When a doctor over-diagnoses autism

N0036342 Doctor signing letter

Image by wellcome images via Flickr

There are plenty of theories as to why autism numbers have sky-rocketed over the past few decades. Opinions fall into two broad categories: Either the increase in autism is real (usually placing the cause on environmental factors such as toxins and vaccines), or the increase is largely one of changes in diagnosis (due to such things as broadened diagnostic criteria and increased awareness). One of the possible factors increasing diagnosed numbers, is misdiagnosis – particularly over-diagnosis. Misdiagnosis could be due to diagnosis by those without credentials (such as self-diagnosis by lay-people), but misdiagnosis can also be by those with the correct credentials (such as developmental pediatricians). I’m going to share a story about an example of the latter. I want you to help me make sense of it.

There is a particular doctor who is well-known in the local autism community, for being the “go-to” guy when you can’t get anyone else to confirm that your child has autism. (Hear alarm bells going off already?) I’ve personally heard and seen his name recommended to others in that capacity. It should not be surprising then that I recently came across a very confused and upset parent, who was told by this doctor that her son has autism, when she sees no convincing evidence of it in her son at all. She’s attended seminars and such like after the diagnosis, and though all the other parents around her showed agreement and recognition of the autistic traits spoken of, in their own children, she found no such recognition about her own son. Needless to say, she’s decided to seek a second opinion (and on her description of her son’s behaviour, I think that is a wise course of action).

This doctor has also apparently shared the opinion that all gifted children have Aspergers, so if you were to take your gifted child to him, chances are pretty good you’re walking out of there with a diagnosis of autism too. I’ve seen this doctor particularly recommended to people who were keen to get government paid financial assistance for their difficult child. This same doctor is also known for being a bit too fond of medicating children, where other pediatricians are far more reluctant to fall back on medicating the young.

He’s not cheap either, if you don’t approach him through the public system. You’re looking at almost $400 for an hour session, which is all he requires to make a diagnosis. (I should perhaps add that my own son’s pediatrician only saw him for an hour before making a diagnosis, but my son had classic autism, and it was an easy and obvious diagnosis for every professional he has interacted with. If his autism was less severe at the time of diagnosis, I would have expected longer or multiple sessions. And his pediatrician has seen him many occasions since then too of course.)

All of this is hearsay (even though I’m reading these things on multiple local forums, and his name and reputation is well-known in the autism community). From what I can see, he is qualified and respected in his field, though I admit that I wouldn’t know where to look to find evidence that he wasn’t. I do not know whether there are any checks and balances on over-diagnoses either – perhaps there are and he has not being found to be over-diagnosing via those systems, I just don’t know. And so I’m not sharing his name or his practice. But I am nevertheless sharing this story, because I think it raises some interesting and important talking points.

One such point is the question of under-diagnosis. There is absolutely no doubt that many people who do have autism, are going undiagnosed, or wrongly diagnosed – there are an abundance of such stories and experiences splashed across the net, and I’ve seen it myself more than once. Maybe this doctor is just receiving the tougher fringe cases of autism – the ones missed by all those other practitioners who couldn’t give the parents the answers they needed.

If he is just keenly aware of autism, and sees it in people in its less obvious forms, is he perhaps revolutionary in his own understanding and perception of how widespread autism is? Should he therefore be seen as a hero, rather than a villain (a villain for confusing, upsetting and misleading parents, and for helping people to get scarce financial assistance when legitimate cases are struggling to get their “piece of the pie”).

Another question is whether there is anything wrong with him helping parents to get that financial assistance? If he sees worthy and needy parents, and he knows how to work the system to get them the support that he sees them in need of, then he is arguably a hero for cutting through the red tape for them (I should add that he does work in one of the poorer areas of the city).

My concerns here go beyond rorting the system, and misleading parents. Overdiagnosis also feeds opinions like those of Michael Savage and Denis Leary. That is, that we’re seeing huge numbers of people diagnosed as autistic, who aren’t really autistic; who just have parents seeking to place the blame for bad parenting elsewhere, and who want the extra money and resources that the government provides to families with diagnosed children.

