Don’t be conned by an Autism Spectrum Maybe for your child.
The DSM or Diagnostic and Statistical Manual of Mental Disorders, and the ICD, The International Classification of Diseases, are two of the most influential and widely used handbooks when diagnosing Asberger’s syndrome. Although the DSM-IV is still used, it has been superceded by DSM-V. The latest version of DSM-V appeared in 2013 and it subsumed Asberger’s syndrome within the broad descriptors for autism. This classification is now called autism spectrum disorder.
Only a medical practitioner with recognised qualifications in psychiatry can make a diagnosis. Everyone else’s opinion is just that.
In the early 1990’s there was a steep increase in the number of children diagnosed with Asberger’s syndrome in the United States when the Federal Department of Education increased services for unspecified pervasive developmental disorder (PDD). The DSMIII was in operation. Diagnoses did not increase in California where services were not enhanced. Children with limitations in social communication were lumped in with children who were genuinely on the autism spectrum. It was noted over time that they suffered loss of self-esteem, and loss of learning opportunities and mainstream experiences.
The DSM-IV articulated that for a diagnosis of Asperger’s the individual must exhibit “severe and sustained impairment in social interaction, and the development of restricted, repetitive patterns of behaviour, interests and activities that must cause clinically significant impairment in social, occupational or other important areas of functioning.”
These descriptors do not change now that Asberger’s is a part of the autism spectrum disorder. All of them need to be present for a diagnosis to be made. In their mildest forms, these impairments still require support in the classroom. Any teacher will recognise quite quickly “severe and sustained impairment” in communication, repetitive behaviour and restricted interests.
In Australia, the same two handbooks are used by psychiatrists to diagnose a child or adult on the autism spectrum. Of concern is the number of people in Australia diagnosed with autism, including the mild form of Asberger’s, (Category 1 on the spectrum) that increased by 42 per cent between 2012 and 2015. Diagnoses often come in twos and threes so the number of diagnoses, 164,000, is not the number of individuals with a diagnosis. Nevertheless, there is an increase of around 50,000 people since 2012.
While there is greater awareness today than in previous decades, it does not allay my fears that there is a situation of over-diagnosis. Many parents of struggling children want a diagnosis such as this to get extra help in the classroom which would not be available without it. And yet, it defies logic that, with the descriptors above, anyone could possibly miss a person walking in our midst or a child in the classroom who has a spectrum disorder.
It is alarming to me that research and advocacy groups are firm in the view that this dramatic increase is no cause for alarm unless the great majority of those people are adults. If they are children in school we have to be circumspect about the motives.