House of Eratosthenes

Between ADD, ADHD and forms of autism, that because of supposed advanced diagnosis, we are discovering that tens of thousands of children have medical conditions that, when we were kids, would have just been chalked up to a kid being a little ‘different’.

One condition, called Asperger Syndrome, is sold as a mild form of autism. Yet, in a publication (PDF) by the Yale Child Study Center, it is described as “a severe developmental disorder characterized by major difficulties in social interaction, and restricted and unusual patterns of interest and behavior.”

A website devoted to Aspergers states that “many in the field believe that there is no clear boundary separating [Asperger Syndrome] from children who are ‘normal but different.'”

The Yale study goes on to say, in describing a diagnosis: “The actual diagnostic assignment should be the final step in the evaluation. Labels are necessary in order to secure services and guarantee a level of sophistication in addressing the child’s needs. The assignment of a label, however, should be done in a thoughtful way, so as to minimize stigmatization and avoid unwarranted assumptions. Every child is different.”

I’ve been noticing a few other things about this whole thing.

As a parent myself, I know a lot of other parents roughly my age whose kids are roughly my son’s age. Everybody I know, personally knows at least one other person, whose kid has been “diagnosed” with something. Everyone has a story. There seems to be a “two degrees of separation rule” at work and when you think about the mathematics involved in two-degrees…you know, that is a lot of kids. Lots and lots of kids. A huge chunk outta all of ’em. Like, we should be out looking for the enormous radioactive meteorite responsible for messing up all these kids, it’s gotta exist somewhere. That — or, maybe it’s the “normal” kids who are screwed up. It’s getting to the point where the non-screwed-up kids are on the brink of being outnumbered.

I also notice something about this word “diagnose.” It is used as such a concretely objective verb…like, you could be a reasonable skeptic about a kid having whatever-it-iz, right up until the kid is “diagnosed” and then you can’t disagree without being just a whackadoodle. As in, last year, little Tommy wasn’t “diagnosed” — he died. Nobody but a crazy person would insist Tommy is still alive, when he obviously isn’t. Like that.

And yet this Yale study…it seems to be giving instruction in how to form an opinion…which is my conventional understanding of what a diagnosis is. Even after it’s formed, you can still sensibly disagree with it, am I right?

Seems we’re losing track of that. We still have folks running around using it to describe some hard, undeniable event, like cutting the umbilical cord, or losing a tooth, or death. “Two years ago, my son was diagnosed with…”

A third thing I notice is captured in Thing I Know #179: Children seem to be “diagnosed” with lots of things lately. It has become customary for at least one of their parents to be somehow “enthusiastic” about said diagnosis, sometimes even confessing to having requested or demanded the diagnosis. Said parent is invariably female. Said child is invariably male. The lopsided gender trend is curious, and so is the spectacle of parents ordering diagnoses for their children, like pizzas or textbooks.

Where are all the little girls being diagnosed with things? How come the population of screwed-up kids seems to be so overwhelmingly male? Come to think of it, where are the stats about all the kids being diagnosed with this-thing or that-thing, so that such gender ratios are available to us unwashed masses for extrapolation?

What’s up with these crusading parents who are pushing to have their kids diagnosed with these things? How come it’s thought to be in good harmony with professional ethics, to even listen to them? And where are the dads? How come all these parents pushing the docs to diagnose their kids, and talking and talking and talking about the diagnosis thereafter…how come they’re almost always mothers?

Gee, if I didn’t know better I’d say the moms nowadays were confused about how to relate to their little boys — unable to cope with the tidal wave of energy that every grown man knows is charging through every cell of a young boy’s body, having once been at that age himself. If I didn’t know better, I’d say we have an unexplored gender thing going on…wherein medicine is being used to shoehorn the complicated psyche of a budding male, into a simpler form that a female can understand, in ways nobody ever said she was supposed to be able to. I mean, that’s what I would think…if I didn’t know better.

But, eh, come to think of it I do know better. I’m personally involved in some of this stuff, and I’m sad to say what’s written above makes perfect sense.

We can only speculate about whether it is even so, essentially arguing in a vacuum about it…until someone provides the statistics I commented that I would like to have.

Rather curious that nobody’s done so, isn’t it? I mean, y’know…since we’re all supposed to be so worried about it and everything.

I’m a bit late to the game here but for once I actually might know what I’m talking about.

As the parent of an autistic child (PDD-NOS) I can tell you with certainty autism is very real and a very big problem.

There has been an enormous growth in the number of children diagnosed with autism in the past 10-15 years. I attribute this to several factors; increased awareness by physicians and parents and increased funding for services.

