Autism and Overdiagnosis: Rampant, in psychologist's opinion

[Anonymous]

I'm glad to hear this side of the "autism epidemic" story getting out:

Interview with Dr. Enrico Gnaulati, clinical psychologist and author of the recent book Back to Normal: Why Ordinary Childhood Behavior Is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder.



"A child may have a cluster of speech and language, fine- or gross-motor delays, social and emotional difficulties which get lumped together as a case of mild ASD. That child may actually need services to address these developmental problems. However, separate, milder diagnoses can be used such as a Mixed Receptive-Expressive Language Disorder, a Communication Disorder Not Otherwise Specified, and a Developmental Coordination Disorder, and an Adjustment Disorder.

Parents are often unaware of how a severe diagnosis like ASD can follow a child and have unfavorable effects as that child enters adulthood, such as being denied, or having to pay more for, disability and life insurance, be prevented from pursuing certain careers in law enforcement and the military, or be denied a trucking or pilot’s license in many states, as well as a host of other restrictions.

If an ASD diagnosis applies it can be effective in getting a child much needed services and lead to a child’s limitations being accepted and worked with in humane, realistic ways. If, on the other hand, the diagnosis does not really apply your child may face false life limitations and restrictions."


http://www.beaconbroadside.com/broadside/2014/04/autism-awareness-month.html

[Anonymous]

Well this twit doesn't know what he's talking about diagnoses of "Mixed Receptive-Expressive Language Disorder, a Communication Disorder Not Otherwise Specified, and a Developmental Coordination Disorder, and an Adjustment Disorder" are not necessarily "milder" and can need as much intervention and have long term consequences as ASD. Much easier to get insurance coverage with an ASD diagnosis.

Also, he's obviously not keeping up with the latest literature b/c MERLD and NOS are out of the current DSM, so his book is already out of date.

I'm also sick to death of the autism stigma. A child who presents with many autistic traits when young and gets that diagnosis should get the help they need instead of parents who balk at the diagnosis.

[Anonymous]

Thanks for informing me of all the ways my child is going to be discriminated against bc of his disability.

[Anonymous]

I don't know what this person is talking about. My dad is autistic and he's led a successful life as a short order cook, had 12 kids and has a a hilarious Instagram.

[Anonymous]

Yes, and when is OT and ST not "humane" or "realistic?"

[Anonymous]

Anonymous wrote:I don't know what this person is talking about. My dad is autistic and he's led a successful life as a short order cook, had 12 kids and has a a hilarious Instagram.

Wow, can you do an AMA thread? Autistic short order cook instgraming dad, 11 siblings. Or write a mkvie script. Sounds like an interesting childood

[Anonymous]

Anonymous wrote:Thanks for informing me of all the ways my child is going to be discriminated against bc of his disability.

I feel the same way. Sad.

[Anonymous]

How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

[Anonymous]

Anonymous wrote:How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

It's not an uncommon problem. My son was first DXd with mild to moderate MERLD. His other problems weren't apparent until his language improved. Then his perservative interests became REALLY apparent, as did his social skills deficits.

Nothing this guy is saying is new. The debate over the rate at which ASDs are diagnosed is more than a decade old. The argument over whether some kids with a DX of ASD should actually be dxd with MERLD is also not knew. Sowell's book "Late Talking Children" came out in 1998.

[Anonymous]

Anonymous wrote:Well this twit doesn't know what he's talking about diagnoses of "Mixed Receptive-Expressive Language Disorder, a Communication Disorder Not Otherwise Specified, and a Developmental Coordination Disorder, and an Adjustment Disorder" are not necessarily "milder" and can need as much intervention and have long term consequences as ASD. Much easier to get insurance coverage with an ASD diagnosis.

Also, he's obviously not keeping up with the latest literature b/c MERLD and NOS are out of the current DSM, so his book is already out of date.

I'm also sick to death of the autism stigma. A child who presents with many autistic traits when young and gets that diagnosis should get the help they need instead of parents who balk at the diagnosis.

In our MERLD Facebook groups, we have new parents coming in every almost day with the MERLD diagnosis. It's still widely being given out and it remains in the diagnosing codes for another year or two even if the DSM 5 put it all under Language Disorder. It's too bad they got rid of MERLD; it's such an exact descriptor for so many kids.

Also, I would say about 90-95 percent of the kids in our groups grow out of MERLD and learn coping skills to deal with the disorder. Many of our kids' receptive language comes in much later than typical kids, and once their receptive catches up, their autistic traits disappear. But when they are young, they have a lot of similar behavior tendencies and get misdiagnosed frequently.