My instinct is to see this doctor as a man exploiting desperate parents, for the money that comes with a diagnosis (either being paid by them directly or by the State which pays for their visits). It’s hard not to be cynical when you hear that he supposedly thinks all gifted children have Aspergers. But why would he risk his practice and reputation for the sake of more patients (and money)? Well it’s hardly inconceivable that a doctor would do such things (recent local news story as case in point).

So with limited information, but plenty of clues to “something” going on, I put it to you: If (and that is a big “if”) this doctor really is over-diagnosing autism, does that make him a hero, or a villain? If he is over-diagnosing, is he just a cog in the wheel of a messed up system that makes it too hard to get support, or is he part of the problem itself?

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28 Responses to When a doctor over-diagnoses autism

  1. Melissa says:

    I have to say I’ve seen less evidence of overdiagnosis as underdiagnosis. Especially in the older generation of pediatricians. The attitude that “he’s a boy” “he’s just a slow developer”, or just really not being up on milestones is pretty rampant (and in at least 3 pediatricians that I can think of offhand). The need for early intervention isn’t particularly understood (at least in practice) by certain people in say, my in-laws’ generation… nor by certain pediatricians who came out of that generation, at least not in practice. They can see the benefit to it, but not really the theory behind it.

  2. mamafog says:

    I have not seen much over diagnosis either, and I’m not sure what the harm is, if the child is getting services that help. If the child does not have autism, but other delays I would guess they would respond very well to therapies, and maybe “graduate”.

    Here it is common to get a diagnosis of PDD-NOS from the local regional center. They don’t often (if ever) give the dx of autism, because then they are on the hook for services beyond age three. Most everyone then goes to a developmental pediatrician (there’s really only two in the area) and then they get the dx of autism and go back to the regional center for a change in dx.

    I have seen parents who don’t take the dx of PDD-NOS from the regional center as a serious issue and then do nothing, waiting losing years that their child could have been helped.

    I’m no expert, but I can see that many gifted students have spectrummy traits. My husband was a gifted student, and we both agree if he was a child today that he would be diagnosed with Asperger’s or ADD. The things his mother told me that the parents of gifted children were told as advice to deal with them, were basically letting them use their intelligence as an excuse for bad behavior. I’d like to think things are different now. But if kids in gifted classes would benefit from some of the things learned from autism therapies – shouldn’t they be offered these advantages?

    • It’s important to accurately identify what condition (if any) a child might have. If a child doesn’t have autism, but has some other condition, then that needs to be dealt with accordingly. Handing out autism diagnoses is not just an issue of over-diagnosis, it can also be misdiagnosis. Of course, treatments aren’t free either, and there aren’t enough services available for the children who need them most, it seems ill-advised to burden those services with children who don’t actually need them, but might benefit from other interventions.

      If a gifted child is acting up or behaving badly, or whatever other issues might be going on, parents (and those children) need to be taught how to deal with that appropriately: The therapies for autistic children are not going to be appropriate for any and every behavioural issue.

      I was a gifted child, and regularly put in gifted classes, but for all the tests and questionaires I have taken to see if I have any “autistic traits”, the fact is I really don’t. I am not autistic, not even slightly. In those gifted classes (some of the other students in those classes have gone on to do some very impressive things at university and beyond), no one had quirky repetitive behaviour or the inability to understand nuances of verbal or social communication. One girl had dyslexia, that’s about it. I’m not saying some gifted children don’t have Aspergers, of course they do. But there is no necessary link between genius or giftedness, and Aspergers. I’ve written a previous post on this topic that you might find interesting: “Intelligence, Autism, and Genius“.

      Thanks for your comment, it raises lots of interesting and important issues.

  3. Jack says:

    One our first visit back to the pediatrician after our sons diagnosis of autism we saw a locum. The first question the locum asked us was ‘Do you think the diagnosis of autism was right?’
    My wife and I looked at each other, looked back at the locum and said nothing. I finally stammered out, ‘I think so’. After the appointment we both were very confused and a little angry that a specialists would throw these sort of questions around.

