CAN WE REALLY RELY ON A DIAGNOSIS OF AUTISM?

 by Ray Ferris

author of the book “The Art of Child Protection.”

You can purchase it from him by writing to rtferris@telus.net

Ray Ferris receiving Justice Award

"A few days ago the local newspaper reported that in the USA, between 2001 and 2011, the incidence of diagnosed autism increased by 20% and during the same period, the diagnosis of bipolar disorder rose by 40%. During the same week it was reported in the British paper “The Guardian” that there had been an alarming increase in the administering of psychotropic medications to young children. There was no doubt that anti-psychotic medicine was being given quite inappropriately in many cases.

There was especial concern that psychotropic medicine is only tested on adults and not on children. There is a known incidence of side-effects among adults. However, one always has to balance risk against benefit in any medication. The concern is that the side-effects in children are not really known and the long-term effects on children could be very dangerous. Already the incidence of side-effects is a cause for caution.

Nobody really knows the reason why there is such an apparent upsurge in autism and other childhood behaviour disorders, or why there is such an increase in bipolar cases in adults and children. This is probably because there are a number of reasons and there are different theories about them. Probably the least likely causes are environmental. It is possible that increases in pollution and radiation can have a small effect and there is also a theory that multiple vaccination shots can cause autism. The problem with these ideas is that the only evidence is anecdotal and unreliable.

    Another possible cause is that physicians are becoming more knowledgeable about the symptoms of autism and are therefore much quicker to detect and diagnose the disorder. This could well contribute to some of the increase. The problem with a lot of this is that the diagnosis of autism, attention deficit disorder and hyperactivity have very indistinct parameters and are just as easy to over-diagnose as to under-diagnose. Political correctness can enter the equation. When children were known to have marked intellectual deficits, otherwise known as low intelligence quotients, we used to use terms like retarded, or the term imbecile for profound retardation. Now we no longer use such terms and they are considered to be offensive labelling. We have tried alternate labels, such as “developmentally challenged” and “special needs” children. There can be no doubt that many of these children now find themselves categorized as autistic. This is much more acceptable to parents. There can be little doubt that many of the children who are considered to be autistic, really function in the range that used to be considered retarded. One can change the label, but what we can realistically expect from these children changes very little. We also have to remember that many of the ideas are still in the hypothesis stage and have not been confirmed with reliable research. But surely, you must ask, would responsible physicians really follow something that is just an unproven hypothesis? Well, let me remind you that shaken baby syndrome is just an unproven hypothesis, but it has been taken as gospel truth by many responsible physicians and it has sent hundreds to prison.

    We also have to remember the human element. When frantic parents go to doctors and psychologists, seeking some answer to a child’s behaviour problems, of course they want to help. Send them away with a prescription that may work. If it does not, no harm has been done and at least the parent may feel better. Also don’t underestimate the placebo effect.

    This leads naturally into the third possible cause for the upsurge in diagnosed disorders. We are now all familiar with terms like attention deficit disorder, hyperactivity and autism. Normal energetic young boys, who find it hard to sit still in a classroom, are too easily labelled as hyperactive. Probably better to learn to channel their energy. Bright kids who are bored in school may well suffer from a form of attention deficit disorder. Apparently the average audience cannot follow a political speech for more than four minutes. Do they have A.D.D. or are politicians usually boring?

Is a lot of the problem really due to over-diagnosis and our eagerness to have quick fixes for everything? A pill for every ill?  I think before we can get the right answers, we sometimes have to ask the right questions. All I am doing here is asking some questions. Do any of the readers of this blog want to venture some answers?"

"Next time, I want to address the issue of what 

we can truly reasonable expect the schools and the health care system

to do with very challenging children like Ayn." Ray Ferris

Ray Ferris is an occasional GPS post writer. Retired now, Ray speaks from 31 years in child welfare and protection as a social worker, district supervisor and family court coordinator. He cannot tolerate injustice imposed upon families by ineffectual case work. 

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