Autism diagnoses are up 78% in 10 years. We're dramatically overdiagnosing it

OP here (FYI - I am not the author).

My big concern with misdiagnosing autism in high-IQ children is that it conflates autism with introversion -- a conflation that has been progressing for some time now, and which has been accelerating in recent decades. This is bad for the legitimately autistic, and it's bad for introverts.

It's bad for the autistic because it lumps a fairly heterogeneous set of children into the same spectrum, confounding our best efforts to get to the true roots of autism. If we're treating too many nonautistic children as "autistic," then by nature, we're diluting the actual pool of people we should be studying and helping. We're throwing too many red herrings and exceptions into the data set.

It's bad for the introverted and highly intelligent because it further stigmatizes both of those things, especially in combination. By establishing extroversion and median IQ as "ideal," we're insinuating that the introverted and gifted are somehow defective. We're behaving as though our gifted children should be bent and twisted into acting more like everyone else, when in fact, we should be nurturing their gifts.

While autism-spectrum disorders, introversion, and high IQ can certainly overlap, they are not by nature the same things.

This is a complex issue and is essentially being boiled down to "smart people are misunderstood." A topic that garners a lot of empathy here.

Autism Spectrum Disorder isn't just that the child is introverted. They must show several signs in order to be diagnosed. According to my partner (with a Master's in Social Work), it's also not something one can diagnose or counter in minutes like the author states he did with one child. That seems like a large credibility strike. Here information on how a diagnosis is made: http://www.autism-society.org/about-autism/diagnosis/

Further there's nothing but anecdotal evidence given in the article for making the leap from "diagnoses went up" to "we're misdiagnosing it." This is really just an opinionated fluff peace that resonates with our community.

And so the backlash against autism spectrum begins...

There are many things wrong with the article, but my main gripe is how the author totally ignores the Asperger's end of the spectrum. Calling it a spectrum provides great insight (there are a large number of behaviors, and individuals have various combinations of each to a varying degree), but the author uses it to blur the line between what I would call functioning and non-functioning individuals (and seemingly on purpose). "Full" autism causes people to be unable to cope with the regualar world and all its stresses (see article about how autistics can take an airplane[1]). The author is exploiting the fear of parents whose children are found to be on the "autistic spectrum" (but more likely on the more functioning Asperger's end) and justifying a refusal of the diagnosis.

My perception is that Asperger's individuals (and the William in the article seems to fit--though I am not a doctor) have quirks and are difficult to raise. They have emotional issues and are socially maladapted. But they can lead fully independent lives and often contribute greatly to society. My issue with the author is that I believe Asperger's children can benefit greatly from psychological help, to teach them emotional and social skills in a way that parents can't. I believe that in certain cases, this help is critical to making the difference between the Asperger's person leading an almost normal life (including getting married and having kids), and leading a miserable life as a social outcast (bullied, unable to be in a relationship, unable to deal with child-raising).

So I think more nuance is in order, more distinction between autism and Asperger's (even though they are on the same spectrum), and more help for Asperger's children and adults, not less.

[1] http://www.bbc.co.uk/news/health-23989422

Hello, author. Meet me. I was much like the boy in your article--except in one way.

I was thrown into tests at a young age which showed a high IQ. I had difficulty in school with outbursts. I did not easily read social cues from others. I had strange interests, like an obsession with the Civil War or (in sixth grade) a personal God that I carried around with me because I liked the word "polytheism."

I was an obsessive and voracious reader, but always an outcast. I was ridiculously pedantic--in first grade I refused to write "Mr." with a period at the end of it (I'm American) because in Roald Dahl books, he didn't use the period after "Mr".

I still write my periods outside of quotes, and I argued with a teacher in college regarding two sentences after a period. These and other arguments eventually led me to dropping out of college. Fortunately, I found computers and entrepreneurship--plus a lot of books on how to read body language--and I've done pretty well for myself since.

Oh, and did I mention I'm a woman? Yep, born female, with every issue you describe.

FTA: "Jordan secretly confessed to me that his English teacher must be dumb because she referred to certain assignments as “homework” when she allowed them to be completed in class. She should have renamed them “schoolwork,” he said, because they were being completed at school. In twenty-five years of therapy practice, I’ve never known a girl to make such a comment."

Well, good news for you, then, sir: There's an entire subreddit of us. http://www.reddit.com/r/2x_intj Perhaps you should come visit sometime. Or are you too busy making gendered statements and deciding that it must be "masculinity" that causes these issues, instead of diving deeper into the issue?

I certainly could have benefited from a class on how to understand facial cues. I could still benefit from a class on tact. I still make people uncomfortable sometimes when I talk to them.

I'm a female, an introvert, and I have been diagnosed with ADHD. (A diagnosis which unequivocally changed my life for the better.) Making light of issues like this, or narrowing them to "boys will be boys", is a sad misinterpretation of a real issue. Do I have Asperger's? It's certainly been suggested to me several times by others, but ADHD more fits who I am.

To those of you reading this, I hope you don't take it too literally. There are kids out there who need real help. I wish I would have had more of it. Asperger's/autism or not, school was pretty much miserable for me, and I would have been grateful for the opportunity to learn how to really connect with others.

Sometimes a jump in diagnoses just means we had previously been misdiagnosing or under diagnosing. Don't just call an increase an over diagnosis. If we suddenly had an increase in obesity or cancer we wouldn't say "i call bullshit, doctors are cashing in on this". Maybe there is something else going on but automatically calling over diagnosis is just as bullshit as anything else.

I am very happy to see this topic opened for discourse by a longstanding professional.

Some of my closest friends in elementary school fell into the above-average + introverted group. To teachers they stood out like sore thumbs. To those of us with similar interests and abilities, but more extroverted, they were just kids who double checked their answers before blurting them out.

In an age where there is a tendency toward pills and therapy as solutions for almost anything (not trying to spawn a pharmaceuticals debate), articles like this feel like a breath of fresh air. Being intelligent does not a disorder make.

Personally, I would like to see a move away from the approach of putting labels on everyone, which is made worse by treating the DSM-V as dogma. The DSM has kept back legitimate science in the area by forcing everyone into discrete boxes instead of recognizing the continuity of many symptoms. The NIMH is already moving away from it and most organizations except maybe the APA should move away from it. This would promote an environment where we spend more time measuring and researching body chemistry to better understand the relationship of what is happening in the body that produce undesirable psychological symptoms. Every person that is diagnosed and sent off with drugs is a lost opportunity to collect information about the state of their body and their symptoms and using computing to discover other leads on how to better treat or cure those specific symptoms instead of a broad classification which imperfectly characterizes many people.

I dont remember the exact numbers but this reminds of a story in Norway recently where overnight they went from 30% of the population being vitamin D deficient to 90%. The cause of this was a change in the official definition of vitamin D deficiency

Put it this way. Everyone is somewhere on the autism spectrum. I don't think we're over diagnosing it as such, but more diagnosing it at a lower level.

Autism diagnoses are up 78% in 10 years. We're dramatically overdiagnosing it*

Look at the funds being thrown at autism. If your child ain't autistic, no funds and job for all those special ed teachers, schools and psychologists.

Ten years ago it was ADD, now it's autism. Psychiatry is bullshit, and the pharmaceutical industry it drives is dangerous.