    • It does seem to be in poor taste for a specialist to ask a newly diagnosed child’s parents, whether the parents think the diagnosis is correct! Isn’t that their job – to get it right in the first place, and to otherwise to up-front if there is doubt? I do respect when specialists openly admit to uncertainties – especially when they say more observations and time will be needed before a diagnosis can be confirmed. But planting seeds of doubt as a family is coming to terms with something as serious and life-changing as autism – where there is no reason to doubt and the family hasn’t expressed doubt – is in an other category.

  4. Bulldogma says:

    As with anything else, we may see a societal shift in favored diagnoses. So many times we have seen the over-diagnosing of ADHD or ADD and the child is put on medication which basically turns them into a partially-comatose, zombified organism at school and makes them easier for incompetent parents to handle.
    Just as some doctors get stuck in a rut believing that every child is “fine” and “normal,” there can be those who see “issues” where there are none. Neither end of the spectrum is a good thing. We had to jump through hoops to get a proper diagnosis of Aspergers for our daughter simply because few doctors were familiar with how the symptoms differ in girls. It took years, yet interestingly, when we had her observed in school in preparation for her IEP meeting, the school therapist witnessed subtle stimming behaviors the entire day! (Hair twirling, chewing on hair and clothing, rocking, foot tapping, etc.) The therapist wondered why it had taken anybody this long to do an IEP.
    We also have to remember that any misdiagnosis throws the statistics, making it even harder to look for variables associated with true cases of autism. Sure – some accidental misdiagnoses will happen, but to have a doctor that is stuck in a rut and seeing things that do not exist… that’s just bad practice in my opinion.
    *Great post! Very thought provoking!

  5. Jenn@FFP says:

    It’s easy to pass judgement on a situation we have no personal knowledge or connection to but I’d like to think the increase in Autism numbers is due to more research and awareness and not some dubious intentions of bad doctor. The problem with accurately diagnosing ASD is there is no litmus test for it! Of course more severe cases are easier to pinpoint than mild cases but I’d like to think a doctor (who is bound by his oath of “do no harm”) is earnestly trying to help people.

    Doctors and parents need to work together instead of one leading the other. Both bring valuable knowledge to the table when it comes to the welfare of the child but it’s ultimately the parent’s responsibility to do what’s in the best interest of their child. If a parent feels a doctor has mislabeled, misdiagnosed or over (or under) medicated their child, then it’s a parent’s duty to their child to seek a second, third, or even fourth medical opinion. We may not be medical professionals but we know when something’s not right with our kids. We need to grab the bull by the horns, so to speak, and never quit seeking out the answers that will help our kids and our family.

    Truth be told, you never know how you’re going to deal with the diagnosis until you get. We knew something was wrong with my oldest son for years but no one ever thought ASD. Everyone assumed it was a learning disability but nothing was helping. The situation kept getting worse but the pediatrician kept referring us back to the school for intervention (since the biggest problems were slow academic development) and the school kept altering his IEP. No one was dealing with the big picture. Only until we moved to a different state did the “A” word come up. I had to do lots of research since my only exposure to Autism was the movie “Rain Man”. It took tons of testing in a variety of areas and a team of people to come up with his diagnosis: high functioning Autistic. Regardless of whether he REALLY has ASD, the therapies we’ve used as a result of this diagnosis are working to make his (and our) life better. I no longer feel like a fish out of water when trying to help him with his school work or getting him to do his chores or clean his room. We have all learned how to quash melt downs, tricks to help him remember social ques and skills to help him inside & outside the classroom. He is more self confident and aware of the people around him. It’s a life long journey we all will travel but at least we are now traveling with knowledge.

    I apologize for the long comment but I found your post interesting & had to put in my two cents! 😀

    ~Jenn

    • Hi Jenn.

      Don’t apologize for the long comment, I found it very interesting!

      And I do agree that the increase in autism numbers is significantly due to other factors, such as broadened diagnostic criteria, increased awareness, and changes in how co-morbid conditions are categorized. There is strong evidence to support those factors as the cause for the increase, these two posts from Neurologica Blog are a good introduction to understanding the increase: http://theness.com/neurologicablog/?p=3079 and http://theness.com/neurologicablog/?p=2224#more-2224. (I’m tempted to do a general post about the causes of the increase in autism numbers, there is a lot of misinformation and confusion about the issue out there.)

