Overdiagnosis of autism

[Tetro Kornbluth]

As a teacher, I have noticed in recent years that more and more students have IEPs for Aspergers syndrome, which is a variant for autism.  Given the change in medical classifications, Aspergers no longer exists and is now just classified as autism.

That's the reclassification as done by the Diagnostic and Statistical Manual of Mental Disorder 5 (better known as DSM5), which was published two years ago and whose alterations, not just in regards to Aspergers, have been... controversial, even by the standards of the DSM, a notoriously controversial book. The whole affair about its publication in the US led to the National Institute of Mental Health to reject the document and place its own guidelines for mental health treatment. I don't know if Aspergers is included in the latter* but it would surprise me if it weren't. That's right, for the past year at least US health institutions can and do recognize two different taxonomies of mental illness. Read into that what you will.

(* - the main division was between, as always, purely behavioral diagnosis a la the DSM or supposedly biochemical ones... but very little of those exist anyway as well as the other hoary perennial of discreet categories of mental illness versus approaches that see mental 'issues' in terms of spectrums)

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But that doesn't answer which is the correct diagnosis?. I assume you aren't arguing "X is really much worse than Y therefore Y doesn't really exist (or worse, X doesn't exist because Y doesn't either)"?

Being diagnosed with a 'mental condition' which includes Aspergers in certain cases in Ireland alters one's opportunity in access to healthcare, education, insurance and employment among other things. Yet both my experience and statistics tell me that is somewhat necessary for a lot of people given the complications that arise, people diagnosed with Autistic spectrum disorders are more likely to suffer from depression, anxiety, unemployment, and homelessness among other things.

Note that btw, I hold this to be an entirely separate issue from whether Autism 'exists' or not. As if that's really important.

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Well, that's an issue of the educational establishment. Not to mention parents.

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Distrusting psychiatrists is a good idea but I think you have to an eliminative materialist on the issue of 'folk psychology' (what is laziness anyway?), well perhaps not a strict materialist but certainly an eliminativist.

Also Al is correct

There's a definite overdiagnosis of male autism...

[Tetro Kornbluth]

Absolutely. It basically means "socially awkward" at this point. As someone who has a family member who is very severely autistic, it's very insulting when I see kids with some odd quirks thrown under the same umbrella.

So basically you are arguing that 'I don't think weird people are weird enough to be considered weird because they are not like one member of my friend'? I mean, fair enough, if you treat a condition like autism as a enclosed box or list that everyone needs to meet in order to be diagnosed despite the clear damaging silliness of such a strategy.

Obviously though special needs money should go where it needs to, and autism, whether aspergers or low-functioning or anything in between, is the childhood condition de jour at the moment so....

I'll add here, what's interesting about Aspergers was the social identification that has come with the condition so much so that people actually campaigned to maintain themselves as diagnosed as having a mental condition. A strange charge against a document that was originally designed to keep psychiatry together and more open and transparent (LOL) after the homosexuality wars of the 1970s (it was a 'mental condition' once).

[Tetro Kornbluth]

There's a definite overdiagnosis of male autism...

That's what I was thinking as well. The stats I found has the rate at 1 in 42 for males and 1 in 189 for females. I can believe the female rate, but it's the male rate that seems wildly high. No one seems to have a legitimate medical reason as to why the rate has been climbing so much in recent years (and I don't want to hear anything about the debunked and absurdly stupid notion that the cause is vaccines).

How do you know they aren't just, you know, better at finding cases*? Why is 1 in 42 necessarily absurd? More people are afraid of Spiders (which is very common, especially in Women) yet in my part of the world at least, Spiders are totally harmless annoyances.

(*- Btw, this isn't what I necessarily believe).

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There is very likely a genetic element to any autistic spectrum disorder. And you post on Atlas forum, so you know...

[Tetro Kornbluth]

Absolutely.

I would know. I was one of those "misdiagnoses" and it wound up giving me self confidence issues that I never really got over. To this day I still can't tell if anyone in high school actually liked me or was just playing the "pity the special ed kid" game like I was some sort of zoo animal.

I had that... except they didn't know about my diagnosis (I got no special education... inside School anyway).

[Tetro Kornbluth]

I'll add here, what's interesting about Aspergers was the social identification that has come with the condition so much so that people actually campaigned to maintain themselves as diagnosed as having a mental condition.

I find that quite odd too.  Some of them seem to be proud of it.  I get accepting it, I get finding comfort in knowing why you do the things you do, I don't get wearing it as a badge of honor.

