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Thomas Sowell
Thomas Sowell
20 Aug 2014
The Media and the Mob

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Autism Cures?

Comment

"New Ways to Diagnose Autism Earlier" read a recent headline in the Wall Street Journal. There is no question that you can diagnose anything as early as you want. The real question is whether the diagnosis will turn out to be correct.

My own awareness of how easy it is to make false diagnoses of autism grew out of experiences with a group of parents of late-talking children that I formed back in 1993.

A number of those children were diagnosed as autistic. But the passing years have shown most of the diagnoses to have been false, as most of these children have not only begun talking but have developed socially.

Some parents have even said, "Now I wish he would shut up."

I did absolutely nothing to produce these results. As a layman, I refused to diagnose these children, much less suggest any treatment, even though many parents wanted such advice.

As word of my group spread, various parents would write to ask if they could bring their child to me to seek my impression or advice. I declined every time.

Yet, if I had concocted some half-baked method of diagnosing and treating these children, I could now claim a high rate of success in "curing" autism, based on case studies. Perhaps my success rate would be as high as that claimed by various programs being touted in the media.

If a child is not autistic to begin with, almost anything will "cure" him with the passage of time.

My work brought me into contact with Professor Stephen Camarata of Vanderbilt University, who has specialized in the study of late-talking children— and who is qualified to diagnose autism.

Professor Camarata has organized his own group of parents of late-talking children, which has grown to hundreds, as compared to the several dozen children in my group. Yet the kinds of children and the kinds of families are remarkably similar in the two groups, in ways spelled out in my book "The Einstein Syndrome."

The difference is that Professor Camarata is not a layman but a dedicated professional, with decades of experience— and he too has expressed dismay at the number of false diagnoses of autism that he has encountered.

What Camarata has also encountered is something that I encountered in my smaller group— parents who have been told to allow their child to be diagnosed as autistic, in order to become eligible for government money that is available, and can be used for speech therapy or whatever other treatment the child might need.

How much this may have contributed to the soaring statistics on the number of children diagnosed as autistic is something that nobody knows— and apparently not many people are talking about it.

Another factor in the great increase in the number of children diagnosed as autistic is a growing practice of referring to children as being on "the autistic spectrum."

In other words, a child may not actually be autistic but has a number of characteristics common among autistic children.

The problem with this approach is that lots of children who are not autistic have characteristics that are common among autistic children.

For example, a study of high-IQ children by Professor Ellen Winner of Boston College found these children to have "obsessive interests" and "often play alone and enjoy solitude," as well as being children who "seem to march to their own drummer" and have "prodigious memories." Many of the children in my group and in Professor Camarata's group have these characteristics.

Those who diagnose children by running down a checklist of "symptoms" can find many apparently "autistic" children or children on "the autism spectrum."

Parents need to be spared the emotional trauma of false diagnoses and children need to be spared stressful treatments that follow false diagnoses. Yet the "autism spectrum" concept provides lots of wiggle room for those who are making false diagnoses.

Real autism may not get as much money as it needs if much of that money is dissipated on children who are not in fact autistic. But money is money to those who are running research projects— and a gullible media helps them get that money.

To find out more about Thomas Sowell and read features by other Creators Syndicate columnists and cartoonists, visit the Creators Syndicate web page at HYPERLINK "http://www.creators.com" www.creators.com. Thomas Sowell is a senior fellow at the Hoover Institution, Stanford University, Stanford, CA 94305. His Web site is HYPERLINK "http://www.tsowell.com" www.tsowell.com.

COPYRIGHT 2008 CREATORS SYNDICATE, INC.



Comments

4 Comments | Post Comment
Good article Mr. Sowell. I have worked with children diagnosed with special education needs, including autistic students since 1969 as both teacher and clinician. The current huge increase in the numbers of children being diagnosed with "autistic spectrum" disorders has been a bit of a mystery to me until I read your article this morning. I have long felt that if "professionals" simply left most kids alone and provided them with safe, clean and interesting environments to learn and grow in, all would be eventually well. I'll pass this on to our staff today.