      I agree too that if the therapies used with a child, helps the child, then that is absolutely of vital importance, and indeed lends weight to the idea that the diagnosis was correct in the first place. (There are still very good reasons though for making sure the diagnosis is still the correct one (such as the reasons mentioned in my post, and by the previous commenter), but I do know you’re not arguing against the importance of correct diagnosis.)

      Thanks for your comment! 🙂

  6. KDL says:

    No one is doing anyone any favors by over-diagnosing a child. I wonder if there is any difference because of the way your government handles services. I would *guess* (and I don’t know if there’s a way to accurately measure it) that here in the US there is more trouble with under-diagnosing children with autism. Most parents do not know about the services that are available, and unless their child’s symptoms are severe enough to be recognized by themselves and/or a medical professional before age 3, they will generally not receive services until the preschool years. Generally those services are limited to those particularly related to education, not community inclusion. In order to receive more social services beyond the age of three, your child has to be in the bottom 2% of daily functioning skills. There’s no support or funding to attract a parent to the autism label, there’s just lack of information and stereotypes pushing parents away from seeking a diagnosis.

    • Very interesting thoughts there KDL, and yes, I think you’re absolutely right that over or under diagnosis is definitely influenced by a country’s resourcing schemes, as too by cultural and societal differences, and variations in attitudes towards autism. I’ve been reading a lot lately about differing trends of autism diagnoses between countries, and the reasons for those differences. It’s an interesting topic that I’m working towards writing a post on (when I get the chance).

  7. Mary says:

    I am an autism teacher in a large, poor urban school district on the west coast and I have to say that we have a TON of overdiagnosed kids from the early intervention level through elementary school. I’m not sure if my city is similar to others out there, but we really seem to have a major problem of overdiagnosed kids. It really has become an epidemic around here and I have to say that it sickens me the way these people around here, who call themselves professionals, give out these diagnoses like free candy. Diagnoses that are literally based on 15 minute observations, or NO observations at all and parent report only, kids with behavior issues only (behavior issues that stem from documented dysfunctional families, neglectful parenting, or documented PTSD), kids with only communication delays, etc…We will receive reports from doctors that actually say “I THINK the child has autism” or “this child seemed shy and also tends to tantrum, therefore PDD seems like the most appropriate diagnosis.”…. A doctor should never give a diagnosis that they are so unsure of that they “think” it is accurate. We also have some parents who try and push for the diagnosis because it is considered a lifelong disorder and will qualify them for SSI that they would not have received otherwise…..& I have heard some parents actually admit this & while it seems very noble for a doctor to give out this diagnosis for the purpose of allowing the child to receive additional services, what people fail to understand is if you oversaturate & overpopulate a public school program with a mixture of kids who actually have autism and other kids who just have behavioral issues, the quality of those autism services that were at one time fantastic, are now thinned so much that they are no longer beneficial for ANY of the students & the students taking the fall the most are the ones who actually have autism-they are no longer benefiting from these programs because they are now sharing classrooms with triple the amount of students, many with disruptive behaviors & no symptoms of autism. I think these clinicians need to spend more time giving thorough diagnoses and also more time advocating for programs that meet the needs of these other children with behavioral issues and communication delays.

    • Thank you for sharing your experiences and those comments Mary. I think it’s particularly important to hear from people at the front lines like you are, seeing the run-on effects of over-diagnosis.

      I just want to add too how much I respect teachers like you who work with autistic children, and who are so passionate about making sure our children get access to the help and services they need.

    • Misdiagnosed says:

      I’m someone who has been misdiagnosed with Asperger’s Syndrome.

