Michael Weiner a/k/a Michael “Savage,” a nationally syndicated conservative commentator, claimed that autism is “[a] fraud, a racket. … I’ll tell you what autism is. In 99 percent of the cases, it’s a brat who hasn’t been told to cut the act out. That’s what autism is.” He also said that autistic kids needed fathers to tell them to stop acting “like a moron” and that greedy doctors and drug companies were overdiagnosing autism.
What a tool.
I honestly don’t see how anyone can listen to him. He has said some ignorant things in the past, but this is unbelievable. I’ve seen autistic kids, and I’ve never thought the ones I’ve seen were “acting.” Obviously, Savage doesn’t have anyone in his family with autism, and no one with an autistic child is “close” to him.
Autism is a real and serious condition.
Placing children on the autism scale, or diagnosing children with mild forms of autism is akin to ADD or ADHD and is over-diagnosed and is used as a crutch by people with poorly behaved children.
I do not listen to Savage and did not read the links, but there is a strak line to be drawn btween true autism and “mild autism”
http://www.childbrain.com/pddassess.html
I did this assessment on myself, my father and my sons(age 3 and 6) we all grade out as mild PDD. Of course once you look at the assessment and the scoring instructions you will realize that just about everyone will grade out as mild PDD.
Yeah, tell that to my brother and sister-in-law. Tell that to Hannah in my church, who has profound autism and her parents and grandparents. Tell that to…well you get the picture!
Paddy, with whatever respect is due, you don’t know what the hell you’re talking about.
Autism has become recognized as a “spectrum disorder” because it was realized that children who almost–but don’t quite– meet the strict classic autism criteria actually have the same disorder, but to a lesser degree.
Yes, at the mildest end of the spectrum, kids can be nearly indistinguishable from “typically developing” kids. Thus, your PDD results. These kids may need significantly less assistance, geared to specific areas of weakness for them. They may not need much at all.
Others who are “on the spectrum” may be significantly impaired, although not classically autistic. I’m chronicled my son’s case before, but will review in brief. The DSM-IV criteria for diagnosis of autism requires eight specific categorized findings, with two from category A. I won’t review them, but that’s the statistical requirement. My son had eight, with one from category A. It was *that* close. His specific impairments are unilateral weakness, poor muscle tone, specific focused obsessions that limit his ability to relate to others, severely delayed speech, recurrent self-biting, poor feeding, very limited fine motor skills, echolalia. I’m sure I left some out.
He is a wonderful boy who is better behaved than his peers. He has made vast improvements due to 18 hrs/day of maternal attention, intensive speech, occupational, physical, and developmental therapy, First Steps, and about $30,000 cash out of pocket in the first year.
Savage later backtracked and said he wasn’t talking about classic autism, but rather he was talking about the “fraud” of autism spectrum. So he was calling my kid, my family, a fraud. According to him, I need to yell at my kid and tell him to stop behaving in the manner that he is. In Savage’s world, it’s either autism (as defined twenty years ago, never mind new thinking, theories, and discoveries), or it’s a normal kid who is a brat. As is frequently the case, He doesn’t know what the hell he is talking about.
Your “crutch” reference would put you in the same category.
Also, although children with autism do have attention deficits, it is a different disorder than ADHD. You and Savage are both conflating the two. Throughout the couple of days I listened in, he repeatedly used the two diagnoses interchangeably, further illustrating his cluelessness. You state that overdiagnosis is akin to overdiagnosis of ADHD and is “a crutch for parents with poorly behaved kids”. What is your evidence for that? Savage says 99% of those diagnosed shouldn’t be (including my son, who in his book–despite the above challenges, is on the Savage “normal” scale). What percentage of autism do YOU think is just a trendy excuse for awful kids?
I also wasn’t such a big fan of Savage’s grand unifying theory that autism is a scam for money. Money for the parents, money for the drug companies, etc. Did I miss the drug for autism? Sure, there are antipsychotic meds for severely autistic kids. But he’s not disputing that autism exists, and thinks “really” autistic kids should be helped. So including kids on the spectrum isn’t helpful to the drug companies, really. And I apparently haven’t figured out how to milk this diagnosis cash cow yet. We are extremely fortunate to be able to provide for our son. But I can assure you, the money flows out, not in.
But T, I do know what I am talking about.
