That Problematical Autism Explosion

"The pretend epidemic of autism is related to the inclusion of people less and less different from non-autistics."
"This means that, across all disciplines, the people with or without autism who are being included in studies are increasingly similar. If this trend holds, the objective difference between those with autism and the general population will disappear in less then ten years."
"The definition of autism may get too blurry to be meaningful -- trivializing the condition -- because we are increasingly applying the diagnosis to people whose differences from the general population are less pronounced."
"[There is no gold standard, no biological marker such as a blood test] to tell you this one is autistic, this one is not. People tried all possible solutions, but with the constant enlargement of the criteria."
"Fifty years ago, one sign of autism was a lack of apparent interest in others. Nowadays it's simply having fewer friends than others. Twenty years ago you would ask for a complete absence of facial expression. Now it's less facial expression, fewer friends, less reciprocity -- it's become more and more fuzzy."
"You could not be ADHD and autistic before 2013. Now you can. This is justified in some cases where people have both presentations. But it also authorizes to label as autistic pure ADHD people."
"The cliche that you will see everywhere is, 'oh, you have more autism because they are better recognized', which is absolutely wrong."
"It's not that they are better recognized. [It's that people with less profound deviations from] normal [are being diagnosed with autism]."
Dr.Laurent Mottron, professor of psychiatry, Universite de Montreal

"Panicked parents falsely assumed the rapid increase in rates was due to vaccination — not realizing it was First described in the 1940s a decade later severe autism instead a consequence of looser definitions and assessments."   Getty Images

First identified as a condition in the 1940s, a decade later it was assumed that severe autism affected five to ten children for every 10,000 in any population. That estimate rose to one child in 59 by the year 2014 -- according to figures released by the U.S. Centers for Disease Control and Prevention. By any standards of measurement that represents an enormous spike. The mystery is, what could account for it? Are children in those numbers really legitimately to be classified in the autism range? What could possibly be causing what certainly appears on the surface to look suspiciously like an epidemic?

Ah, of course, that would be inoculations. Those same inoculations against diseases that once swept a deadly swath of destruction through the global community. And still do, in some backward areas of the world, now trying to 'catch up' by fast-tracking inoculations for children, led by the UN's WHO. And then the backlash, the uninformed but persuasive opinions with no basis in medical science whatever promulgated on social media by celebrities, that autism is caused by inoculations. And so many convinced this to be true, aided by a since-discredited scientific paper, that measles and other once-rare diseases have returned.

The anti-vaxxers have a huge, faithful following. Medical science, dismayed but forgiving to a fault, expresses the opinion that these 'misguided' parents who withhold vaccine inoculations from their children simply need to be educated; that their fears for the well-being of the children have led them down the confused garden path of inviting disease rather than spurning its onset. A newly-published study looks at the prevalence of autism diagnoses and has arrived at a not very surprising conclusion; the condition is being over-prescribed, partly thanks to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders.

Published in JAMA Psychiatry, Dr. Mottron and his colleagues involved in the research project identified the explosion in diagnoses of autism as having resulted from the broadening of the "autism" definition to the extent that differences between those diagnosed with autism and the balance of the population are seen to be diminishing. The research reviewed eleven meta-analyses -- studies of studies -- published from 1966 to 2019 comparing individuals with autism and those in the population considered to be autism-free.

The magnitude of the differences observed between those with autism and those without was of particular interest to the researchers, in how the "effect size" changed over the period studied. Close to 23,000 people diagnosed with autism in total were included in the study. Traits assessed including "emotion recognition", recognizing emotions in other people, and brain size, in recognition that people with autism tend to have a slightly larger brain volume, along with other traits that were assessed, seeing shrinkage in measurable differentiation by 45 to 80 percent.

Too many people with mild and dubious symptoms not very different from people without true autism are being diagnosed with autism, invalidating study results, concluded Dr. Mottron. This is a situation whereby any child or adult exhibiting symptoms barely resembling autism now is being diagnosed with autism. The result overwhelms specialty clinics and related services to the extent that true autistics are being denied the assistance they require. Diagnostic criteria have been loosened unhelpfully.

In the opinion of some experts, the over-diagnoses began in 1994 as a result of the American Psychiatric Association releasing the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders, considered the officially sanctioned encyclopedia of mental illness. Merging Asperger syndrome with autism increases three-fold the rate of autism diagnoses, according to Dr. Frances of Duke University. Even more critical, classic autism and Asperger's were collapsed into a "spectrum" making misdiagnoses even more common, in the current (fifth) edition of the manual, DSM-5.

"Probably the biggest mistake we made in DSM-IV was including Asperger's, a much milder form of autistic disorder with unclear boundaries to normal diversity, eccentricity and giftedness."
"Careless diagnosis, often related to requirements for extra school services, resulted in a fake epidemic -- a 50-fold increase in the past 25 years."
"Panicked parents falsely assumed the rapid increase in rates was due to vaccination -- not realizing it was instead a consequence of looser definitions and assessments. This has led to measles epidemics all over the world."
"[Over-diagnosis is also harmful for parents and children] stigmatizing them, causing needless worry and reducing expectations."
Dr. Allen Frances, emeritus professor of psychiatry, Duke University, chair, task force DSM-IV