      I come from a highly dysfunctional home. Both my parents have/had Narcissistic Personality Disorder and other major psychiatric problems. Both parents bullied me, emotionally and physically abused me. I was the family scapegoat. I have a high IQ. I also have a congenital neuro-optical problem that caused me to have poor gross motor coordination as a child and mild dyslexia. My competent MD wrote a report and explained *exactly* what I needed to succeed. He explained to my parents that, as my brain matured, I would “grow out” of nearly all the problems. (I’m mildly dyslexic and I don’t have depth perception. That’s it.) Instead, my parents listened to a quack, who prescribed completely useless, expensive and abusive treatments. He advised my parents to have me participate in a sport that I have absolutely no talent for. My nutcase mother took it to extremes, and I burnt out. I had problems learning social skills, because my parents had/have poor social skills and are reclusive. My mother was so “happy” when another quack “diagnosed” me as having Asperger’s Syndrome. My mother was happy with the diagnosis, because she could throw yet another pity party. I was fortunate that my maths teacher advocated for me, because Special Ed was the absolutely wrong place for me. My parents had a history of choosing to send me to inappropriate or substandard schools.

      As an adult, I have a friend who is a school psychologist. Part of his job is to evaluate children who have been diagnosed with Asperger’s or Autisim. Whenever he does a work-up on one of these children, he makes it a point to remember me. He’s worked-up children who come from abusive homes and who are definitely “on the spectrum”. However, he’s worked-up children who’ve had pushy parents, parents who are trying to game the system (especially Social Security Disability) and have abused their children to the point they have Asperger’s like symptoms due to extreme stress. The problem with the DSM-IV definition was that most highly intelligent, nerdy kids fit it–and it is a real problem for intellectually gifted girls who are into science or maths. This problem has been discussed on at least one gifted web site. I feel compassion to the parents with truly disabled children, who have to fight like the dickens to get the help their children are entitled to. However, I hope that, one day, parents who intentionally abuse the system get referred to Child Protective Services. I hope that, one day, Child Protective Services would take emotional abuse seriously and remove children who are being severely emotionally abused from their parents (like me, when I was a kid).

      • Ashley says:

        Your childhood sounds nearly identical to mine. My stepmother met my father while he was still married to my mother, and about a year after my parent’s divorce my father was remarried to my stepmother. Although the details are a bit murky, it’s believed that my stepmother played some role in their divorce. A few years into their marriage, around the time my younger sister was born, my stepmom became convinced that I had high functioning autism (I was 5 yrs old). My own parents were very emotionally distant at that point and preoccupied with their own ambitions, so they didn’t care to be involved in my childhood. My mother gave up custody when my father remarried, and was enjoying her freedom and social life; and my father was in college, and working full time as an apprentice. My stepmom became mentally and physically abusive, and began to make a lot of claims about my mental and physical health that were either exaggerated or otherwise untrue. I was told I had allergies that I don’t have, and I was also told that I had no social skills. I was taken to three or four specialists. The first couple said I did not have autism, and the fourth gave a somewhat strange partial diagnosis. The fourth specialist spoke to me for about five or ten minutes, and then met with my stepmother for close to an hour. We left with a diagnosis that said I had poor eye contact and a slight stutter; so he concluded that I had characteristics of autism, but wrote that I would grow out of them by adulthood. It’s too bad he couldn’t observe me at home, because he might have noticed that in addition to poor eye contact and a trembling voice, that I also flinched around certain household objects from being beaten with them so often. But, i never dared to tell anyone I felt mistreated, because my stepmother threatened me that she could convince others that I was insane and needed to be committed to a mental institution (and the scary thing is, is that I believe she could have).

        I’ve come to the conclusion that some parents look for any possible mental or physical problems in their children that they can exploit to get attention, endear themselves to their spouse, and feel a sense of control that comes from deceiving others. Perhaps I am on the spectrum; I am intellectual, shy, and I have a lifelong love of reading fiction. But I have no sensory integretation problems, problems with eye contact (outside of abusive or demeaning situations), problems reading non verbal cues (I’m actually extremely sensitive to any perceived slight), and problems with empathy (the sight of any person or animal in distress usually brings tears to my eyes). The problem that I have with diagnosing autism in children who are very shy or who have suffered abuse; is that a diagnosis of a developmental disability, that is defined by problems with social interaction, is going to compound all of their existing self esteem issues. At least that’s been my own experience. I have a lot of problems trusting others and feeling safe enough to be open with others, and at the same time I fear that I might have a disability, because of everything I was told in my childhood. It just makes me feel like I’m less than human. Telling someone that there’s something wrong with them makes them feel like they’re defective, and are not worth having a relationship with.