I have experience in the world of special education. A majority of kids do have problems, real problems, problems that are difficult to treat and are worrisome for their parents and families.
A growing number of kids are “placed” on the mild end of the scale, like ME and MY children. These kids, and I quote “may need significantly less assistance, geared to specific areas of weakness for them. They may not need much at all.” Being on the spectrum is not a blanket excuse for not behaving, especially if one needs little to no treatment.
I emapthize with you and your plight. The small part of his situation that you have outlined is obviously profound and trying. I have very good friends that are in nearly the exact same boat as you. I have a problem with the people who use the expansion of this disorder into a spectrum disorder to absolve themselves of any responsible parenting at all.
My comment of ADHD and ADD were not made in antempt to conflate them, rather an attempt to demonstrate how many people are starting to use the autism spectrum like people used ADD/ADHD. I realize they are different disorders. I also recognize that ADD/ADHD is a real condition.
I think many if not most people are diagnosed correctly, it is in the care and follow up where the system breaks down. I do not think this is a money grab and I do not think that having a parent tell them to stop acting “like a moron†will work either. I think that their are people who are making it tougher for people like T and my friends and skewing public perception of autism and it is those people I have a problem with.
In reviewing my original post, I am not nearly clear enough in my point.
My point is this: Autism is a real and serious condition. (Note this is the first line of the OP) However, there is a growing number of people who are abusing the broadening definition of autism to cover for their lack of parenting skills and/or their inability or unwillingness to parent their children.
No physician “placed” you into the PDD diagnosis. You used a rating scale on yourself and members of your family and “placed” yourself there.
These are medical diagnoses. I did not diagnose my own child. I had a partner do an evaluation, and then make an appropriate referral to a developmental pediatrician. The point isn’t merely whether you line things up, or spin things (we all can do that, and may choose to), but the degree to which these behaviors are repetitive, obsessive, and prevent appropriate relating and communicating with others, learning, etc.
In general, parenting nowdays isn’t what it should be. Some of those kids will happen to be autistic. But the diagnosis requires meeting criteria, even to merely be on the spectrum. I’m not sure what it would accomplish to have a parent make the diagnosis as an excuse. Pretty much all programs that result from the diagnosis need ongoing care plans from a physician. Maybe that isn’t the case within the schools. If not, it should be.
Within the schools, is there really an epidemic of parents being confronted about their poorly behaving child, and saying, “He’s autistic”, without a medical diagnosis? Not, does it happen? But, does it happen a lot? Because Savage’s assertion is that there is not an epidemic of autism spectrum disorder, but rather an epidemic of excuse-making and tolerance of bad bahavior due to overdiagnosis.
So, if I understand Weiner/Savage correctly, we should return to the practice of beating people ‘to drive the demons out of them’?
I’m against such a move, myself – but there are a few public figures who might benefit from such therapy…
Certain radio talk show hosts come to mind…
The debate seems to have been sparked by questions about the excess number of cases we’re seeing now. Are the bunches of new cases due to more kids being affected? Or is the diagnosis being broadened inappropriately (the “excuse for bad behavior” hypothesis)? Or is it being broadened appropriately, identifying previously not-recognized cases.
My professional opinion is that the number of real cases is way up, and we’re also recognizing legitimate, previously undiagnosed cases through appropriate broadening of the diagnosis to reflect a likely identical pathogenesis in both the severe and the mild cases. Just as third, second, and first degree burns are all burns (although requiring different levels of care), autism varies in the breadth and depth of it’s expression.
I don’t really think that people making excuses for their kids is a phenomenon that is skewing public opinion. That worldview was totally unknown to me until Savage made it the focus of his discussion for a few days, and it was clear that his “I’m doing it for the kids” discussion was a pathetic attempt to cover his self-exposed ass. Too many people have or know an affected family vs. the relatively smaller number of people who may be using an inappropriate “diagnosis” as a “get out of jail free” card for their bratty kid.
Savage would have been about as wise to offer himself as an expert on global poverty, and make his central thesis “I once knew someone on Welfare who drove a Cadillac.”
