strawman meant to be taken seriously, and intentional hyperbole.
No, no one is saying "toothaches and ear wax" as a basis of autism (at least not yet, give the social workers some time!); but children are being "diagnosed" in schools as autistic because of simple speech impediments, or poor motor skills (though well within normal human range) or an obsessive interest in a subject (because we all know little kids don't EVER normally become obsessed with cowboys or dinosaurs or ponies or even geography or spelling, right?).

Its the equivalent of saying that any teenager who ever wears black or gets depressed should be diagnosed as on the "suicidal spectrum"; shit, that has in fact happened, getting kids locked up in "treatment centers" for doing nothing more than expressing normal teen behaviours.  Similar things are now happening with younger children and aspergers (just like it has been happening with the even more over-diagnosed ADHD for the last decade or so).

Frankly, dude, I'm surprised you'd be coming down on the side of the nanny-state on this one.  Could it be that your desire to argue with me is proving to be a force even greater than your otherwise famous conservatism?  I mean shit dude, bad enough you're coming down on the side of jhkim on this one, but now you're actually agreeing with Ghost Whistler!  What next, Jackalope?

RPGPundit

Quote from: RPGPundit;281797Frankly, dude, I'm surprised you'd be coming down on the side of the nanny-state on this one.  Could it be that your desire to argue with me is proving to be a force even greater than your otherwise famous conservatism?  I mean shit dude, bad enough you're coming down on the side of jhkim on this one, but now you're actually agreeing with Ghost Whistler!  What next, Jackalope?

I didn't realize we were talking politics. This isn't the politics forum.

Last I checked this was just a rant about autism diagnoses not being real because there wasn't enough panic in the streets.

But hey, it's not like you would hold someone's politics against them... oh wait... you just did.