Thanks, Robert Reilly
Comment: #1
Posted by: Robert Reilly
Fri Jul 18, 2008 7:29 AM
Despite his politics, Sowell is absolutely right. But misdiagnosis of autism goes far beyond just ‘late talkers'. It includes mentally retarded children, childen diagnosed with genetic mental retardation syndromes (Fragile X, Downs Syndrome) and even Romanian orphans who have suffered extreme emotional deprivation.. Small subgroups in all of these conditions qualify for an ASD diagnosis which says a lot about the validity of DSM-IV, ICD-10 and all of the ‘Gold Standard' diagnostic tools (ADOS, ADOS-G, ARI-R etc. ) all of which are based on DSM-IV and ICD-10 diagnostic criteria.
Kanner's definition was incorporated in DSM-III (1980) as ‘A pervasive lack of responsivness to other people - autism'. To qualify for an autism diagnosis, Kanner's definition had to be met.
DSM-III (1987) relegated Kanner's definition to just one of five isolated symptoms and was no longer required to qualify for an autism diagnosis.
The global autism pandemic began in 1994 with the publication DSM-IV. DSM-IV completly removed Kanners definition entirely and substituted his definition with the vague, ambigous and subjective ‘Qualitative impairment in social interactions'.
There was another era, long forgotten, in the 1950's when another unexplained rise in the incidence of autism ocurred.
Kanner explained that phenomena in an article published in Behavioral Science. An explanation that holds up today in explaining the perception of a global autism pandemic.
http://neurodiversity.com/library_kanner_1965.html
Kanner wrote:
“While the majority of the Europeans were satisfied with a sharp delineation of infantile autism as an illness sui generis, there was a tendency in this country to view it as a developmental anomaly ascribed exclusively to maternal emotional determinants. Moreover, it became a habit to dilute the original concept of infantile autism by diagnosing it in many disparate conditions which show one or another isolated symptom found as a part feature of the overall syndrome. Almost overnight, the country seemed to be populated by a multitude of autistic children, and somehow this trend became noticeable overseas as well. Mentally defective children who displayed bizarre behavior were promptly labeled autistic”
He also wrote:
“By 1953, van Krevelen rightly became impatient with the confused and confusing use of the term infantile autism as a slogan indiscriminately applied with cavalier abandonment of the criteria outlined rather succinctly and unmistakably from the beginning. He warned against the prevailing “abuse of the diagnosis of autism,” declaring that it “threatens to become a fashion.” A little slower to anger, I waited until 1957 before I made a similar plea for the acknowledgment of the specificity of the illness and for adherence to the established criteria”.
Comment: #2
Posted by: Robert Jensen
Fri Jul 18, 2008 5:05 PM
Interesting article and raises some important points. But I have a number of problems with it as that father of a son with autism.

One of the most difficult things with autism is that it can not be detected by a blood test or a medical test of any kind. It can only be determined by certain behaviors or lack of behaviors. Late talking is just one of those characteristics. Repetitive or other stereotypical movements like hand flapping are also another sign. No or low eye contact and a number of other symptoms. When our son Thomas was evaluated they looked at a whole host of behaviors. Thomas could not imitate stacking blocks and so forth. It was an all day long rigorous test. Because he didn't respond to his name they checked his hearing. They checked his eyesight because he didn't make eye contact. It was obvious in our case what Thomas had. They went down the list of 20 or so possible autism characteristics and they checked nearly all of the boxes after other possible diagnosis were eliminated.

For other parents with less severe kids it is not so obvious. They may only have 4 out of the 20 boxes checked. Autism is a spectrum disorder. That means that there are numerous degrees to which the autism affects the child and some kids only express some of the characteristics while others have many of them. Their kid may not be autistic, but I believe they must exhibit at least three of the behaviors to be given a diagnosis of autism.

Autism is a broad diagnosis and there are many degrees. There is Aspergers which is a high functioning type of autism. These people can be highly intelligent savants. They usually are socially inept but are able to talk just fine. Their passion for their obsessions allows them to be masters at math, or musical instruments or whatever their passion is. It is difficult to channel these people though into looking outside their passion. I know a boy that loves trains so much that he will play with them all day long every day and when someone comes to visit he talks with that person about his trains. In fact he will talk your ear off about trains until you are tired of it. But he wont sense that you are tired of it and keep talking and talking and talking. If you start talking about planes with him he will get upset and keep talking about his trains. Another type of Autism is PDD or pervasive development disorder. Some of these kids have speech until 2 or 3 and then lose it. Other never get it. There is mild autism, moderate autism, severe autism and the list goes on, with specific characteristics attributed to each degree or classification.

Parents know that early intervention is the critical component for helping their child reach their full potential as these younger years are where the most mental and social development take place. So there is a lot of pressure to do something quick. If there is even a suspicion you need to be pro-active to get the best results.

Now if a kid exhibits some of these behaviors and then outgrows them is it possible to be "cured" from autism? Autism is a list of behaviors and if you can eliminate those behaviors you can technically see a cure. But some will ask maybe the child didn't have autism to begin with and this is a possibility. Each child also has a unique capacity to improve. It depends on that child and the help they get. Some kids who are severely autistic can some how snap out of it. Others who are mild don't make any progress at all.

