Some people make it up

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The existence of such people is often proposed, as a significant group who wants to be diagnosed with autism, but where's the evidence?



The difficulty frequently stems from insurance not covering it or not having insurance at all, which is less of an issue in the US at this time. There are other issues as well, such as finding someone who diagnoses adults (many only do children, or at least primarily do children and don't seem prepared for adults).

Because Hipsters and Tumblr/DA/LJ Users (big overlap)

EDIT: I can see people overstating symptoms to show they aren't NT or something......

Again, such statements seem to be based more on assumptions than on any demonstrated willingness to fake it in large numbers. The people using tumblr and LJ are people using all the other parts of the internet as well, so it's not like they're these unique bastions of people trying to be snowflakes (and I don't think most people on either are trying to be snowflakes).

I think it's hard to quantify because a lot of diagnosis in later life is based primarily on account. And in some cases it's proposed as an explanation for other mental health issues. How can psychiatrists know whether the person they're dealing with wants to be pathologized or not? And how do they know it's not their mental health issues that are causing their social problems? Rather than vice versa?

Are childhood files checked?

Personally, how frequent do you think autism is?



Yes I agree I do think there should be better services for adults. Is the diagnosis process for adults quite in-depth?

Last edited by Acedia on 20 Mar 2014, 6:48 am, edited 1 time in total.

There seems to be a lot of touchy feely bovine excretion here, aka opinion unsupported by data.

"I have a feeling there are lots of people who..." and so forth.

I don't have any data from which to form a hypothesis about the rates of ASDs in the population or the rate of deliberately obtained misdiagnoses. Given the general oddity of human behavior, I would hazard a guess that there must be some, but given my essentially solipsistic method of trying to understand the behavior of others, I can't believe that this is something that happens in any significant numbers at all.

Two relevant bits of information that tend to suggest that the "lots of people faking it" conjecture is false:
1) The huge increase in ASDs is primarily in school age children not making the decision to diagnose themselves but having diagnosis imposed on them by adults.
2) There has been a drop in the number of people labeled "ret*d" that correlates with the increase in people labeled "autistic" suggesting that the rate of atypical neurology in the population has not changed as much as the rise in ASD diagnoses might suggest--some large part of that rise is just changing the label on those people.

There seems to be some fairly strong emotional desire on the part of the "there must be lots of fakers out there" people for their conjecture to be correct and I don't understand this. What difference does it make to you, personally, if someone else is mislabelled with the diagnosis they gave you?

I don't get it.

Link to the statistics please?

The difference is that it makes it harder to be taken seriously. It means people rightly question the validity of the diagnosis, or whether the condition is over-diagnosed, and if it needs to be diagnosed at all. The 'autism is a difference' advocates encourage this type of thinking. For a lot of people, including myself, it's not just a difference, if it were I wouldn't want to be diagnosed.

In Uta Frith's words


And there seems to be more of an emotional desire to deny the idea of people feigning autism than the reverse. I find the defensive responses to be completely bewildering, and I don't get it.



Mental illness and autism are diagnosed based on behaviour, as Lorna Wing said behaviour is elusive. I imagine it's incredibly difficult to measure.


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Last edited by Acedia on 20 Mar 2014, 12:22 pm, edited 1 time in total.

Anecdotally this wouldn't be too difficult?



But will the psychiatrist be interviewing the person's friends to see if everything matches what the person is saying? And don't some people report that people haven't believed them??



I completely agree.

If they're available, or people who knew the adult as a child.

An autism diagnosis is pathologizing. It's not particularly any more popular than anything else that isn't a personality disorder. Someone looking for a diagnosis is asking to have their behavior/mental state/etc. categorized as pathological in some way.

I guess what I'm asking is, you make it sound like people are rushing to get an autism diagnosis in droves to avoid facing other issues, and I don't see where this is coming from beyond supposition.



I am not sure. The numbers have changed over the years as the diagnostic criteria have been refined or otherwise altered.



It's similar to that used for children, using "adult" versions of some of the same tools - ADOS and ADI-R for example, as well as the Vineland Adaptive Behavior Scales.

Do you have a link to statistics about people pretending to have autism so they won't get labeled with something else?



You've chosen to categorize them as defensive and emotional. Have you considered the possibility that disagreement may be considered and rational, or are you expressing a bias against disagreement?

This is my reason: Cultural bias is ableist (or disablist, depending on where you live). That is, the idea that diagnoses can help explain a person's history is not necessarily widely accepted as valid. Rather people are more likely to view it as "using it as an excuse" or "using it as a crutch" or some other negative judgment suggesting that it is inappropriate to actually acknowledge real and valid difference.

This bias leads to people assuming that on some level people who have mental illnesses, developmental disabilities, etc. on some level choose to be that way. That in some sense that they are morally culpable for being the way they are. OR they may view such people as being incapable of being responsible for anything, and deny that they have the right or even the capacity to make decisions about their own lives.

In this context, in a society with such negative views about mental illness and developmental disabilities, people are predisposed to producing theories about how people are just trying to get a diagnosis for some reason other than they honestly believe that this may be the source of many of their problems. In this context, in this society, I believe that questioning such assumptions - especially when they are not accompanied by statistical evidence - is appropriate.

