Meant to cover this on the radio yesterday but ran out of time. It's part of what a diagnosis means series. Remember any diagnosis has implications not just for the individual who gets the diagnosis but also dictates how society views them and what we're willing to spend to make them better. The CDC says 1:88 American children have an autism spectrum disorder problem. This seems high to me and it begs the question, are we simply better at detection or have environmental factors caused a surge in autism? Some are dismissive of this surge in autism and compare it to ADHD over diagnosis in the 90's. In other words a fad diagnosis. Don't get me wrong, autism spectrum disorder is real. What I'm trying to get at here, have we loosened the definition so much that we're including kids who are just "difficult" and do not have "true" autism. What is "true" autism anyway?
We know that autism is due to atypical brain development but unfortunately there is no blood test or brain scan as of yet to clinch the diagnosis so we rely on subjective criteria. And no question in the last decade these criteria have loosened e.g. ten years ago fifty percent were intellectually impaired, now it's only a third. This means a lot more kids are labelled "autistic".
Some parents are upset that if the diagnosis is too loose there won't be enough resources to help those who really have the disorder. I understand their concern. A child with severe autism needs special schools, ultimately adult day programs, residential opportunities and structured community integration. Is all this care and support appropriate? Yes. Is it good? Definitely. Expensive? You betcha. And that's the rub.
In an era when government services are being sharply curtailed hard questions must be asked about what we're spending and why. We should be careful diagnosing any disorder so that we don't not only pathologise variance in human behavior but we also divert scarce resources from those who need them most.
