Overdiagnosis of Asperger's/Autism? Your Thoughts

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I'm curious to hear anyone's thoughts on this:

Asperger’s History of Overdiagnosis

It's a NY Times oped piece by a psychiatrist named Paul Steinberg. He argues that social ineptitude and special interests aren't enough for a definition of Asperger's and autism. According to him, there must be verbal/linguistic impairment for someone to be truly autistic.

I don't necessarily agree. For me, I can personally relate to pretty much all of what I read about AS except for linguistic problems. I never had verbal/language problems as far as I know, and I actually enjoy figurative, metaphorical language.

In fact, I thought the difference between AS and HFA was the lack of major language delays in the former. But now it makes me wonder, is lack of understanding social dynamics and fascination with special interest not enough to have AS, or is the author off base in his opinion?

I thought AS was HFA? Also, I'm not sure what to think about this... I believe I'll need a while to mull this over.

I also know people with autism/AS think differently, learn differently, even process things differently. But even people without AS can have these issues too. But I wonder how do doctors know these kind of things are due to being on the spectrum than just having a learning disability.

That guy (or maybe NYT) has an agenda and seriously needs to update on his Aspergers trivia (look at all those stereotypes!). If you check his website (link), you'll find he has no authority when it comes to Autism or Aspergers. Just because he has a psych degree, doesn't make him credible. Dude is just an ableist talking out of his ass.

I think ASD has more to do with a person's mode of thinking rather than their specific social inadequacies. The way I see it, the social problems associated with ASD are merely a side effect of an object-oriented way of looking at the world. Autistic people tend to process the world through the intellect rather than through intuitive social understanding, and this is what leads to issues in normal human interaction.

Diagnostically speaking, I think it makes more sense to examine the root causes of a person's behavior when determining whether ASD or another social disorder is appropriate. The author of this article seems to only look at the symptoms, which is a bit myopic.

That said, it is of course possible that some ASD diagnoses are inappropriate. I just think that he is approaching the problem (if one exists) from the wrong angle.

Isn't that kind of like "comprehending colours"? You perceive sounds. They need to be in some kind of pattern that conveys meaning for comprehension to happen.

AS is not the same DX as high functioning autism. There has to have been a speech delay/regression to get a DX of HFA but not for AS.

http://www.autism.org.uk/about-autism/a ... rence.aspx

They won't be distinct for long following the release of the DSM-V, however. In fact many of the leading researchers in the field of ASD believe that never really has been a huge distinction between AS and HFA, nor is there a consensus over the hierarchical method of diagnosis. I think it makes more sense this way, considering that its called the autism spectrum for a reason. But that is another discussion entirely, and I have already derailed the thread enough.

I do not agree with the article. They seem to be forgetting that it's a spectrum and not all individuals with it will display all of the traits with it for one.

Some of it appears factually incorrect, they have over-simplified descriptions of children diagnosed with it. If there truly are clinicians misdiagnosing people with AS then they ought to be struck off, because a proper, thorough assessment would show whether it was AS or not, and would investigate all relevant behaviours. There are other factors not mentioned in the article, such as sensory issues, vestibular & proprioceptive issues, meltdowns and a variety of other things common in autism.

They say: ...but then fail to discuss the taking things literally, failure to understand humour properly, and many people with AS don't have flat affect.

There is also something else which is not mentioned. There will be people in the population who fit the profile for BAP and therefore will display some of the traits to a milder degree. Perhaps this has confused some unenlightened clinicians and led to a DX.

I can't say whether over-diagnosis is happening in the US, I highly doubt it here in the UK. Most people would have to be assessed on the NHS here and they do not give diagnoses lightly, because they are cash-strapped and don't want everyone claiming on their services. Adults particularly have to fight tooth and nail to even get an assessment a lot of the time.

I see the guy who contributed to the article is a psychiatrist. Well my own personal experience with psychiatrists in the AS assessment process was very negative, absolutely no screening tools used, a very superficial interview, no analysis of information and no attempt to ascertain childhood information. However, my experience with a psychologist was a highly thorough assessment, ruling out of other potential conditions, bone fide testing tools and access to historical information. Guess which one gave me the diagnosis?

I believe personally, that AS should always have been included as an ASC for diagnostic purposes.

Whether the IDC10 will be similarly revised to incorporate AS under the autism umbrella I can't say, however, what I can say is that US citizens on here seem to be unaware that it's much more likely to be the DSM that will fall out of use in favour of the IDC, so what you say is by no means assured:

http://www.apa.org/monitor/2009/10/icd-dsm.aspx

I'm having to repeatedly post this link/information on various threads here...

I don't exactly agree with everything in this article, but I am prepared to accept (perhaps a little more evidence will completely convince me) that autism spectrum disorders are overdiagnosed. I don't have a problem with this conclusion.

I do have a problem with people who hear that "aspergers is over diagnosed" and think that it means that some diagnosed people are just faking, are actually normal healthy people, and just need to 'suck it up' etc. That's not what it means at all. It simply means that these wrongly diagnosed need a new name for their condition (illness, difference, whatever you want to call it) and perhaps different forms of treatment.

Psychiatric diagnoses have been multiplying for decades now and this is unlikely to stop. Autism was once considered to be related to schizophrenia, until some doctors looked more closely and saw that schizophrenia had some characteristics while autism had others, and that separating the categories would be more accurate. Now Paul Steinberg is saying "Autism usually involves language acquisition problems, but some people who are diagnosed autistic don't have these problems. Perhaps separating them into a different category would be more accurate" (paraphrasing)

I'm not say that he is right about this, but what I am saying is that a) this argument is not that revolutionary or controversial, but part of the process of refining psychiatric diagnoses, and b) even if some people have been wrongly diagnosed, this does not mean these people are just pretending or are completely healthy, it just means that a doctor incorrectly diagnosed their real problems using imperfect criteria and knowledge.

So, is he saying that Asperger's Syndrome doesn't exist? I don't get it. If only those with language delays are diagnosed, then AS would no longer be diagnosed.

I think that he may be getting at something, but I'm not sure what exactly. Just distinguishing people based on language delays goes against everything that I've learned about Asperger's so far.

Perhaps there is another distinguishing factor between those with social disabilities and those with Asperger's or Autism. I would buy that.

I kind of agree, maybe.

I personally think what is called "Asperger's" or "HFA" is a lot of completely different things that are grouped together under one label.

Ok-let's make a distinction now.
There's a difference between:
claiming you have Asperger's because you were actually diagnosed with it
claiming you have it because you made a lot of accurate research, and you think you can have it
claiming you have it because you you saw some of the simptoms, made an unaccurate research on wikipedia, and you came to the conclusion you could have it
claiming you have it because you fit the stereotype of the "introverted/shy, intelligent, and good at math and science kid", or the "nerdy" stereotype (people do this a lot)
claiming you have it just because you think it's "cool" (this is what most people actually do)

Never did understand why people who obviously have it mildly would self-diagnose...

Exactly. While there are some exceptions, High-Functioning Autistic people generally require speech therapy, whereas Aspies do not. There is a lot more to ASCs than a linguistic delay.

Unfortunately, there are many Paul Steinbergs (i.e. psychologists who don't know sh*t about conditions they are supposedly qualified to advise on) around.