Here are some articles about the phenomenon... (If true it's kind of appalling)

Anecdotal report from Australia
Criminal charges for pervert accessing support workers by posing as an autistic
Popular shock jock convinced most people with autism are faking it
Accusations a celebrity faked autism in her child for ratings
Mother accused of munchausens by school staff when she tried to get support for her autistic child

This was all stuff from the first few pages specifically related to a google search for 'faking autism'

I did notice something buried within this issue:
- Some people (not many) believe ALL autism spectrum disorders (ASDs) are fake, therefore ALL diagnoses are fake. These people believe everyone with autism is faking it.
- Mental health services require improvements to accommodate those families "faking autism" to get any kind of mental health funding for their children at all. That seems pretty desperate, if true.
- Most people do not really understand ASDs, so they can be fooled into thinking some mean jerk is actually autistic, just because they persist in some kind of unseemly behaviour. They may also disbelieve someone is truly autistic - "But she communicates soooo well..." and "but his eye contact is so normal... he's not autistic .. what a fake" etc.

I suspect a normal person would have a hard time performing autism authentically for any prolonged period of time. Under professional scrutiny these individuals would most likely fail to get an autism diagnosis. The accounts I read where people actually were faking autism, they were very poor at it and only passed due to other people's ignorance about the condition.

I think the danger with the whole "faking autism" concept: genuinely autistic people are being accused of fakery more often than the infrequent yet spectacular examples of genuine fakery. It is probably not good for the individual autistic being accused, or the autism community in general.

I would have to argue that a lot of autistic people probably don't even look autistic or act typically autistic all the time, even though they are. Just because they aren't melting down, stimming or zoned out at any given moment doesn't mean they do not have the condition. Professionals even have their own biases in handing out or withholding diagnoses, so depending on the quality of the professional doing the scrutinizing, a person who is genuinely on the spectrum might not get diagnosed as such. This happens with many women, who display symptoms differently than men, and therefore do not get diagnosed based on the preconceptions of the male stereotype. Unfortunately there is no blood test or genetic proof that can be provided that one is undeniably autistic.

In comparison to mental illness? It is the fastest growing developmental disability I believe.



I understand what you mean semantically (don't know if that's the right word), but I mean to be pathologized with something you don't have, and the clinician's ability to differentiate reliably between the two. The seeking to be pathologized.

Also you didn't answer the two questions, so I'm assuming they're plausible/right? Which means there is validity in questioning the diagnostic process. There is a flaw in it, and it can be exploited?

This below comment is just digressive thought, but somewhat related.

Language/speech problems, sensory issues, attention problems and intellectual difficulties that lead to poor social integration and educational issues are an understandable set of problems that need intervention. A personality type, such as a schizoid personality, is debatable if whether it's a disorder. Many don't think personality types should be pathologized. Unless you believe that personality is heritable rather than something that is ever-changing and modifiable, contingent on your environment and experience.



Can you find where I said it wasn't conjecture but rather fact based on data?



No, rather explain other problems in their lives, and I don't think it's droves. And I think people like that should be given help. I think psychiatry should start helping people without labelling, or making them spend a great deal of money. I think mental health services have to change.

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Last edited by Acedia on 20 Mar 2014, 12:52 pm, edited 6 times in total.

Answered***

I'll consider it, but I personally doubt it. You have a dog in this fight and I think that's why you take the same position on this argument.



And you know I don't think that. I think over-diagnosis of autism happens when people see it as an answer for their own mental health issues. Or in a few rare cases because they want that particular label. The aspie supremacist types come to mind for the latter group. I don't think I'm the only one who has noticed the type of threads I mentioned in my first post, how else should I view those threads?



I agree with this, and this what worries me with over-diagnosis.

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Last edited by Acedia on 20 Mar 2014, 12:40 pm, edited 2 times in total.

Actually, no, I do not agree with Adamantium describing it as emotional, either. However, I focused my energy on answering you and forgot about that bit of his post. I do agree with him that there isn't anything particularly empirical to support the idea of people flocking in droves to fake autism.

The primary reason for the increase in diagnoses is children being evaluated, not adults, so that doesn't really demonstrate anything about adults seeking diagnosis.

I can't reply to everything now, will try after I've slept.

Based on threads on wp, it seems that there are people who want to have autism as the eggsplanation for their problems without having some key traits of autism, such as people posting a list of their traits that match with autism, but not having the big ones like poor social cognition when they say that they pick up easily on what other people are thinking and feeling, or the traits that match autism are the more minor ones that affect most people like small stims that most people do or attention to detail that many people have.

For the childhood history issue, I would put the social/comm cutoff at age three. If there are no significant social/comm deficits by age three, then the person was developing along a neurotypical trajectory in early childhood, which indicates lack of autism, and deficits that develop later are less likely to have autism as cause. Researchers can now identify autistic traits in baby sibs before one year old, so three years is plenty of time for some social/comm differences to be identified. The RRB cutoff, I would put at age five, since research shows that RRBs show up later than social/comm deficits in many autistic children.

It would be best to have objective diagnosis based on battery of simple objective tests.

Also, the possibility that there are these kinds of people like there are people with munchausens faking autism doesn't mean that there are large numbers of these kinds of people, but ackshuly, it can be harmful to other people if only small number of these people are vocal and influential, which they might be if they ackshuly have good social cognition and communication skills due to not having autism.

That's what I think as well. No one who's sane would want to imitate the symptoms of a disorder.