Child WAS diagnosed as having ASD by Dr. Greenspan?

[Anonymous]

A parent made the allegation that Dr. Stanley Greenspan did not like to give out ASD diagnoses for fear of the stigma the child might face or for fear of upsetting the parents. Instead, he supposedly gave out alternative diagnoses. Has anyone's child actually been diagnosed as having Autism or ASD or Aspergers by Dr. Greenspan before he died last year?

[Anonymous]

Not that I know of. I have met a half dozen people who saw him and got the diagnosis he came up with that isn't in the DSM and I think all of them have since gotten an autism spectrum diagnosis.

The man was brilliant. Didn't know him personally, but have read his books and articles. The thing is he knew his clientelle and I'm sure I will get shot down for this, but I think people were more willing to listen to him and recommend him if he left the A word out of the feedback.

[Anonymous]

This is so patently false. He writes over and over again in his books about working with autistic children. If you look at the hoax column, you'll see a parent there who knew many he diagnosed with autism.

[Anonymous]

I am curious as to why the OP needs to know. I did not know him and my dc was not a patient. I have read some of his books. If he were still alive and OP was considering making an appointment, that would be one thing. But it seems to me that OP is trying to drum up trouble for someone who can no longer defend himself.

[Anonymous]

Well, it is true that he was reluctant to diagnose kids with ASDs because he though it would cause parents to downplay expectations (as I wrote in the other thread, patronizing). I know of one family that went to him and were told their DS did not have an ASD and he was later diagnosed with one -- and, trust me, it fit. I believe he came around somewhat toward the end of his life and did write the book "Engaging Autism." Perhaps he learned that parents wouldn't panic and lose their heads. In any event, when I hear someone say Dr. Greenspan (and Serena Weider, in addition, who told us our DS didn't have an ASD and he most certainly and obviously does) cleared their DC of having an ASD, I think it really doesn't mean much.

[Anonymous]

Anonymous wrote:I am curious as to why the OP needs to know. I did not know him and my dc was not a patient. I have read some of his books. If he were still alive and OP was considering making an appointment, that would be one thing. But it seems to me that OP is trying to drum up trouble for someone who can no longer defend himself.

This is why people shouldn't question any OP's motivation for writing a thread. My child was diagnosed by Dr. Greenspan as NOT having ASD and he had very autistic-LIKE symptoms but it was confirmed by at least five people afterwards that he did not have ASD. I have a lot of respect for the man and my child saw him numerous times and just one month before he died also. I'm the OP and I'm not trying to drum up trouble. I just want to know where those parents are that I personally met whose children WERE diagnosed by Greenspan as having ASD. I could see the difference between their children and my child and understood Greenspan's thinking better after I was able to recognize the difference.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am curious as to why the OP needs to know. I did not know him and my dc was not a patient. I have read some of his books. If he were still alive and OP was considering making an appointment, that would be one thing. But it seems to me that OP is trying to drum up trouble for someone who can no longer defend himself.

This is why people shouldn't question any OP's motivation for writing a thread. My child was diagnosed by Dr. Greenspan as NOT having ASD and he had very autistic-LIKE symptoms but it was confirmed by at least five people afterwards that he did not have ASD. I have a lot of respect for the man and my child saw him numerous times and just one month before he died also. I'm the OP and I'm not trying to drum up trouble. I just want to know where those parents are that I personally met whose children WERE diagnosed by Greenspan as having ASD. I could see the difference between their children and my child and understood Greenspan's thinking better after I was able to recognize the difference.

Thanks for the followup. I get why you asked the question, given that ridiculous comment an PP made about him not wanting to tell parents their children were ASD because he was afraid to hurt their feelings. In all his writings, Greenspan had a very nuanced view of autism/ASD. He felt it was being rampantly misdiagnosed, and wrote about that not long before his death.

[Anonymous]

I'm the PP who wrote that he didn't tell parents the diagnosis and that is absolutely the truth. It wasn't because he didn't want to hurt their feelings, it was because he felt they would lower their expectations for their child's development. Greenspan was an optimist and felt floortime could change the course of a child's development. I think he was a visionary and floortime did an enormous amount to help my DC who has an ASD.

Greenspan did change his approach to diagnosing ASDs later in life -- though I think he still had a reluctance. Perhaps because my DC is a teenager I remember the older days and there is no question that he had an aversion. His influence over therapists in this region is great, and mostly positive. A lot of speech therapists and OTs use floortime, and I think thats great. But you will also often hear the line from therapists that "the diagnosis doesn't matter. What matters is the therapy." That is pure Greenspan and I strongly disagree. I think this reenforces the reluctance to address ASDs like any other medical diagnosis and perpetuates the shame.

Greenspan did not lack for ego and I don't doubt that he questioned the diagnosis of other clinicians. But it is also true that even later in life when he would use the "A" word with parents, that he misdiagnosed kids who absolutely did have ASDs. As I said, the man was a visionary. But his approach to diagnoses left much to be desired.