        I do believe that there are cases of high functioning autism in the general public that should not be disregarded or overlooked, but I also feel that the parent’s motivation should be examined as well for possible cases of Munchausen by Proxy. Especially in situations of step parents, guardians, or foster parents seeking a diagnosis. I think it is easier in these situations for the parent figure to view the child as an extension of themselves, and as a means to gain attention and sympathy for themselves. It’s far easier in these types of situations for the child to become a scapegoat. I also think these situations occur a lot in borderline parents, so the motivations of the parents is just as important a part of the diagnostic process. I also think that there needs to be a threshold for autistic behaviors, because a lot of these behaviors are highly subjective, and occur quite often in the general public. Everyone will have one or two interests that they become experts in, how else would a graduate student find the ability to focus for long periods of time on one subject? Autistic characteristics need to be put in some proper perspective. Labels, especially ones that are not appropriate to the child, can be extremely painful to overcome and should not be given out so liberally.

      • Ashley, you’re dangerously close to the old and unambiguously disproven theory that abuse and parental issues cause autism. It is a false idea, and one that has done extreme damage to many families. I’m sorry for the pain and horror you’ve been through, but you’re casting far too wide a net in suggesting that an autism diagnosis should be accompanied by considering the guardian’s (etc) motivations: A child either has autism or they don’t, their parent’s motivation is irrelevant to that. I also get the impression you are confused about what is required for an autism diagnosis, from what you think is required for it and from your description of how easy and subjective you think it is to get one. If you have genuine concerns in this area – and not just concerns that arise from your own past – you may be interested in doing research into the changes being made to the autism diagnosis under the DSM-5 this year, which is another topic I have written many posts on.

        Again, I’m sorry you’ve been through hell,, but the general attitude and views you hold and promote here, just encourages innocent and needy families to go through their own hell too.

  8. Kristi says:

    I think if a parent is taking a child looking for help with behavioral issues, casting those problems asside as bad parenting because they may not be autistic is not helpful and quite mean spirited. We are not all experts in autisim. We take our children for help because we love them and we want what is best for them. Not one person is the perfect parent; Bo doctor is the perfect doctor. We do the best we can. Please dint make us feel bad for seeking help and answers.

    Concerned Mom

  9. buddy roe says:

    Overdiagnosis for sure! I’ve seen so many parents and their children pull the IEP card or the autistic card if they’re kid can’t perform well academically. As a former teacher, the kid would tell me, “I’ve got IEP,” and then ask if that meant they could take a different test. If they didn’t like it, they would drop out and start at another school. Well, sorry, but standards are standards and all kids are not as clever as others. Somebody has to finish in last place. When I was coming up, we weren’t so sensitive about the fact that some kids are brighter than others. But maybe my military experience where excuses are not tolerated and standards are enforced is at play here. Trying not to get killed in Iraq made me realize how soft and wussy our kids are, compared to children in the underdeveloped world.

  10. Anxious man says:

    I would like to share my story why right diagnosis matter (my English… sorry):

    This is interesting stuff. One psychologist who happened to be ASD specialist as well and tried to diagnose me with ASD. Well, I was having terrible anxiety episode. I couldn’t speak what went trough my mind. She was twisting my replies to make them fit into the spectrum. It just increased my anxiety. I don’t think it was intentional but this kind of stuff happens when your professional life revolves around it.

    Extreme social anxiety makes you unable to speak clearly, your eye contact will suffer significantly, your short term memory will be next null etc. Things that you see in ASD as well but only very superficially similar. I was in very desperate state and started to believe in it. It sounded like I was doomed and I was becoming seriously suicidal because of it. My anxiety worsened quite a bit. It was hell. I met another expert later who said that I basically have extremely bad anxiety disorder and no developmental disorder what so ever. It saved my life. I’m on a right track for better future.

