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Autism Spectrum Disorder

Is Autism Over-diagnosed?

Erin Thomas

By: Erin Thomas

The current incidence of autism in the U.S. is 1 in 50 children. While this alarming rate is prompting research into causes and treatments of autism, it has also caused many to raise eyebrows and propose a different idea…Is autism simply being over-diagnosed today? The answer is not so clear.

One study showed that incidence rates for autism in the U.K. increased fivefold in the 1990s, but incidence in 8 year olds reached a plateau in the early 2000s. The rate then stayed stable through 2010. It has not been determined whether this same trend applies for the U.S.

ASDs are often first detected around 18 months and even earlier in some cases. But the truth also remains that some diagnosed cases of autism are considered to be “outgrown” at later ages. This may be because ASDs share some neurodevelopmental symptoms with other conditions, leading to mistakes in diagnosis at a young age.

One study compared three cohorts of people diagnosed with ASDs: young children (3-5 years), children (6-11 years), and adolescents (12-17 years). Data was collected to identify conditions that distinguished individuals who had a current diagnosis of an ASD from those who had a past but not current diagnosis of an ASD. The symptoms in the young children 3-5 years old who currently had an ASD diagnosis were moderate/severe learning disability and moderate/severe developmental delay. In children 6-11 years old the distinguishing symptoms were past speech problem, past hearing difficulties, and current moderate/severe anxiety. In adolescents, the distinguishing symptoms were past hearing difficulties, current moderate/severe speech problems, and current mild seizures or epilepsy. Overall, the study suggested that co-occurring neurodevelopmental and psychiatric syndromes could be associated with a change in ASD diagnosis.

Another claim regarding the over-diagnosis of ASDs is that the spectrum has become too wide and inclusive, making it difficult to distinguish Asperger’s and high functioning parts of the spectrum from pure social disabilities. Some physicians argue that a few socially odd tendencies or repetitive behaviors may be enough to label a child as autistic today, whereas just a few decades ago these children would not have been included on the spectrum. Physicians such as Paul Steinberg argue that more biological markers are necessary to separate ASDs from social disabilities. He warns that because Asperger’s syndrome is so loosely defined today, we put children who are introverted, quirky, or challenged when it comes to relating with their peers in danger of being wrongly diagnosed as having Asperger’s. Steinberg says that with the erroneous diagnosis comes lower self-esteem and poorer social development when they are placed in classrooms with children who actually have an Autism Spectrum Disorder. For an adult with a social disability, a misdiagnosis of Asperger’s on his or her permanent medical record can be a hurdle when searching for employment. Ultimately, there is a concern that as a society we are pathologizing quirks while undermining the severity of classic autism symptoms, such as difficulties in language acquisition and development.

 

Nordqvist, C. (2012, January 23). "Autism Overdiagnosed? Possibly, Because Many

Children Seem To "Outgrow" It."Medical News Today. Retrieved from

http://www.medicalnewstoday.com/articles/240649.

Steinberg, P. (2012). Asperger’s history of over-diagnosis. Retrieved from

http://www.nytimes.com/2012/02/01/opinion/aspergers-history-of-over-diagnosis.html?_r=0.

Taylor B, Jick H, MacLaughlin D. Prevalence and incidence rates of autism in the UK: time

trend from 2004–2010 in children aged 8 years. BMJ Open 2013;3:e003219. doi:10.1136/bmjopen-2013- 003219.