How many kids out there

[Anonymous]

have an Asperger's or HFA diagnosis that's not really correct? I've read a few of Stanley Greenspan's books so I'm basing this on his definition(s). Some of the so-called "spectrum" kids I'm meeting have WAY too much emotional affect to actually be autistic. It's clear they have some delays, but these kids are walking around with ASD diagnoses which are a pretty heavy burden. I get it that they need a diagnosis to get the services, but at this rate I'm starting to understand why some people say autism is over-diagnosed. A lot of these kids are going to "recover" somewhere in late childhood. What's going on?

[Anonymous]

I agree PP. I think a lot of docs see kids with SPD and apraxia and say "spectrum". It's also a way to get services.

[Anonymous]

What do you mean by "emotional affect"? I do agree that ASD is over-diagnosed...the spectrum is huge.

[Anonymous]

OP here. This is copied from elsewhere, as it describes it better than I could in my own words:

The effects of emotion directly influence much of the way we perceive our everyday lives, affecting how categorize information, make decisions, evaluate risks and solve problems. (Isen 1999) Within emotional research literature, the term used for the way that emotions affect cognition is “emotional affect“. Emotional affect is the term for emotional reactions that have a high probability of producing changes in awareness, facial expression, body language, physiological function, and behaviour. These reactions change the way we process information and perform tasks, depending on whether the conditions are perceived as positive (e.g., supportive, caring,) or negative (e.g., threatening, punishing). (Hayes-Roth et al 1997) Affect can be differentiated from cognition because it tends to influence motivation and arouse feelings, whereas cognition is concerned with facts. (Cacioppo and Petty 1989)

[Anonymous]

OP again. I'd like to make clear that I'm CERTAINLY NOT intending to come across like I'm blaming parents for accepting this diagnosis. So if I did come across that way, I apologise. I there's such a gigantic scare about autism nowadays that kids with any kind of delay are being labeled (by the school system) as "autistic-like" or "on the spectrum" in a pretty irresponsible fashion. The "autism spectrum" has expanded so broadly that the clinical definition seems meaningless.

In my opinion, of course.

[Anonymous]

I'm not a psychologist, so don't completely understand what you are trying to get at with "emotional affect." My son is very low-functioning, completely nonverbal, has no communication skills at all. Yet, he's emotional. He gets mad if something's out of place or routine is changed. The difference for us is that emotions are not tied to social interaction but are more about changes in environment or routine. We take my husband's car to school? He freaks out. His boxes are not in the right hand corner of the living room? He freaks out. He's mad, he grimaces, he whines, he rocks.

He also occasionally even enjoys hugs and he smiles. And/or makes noises showing content. Nowhere near like an NT child would. But it's there. I don't have much exposure to high-functioning kids, but I would assume they can have a wider range of appropriate emotional responses to things.

[Anonymous]

Anonymous wrote:OP again. I'd like to make clear that I'm CERTAINLY NOT intending to come across like I'm blaming parents for accepting this diagnosis. So if I did come across that way, I apologise. I there's such a gigantic scare about autism nowadays that kids with any kind of delay are being labeled (by the school system) as "autistic-like" or "on the spectrum" in a pretty irresponsible fashion. The "autism spectrum" has expanded so broadly that the clinical definition seems meaningless.

In my opinion, of course.

I really agree with you. I don't even have a solid understanding of what the PPD-NOS/HFA diagnosis is anymore, because it seems to include everything.

[Anonymous]

As OP shared, I am also slowly becoming a fan of Dr. Greenspan's view that we need to focus more on addressing a child's specific needs (sensory processing, auditory processing, attention, etc.) rather than label every other child 'ASD' or even 'PDD'. Addressing the labels will not assist a child, but rather parents and their physicians/therapists working on the child's 'symptoms' would be more productive.

[Anonymous]

Anonymous wrote:As OP shared, I am also slowly becoming a fan of Dr. Greenspan's view that we need to focus more on addressing a child's specific needs (sensory processing, auditory processing, attention, etc.) rather than label every other child 'ASD' or even 'PDD'. Addressing the labels will not assist a child, but rather parents and their physicians/therapists working on the child's 'symptoms' would be more productive.

My child has all of the above; ADD, SPD, dyslexia, and social problems (hence PDD)... at least we have several places to intervene rather than one blanket diagnosis

[Anonymous]

The spectrum is very broad. Many, many children have emotional affect, yet still meet the criteria for the spectrum. Be wary of Greenspans definations. As you will note, there is no scientific data to support his interventions.

The diagnosis is less important than jumping onto an intervention asap. And with the proper intervention, many children can recover from some of the symptoms. It is not a "cure" but if many of the sympoms are addressed, they may not appear to have the diagnosis any longer.

[Anonymous]

I was talking to a speech therapist about this...she said the HFA diagnosis is almost meaningless now because it is so broad, but it enables children to get treatment that they need. I've been reading about PDD-NOS and it's so confusing...if a child has some very mild symptoms of autism that only show up in the school or neighborhood environment, they can be diagnosed on the spectrum. I worry that every "quirky" kid is being diagnosed...but at the same time, intervention can only be beneficial.

[Anonymous]

I thought that Greenspan did have research supporting his DIR approach?

[Anonymous]

My son was evaluated by FCPS child find and found eligible for services based on autism. I don't really think he has autism, nor does his pediatrician. He definitely has a lot of quirky traits and difficult behaviors, but he is talkative and often socially engaged - very self-directed, though. His pediatrician is an older man who has seen a lot of kids in his career. Many come in between 2-5 y.o. with autistic-like characteristics that fade as the child matures. We went ahead with services, which was the right decision, but I'm really uncomfortable with the autism label and hope it doesn't hinder his classroom placement in grade school and beyond.

[Anonymous]

In FCPS a child does not need an autism diagnosis to qualify for services under the eligibility of autism. The child just needs to meet the requirements (which includes impaired verbal/nonverbal/or social skills that impedes his ability to access the general education curriculum).

[Anonymous]

Yes I believe Greenspan thinks too many kids are being diagnosed with ASD when they are clearly not.

Gaps in processing usually signal a regulatory disorder or something else. When the social affect is lacking or compromised, when subtle social skills are not read properly, when there is a lack of a range of emotions, then you should see Greenspan and he may give you an ASD diagnosis.

Most ASD kids are pretty rigid and inflexible and get pretty angry in various situations. Regulatory kids can get like that too. But what Greenspan means is that ASD lack the RANGE of emotions - from angry all the way to being able to express intimacy, joy in relating, happiness with interacting with another person. Regulatory kids can do that, but ASD kids are not able to do that so easily.

Greenspan alluded to the fact that many kids seen by big name autism clinics are also being diagnosed incorrectly. I agree with this too. They are having a tough time distinguishing between regulatory issues and ASD.

However, lots of parents want an ASD diagnosis so they can get insurance to cover for therapy as most therapy for regulatory issues are not covered.