No it doesn't, it's only a label. Nobody understands that.

[Tetro Kornbluth]

Obviously, psychiatric conditions are not binary. Everybody is a little depressed sometimes. Everybody has attentions problems sometimes. It's not like HIV, where a person is 100% negative or positive. The issue is not misdiagnosis (a false positive) so much as the entire paradigm for how we think of the problems is flawed.

Unflaw the Paradigm please.

[Tetro Kornbluth]

When I was in elementary school, our school hosted a "handicapped" program that gave the least disabled autistic students a chance to receive facilitated education within the public school system. During the school year there were about five or so in the program.

Those autistic students usually had poor motor control (I recall the spontaneous vomiting vividly), had learning disabilities, and lacked speech ability. OTOH, these kids (used loosely, since they were easily over elementary school age and most likely adolescents) could relate to other kids emotionally. They remembered who were nice to them (the girls) and who bullied them (the boys), and didn't engage in the stereotyped "autistic" activities with mechanical devices like repeated toilet-flushing, light-switching, etc. I guess that was the reason why they were selected for mainstreaming.

Autism was nothing short of severe disability. Perhaps the definition of autism has changed from the 1980s, because the autism that is being described on this thread reminds me of these kids from my elementary school days in nothing of the kind.

Up until the 1980s basically to be defined as Autistic you had to have an IQ of under 80 ('retarded' or borderline such). Changes in psychiatry since then have made that definition effectively obsolete (although those are still the most severe cases).

The explosion in cases of Autistic Spectrum Disorders didn't happen until 1994 with the publication of DSM-IV.

[Tetro Kornbluth]

I'll add here, what's interesting about Aspergers was the social identification that has come with the condition so much so that people actually campaigned to maintain themselves as diagnosed as having a mental condition.

I find that quite odd too.  Some of them seem to be proud of it.  I get accepting it, I get finding comfort in knowing why you do the things you do, I don't get wearing it as a badge of honor.

No it doesn't, it's only a label. Nobody understands that.

can't "campaigning to have a diagnosed medical condition" have a lot to do with keeping the insurance money flowing, especially in the US?  I know the medicalization of addiction has been a huge boon to the multibillion dollar addiction/recovery industry, and even confers certain privileges on those diagnosed with addiction (you can't be fired for having the disease of addiction, etc).

Yes, but is this really a problem?

[Tetro Kornbluth]

I'll add here, what's interesting about Aspergers was the social identification that has come with the condition so much so that people actually campaigned to maintain themselves as diagnosed as having a mental condition.

I find that quite odd too.  Some of them seem to be proud of it.  I get accepting it, I get finding comfort in knowing why you do the things you do, I don't get wearing it as a badge of honor.

No it doesn't, it's only a label. Nobody understands that.

can't "campaigning to have a diagnosed medical condition" have a lot to do with keeping the insurance money flowing, especially in the US?  I know the medicalization of addiction has been a huge boon to the multibillion dollar addiction/recovery industry, and even confers certain privileges on those diagnosed with addiction (you can't be fired for having the disease of addiction, etc).

Yes, but is this really a problem?

I have argued that the recovery industry in the US is basically an insurance and court-system fueled snake oil gravy train, so, yes.

Yes, but is that a bad thing?

[Tetro Kornbluth]

I'll add here, what's interesting about Aspergers was the social identification that has come with the condition so much so that people actually campaigned to maintain themselves as diagnosed as having a mental condition.

I find that quite odd too.  Some of them seem to be proud of it.  I get accepting it, I get finding comfort in knowing why you do the things you do, I don't get wearing it as a badge of honor.

No it doesn't, it's only a label. Nobody understands that.

can't "campaigning to have a diagnosed medical condition" have a lot to do with keeping the insurance money flowing, especially in the US?  I know the medicalization of addiction has been a huge boon to the multibillion dollar addiction/recovery industry, and even confers certain privileges on those diagnosed with addiction (you can't be fired for having the disease of addiction, etc).

Yes, but is this really a problem?

I have argued that the recovery industry in the US is basically an insurance and court-system fueled snake oil gravy train, so, yes.

Yes, but is that a bad thing?

I just said that it is, according to good and bad I define these terms, quire clear, no doubt somehow


now, since you've asked twice, do you consider the addiction-recovery industrial complex to be bad?

This subject has nothing to do with addiction.