Here's an article about the study talked about in your link. Small study, but 18 percent who were diagnosed at age 2 no longer met the criteria at age 4.
It's a very small study, and the design looks to me like it is subject to confirmation bias (they chose their evidence selectively and found what they were looking for). This is not yet convincing to me.
And yes, diagnosis at age 2 has historically been very difficult (and note that several years ago, when those early diagnoses in this study happened, the improved standardized tests that are now in use weren't available, so those *were* subjective early diagnoses.
Last, as the autistic author at the link I posted notes, these studies of "success" in becoming "normal" are typically not asking autistic people how hard it is to be them, or how hard it is to "pass" for normal-- only observing from the outside how successfully someone looks "normal."
There is a powerful anti-autistic bias in those studies, in the sense that they do not really take the experience of autistic people into account. Some who pass do it because they've been well trained to pass, but there remains a cost in effort to keep that up.
Yes, there is a line of thinking in the popular media about how "everyone's a little Aspie." (a term I hate, but that's neither here nor there.)
This article isn't really about "overdiagnosis" per se-- the headline is misleading. It's part of a much larger conversation that pits the parents and caregivers of severely ("classically") autistic people against the Asperger's community (many of whom are able to "pass" or "become normal," ahem, see above.) Some people want to exclude Asperger's from the definition of autism and devote all the resources available to helping the most impaired.
As we see it in our house, having a high IQ is no guarantee that autism won't be a problem. It's been a huge challenge for DS11, making his life really difficult at times, and it will continue to be so.
DeeDee I'm not sure if you're misunderstanding what I'm saying or not--I'm not telling her to go to a neuropsych vs. an autism center or what exactly an eval should entail. But I do believe there are poor centers or quacks out there who will diagnose based on superficial characteristics.
That is true. The quacks can often be recognized by the setup where the diagnosing doctor also has a cure-all treatment to sell. By contrast, in a typical hospital autism center the diagnosing doctor gets paid whether or not the diagnosis is made, they have no financial stake in treatment, and there are long waiting lists for treatment programs; the incentive is more to be correct in the diagnosis so that the right folks get on the treatment list, since everyone will earn their money regardless.
So what you say is true, BUT there are also lots of practitioners who will see a child who clearly has autism, and say "oh, he's just quirky." Or "oh, he's just gifted/has overexcitabilities." DS11 lost several years of early intervention because of several doctors' failure to diagnose what was very clearly there.
In my family's experience (which is extremely rich and varied around this issue) overdiagnosis is less harmful than underdiagnosis. In the case of overdiagnosis, a *good* therapy team will still base treatment decisions on the actual problems to be solved, so there is relatively little harm. Whereas in the case of underdiagnosis, the child and family get no help whatsoever.
Your characterization of being "slapped" with an autism diagnosis makes it sound like diagnosis is always bad. In our case, it brought much-needed therapeutic help that we had sought for years. Not so much a slap, more like a support.
I am not saying rah-rah, let's diagnose everyone-- but I do think the likelihood of underdiagnosis is greater for gifted kids than that of overdiagnosis, and I think that if parents seek help from reputable professionals who are using evidence-based practices, the risk of harm from seeking diagnostic information is small.
I think since this is a "spectrum" there is a gray area and there is no consensus among professionals about how to define that and who in the gray area should be diagnosed. A "good" center should be able to do it accurately in an older kid over age 2 or 3 but it's not a hard science. So much is subjective.
My point is this: there is not "no consensus." There are now standardized instruments (most notably the ADOS) that let you get a handle quantitatively on the behavior presented by the child. Yes, it's a snapshot on that day, and yes, there is still some interpretation, but much less so than there used to be.
Nobody has to get their child diagnosed who doesn't want to, but stigmatizing diagnosis itself as a slap or a problem strikes me as not a very helpful position vis-a-vis parents like ElizabethN whose kids have problems that are not yet well-understood, yet real.