  11. Sara says:

    “…want the extra money and resources that the government provides to families with diagnosed children.”

    Would you please expand upon this comment? We’ve been trying to get help for years and have not been able to receive a penny in assistance. Our daughter (diagnosed 6 years ago) was turned down for SSI and Medicaid because we make enough to pay our bills. Our insurance doesn’t cover much of what she needs and what they do cover still leaves us with thousands of dollars in yearly medical bills.

    • The extra support is the opinion of doctors in the field, read “Unstrange Minds” if you haven’t already, some of the relevant parts of the book are highlighted in my other post: https://autismandoughtisms.wordpress.com/2011/07/22/ill-call-a-kid-a-zebra-recognising-fashionable-autism/
      As to Medicaid and SSI, I’m completely unfamiliar with those systems since I am apparently not from the same country as you, you’d have to expand on what they are and what is required to qualify before I could make any sense of that point.
      I’d also point out that I am familiar with an untold number of stories from other parents and professionals that a diagnosis was key to accessing real services, you’re the first person I’ve heard of who thinks it’s entirely irrelevant to service provision. I’m sorry you’re finding it so hard to get services, but it’s quite a leap to say that that therefore a diagnosis makes no difference for everyone else (which is simply untrue).
      I hope you get the help you need soon. I recommend doing a search to find a charity or service provider in your own country, who might be able to help you.

  12. Anton Agnew says:

    This was an interesting read and resonates with me as my nearly 3yo. daughter has just been diagnosed with Autism after a 1hour, $400 consultation with a well regarded Devolpmental Paedetrician and I’m struggling to see how he arrived at this diagnosis. Is there any chance you can email me the name of the Paedetrician you are referring to?

    • Hi Anton, I’d feel more comfortable telling you a yes or no answer to the name you give, rather than just giving you the doctor’s name. But yes, with that proviso I am willing to email you, and will do so within the next day.

  13. Alex says:

    I have a concern over an in- law. She seems determined to have all of her children diagnosed with Autism. She has been to several different doctors before finally finding one that would render her the results she wants. She seems to know all the right things to say, almost like an online check list. No one has seen these behaviours in her children. My wife is a teacher and deals with autistic children and does not see the same traits in this persons children. It’s really frustrating when I see how hard it is for some people to get effective help. Is it best just leave her to it? An example is her 3 year old who gets annoyed when told not to do something. That’s pretty much it, he has no compulsive traits, his speech and manors are normal. She says when he hits someone it’s not that he is angry but likes the feel of it (although I have never seen him hit anyone). I’m not sure if it’s fair on the child or those that need real help. Any advice or information would be good

    • Hi Alex, that’s a hard situation to deal with, for many reasons. First off, it is possible her child has these traits but they are most obvious or mostly occur at home where she sees them, which can happen for a variety of reasons and can make it hard to judge from the outside looking in. It may also be possible that the autism is quite mild and the other professionals she saw weren’t attune to the finer points and relevancy of the behaviours she was concerned about.

      Having said that, it is also possible she is for some reason obsessed with achieving an autism diagnosis, as you suspect. And that is concerning for a whole raft of reasons, of which you appear to already grasp. In that case, there is not an awful lot you can do, it is up to the professionals the child and family interact with to identify the issue and respond appropriately – the more people that become involved with the family, the higher chance someone else will spot what’s concerning you and will act in a professional capacity to address the issue if it exists.

      I don’t think you’re going to get much traction from approaching the parent yourself about your concerns, unless you do it very tactfully and show intense interest in understanding which allows the parent to talk openly and freely so they are in turn open to hearing your own concerns – if you approach them confrontationally they will likely become defensive and close off from you, which won’t help anyone. I’d suggest trying to stay on the parent’s good side so you remain in the child’s life and can just keep a friendly eye on how they are going, rather than doing anything which might isolate you from the family. In terms of taking the issue yourself to a professional because you’re concerned of what damage this might do to the child, short of abuse or neglect I wouldn’t have thought there was much you can do, you are probably best trusting the professionals to watch and respond as I suggested above.

      I don’t know if my reply has been helpful, good luck with the situation either way.

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