Of late, there has been a reaction against the “medicalisation of distress.” This means that normal reactions that would have been ignored a generation ago have recently been converted into “illnesses.” A cold becomes bronchitis. A seizure becomes epilepsy. A child walking on its toes becomes autistic or, even better, “on the spectrum,” which has to be one of the most damaging medical ideas ever proposed.
This vague supposition appeared about ten years ago and I first heard it from the mother of another one of those shy, socially anxious children who, from time to time, appear in the office because they “too quiet.” It used to be these children would be brought in for suspected “Anaemia.” That’s gone the way of the dodo, the cry is now, “is he on the spectrum?”
The diagnosis of autism became popular in T&T in the late 1990s. I well remember my first experience. The four-year-old child was severely brain-damaged from birth, unable to walk or talk and needed a lot of therapy, especially physical, which was not available at the Children’s Hospital at the Eric Williams Medical Sciences Complex (EWMSC) (and still isn’t) and, as is customary in T&T, the mother was undergoing terrible hardships trying to get help for her child. The mother came into the clinic and happily informed me that the problem was not the child’s brain because the child had been diagnosed as “autistic” by a newly arrived “psychologist” and that she would not be returning to the EWMSC. I could not dissuade her; we were not doing enough for her child, and I hope she has done better with the “psychologist,” but her child certainly was not autistic.
Autism has become socially acceptable. That has its good points. Brain damage was not and still is not.
There has been a tremendous increase in cases of autism since then, partly because it’s much more attractive for parents to say their child is “on the spectrum,” which is a rather appealing and dramatic phrase and immediately boosts the well-being of anyone involved with the child (and no doubt with the child too). All that is well and good. Except the child may not be autistic or ten per cent autistic or 25 per cent autistic, as some people are now saying.
But the major reason why there now appears to be more cases of autism is the change in diagnostic criteria, which were very strict up to about 1987, when they were massively relaxed. Suddenly, cases of autism went from one in 5,000 children in the 1970s to one in 1,000 in the 1980s. By 2000, cases had reached one in 150. The criteria for diagnosing autism were again relaxed in 2013 and we are now at a rate of one in 31 today.
These are unbelievable figures. This is overdiagnosis. And when one sees adults arguing that they or their children are autistic and therefore need special consideration in society, one becomes a bit alarmed.
We have reached the point where people are now “self-identifying” as “autistic” or having “ADHD.” Dr Google or Professor Chat GPT play important roles in this. So does social media. Videos on TikTok frequently pathologise “normal everyday experiences,” such as forgetting where you put your wallet or misplacing things at work, as symptoms of ADHD
Of course, there are autistic people and it can be argued that many of mankind’s inventions and scientific leaps forward are due to autistic personalities, but nowadays, everyone with a slightly different child seems to want to jump onto the bandwagon and have their child declared “autistic.”
There are many advantages to this. Unlike “slow” or “retarded,” it’s socially acceptable and educationally favourable. You can get classroom privileges, classroom aides and extra time for exams. There’s an incentive to seek such a diagnosis, as it is the gateway to access special adjustments at school. At the same time, it prevents help being accessible to the children who truly need it.
It also runs the risk of people becoming aware of the over diagnosis and reacting negatively by cutting back on specialised services which are still badly needed.
We have to learn to accept the “infinite variety” that Shakespeare spoke about with regard to human development. Variety is the spice of life and all that, no?
Can’t some differences, big or small, be normal and good for humans? Can we not celebrate human diversity? We are not all computers. Not as yet.
