Kristina – how about “autismi multi illi et / terris iactati et alto” to describe the situation under which we all find ourselves?

(… had to memorize the first few lines of the _Aeneid_ in HS Latin class a few zillion years back… the hexameter is right in the example above, I think, but I’m not sure my grammar is correct…)

Are my interpretations of the interview, it looks unclear,

Medscape: What are the significant changes in diagnostic criteria for autism between 1980 and 1994?

Dr. Gernsbacher: Whereas the 1980 DSM-III entry required satisfying six mandatory criteria, the more recent 1994 DSM-IV offers 16 optional criteria, only half of which need to be met. Moreover, the severe phrasing of the 1980 mandatory criteria contrasts with the more inclusive phrasing of the 1994 optional criteria. For instance, to qualify for a diagnosis according to the 1980 criteria, an individual needed to exhibit ”a pervasive lack of responsiveness to other people.” In contrast, according to 1994 criteria, an individual must demonstrate only ”a lack of spontaneous seeking to share…. achievements with other people” and peer relationships less sophisticated than would be predicted by the individual’s developmental level. The 1980 mandatory criteria of ”gross deficits in language development” and ”if speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, pronominal reversal” were replaced by the 1994 options of difficulty ‘’sustain[ing] a conversation” or ”lack of varied …social imitative play.” ”Bizarre responses to various aspects of the environment” became ”persistent preoccupation with parts of objects.”

The concept of what autism is has not been broadened, it has been vastly expanded to the point of not being recognizeable at least according to DSM-III criteria.

Under DSM-III it was almost unheard of for a Down’s Syndrome child to qualify for a PDD diagnosis, now it commonplace.

The vastly expanded concept of autism began with Edward Ritvo who headed the APA’s study group charged with defining diagnostic criteria for PDD’s that resulted in DMS-III-R. The concept was further expanded in DSM-IV under the leadership of Fred Volkmar who heads that study group and will introduce the updates to the next DSM-IV revision.

There is an autism epidemic and I would describe it as the “Ritvo – Volkmar” virus.

“exasperated that there is a single word to describe such a multitude of human situations”—

It seems more and more as if one ought to speak of “autisms.” I do see something underlying those “on the spectrum”—-of late, it has seemed (anecdotally, yes) to me that Charlie has more in common with other kids (asd, autistic, PDD-NOS, Asperger’s…..) as they all get older, regardless of how much language they have.

Tantae molis erat intellegere quid autism sit (couldn’t manage the meter).

I hope this hullabaloo will gradually lead to an acknowledgment that individuals who have particular genetic configurations are susceptible to the presence (or lack) of external effects, and that they should be given the resources to remove/obtain those effects in order to function to the degree they feel is most appropriate for themselves and their society. This all could include ABA, facilitated-communication devices, sensory integration therapy, supplements, medications…

I have no problem having such an outcome be considered the result of greater awareness of an issue that needs to be addressed rather than the increase of occurrences of that issue… in a sense, that feels to me like a matter of semantics (does something functionally exist for a society before we’re made aware of it?). I do think it’s important for both adults and children who need services to have those services provided to them, and it seems to me that projection of urgency is one of the few ways to get our society to respond. Granted, it is really problematic in my view that only a minority of opinions on the matter are aired by the most visible organization that claims to “speak” for autism.

Either way, though, we’re back to the question of medicalization: whether autism is a condition that is now better (?differently?) diagnosed or whether there has been an increase in occurrences (and I still wish and wait for a study that really quantifies the presence or lack of “autistic traits” in individuals over a span of time according to similar criteria, rather than the significantly different criteria of DSM-III and DSM-IV), are there useful medical or biomedical resources to be applied (whether chelation or supplements [like 5-HTP or melatonin] or medication to address perceived ailments [GI or otherwise]), and/or are there useful behavioral resources to be provided (ABA, SonRise, Floortime, etc), or should we proceed ad-hoc disregarding medical/behavioral resources as quackery at best, over-medicalization at worst? And if we decide that interventions can be useful, how can we decide which are legitimate, given that there is relatively little scientific proof for most anything out there, and yet a significant body of anecdotal report of positive results?

I know that anecdotal evidence is dismissed by many, and I’m sure that there is plenty of overstatement out there, but I really hesitate to inherently invalidate what parents report about their children’s response to particular therapies… it seems (to me) a small step between doing so and engaging in the kind of lack of respect/validation for individuals’ descriptions of their own health situations that I’ve seen documented so convincingly by neurodiversity advocates — “you can’t possibly be feeling that pain because I am a doctor and I *know* what it looks like when people feel that pain”.

Wow!

Wonder how GR will cope with that wee bombshell!