A word about the “assessment scale” referenced above by Paddy. It has the following disclaimers: “This is an experimental screening tool that requires a traditionally established PDD diagnosis.” And, “*Warning*–This is not a final diagnostic determination.” Followed by, “This Score May Suggest: diagnosis” It is a screening tool. A good screening tool is sensitive (doesn’t miss actual cases), while not always being as specific (in order to be sensitive enough to not miss real cases, it might be sensitive enough to capture people who aren’t affected, that is “false positives”). The best tool would be 100% sensitive and 100% specific. But usually you have to lose some specificity in order to not miss real cases. But as noted in the disclaimers, this is a tool that people could use that can then spur them to seek medical attention and be diagnosed, or not, as appropriate. No one should be waiving one of these screening tools around and acting like it is the diagnosis solely based on that tool.
T,
You are obviously more well versed inthis than many ever will be including me.
I cannot quantify the frequency that this is happening nor can I speak directly to all of the details that occur in a school setting.
All I am saying is that out among the minimally educated about autism populace there is a growing backlash(too harsh a word, but the best I could come up with) to the prevelnace of autism “diagnosis” as an excuse for bad behavior.
ANOTHER TALK RADIO NETWORK SHOW BLAMING PARENTS FOR AUTISM
It’s Roy Masters – the father of Mark Masters -Weiners syndicator!
http://www.youtube.com/watch?v=SZE6EaIX5dk
My feelings on autism is that there needs to be more commonly used classifcations, like T suggested about 1st degree and second degree burns.
Cases of “classic” autism are being diluted by the influx of the “new” autism, IMHO. Most of the “classic” autistic people can not function outside of a specically developed care facility, or without caregivers that have been very specially trained to handle it.
I don’t think the same could be said of the “new” autism.
There’s the problem, Jason. There’s really no way to tell, initially. I mean, many kids who end up doing very well are completely nonverbal at 3-3 1/2 years old. In my son’s case, he appears to the casual observer to be developmentally normal (after 9 months of therapy, and further development), but at age two he met almost all of the criteria. Absent early intervention, he might well look autistic at this point.
It’s fairly unique to humans that we are born with incompletely developed brains, with myelination still occurring into the second postnatal year. It is in that window that intervention yields the most results. Think about the classic cases of feral children who first hear language after age four or so, and can never learn anything except very limited language. Miss that window, and the task is much harder.
How you feel about classification depends on what your goals are. If you just have to know right now exactly where your kid fits in, then this isn’t the disease for you. Because you’re not going to know what positive effects time and training are going to have until you go through with it.
But it is so important for all kids who are significantly developmentally delayed to get help. The earlier, the better. That is more important that knowing the exact diagnosis right now, which is often hard to pin down precisely.
My approach is that by age two, I want to know if the kid is developing typically, or not. For the present discussion, those who aren’t developing typically might be either obviously autistic, or have Pervasive Developmental Delay- Not Otherwise Specified, as is my son’s diagnosis. Then you get these kids in the therapies they require, whether it be only speech, speech and physical, occupational, etc. As time goes by, it becomes easier to refine these provisional diagnoses based on how the kid is doing.
The irony is that it’s the kids who are on the autistic spectrum, yet not classically autistic, who probably gain the most from early interventions. That being because, being less effected, they have a greater capacity for improvement. If you saw a room of mixed autistic and PDD-NOS 2 yr. olds in a room, your impression might be that they all are autistic, which if you based it on pathophysiology they all probably are–just at different points on the continuum, or spectrum.
So, best practice is to cast a wide net for early intervention. If they improve to the point of no longer needing services, discontinue. Taxonomy is important, but it’s counterproductive to be a slave to it.
T, let me rephrase and see if I’m understanding:
We are identifying more kids with autism. We don’t know for sure if there are actually more cases, ore we’re just better at identifying it. The latter is assumed, however.
If we’re better at finding it, we think that we’re actually solving cases of it by early treatment, just like cancer. Some cases that wouldn’t have been found before may have self-corrected in time, and some may have gotten worse to the point that correction would be nearly impossiable.
Like cancer, early detetction does not promise success, but it increases the chances.
Am I on track here?
Pretty much.
I think it’s actually primarily more cases.
My reasoning is that the prevalence has gone from something like 1 in 10,000 kids a couple of decades ago, to roughly 1 in 150 now. Given that, on the one hand I can’t recall another illness where changes in screening alone made the numbers change that profoundly. Also, in our personal case of having a child who doesn’t have the classic diagnosis, I can’t imagine him going into an evaluation and escaping without some diagnosis, given his obvious disordered development.
Opinions vary. It’s probably more detection, and more cases. How much of one vs. the other is an area of intense debate.