It seems that whether one thinks rates of neurodevelopmental disorders have increased or have stayed stable has little to do with actual data. Here is an attempt to present data.
In my personal experience, I have observed the fourth point. While most of this blog post may not be surprising to me, it is presented from a different perspective. I was unaware of the challenges faced by doctors and assessors in definitively identifying symptoms and creating or modifying diagnoses. The LCD, or local coverage determination, appears to be more flexible than rigid.
Individuals are not inherently ignorant. Describing behaviors exhibited by their children (derived from reading the symptoms of ASD and ADHD) to professionals and encouraging these behaviors at the appropriate time and location is relatively straightforward. The majority of deductions are based on the information provided.
The advantages associated with these labels often exempt individuals, except for medical and educational professionals, from accountability. Parents are not required to “parent” their children because they are victims of a medical or psychological condition.
It is also noteworthy to me at least that individuals may return to the medical field to retract or undo the label. ASD and ADHD are not irreversible conditions; one either has them or does not. While symptoms can often be managed through pharmaceutical or psychological interventions, an individual’s diagnosis remains unchanged.
We can delve deeper into the various circumstances that can be manipulated for personal convenience or to obtain assistance. For instance, handicapped parking placards when there are no true disabilities and the proposed intractable pain resulting from a car accident ten months ago that prolongs disability benefits thus enabling that person from working despite the pain dissipating four months ago. These are just a few examples.
I acknowledge that this may appear as “sour grapes” or an irrationally skewed view of humanity. However, most of us have witnessed or heard about such situations, or perhaps even experienced them ourselves. I was raised with a rosy outlook on life, but this perspective began to crumble years ago when I grew weary of the constant challenges.
A large proportion of the rise in ASD diagnoses can be explained by diagnostic changes—but not all of it. Two things can be true at once. This author group has been, IMO, disingenuous about this in their own research publications, which seem to have a socio-political, rather than scientific, endgame. There has been a significant rise in severe autism cases (as demonstrated in this author group's own study data), that cannot be blamed on diagnosis. We can call out over-diagnosis and shifting definitions that have had a large impact, while also searching for the cause of smaller, but epidemiologically crucial, increases in autism incidence.
The data seem confusing and contradictory. Is there an alarming increase in severe, nonverbal autism that cannot be explained by a corresponding decrease in other diagnoses such as cognitive impairment? If so, articles like these provide false reassurance that we are not facing a public health disaster
The data do indeed suggest a rise in debilitating and severe autism, not subject to trendiness and diagnostic creep. California’s DDS data is probably the best and clearest evidence for this, it’s reliable, exhaustive and of long-standing duration, and actually tightens diagnostic criteria in 1998 to forestall increased numbers.
Bet you dollars to donuts that a sizeable chunk of kids labeled “ADHD” are actually sleep deprived from undiagnosed sleep disorders. I’m a sleep specialist and see it all the time.
I need someone to clarify how the limits of the two diagnoses manifest in Sweden compared to the USA. Unless you are applying for some type of insurance that requires underwriting, applying for a job in the US, in most cases, wouldn't bring the ASD/ADHD "stigma" into the light. Is it more open in Sweden, and thus does the duality of early benefits and later detriments become more restrictive there over here?
I live in Sweden and employ people. One difficulty facing employers is that, in general, it is impossible to fire people for not doing their jobs properly. Or for in general being obnoxious, or a petty thief. The last hired are required to be the first to be let go .... and if you start hiring again you have to offer the job to those who were layed-off. The labour laws were written with perfectly fungible thus replaceable assembly line workers in mind. There are all sorts of caveats here, protection for small businesses, and some limited ways to protect valuable employees you want to retain when there is a layoff, and ways to hire people for a trial period, but it is basically "employer beware". Getting rid of an employee that you no longer want but who doesn't want to leave is supremely difficult. It's easier to end a marriage. This means we ask, up front, if there are any conditions that might effect your ability to do the job. And you had better not lie about this, because firing people for fraudulently representing themselves is one of the things we can do. Right now in Sweden there are a large number of young adults who benefitted from some diagnosis which got them private tutoring, smaller class sizes, and the ability to go home if it all got to be too much. As a result they have outgrown their diagnosis, can function at work as well as anyone, might be a model employee - and all of this would be a great triumph if only they could prove it to people like me who are hiring.
“ The most damning statistic: boys are more than twice as likely as girls to be diagnosed with ADHD. Doctors have made boyhood into a disease.
Similarly, the youngest children in any given classroom are far more likely to be diagnosed with ADHD than their older classmates; relative immaturity is now a psychiatric condition. If your kid was born in August and pees standing up, go ahead and start stockpiling amphetamines now.”