[Anonymous]

Anonymous wrote:I'm the PP who wrote that he didn't tell parents the diagnosis and that is absolutely the truth. It wasn't because he didn't want to hurt their feelings, it was because he felt they would lower their expectations for their child's development. Greenspan was an optimist and felt floortime could change the course of a child's development. I think he was a visionary and floortime did an enormous amount to help my DC who has an ASD.

Greenspan did change his approach to diagnosing ASDs later in life -- though I think he still had a reluctance. Perhaps because my DC is a teenager I remember the older days and there is no question that he had an aversion. His influence over therapists in this region is great, and mostly positive. A lot of speech therapists and OTs use floortime, and I think thats great. But you will also often hear the line from therapists that "the diagnosis doesn't matter. What matters is the therapy." That is pure Greenspan and I strongly disagree. I think this reenforces the reluctance to address ASDs like any other medical diagnosis and perpetuates the shame.

Greenspan did not lack for ego and I don't doubt that he questioned the diagnosis of other clinicians. But it is also true that even later in life when he would use the "A" word with parents, that he misdiagnosed kids who absolutely did have ASDs. As I said, the man was a visionary. But his approach to diagnoses left much to be desired.

PP you're only right about one thing here - that Greenspan hated that parents didn't do enough to help their children and parents of ASD children sometimes became more complacent. But regardless of whether a child was diagnosed with SPD or ASD, Greenspan had tall expectations for parents. My child was not diagnosed with ASD yet I was asked to do four to six sessions of floor time per day along with four sessions of OT per day. Greenspan was an optimist for MOST children, even those with autism, and he had reason to be. He said that if autism is caught very early and very intensive floor time is done with the parents mostly, floor time could profoundly change the child's brain permanently and make it more typical. He was right. But most parents don't want to sit there for 6-7 hours a day and do floor time with their child. But he knew that if they did, their child's brain would significantly change.

But you're wrong to say that Greenspan believed the diagnosis didn't matter. Read his ICDL articles which are free and online and you'll see that he absolutely felt the diagnosis did matter..because if your child is diagnosed with ASD, the wrong therapy may be suggested for him. Greenspan was not averse to ABA but said it was for only some autistic children, not all ASD children. He said social skills groups were fine for children with ASD but that regular play dates were better for non ASD children. To know whether ABA was better or floor time was better, and to know what kind of social therapy is better for your child also, the child had to receive an accurate diagnosis.

[Anonymous]

Well, this probably is a digression but your post elaborates on some of the big problems with Greenspan, whom I have said repeatedly was a visionary, but a limited one. First of all, he "hated the parents who didn't do enough." This is true, he treated many parents with contempt. And the problem is that if a clinician doesn't take families as they are (sometimes the mothers have to work, sometimes there are other children in the family, sometimes loving and dedicated parents simply can't do everything he prescribed) then what good is their approach? We all know how easy it is for us moms to feel guilty about anything and everything. How about telling them that because they didn't spend 7 hours a day in a therapeutic session with their child, their child is still autistic? I don't think its healthy for anyone to spend that amount of time one on one with their child, and I think it is a distortion of the parent-child relationship. But ultimately, I think it is a recipe for parental overload and family breakdown and I don't see how either of these things help the children. And I don't see how making parents feel bad about themselves -- which he did on a regular basis -- is helpful either.

And the second problem was his war on ABA. Now I believe that floortime was a far superior approach for my DS than ABA, and he is on the spectrum. But it is simply wrong to say that Greenspan was not averse to ABA, he was at war with ABA -- including for kids with ASDs. Which is unfortunate because a blend of the two approaches might be perfect for some kids.

He created this great thing and it has helped tons of kids and will long outlast him. But he was far, far from perfect. And I think its telling that we have no parents on these boards who have come forward to say he diagnosed their children with ASDs.

[Anonymous]

Well said 7:14.

I don't quite get why OP started this thread. OP came back to say that her/his child was not diagnosed ASD and that was the RIGHT diagnosis, so why do you care if other kids were diagnosed with ASD by him?

My take on Greenspan is unless a child was severely affected a lot got lumped under "regulatory disorders" that other clinicians would call HFA, PDD-NOS, Asperger's, etc.
It doesn't matter if you call a behavior "autistic" or "autistic like" because as long as the child is at a certain level of functioning, it will be treated the same way in the school setting and you will be given likely the same recommendations for home. It's semantics.

[Anonymous]

10:06 again..

Wanted to add, I find it interesting how upset people get with the whole autistic/autistic-like debate. You don't have to prove anything to us all. We are not the teachers working with your child. If your child goes to a SN private school. it won't matter if your child has SID, autism, autism like features or regulatory disorder. They can either work with your individual child's strengths and challenges or they can't. If a child is struggling despite all their efforts, coming back and saying he is "autistic like" or it's a "regulatory disorder" doesn't do anything unless the diagnosing clinician can come and make some novel recommendations the school can handle. In a public school "autstic like" language issues and "autistic" language issues will often need the same approach.

[Anonymous]

Wow, a lot of debate and no one answered OP's question. She was probably just curious.

