Autism Spectrum Disorders (ASD) are both under- and over-diagnosed, in that I have met many young people and adults who clearly demonstrate enough characteristics to meet DSMIV diagnosis criteria. Yet I have been asked to work with several younger children with a diagnosis of ASD, who do not seem to meet the DSMIV criteria.
There is a huge amount of work that needs to go into diagnosis in order to ensure accuracy. Children and young people need to be observed in a range of settings, and adults from both family and educational settings need to be interviewed with in-depth diagnostic tools.
People for whom dyspraxia, dyslexia or intellectual disability are issues will need further care takento ensure the right diagnosis or dual diagnosis are arrived at. For some families a diagnosis of specific learning difficulty (SpLD) is more palatable than one of ASD. This can be seen as problematic in education, where although there are overlaps of issues for the child/young person, the approaches need to be tailored far more for ASD than SpLD. Again, some people theorize that SpLD are actually part of the spectrum, being just milder in terms of theory of mind.
Children and young people with serious social skills difficulties, who struggle with any sort of interpersonal communication, should be offered the opportunity to learn these skills in a family or small group setting at schoolbefore being labelled ASD. It could be that the person has lived in a home with minimal social contacts, and so has not had the opportunity to learn these skills, rather than being hard-wired differently.
We now know that people with classical autism have brains that are both different and function differently, though research has indicated that some people with non-traumatic brain injury may also have the same structural differences. As more research is carried out in the area, it will be interesting to see if the ‘spectrum’ of Autistic Disorders is mirrored in brain structures and functions.
Some reports from ABC News and Huffington Post stated that just over 1 percent of American children had a diagnosis of ASD, taken from the 2007 statistics released by the National Children’s Health survey. It has to be noted that only 47 percent of participants responded to the survey, which was of 28,000 parents, and asked whether any health professional had ever said the child had an autism spectrum disorder. This is open to interpretation, as health professional could be seen to include many people other than medical doctors and psychiatrists.
Numbers of children diagnosed do seem to be increasing, partly due to greater understanding and possibly to a widening of the spectrum of disorders. The sooner society treats all individuals as valuable people with a range of talents and needs, the sooner labels will become unnecessary!