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Savage Savages Autism: Real Disorder? Medical Disorder? Social Disorder?

Posted Dec 23 2008 9:15pm
Just when you thought the dust, or rather, data had settled on the autism front...

Thank Talk show host Michael Savage for today's discussion - in particular, his remarks that autistic kids are unruly, undisciplined brats. They're offensive, yes. Exaggerated, yes. Partly true, yes. Autism expert Catherine Lord, a prof at New York University, conceded Savage's remarks harbor a "kernel of truth" according to an article on the brouhaha in today's New York Times. Lord acknowledges some kids get the autistic label if no other diagnosis seems to fit. I'm thinking of Pervasive Developmental Disorder Not Otherwise Specified, a catch-all category on the Autistic Spectrum for those not quite meeting the other more severe disorders or other types of disorders (e.g., schizophrenia, anti-social personality disorder). We know this happens. It's no surprise. Kids present with symptoms. They need help. Who can deny kids the label, and thus, the treatment they need? Especially early interventions that show good results. But why include these kids on the autistic spectrum? Should we parse out PDD? Are we combining apples and oranges? Is there a downside?

Speaking of diagnosing autism... here's where it gets really interesting....

Lord argued that Savage's comments perpetuate the "myth" that autism is different than other medical conditions, like diabetes, heart conditions or epilepsy. Really??? Autism is not unlike epilepsy?

For now, we don't have neurological or biological tests for autism, not like other medical disorders. I'm not a medical doctor nor a neuropsychologist, but I wonder how a complex neurological disorder will ever be reduced to a single test. Especially when children exhibit a variety of symptoms that fit categories that have been used differently, some would say creatively, by doctors and therapists.

Are there other medical conditions that defy physiological markers and are best identified by a checklist of behavioral symptoms? Do we really want to equate autism with medical disorders? Do we want MDs diagnosing it? Or psychologists?

There is a difference between epilepsy and autism - the later, a profoundly social disorder, one affecting social interactions, that is, understanding and communicating with other people. One best treated by behavioral interventions and training. The last I knew, people with epilepsy have fulfilling, complex social lives. Call me biased, but as a social psychologist with clinical experience, I have to think autism is quite different than many medical disorders. Doesn't take a Ph.D. to figure out that some disorders are not best viewed and treated as faulty neural networks.

Questions plaguing psychologists, perhaps even Lord herself, Chair of the Early Intervention in Autism Committee at The National Academy of Sciences.
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