Is The Huge Rise In Autism Diagnoses Really Good News? We’re Not So Sure | Letters

Prof Gina Rippon dismisses excessively easy nan genuine concerns astir overdiagnosis of conditions specified arsenic autism and nan medicalisation of normal behaviour (Why nan antagonism complete nan emergence successful autism diagnoses? It’s really bully news, 21 July). She correctly observes that location has been an astonishingly ample summation successful test rates since 1998. She besides notes correctly that, earlier nan 1980s, autism was diagnosed infrequently because of its “overly narrow” definition.

However, successful arguing that galore children result missed retired connected nan thief they needed, she draws nan incorrect conclusion. She fails to mention that different diagnoses were disposable for specified children, including societal anxiety, attraction shortage hyperactivity upset and learning disability, among others. Children needing thief were often diagnosed pinch 1 of these, and pinch capable reliability to alteration thief to beryllium offered wrong disposable resources. Moreover, it is good known that nan test of autism by itself does not bespeak immoderate circumstantial benignant of intervention.

Rippon besides welcomes nan soaring rates of diagnosis, assuming it someway explains nan behaviour of those fixed it. However, autism is conscionable a descriptive diagnosis. The diagnostic criteria comprise a ample cluster of behaviours, specified that 2 group pinch nan test whitethorn show nary behaviours successful common. The communal underlying psychological aliases neurological abnormality, if 1 exists astatine all, is simply not known. I callback during my objective profession successful kid and teen intelligence wellness services (Camhs) being asked by parents of a boy pinch an autism diagnosis: “We cognize he has autism, but why does he behave nan measurement he does?” The only disposable mentation would beryllium an individual appraisal of nan kid concerned and nan settings that trigger immoderate behavioural difficulties.

Rippon ends by claiming nan precocious rates of autism diagnoses are simply a reflection of quality diversity. However, successful doing so, she inadvertently reflects what those concerned astir overdiagnosis are really saying. It’s precisely because we invited quality diverseness that we wonderment why specified precocious levels of test are basal to understand it.
Dr Richard Hassall
Knaresborough, North Yorkshire

As location are truthful galore references to a “bad aged past” successful Gina Rippon’s article, I thought it mightiness beryllium adjuvant if I commented connected immoderate of nan misapprehensions she expresses. I worked arsenic an world kid psychiatrist from nan 1960s to nan 1990s, including arsenic a psychiatrist to a schoolhouse for autistic children. First, nan emergence successful diagnoses has been moreover greater than Rippon suggests. In nan first version of my textbook, published successful 1986, I springiness nan prevalence arsenic 3 to 4 per 10,000 children. It is now at slightest 100, a 30-fold rise. Second, nan emergence is either wholly aliases almost wholly owed to a redefinition of nan condition. So-called Asperger syndrome has been abolished arsenic a diagnosis and merged into “autistic spectrum disorder”. Third, I do not recognise nan expected trouble successful diagnosing girls pinch this condition. Certainly, I had nary hesitation successful doing truthful erstwhile it was indicated.

Whether nan redefinition of autism is bully news aliases bad news, I, for illustration galore others, would find it difficult to say. Alongside nan alteration successful meaning has travel a invited simplification successful stigmatisation and greater willingness to be applicable services. On nan different hand, kid intelligence wellness services are overwhelmed and galore parents are disappointment by their incapacity to get what they, rather unrealistically, spot arsenic life-changing help. Rather than seeking a definitive diagnosis, galore would beryllium amended served by encouragement to spot their problematic children arsenic “different” and needing an upbringing tailored to their peculiar strengths and difficulties.
Philip Graham
Emeritus professor of kid psychiatry, University College London

Gina Rippon presents nan astonishing emergence successful autism diagnoses arsenic grounds that much members of marginalised groups are benefiting from being diagnosed. It is existent that increasing numbers of group are suffering intelligence distress, and nan grounds links this pinch accrued poorness and inequality. It is besides existent that entree to services and use typically still requires a psychiatric diagnosis.

But it is wholly unjustified to picture autism arsenic an incurable, neurodevelopmental encephalon disorder, isolated from successful nan lawsuit of a mini number of individuals who will require lifelong support and whitethorn ne'er unrecorded independently. The hold of autism diagnoses to perchance see billionaires for illustration Elon Musk, on pinch celebrities and others pinch successful careers, is unsupported by evidence. In fact, contempt Rippon’s declare of “stunning advances”, nary neural aliases familial facet robust capable to assistance test aliases foretell curen consequence has ever been found.

Additionally, location are important disadvantages to framing diagnostic labels arsenic identities to beryllium celebrated. The experiences described by galore group now claiming to beryllium autistic are amended explained arsenic consequences of nan rootlessness and individualism that characterise mundane life today, nan effects of what sociologists telephone “victimhood cultures”, nan invidious power of societal media, and nan publication of maltreatment and different adverse experiences to distress of each forms.

We do not request yet different measurement to individualise and commodify nan grossly uneven impacts of these societal pressures. Instead, we request to fundamentally toggle shape our profoundly unequal society, dismantling nan myths that make inequality look inevitable.
Dr John Cromby
Honorary professor of mental health and psychology, University of Nottingham