How to Solve a Problem Like Allen Frances?

Allen Frances is at it again, for some reason I can't generate the link but it's in todays New York Post.(.http://www.nypost.com/p/news/opinion/opedcolumnists/america_false_autism_)

So I thought I'd drag out an old post, as it is still relevant in addressing the tripe he keeps dishing up.

This article  http://www.project-syndicate.org/commentary/frances1/English had me seething. The author, Allen Frances, is a psychiatrist and was the chair of the DSM 1V task force. A quick google search also reveals several controversial articles he has had published in the last year or so about the current revision of the DSM.

I suppose it was to be expected he would have ASD in his sights. Being a spectrum disorder it is easy to make a flimsy argument that the perimeters are now too broad and kids who are simply shy or quirky are being falsely labelled as Autistic. (I know Mr Frances is not the only person spruiking this idea) The proof of this, he suggests, are the ever increasing amount of children, and adults, being diagnosed (dx) with an ASD. He goes on to suggest this increase in numbers is being driven by parents who are becoming informed about ASD and it's various symptoms via the internet. And the motivation for parents wanting this life long disability dx?  Apparently it's de rigueur. The trendy thing to have.  And as an added bonus apparently your child then gets access to "expensive school services".

So how do we scheming parents manage to fool the speech therapists, developmental psychologists and paediatricians into giving our perfectly normal offspring this groovy label? Well he doesnt explain that part. So we are left with nothing more than the claim. No evidence, no research, not even an example.

Would any parent really want this for their child (Munchausens by proxy anyone?) or conversely would professionals really be willing to diagnosis a child with Autism with no clear  evidence of neurological abnormality?  Are there really that many kids walking around misdiagnosed with Autism and Aspergers that can account for the increase in numbers?

Frances states "A second possible explanation for the explosion in Autism is that previously missed cases are now being more accurately diagnosed. This is probably a factor, but again only a minor one."

How curious. Greater understanding of how broadly ASD presents, despite there being clearly defined criteria in the DSM would most certainly account for the increase.  As would better assessment tools. In fact I am sure it is the major reason for the increase in numbers. Having recently finished Roy Grinkers 'Unstrange Minds ('http://www.unstrange.com/unstrangesummary.html) in which he convincingly outlines this theory, I am of the mindset that we are certainly getting better at identifying Autism, and therefore are now correctly diagnosing those who were once thought of as obsessive, neurotic or psychotic,  amongst other incorrect terms.

In fact at the very beginning of the article the author says that the sharp increase in diagnosis occurred directly after the publication of the DSM 1V. Surely this supports the above notion of increasing understanding leading to increasing identification?

He also states that the "fear of Autism is so great". If this is the case why are parents demanding their children be diagnosed as Autistic? There seems to me to be some inherent contradictions in the article.

The problem I see with someone in this mans position espousing this idea of Autism being the latest "fad",  is the impact not just of invalidating what all us parents and our beloved children live with each day, but the potential to add doubt into the minds of the public and those authorities who have the power to make service funding decisions. The fact is whether Allen acknowledges it or not, there is a woeful lack of  services available to Autistic people and their families, any reduction in these could be catastrophic. More importantly professionals who are charged with the responsibility for diagnosing ASD may begin to apply stricter or narrower criteria thus leaving vulnerable children without access to necessary early intervention services and support.

Frankly, this article hurt me. I cant help wonder if my son would be one of those children he refers to as quirky but essentially normal. Never mind he can't tell you red from green unless it's on a traffic light. The fact he has constant need to try to control his environment to avoid anxiety. That he cannot communicate effectively despite being verbal. That he needs structure to his day and help to even play otherwise he is overwhelmed.  That he is interested in other children, but really has no idea how to interact socially. That he does not sleep well.

Now Allen may well say if my child has all the above issues, then he clearly falls on the spectrum and is therefore not the kind of kid he is referring to in the article. But the thing is I have never met another child with ASD who was not as least equally affected by Autism as Harri, and in most cases much more so. So where are all these quirky misdiagnosed kids he speaks of? Where are they hiding? If it is so cool to have a child with Autism that parents are insisting on the diagnosis, thereby creating skyrocketing stats, where the hell are they? I have never met or heard of an Autistic child who was not affected deeply by their neurological wiring. Are some quirky? Yes sure they are. But the manifestation of ASD in each person cannot be faked. Not for any sustained length of time anyway. Mr Frances should know that.