Psychologist-types don't like to talk about the "one-third" axiom much. It makes our field seem too primitive and we desperately want to be thought of as real doctors.
It goes like this: one third of the people we treat get better, one third stay the same and the last third we don't talk about.
With April being Autism Awareness month and the advertised incidence dropping to 1 in 88, we have to discuss the reckless expansion of the diagnosis and the dangerous lure of the services it brings, or 33 percent are going to keep getting worse.
I've been providing behavioral support services to children and families affected by developmental disabilities in the Central Valley since 1991. In the early '90s, autism was very rare, maybe 1 in 1,000, and I'd only have a couple on my caseload. The autistics were easy to spot, silently rocking in a corner or screaming as they tip-toed naked around their kitchens.
I'm still working with the same kind of kids, but everyone today seems to have autism. I met an area family for the first time recently and the 3-year-old I was there to help looked me in the eye and told me, "Go home." He's got autism, now.
No one can diagnose a complex disorder from a single interaction, but I'm going to spend months and maybe years working with this family to change behaviors that this rude boy would likely grow out of and, despite my best efforts, maybe make it worse.
For pure and understandable motives, parents still lobby for the diagnosis. An autism diagnosis brings more services.
The Stanislaus County Office of Education lists three pre-formal diagnostic (too young to diagnose) intensive classes of six to eight students as well as five elementary autism classes, which come with two full-time autism specialists.
A student with the same delays but not diagnosed as autistic doesn't usually get that kind of specialized support.
My hometown sends some students to these specialized classes, according to Larry Mendonca, director of pupil services and special education for Oakdale Joint Unified School District, who says a pre-formal autistic student "can easily run upwards of $75,000 a year to educate." A good investment if we knew the intensive early treatment would reduce later need for services. We know that's not true because we don't see any decrease in demand for services over time, only families and therapists like me demanding ever more.
Back in 2011, a real doctor named Allen Frances called the autism label "fashionable" and motivated by "financial incentive" in an article titled "The Autism Generation." Frances was chair of the DSM-IV Task Force and warns the autism epidemic is set to spread further next month when the DSM (Diagnostic and Statistical Manual of Mental Disorders) 5 is published. The DSM is the psychiatrist's Koran, and the new "autistic spectrum" diagnosis will include some of us now considered normal or with another disorder.
The epidemic isn't spreading; the diagnosis is.
Taylor, a resident of Oakdale, is a behavior analyst. He was a visiting editor at The Bee in 2012. Send questions or comments to firstname.lastname@example.org.