Autism Epidemic Denial : The Flip Side of the Autism Services Obtainment Argument
Posted Apr 06 2009 7:12pm
Reported cases of autism spectrum disorder diagnoses have risen dramatically in the past 15 years. There can be no dispute that the expansion in the definition and diagnostic criteria of autism disorders in the DSM play a significant part in that rise. Another argument often made by those who would argue against any real increase in autism disorders is that the increasing availability of autism related services results in more autism diagnoses as physicians assign an autism diagnosis in questionable cases in order to qualify a child for receipt of those services.
I suspect that such incidents do occur but I have no idea whether "service obtainment" diagnoses occur with such frequency as to have a measurable impact on the numbers of autism diagnoses. I have never seen any reports of studies which accurately measure such an impact.
On the flip side I have never even heard anyone mention whether the provision of services specific to autism could result in children who actually have autism being denied an autism diagnosis as a result of autism service providers placing pressure on diagnosing physicians or psychologists. If it sounds too bizarre to contemplate read the story of Alex Thompson and his family in the UK where Alex's treating physician was subjected to pressure to give Alex a different diagnosis for his autism disorder by the local service provider.
In NHS trust apologises to newsreader after changing son's autism diagnosis the Telegraph reports that the chief physician in the organization responsible for assessing Alex admitted to having withdrawn his autism diagnosis under pressure from organization's education officer. The story also indicates that the physician discharged Alex from her care because his parents, who fought a years long legal battle to have his services restored, had made it impossible to continue.
The Thompson's are certainly not unique in being labelled by officials as difficult because they fought for their child. And according to Alex Thompson's father their situation in fighting for proper care for their child is not unique in the UK:
“We are certainly not the only family to have gone through this. It is happening up and down the country and it has got to be stopped.”
The autism service obtainment argument speculates that the push for autism specific services by parents results in more autism diagnoses being provided in order to qualify children for receipt of those services. The Thompson case illustrates the possibility of a push back factor - autism diagnoses being changed or denied under pressure from service providers seeking to avoid funding of autism specific services.