Autism Diagnosis Change Causes Uproar
An upcoming change in the diagnosis guidelines of autism by psychiatrists may re-categorize 76% to 84% of children with autism diagnoses as being disease-free, according to a Yale University child psychiatry professor.
The new change will be implemented by the American Psychiatric Association for next year’s fifth edition of “Diagnostic and Statistical Manual of Mental Disorders.” The intention of the change, according to experts on the panel, is to better clarify and define the disease. But because many people supposedly only have mild forms of the disorder, and many apparently outgrow the disorder, experts suggest that the new guidelines will drastically reduce the number of children being diagnosed with autism.
This references a 2009 study by researchers from the U.S. Department of Health and Human Services found that almost 40% of children between the age of 3 and 17 years old who had ever been diagnosed with autism no longer have the condition according to the existing diagnosis guidelines. The study sampled 78,037 children.
The researchers estimated that 673,000 children in the United States had current diagnoses of autism at the time of the national survey (2007). The researchers also found that boys were diagnosed four times more than were girls, and white children were significantly more diagnosed than were black or multiracial children.
The estimate that between 76% and 84% of children currently diagnosed with autism would lose the diagnosis was made by Fred Volkmar, M.D. Dr. Volkmar is the director of the Yale Child Study Center, a professor of Pediatrics, Psychiatry and Psychology, and a leading researcher in the area of autism. Dr. Volkmar estimated that about 76% of children now diagnosed with Asperger’s disorder would disqualify for the disease under the new guidelines. And 84% of children diagnosed with pervasive developmental disorder (PDD) would also be disqualified as having this disorder under the new guidelines.
While many question the accuracy of mild autism diagnoses altogether, others have reacted harshly to the new guidelines. Parents whose children are at risk of losing the diagnosis have voiced concern that their insurance will no longer cover medication, and they will no longer qualify for special programs offered to children with autism diagnoses.
The diagnosis change underscores how our modern healthcare system is beholden to the naming of diseases, and how diagnosis is so readily subject to different interpretations. This issue with autism also brings to issue the possibility of unnecessary medication prescription to children, and the potential of over-medicating our children through their growing years.
For example, one of the most prescribed medications for mild autism cases is methylphenidate HCI (Ritalin®). The FDA now requires a “Black Box” warning label on this drug, because research has found that the drug comes with the risk of significant, serious and possibly life-threatening side effects. These include the possibility of becoming addicted to the drug. It is related to amphetamine in its mechanisms of action. It is a powerful stimulant. Common side effects of methylphenidate HCI include addiction, anxiety, nervousness, irritability, insomnia, headaches, decreased appetite, nausea, dizziness, gastrointestinal pain, and heart palpitations. It has also been known to slow growth among children, cause seizures, and blur the vision.
Kogan MD, Blumberg SJ, Schieve LA, Boyle CA, Perrin JM, Ghandour RM, Singh GK, Strickland BB, Trevathan E, van Dyck PC. Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the US, 2007. Pediatrics. 2009 Nov;124(5):1395-403.
Physician’s Desk Reference, 2005.