[Anonymous]

The answer seems to be no.

[Anonymous]

Anonymous wrote:Well, this probably is a digression but your post elaborates on some of the big problems with Greenspan, whom I have said repeatedly was a visionary, but a limited one. First of all, he "hated the parents who didn't do enough." This is true, he treated many parents with contempt. And the problem is that if a clinician doesn't take families as they are (sometimes the mothers have to work, sometimes there are other children in the family, sometimes loving and dedicated parents simply can't do everything he prescribed) then what good is their approach? We all know how easy it is for us moms to feel guilty about anything and everything. How about telling them that because they didn't spend 7 hours a day in a therapeutic session with their child, their child is still autistic? I don't think its healthy for anyone to spend that amount of time one on one with their child, and I think it is a distortion of the parent-child relationship. But ultimately, I think it is a recipe for parental overload and family breakdown and I don't see how either of these things help the children. And I don't see how making parents feel bad about themselves -- which he did on a regular basis -- is helpful either.

And the second problem was his war on ABA. Now I believe that floortime was a far superior approach for my DS than ABA, and he is on the spectrum. But it is simply wrong to say that Greenspan was not averse to ABA, he was at war with ABA -- including for kids with ASDs. Which is unfortunate because a blend of the two approaches might be perfect for some kids.

He created this great thing and it has helped tons of kids and will long outlast him. But he was far, far from perfect. And I think its telling that we have no parents on these boards who have come forward to say he diagnosed their children with ASDs.

I don't think anyone said Dr. Greenspan was "perfect" so I'm not going to try to defend this strange notion that's now arisen that he was "perfect." Maybe he did treat some parents with contempt. I wasn't one of those parents so I can't validate or verify that. He seemed to me to be a doctor who put children's needs first, second, and last. He's a child psychiatrist for special needs children, not a psychiatrist for their parents. So I naturally expected him (and wanted him) to be an advocate for my child. But even then he wasn't cruel or punishing in his demands of DH and me. He did not ask me to do floor time for 6-7 hours a day for years on end. He asked me to do it for a few months, after which he reduced that to just 4 times a day. That wasn't an unachievable demand for DH and I. And back then my child was merely 3 years old and not in preschool. So he was home with me. What do most parents do with a three year old if they are a stay at home parent? They don't delegate all care and work to a nanny, they don't plant that child in front of a TV or computer for hours. They naturally spend a lot of time with their 3 yr old, take them to parks, playgrounds, have meals with them, maybe do activities at home with them. So it was only natural and expected that I'd be spending at least 6-7 hours a day with my 3 yr old anyway. If I couldn't do it because of a job, he said I should hire somebody to do it for us, but did tell us that floor time with parents was the best approach. He also made sure to tell DH and me that we needed to take at least one day a week out for date night to nurture our own relationship because he recognized that doing all this and raising a special needs children could affect a marriage. I read somewhere that Greenspan thought special needs kids should have many siblings if possible because it would help them a lot. Well, DH and I chose not to have any more children for fear that we wouldn't be able to give DC our full attention if we did. Once when I was bemoaning this decision to Greenspan he told me, "Don't beat yourself over it. You guys acted in the best way you knew how." And each time we saw him he would ask us, "So mom and dad, are you taking time out for yourselves?" So none of these things show that Greenspan had contempt for parents, at least not for us. But again, we followed his instructions and with each visit he saw a nice gradual improvement with DC.

So perhaps he had contempt for those parents who he felt could do more but weren't. And let's be honest here, there may be parents who don't want to spend 6-7 hours with their child at home even if they could. Maybe those were the parents he felt frustration with. But if your child has autism or any special needs that requires attention, what do you expect your child's psychiatrist to say, "Oh I get that it's too hard and maybe you feel it's even unhealthy for you, so I don't want to push you to do floor time any more than you feel like?" It's like a dentist telling a parent whose child has fifteen cavities, "I know it's hard to enforce brushing and flossing with your kids so I don't want to pressure you to enforce it any more than would stressful for you." That just ain't gonna happen!

As far as ABA is concerned, I actually heard Dr. Greenspan say to us personally that ABA is suitable for some ASD children, but it was not suitable for our child.

To the PP who wanted to know why I, as the OP, wanted to know if there were any Greenspan-diagnosed autistic kids out there. Curiosity and basically because it surprised me to read that some people he never diagnosed children with that. Hard to believe that one of the foremost autism experts in the country would never have diagnosed any children with autism. He would become a mockery in his field if that were the case. He became an autism expert precisely because he has obviously seen and diagnosed many, many children on the spectrum.

Honestly, for those whose children were diagnosed with ASD, I hope that you found a great program for your kids and they are all improving well. We've been continuing floor time with our child and it has worked wonders. Even though he hardly has any social impairment, we plan to continue with floor time. Since ASD is especially characterized by social impairment, I can understand why Greenspan felt floor time was far superior to ABA for most ASD children. ABA doesn't seem to address the emotional piece that helps to repair the social impairment problem, but floor time does.