I do not believe that parents or professionals are trying to give false diagnosis to get the services their child needs. First of all medical insurance doesn't cover any treatment for autism because according to most insurance companies, autism is not a medical disorder but a behavioral one.

Each state varies with what types of services they will provide for children. We have lived in ND, WA, TX and now PA so we have a flavor for waht is avaialable. If you are above poverty there isnt much you can get, except a waiting list.

In Texas they had an Early Childhood Intervention (ECI) program sponsored by the state of Texas. Your pediatrician would refer you to ECI if there were some general concerns or delays in development of the child. They help all kids with delays in language, walking, or any other developmental steps. They help all kids the same whether they have a diagnosis or not. They have speech therapists, occupational therapists (OT's) and physical therapists(PT's) that come out to your home and work one on one with your child until they are age three. I guess what I am trying to get at is that there was never any advantage to us to have a diagnosis of autism. There was no financial benefit from the state. In fact each time ECI came to our home, our insurance was billed whenever there was OT, PT or speech services rendered. ECI helps all kids equally regardless of disability.

So if a kid cant walk, gets help walking from a PT and then learns to walk, should we say that we should not have helped that child cause he was going to walk on his own anyway? Well you don't know if these kids were really given a false diagnosis of autism or not or if they were lucky enough to overcome their autism. Maybe the services they received actually worked!!!!

Medical insurance does cover delays in speech but will not pay for autism, so in the medical insurance world you actually do not want to have a diagnosis of autism or they may not cover services. We nearly went to court over this issue because our medical insurance would pay for speech therapy for kids with delayed speech, without an autism diagnosis but would not cover it if they did have an autism diagnosis. To me that was discrimination.

Each time you visit a medical doctor they put down codes for each thing you discuss with the doctor. If the purpose of the visit was to discus and diagnosis an ear infection there is a cade for that. If there is also another concern you talk to the doctor about such as skin cancer there is another code for that. There is also a code for autism so if you discuss that with the doctor he will also write that code down. When the insurance company sees a bill with the autism code it is automatically rejected even if other codes are present. It got to the point where we had to ask the doctor to not list a code for autism as all of our regular health related visits were being rejected for payment. We also had to contact the insurance company and each time a bill is submitted for Thomas it had to be done by hand (his account was flagged), because the computer system will automatically reject any claim that has the autism code.

It is not easy to get an autism diagnosis and not just any doctor and not many people are qualified to give one. Now we knew Thomas had something wrong at an early age (12 month). His pediatrician said that nothing was wrong, but we knew there was. We saw another pediatrician and got a second opinion. She referred us to another specialists who then gave us a the diagnosis but this whole process took about 9 months.

I guess the debate will never end. Is there a cure for autism. I don't think so. But some kids do seem to outgrow it. Did they have it to begin with? its hard to say. Should we deny services to a kid who has a false diagnosis? How do you know they have a false diagnosis until they improve? Who is to say who really needs the services?

Its really not until kids are school age that they can begin to qualify for services from the state based only on their diagnosis. But I will tell you that the services the state provides aren't anything that insurance companies don't already provide for children for other conditions like downs syndrome etc.

PA just passed a law mandating that insurance companies provide services for autistic kids so the state may not provide much in the future for those with medical insurance.
Comment: #3
Posted by: John O'Barr
Mon Jul 21, 2008 10:29 AM
Mr. Sowell, you admit to being a layman and you should therefore stick to economics. The full cost of this epidemic will be borne by families and the social welfare system for decades to come. Right now, school districts, sqeezed as they are for funding, are paying the price. When these kids age out and become adults, they will be on disability for the rest of their lives. The only way to ensure that those costs come down is to stop the epidemic from getting worse, not try to deny what is happening to our children. Under-regulation of vaccine manufacturers, and too cozy a relationship between Pharma and the CDC and FDA, have led to a tripling of the vaccine schedule and huge increases in asthma, ADD/ADHD, Autism & Autism Spectrum disorders, extreme allergies, juvenile diabetes, gastrointestinal problems and seizure disorders. Our kids are sick, Mr. Sowell. It isn't misdiagnosis, except to the extent that they really suffer from environmental toxic damage rather than a psychological disorder. We don't want the governments money, we want our kids to get well. Disavowing that there is an epidemic is only going to make the economic problem worse, not better. How many of those kids in your small group got better because of whatever other treatments their parents tried? How many never wound up speaking at all?
Comment: #4
Posted by: Garbo
Mon Jul 21, 2008 1:48 PM
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