Autism Spectrum Epidemic

When I wrote that there really are some good psychiatrists out there, I meant people like Dr. Sami Timini who writes with such sincerity and integrity. He’s written this superb book: Pathological Child Psychiatry and the Medicalization of Childhood

For a synopsis of this book, from Google:

“Currently, it is common practice among the child psychiatric establishment to prescribe powerful and potentially addictive drugs to children who have emotional or behavioral problems. “Pathological Child Psychiatry and the Medicalization of Childhood is a strong challenge to this way of thinking.”

You can find many of his published articles on PubMed, including the following on Autism Spectrum Disorders:

Diagnosis of autism – Current epidemic has social context – BMJ  2004;328:226 (24 January)

Here is an excerpt:

” …The immaturity of children may be a fact of biology, but the meaning ascribed to this immaturity is a fact of culture. Without any tangible evidence of organic pathology and any biological tests to substantiate our hypothesis of a neurological dysfunction, the boundaries of the disorder can expand endlessly and are dependent on the subjective opinion of the person making the diagnosis.

Our notions of child development are culture bound and too often create a blueprint of age dependent expectations that ordinary parents fear our children cannot meet, rather than a set of required behaviours that our children must master if they are to be considered fully human. And why the over-representation of boys?

In my clinical practice I often come across children and adolescents who are labelled autistic. When I focus on their abilities I often find much about them that does not fit the autistic discourse. Once I reopen the question of diagnosis many adolescents ask me to officially “undiagnose” them, which their parents are usually very pleased about.

We can and should do better than this relentless medicalisation of children and must become more competent at integrating medical theory with other perspectives, otherwise we will soon have a grown up generation of children (mainly boys) who have become unnecessarily convinced that they are somehow deficient and incapable.

Sami Timimi, consultant child and adolescent psychiatrist

It really looks like the current epidemic of autism has a social context.  There is no tangible evidence of organic pathology, no biological test to show any neurological dysfunction. It is just a hypothesis, and a diagnosis does become the subjective opinion of a psychiatrist or clinical psychologist. This, to me, is scary. It wouldn’t be if people were more enlightened about autism, but they aren’t.

The issue has become so complex on so many levels. Boys may be overrepresented, but it seems to be happening quite a bit to girls as well. I found this lovely video on YouTube created by a 13 year old boy for his little sister who was diagnosed autistic. He says ‘She is just like you and me.’ This video brought me and some others to tears. The little girl is beautiful, her brother’s warmth and love for her are beautiful, childhood is beautiful.

Chaseboxers
“Look at the stars, Look how they shine for you, And everything you do” – ‘Yellow’ by Coldplay

I’m not only crying because the video is so lovely – I’m also a bit confused. Don’t really know what to think of it yet. Is she autistic, or have her parents just been pressured into getting her labeled autistic to entitle her for services covered by insurance – services like speech therapy. Or does she really have some very mild autism – some developmental delay somewhere, and should any developmental delay be called autism spectrum to begin with? Haven’t we all developed according to our genetic blueprints – faster in some areas, slower in others. And why should uneven development – which happens to lots of people – be labelled autistic spectrum anyway?

Or is she really autistic, even with all the smiles and laughs, and some of the other videos we’ve been seeing on autistic children are only showing them at their worst. You do see her flap her hands a bit at some point when she’s in front of the computer. She may just be waving hi to some character she’s seeing on the video screen. And even if that’s not the reason … when I was a child, I remember seeing children flapping their hands a bit just like that. I may have even been one of those children. Is that really so terrible? And she does line up some toys, but so what. Maybe she likes organizing things. Don’t many children enjoy collecting and sorting objects and toys?

Am I autism spectrum because I don’t get it? Is there really such a great divide between auties and neurotypicals? Or is it more profitable for some to make it seem that way.