By bobb |

From The Daily Telegraph, July 20, 2011

  • Students with autism up 165 per cent over eight years
  • Rates of other mental health diagnoses up by 75
  • Autism attracts more funding, more assistance

SOME parents and doctors are colluding to deliberately misdiagnose school children as autistic so they can get help for other problems, a medical professional claims.

Parents are seeking the autism "label" because funding for the condition has increased and more assistance is available for autism than for other conditions.

The practice may partly explain a huge rise in the number of public school students with autism - up by 165 per cent over the past eight years.

Autism is defined as a neural development disorder and is often characterised by impaired social interaction and communication as well as repetitive and restricted behaviours.

Rates of other mental health diagnoses have increased by 75 per cent since 2003, according to the state government's submission to a federal review of funding for schooling.

Clinical psychologist and manager of diagnostic assessment services at Autism Spectrum Australia Vicki Gibbs said there were various reasons for the surge in the number of children diagnosed with autism.

"The most obvious is that people are more aware of it than before and people are also more aware of the more subtle forms of autism. Another reason is autism now attracts more funding, especially in the early intervention years."

Ms Gibbs said there was a small group of people happy to have their children diagnosed with autism because giving them a label was the only way they could get help.

"Some diagnosticians will give the child that label even when they don't meet all the criteria," she said.

"It's the only way they can get help with their problems."

from http://www.news.com.au/national/some-parents-and-doctors-faking-autism-…

This story is mostly bollocks. Stories like this pop up every few years, usually in Qld or NSW. Sometimes it is ADHD, sometimes autism/ASD. The purpose is to sell papers, fuel prejudice and vilify the most vulnerable members of our community.

The underlying message from the newspaper is that people with a disability do not deserve disability service, support or welfare; the newspapers promote the view that people with a disability and their families are all just bludgers.

Here are some points for thought ...

  • most autism diagnoses and "the early intervention years" occur before school age ... there is still not much funding specifically for school-age children with autism ... so the motivation alleged in the article is not real.
  • diagnosis of autism/ASD is usually done by a team of clinicians, so the parents would have to get a team of people together to misdiagnose their child with autism, and then they would need to find service providers who would be prepared to go along with the misdiagnosis.
  • surely some misdiagnoses would be noticed and reported ... so where are the records of all those misdiagnoses.
  • if Ms Gibbs were aware of any parent getting "deliberate misdiagnosis" for their child, she should have them treated for "Factitious Disorder" (formerly Munchausen's Syndrome).
  • the rise in autism diagnoses has been going on for over 20 years all over the world ... this epidemic of "Factitious Disorder" must be a massive global conspiracy of parents and clinicians (or maybe this is the result of alien abductions).
  • autism spectrum disorders are a group of disorders that include Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) ... which is the diagnostic label used for a person who has "severe and pervasive impairment" due to symptoms of an autistic nature but the person's symptoms do not meet the diagnostic criteria for any of the other specific disorders in the group. Clinicians are remiss when they do not use this "label" for people who meet this diagnostic criteria.
  • the article says the Government says a 75% increase in mental health diagnoses should lead to "a federal review of funding for schooling" but it seems 165% increase in autism is due to parent behaving badly. What increase in autism would deserve a funding review for students with autism?
  • the article alleges education services insist on an inappropriate clinical diagnosis in order for a child to access the resources they need to get an education.

The newspaper did not publish the comment that was submitted saying "IMHO, bollocks".

Aspect posted a response to the article ... see http://www.autismspectrum.org.au/images/media/Media_Release_-_Statement…

Aspect quotes Ms Gibbs ...

It is our experience that parents who present their children for an autism spectrum disorder assessment do so with a view to obtaining an honest and accurate opinion in relation to the child’s development.

This shows the story is a media beat-up.

Aspect's media release says ...

Our view is that the majority of the increase in the number of reported cases of autism spectrum disorders can be properly explained by a greater awareness of milder presentations of the condition and more accurate diagnostic tools.

The diagnostic criteria for Pervasive Developmental Disorders say they all involve "severe and pervasive impairment". There is little or no evidence in the research literature or in Australian disability data of significant "diagnostic substitution" due to "more accurate diagnostic tools". So suggesting that increased diagnosis is due to "greater awareness" suggests that a significant number of parents were unaware that their child had "severe or pervasive impairment" ... or that they chose not to do anything about their child's disability.

This demeans the parents of children that Aspect suggests were unaware of their child's severe impairment due to autism ... as well as their teachers and any associated health professionals who apparently did not pick up or act on the child's severe impairment.

Where is the evidence to support this assertion?

There is some evidence that even though the number of ASD diagnoses in Australia more than doubled between 1998 and 2003, the diagnoses were given for predominantly for severe or profound disability. The Australian Institute of Health and Welfare (AIHW) reports that the Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC) data collected in 2003 showed 87% of people with autism have severe or profound disability (that is, pretty consistent with the diagnostic criteria). According to the ABS SDAC data, autism diagnoses in Australia grew from 13200 in 1998 to 30400 in 2003 ... more than double in 5 years. If the increase from 1998 to 2003 was due to "milder presentations" then at least 50% of people with ASD in the 2003 survey would have milder rather than "severe or profound disability".

Apparently, the increase from 1998 to 2003 was not due to "milder presentations" unless it means "milder severe or profound disability".

I'm hoping to see soon what the ABS 2009 SDAC data says.

Using this term invites Governments to decide that people with "milder presentations" do not require the level of service that people with "severe and pervasive impairment" need and deserve. The term "milder presentations" is unhelpful to the ASD community ... and is not consistent with the available evidence.