An excellent commentary in the Journal of the American Medical Association examines causes for autism overdiagnosis and the harm that causes. The author notes that there has been diagnostic substitution, with a decrease in intellectual disability diagnoses offsetting the increase in autism ones. He also posits that clinicians may give an autism diagnosis because it makes certain benefits available that aren’t possible without that diagnosis. The diagnosis tools are imprecise and can be subjectively interpreted as well as misused. Many so-called signs of autism may actually reflect multiple other possible causes. Many more “early-stage” autism cases are being diagnosed, very mild “symptoms” are being given a diagnosis. Increasingly people may self-identify as autistic because they think they have certain behaviors. As the authors very accurately note, our culture is predisposed right now to finding meaning in life by labeling and identification; it is a way of feeling special.
The harms of this diagnostic expansion are obvious. One is that it medicalizes a person who doesn’t need treatment; it is wasteful of medical resources and diverts those resources from those in true need of help. The most profoundly affected children and adults are the least likely to be able to advocate for themselves. Their condition is trivialized by the expansion of the diagnosis. Being labeled autistic may be self-fulling prophecy, those so labeled may just accept their behavior or limitations, when they could work to change them. Before RFK, Jr. makes a complete mockery of this serious condition; hopefully the medical profession will do a better job of policing itself and create stricter diagnostic criteria and procedures and stop calling children with certain behaviors autistic. (JAMA Article)