Much more, including a closer look at the inexcusably ridiculous diagnostic process, here:
In my personal experience, I have observed the fourth point. While most of this blog post may not be surprising to me, it is presented from a different perspective. I was unaware of the challenges faced by doctors and assessors in definitively identifying symptoms and creating or modifying diagnoses. The LCD, or local coverage determination, appears to be more flexible than rigid.
Individuals are not inherently ignorant. Describing behaviors exhibited by their children (derived from reading the symptoms of ASD and ADHD) to professionals and encouraging these behaviors at the appropriate time and location is relatively straightforward. The majority of deductions are based on the information provided.
The advantages associated with these labels often exempt individuals, except for medical and educational professionals, from accountability. Parents are not required to “parent” their children because they are victims of a medical or psychological condition.
It is also noteworthy to me at least that individuals may return to the medical field to retract or undo the label. ASD and ADHD are not irreversible conditions; one either has them or does not. While symptoms can often be managed through pharmaceutical or psychological interventions, an individual’s diagnosis remains unchanged.
We can delve deeper into the various circumstances that can be manipulated for personal convenience or to obtain assistance. For instance, handicapped parking placards when there are no true disabilities and the proposed intractable pain resulting from a car accident ten months ago that prolongs disability benefits thus enabling that person from working despite the pain dissipating four months ago. These are just a few examples.
I acknowledge that this may appear as “sour grapes” or an irrationally skewed view of humanity. However, most of us have witnessed or heard about such situations, or perhaps even experienced them ourselves. I was raised with a rosy outlook on life, but this perspective began to crumble years ago when I grew weary of the constant challenges.
A large proportion of the rise in ASD diagnoses can be explained by diagnostic changes—but not all of it. Two things can be true at once. This author group has been, IMO, disingenuous about this in their own research publications, which seem to have a socio-political, rather than scientific, endgame. There has been a significant rise in severe autism cases (as demonstrated in this author group's own study data), that cannot be blamed on diagnosis. We can call out over-diagnosis and shifting definitions that have had a large impact, while also searching for the cause of smaller, but epidemiologically crucial, increases in autism incidence.
The data seem confusing and contradictory. Is there an alarming increase in severe, nonverbal autism that cannot be explained by a corresponding decrease in other diagnoses such as cognitive impairment? If so, articles like these provide false reassurance that we are not facing a public health disaster
The data do indeed suggest a rise in debilitating and severe autism, not subject to trendiness and diagnostic creep. California’s DDS data is probably the best and clearest evidence for this, it’s reliable, exhaustive and of long-standing duration, and actually tightens diagnostic criteria in 1998 to forestall increased numbers.
Bet you dollars to donuts that a sizeable chunk of kids labeled “ADHD” are actually sleep deprived from undiagnosed sleep disorders. I’m a sleep specialist and see it all the time.
I need someone to clarify how the limits of the two diagnoses manifest in Sweden compared to the USA. Unless you are applying for some type of insurance that requires underwriting, applying for a job in the US, in most cases, wouldn't bring the ASD/ADHD "stigma" into the light. Is it more open in Sweden, and thus does the duality of early benefits and later detriments become more restrictive there over here?
I live in Sweden and employ people. One difficulty facing employers is that, in general, it is impossible to fire people for not doing their jobs properly. Or for in general being obnoxious, or a petty thief. The last hired are required to be the first to be let go .... and if you start hiring again you have to offer the job to those who were layed-off. The labour laws were written with perfectly fungible thus replaceable assembly line workers in mind. There are all sorts of caveats here, protection for small businesses, and some limited ways to protect valuable employees you want to retain when there is a layoff, and ways to hire people for a trial period, but it is basically "employer beware". Getting rid of an employee that you no longer want but who doesn't want to leave is supremely difficult. It's easier to end a marriage. This means we ask, up front, if there are any conditions that might effect your ability to do the job. And you had better not lie about this, because firing people for fraudulently representing themselves is one of the things we can do. Right now in Sweden there are a large number of young adults who benefitted from some diagnosis which got them private tutoring, smaller class sizes, and the ability to go home if it all got to be too much. As a result they have outgrown their diagnosis, can function at work as well as anyone, might be a model employee - and all of this would be a great triumph if only they could prove it to people like me who are hiring.
“ The most damning statistic: boys are more than twice as likely as girls to be diagnosed with ADHD. Doctors have made boyhood into a disease.
Similarly, the youngest children in any given classroom are far more likely to be diagnosed with ADHD than their older classmates; relative immaturity is now a psychiatric condition. If your kid was born in August and pees standing up, go ahead and start stockpiling amphetamines now.”
Much more, including a closer look at the inexcusably ridiculous diagnostic process, here:
https://gaty.substack.com/p/synthetic-children
Check this out:
https://carbsyndrome.com/the-autism-diet-connection/
The findings described surprise me not at all...!