[Anonymous]

Anonymous wrote:How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

Agree. I have a kid with Asperger's and ADHD. Not being able to talk/speech delay has never been a problem... He attends a Chinese immersion school (and he's not the only kid like this at the school) And yes, many people can't believe he is on the spectrum... Even on this board.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

It's not an uncommon problem. My son was first DXd with mild to moderate MERLD. His other problems weren't apparent until his language improved. Then his perservative interests became REALLY apparent, as did his social skills deficits.

Nothing this guy is saying is new. The debate over the rate at which ASDs are diagnosed is more than a decade old. The argument over whether some kids with a DX of ASD should actually be dxd with MERLD is also not knew. Sowell's book "Late Talking Children" came out in 1998.

+1, this happened to us and even the developmental ped who initially diagnosed my child with ASD agrees it is a language disorder but insists on keeping the diagnosis as he is insistent that you can have autism based solely on history. So, it remains in my child's medical records and he is treated very poorly by some doctors and others who view all autism a specific way. (then it is funny to watch them be confused at the diagnosis)

[Anonymous]

Anonymous wrote:How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

Being highly verbal is a feature of Aspergers (which no longer exists as they have lumped all kids regardless of their functioning together in a "spectrum.") A MERLD or language disorder child would be high functioning autism, not Aspergers. Many language kids are diagnosed autism, when it is not correct. The problem with misdiagnosis is ABA does not work well on MERLD or language disorders and kids need intensive speech therapy. Any behavior problems are generally associated with their frustration/lack of being able to understand or verbalize their needs and it generally gets better as the speech comes in.

Its very nice to see someone publish this and give it the attention it deserves. Then, maybe people will focus more on language disorders and kids will get the help they need vs. being given a generic diagnosis that does not represent their concerns.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

Being highly verbal is a feature of Aspergers (which no longer exists as they have lumped all kids regardless of their functioning together in a "spectrum.") A MERLD or language disorder child would be high functioning autism, not Aspergers. Many language kids are diagnosed autism, when it is not correct. The problem with misdiagnosis is ABA does not work well on MERLD or language disorders and kids need intensive speech therapy. Any behavior problems are generally associated with their frustration/lack of being able to understand or verbalize their needs and it generally gets better as the speech comes in.

Its very nice to see someone publish this and give it the attention it deserves. Then, maybe people will focus more on language disorders and kids will get the help they need vs. being given a generic diagnosis that does not represent their concerns.

I completely agree with this. I have also seen a lot of debate on here about joint attention and how some "autistic" kids have it but because they have repetitive behavior and fixations they are diagnosed ASD, when really it seems like they have a language disorder. Developmental disabilities can also cause tics and many many behaviors that look like ASD. We have been struggling with this because my kid clearly has some big issues - delayed motor and speech and behavioral stuff - but has wonderful joint attention, empathy and pretend play and wants to play with his peers. The problem is not the labeling, I would be the first to say that there is a major issues and lets call it something so we can get help -- the problem is the wasted time spent trying to make it ASD and make it so all the therapies that work with ASD are not applied across the board. My son needs intensive speech and OT, and it is realllllly hard to get that covered.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How in the world would high-functioning Aspies be mistaken for MERLD? The kids I know with MERLD are virtually unable/completely unable to talk.

Most of the kids I know who people doubt are autistic, or the autistic kids I know who people go around saying "He just needs a good spanking" are highly verbal. Some may also have an adjustment disorder. Perhaps all do. Probably all their parents do to.

Being highly verbal is a feature of Aspergers (which no longer exists as they have lumped all kids regardless of their functioning together in a "spectrum.") A MERLD or language disorder child would be high functioning autism, not Aspergers. Many language kids are diagnosed autism, when it is not correct. The problem with misdiagnosis is ABA does not work well on MERLD or language disorders and kids need intensive speech therapy. Any behavior problems are generally associated with their frustration/lack of being able to understand or verbalize their needs and it generally gets better as the speech comes in.

Its very nice to see someone publish this and give it the attention it deserves. Then, maybe people will focus more on language disorders and kids will get the help they need vs. being given a generic diagnosis that does not represent their concerns.

I completely agree with this. I have also seen a lot of debate on here about joint attention and how some "autistic" kids have it but because they have repetitive behavior and fixations they are diagnosed ASD, when really it seems like they have a language disorder. Developmental disabilities can also cause tics and many many behaviors that look like ASD. We have been struggling with this because my kid clearly has some big issues - delayed motor and speech and behavioral stuff - but has wonderful joint attention, empathy and pretend play and wants to play with his peers. The problem is not the labeling, I would be the first to say that there is a major issues and lets call it something so we can get help -- the problem is the wasted time spent trying to make it ASD and make it so all the therapies that work with ASD are not applied across the board. My son needs intensive speech and OT, and it is realllllly hard to get that covered.

Concur. I also have one of those kids who has a lot of autism-like symptoms and related issues, but three professionals so far claim he doesn't have autism. Getting insurance to cover anything has been hell. Especially OT.