As for the former, the incident rate for autism diagnosis increases at almost exactly the same rate as the diagnosis rate for mental retardation decreases. Ask five people today what autism is and you’ll find that at least one of them knows. Ten years ago, I doubt you’d get the same response.

For the latter, funding has increased for early intervention programs for children who show developmental delays such as poor eye contact, speech delays or other behavioral problems. We’ve learned that such programs can frequently get children back on track with a modicum of therapy.

However, as with all programs that thrive on funding, the threshold for qualification tends to be lowered so as to grow the program as much as possible. I know physicians who will diagnose a child as autistic simply to get them into early intervention. They may not truly be so, but the doctor believes that with a little help, he/she will be on track with their peers in short order.

As for the male/female ratio thing incidence rates for autism are almost 9 males for every female. My child attends a school for severely autistic children and those numbers track very closely with enrollment figures at the school. There is no known reason why but it may have something to do with testosterone levels and motor motor neuron function.

I believe that we are overmedicating our typical children and putting labels on them where none may apply. Some of this is lazy parenting, some of it is a desire to push pharmaceuticals. However, I don’t think you can conflate the two.
- Duffy | 02/27/2007 @ 12:09
However, as with all programs that thrive on funding, the threshold for qualification tends to be lowered so as to grow the program as much as possible. I know physicians who will diagnose a child as autistic simply to get them into early intervention. They may not truly be so, but the doctor believes that with a little help, he/she will be on track with their peers in short order.

And I’ve written some material above to this effect: This is contrary to the expectation the public-at-large has when they hear the word “diagnose.” Actually the last three letters of “PDD-NOS,” themselves, are in sharp contradiction to this expectation. People throw around the word “diagnosis” and what they mean to say is, all doubt has been removed and the professional who made the diagnosis, knows what he’s talking about.

Of course the very first thing any mental health professional is going to tell you is that each case is different. This is just common sense and I haven’t said anything to the contrary. As Thing I Know #35 says, “The individual attribute ascribed to the aggregate entity, manifests a weak argument ripe for re-thinking.” I’m a parent, myself, of a boy who’s probably going to be diagnosed with PDD-NOS any week now (his mother ordered a test for Asperger’s and it came up negative).

Nine-to-one is an awfully high male-female incidence factor. I’d be far less suspicious if the professionals had shown more initiative in observing this anomaly, and doing more about finding out what makes it so. I believe you’ve hit on an explanation with the thing about lowering the threshold for qualification. This isn’t something fathers are likely to support; when a troubled or socially-underdeveloped child shares a gender with a parent, it follows that the the child will share some gender-related issues with that parent and can therefore develop an understanding about things. And so by process of elimination it falls to the mother-son relationship to exacerbate these parent-child misunderstandings, to allow them to fester into something that will eventually metastasize into a “diagnosis.”

This is not to say shenanigans are goin’ on with each and every child diagnosed with a learning disability. But it certainly is to say these issues are being handled within the professional mental health community in a manner quite out of harmony with what the public at large expects, and I suppose on that point you and I probably agree.
- mkfreeberg | 02/28/2007 @ 09:01
But it certainly is to say these issues are being handled within the professional mental health community in a manner quite out of harmony with what the public at large expects, and I suppose on that point you and I probably agree.

I’m not sure about that. The public at large IMNHO, seems to be a big contributor to how we go here. Lazy parents and mothers who are astounded at how rambunctious boys can be would rather medicate them into complacence. Adults frequently expect their 4 year olds to behave like adults. This is, quite simply, insane. They’re going to yell, run around, throw things, wrestle and yes, they’ll do all that in church. They’re boys, it’s what they do.

Sensible people, however, realize this and know that it will pass even if it takes 20 years or so. You wanted to be a parent well, that’s part of the package.

I’m a parent, myself, of a boy who’s probably going to be diagnosed with PDD-NOS any week now (his mother ordered a test for Asperger’s and it came up negative).

Interesting. I find it curious that Asperger’s was the first test. That would lead me to believe that he has speech in some form or fashion and is likely not forming the emotional/social bonds as expected. My son was PDD-NOS b/c he was not talking, had poor eye contact and tantrums that far outstripped the norm. It’s 4 years later and he says maybe 4 words but he’s using more sign language and PECS so there’s been marked improvement in communication which showed dramatic decreases in tantrums and such.

If you do get a PDD-NOS “diagnosis” get a second opinion and even a third. Even if you don’t think it is what they say it is, go for early intervention if possible. It doesn’t hurt and if he’s neurotypical, it will only put him ahead of his peers. Good luck.
- Duffy | 02/28/2007 @ 09:21

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Sunday, February 25th, 2007