Autism Spectrum Disorders: Article Analysis

Jolissa Simon
SPED 502
Professor Barbra Johnson
December 8, 2013

Recent History of Autism Spectrum Disorders: Viewpoints on the Increase in Diagnosis
The premise of “Back to Normal: Why Ordinary Childhood Behavior Is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder,” by Enrico Gnaulati, Ph.D. is that autism spectrum disorders (ASD) are up 78 percent in 10 years and that “we’re dramatically overdiagnosing it in everyday behavior” (Gnaulati, 2013). The underlying argument that Gnaulati utilizes is that there is no need for a diagnosis in a large array of those diagnosed with ASD because instead, they are just “brainy, introverted boys” like his client, William. I chose this article because I wanted to discuss the recent history
of ASD and how prominent public figures, such as Gnaulati, have been addressing the increase in the diagnosis of ASD.
It has been a common understanding in the special needs/education environment that we should never see someone’s disorder/disability as defining their character; more importantly, it is universally understood that we should not discuss someone’s disorder in negative terms. However, Gnaulati uses negative language throughout his excerpt, and calls ASD and “unfortunate occurrence” and commonly refers to those with ASD as if it is their defining trait and not using people first language i.e. “autistic daughter” (2013). The problem with language like this is that not only is it offensive to those living with ASD and their families, it gives ASD a stigmata; the fact that ASD can be seen as scary, humiliating, disgraceful – you name it – leads parents and caregivers to shy away from getting help or an assessment. The subtle, negative language riddled throughout the argument fuels the fire that ASD should be avoided at all costs and gives his argument precedence in the sense that he has a “solution” for this unpleasant problem.
It would be completely ignorant to say that ASD is a joyful experience, and that a parent should revel in the diagnosis of ASD. However, the fact is that by viewing ASD as a horrible diagnosis that should be avoided at all costs, you are only harming the child who potentially could have ASD. Putting off diagnosis is extremely detrimental to a child who has ASD; it has been clinically proven by several different studies that the earlier the intervention, the better the prognosis (Buron & Wolfberg, 2008). The first years of a child’s life are crucial for brain development (Buron & Wolfberg, 2008), and since ASD is viewed as a neurological disorder of the brain, it would only make sense to utilize these first years and try to aid in that development. It would be foolish, as Gnaulati suggests, to let this time pass by because there might be a chance that you have a “brainy, intellectual boy.”
Gnaulati’s explanation for professionals over diagnosing ASD is that: “It is tough to distinguish between early signs of autism spectrum disorder and indications that we have on our hands a young boy who is a budding intellectual” (2013).
First and foremost, let’s point out that Gnaulati completely disregards the female population that has ASD, and approximately one in four individuals diagnosed with the disorder are girls (Buron & Wolfberg, 2008). That is 25%, a rather large portion for Gnaulati to ignore. Second, Gnaulati pairs ASD with the offset of a “budding intellectual.” As a parent, which one would you choose? It’s not fair to make that comparison in an ultimatum form when there are other possible diagnoses aside from ASD. Third, his uncomplicated explanation does not mention other possible, viable explanations for the increase in diagnosis. Five years ago, Buron & Wolfberg attributed the increase in diagnosis to three
reasons:
1.
Widened diagnostic goal posts: the definition and conceptualization of autism has changed. It is now accepted that children have more than one disorder (it is no longer considered that some disorders are discrete and mutually exclusive; children can have more than one developmental disorder).
2. We have become better at diagnosing autism, especially in younger children (this includes the improved ability to detect autism and to ensure fewer children escape detection).
3. In the past a child may have received a diagnosis of intellectual disability with no further diagnostic assessments conducted to determine if the child also had signs of autism. These children are now being more accurately diagnosed. (2008)
Gnaulati’s present day reasoning makes no mention of the changes that have underwent for the diagnosis of ASD, and his explanation actually refutes Buron & Wolfberg’s claim that professionals have become better at diagnosing. Moreover, Buron & Wolfberg claim that overdiagnosing has been occurring because it is better to be safe than sorry. Gnaulati does not believe in the sake of diagnosing for the fact that the therapeutic procedures that must be undertook are expensive and time consuming. Yet, it would only seem logical to help your child, especially if treatment is only beneficial and not
harmful. The majority of Gnaulati’s article is spent discussing a client of his named William who was “previously” diagnosed with ASD until Gnaulati began treating him. Gnaulati describes William with characteristics that seem typical of someone on the spectrum: not meeting developmental milestones, captivation with inanimate objects, untypical play, interest in adult-like topics, disinterest in social interactions, obsessive behavior, aversion to vegetables, wild and uncontrollable tantrums etc. (2013). He also mentions how William had an IQ of 144, which placed him in the gifted range, and a formal speech and language assessment “indicated that William was well over a year ahead in all areas” (Gnaulati, 2013). Due to William’s difficulty with social interactions, his doctor diagnosed him as having Asperger’s due to his “communication and qualitative impairments in reciprocal social interaction” (Gnaulati, 2013). Yet, Gnaulati said that upon meeting William for the first time, he “knew, unequivocally, that he was not on the spectrum” (Gnaulati, 2013). He says this because: “William’s imaginativeness, as well as the emotional give-and-take in our pretend play interactions, was proof positive that it was folly to consider him autistic in any way” (Gnaulati, 2013). Yet, Gnaulati says that William is more comfortable isolating himself, explodes emotionally when forced to switch activities, has interests not typical of his age (he is 8 and likes Hitler and Stalin), and will only incorporate new food items in his diet when he has tried them at a fancy restaurant. All of these qualities appear to be that of someone on the spectrum who would benefit from interventionist treatments, yet if Gnaulati qualifies him as not on the spectrum, he will not receive these services based on government regulations, health care laws, etc. Just because someone on the spectrum isn 't low functioning doesn 't mean that they don 't benefit from treatment and services. If a child on the spectrum is lacking social skills that can be worked on and perhaps that child could see success for making a friend, for succeeding at a job interview, at a job, and in a romantic relationship. By telling people that it is just introversion seems like such a wrong thing to do when a big part of the increase in diagnosing is just taking precautionary measures!
Gnaulati is a qualified, clinical psychologist with a Ph.D. and his present stance on ASD is that there is an overdiagnosis and “brainy, introverted boys” need to “beware.” He believed that “the earlier an evaluation is conducted, the greater the risk of a false diagnosis” (Gnaulati, 2013). His current opinion, which was just published this September 2013, contradicts with the past historic viewpoints of many experts, including Buron and Wolfberg (2013). In conclusion, concerning the recent history of ASD, there are huge differentiations in opinion being given about the increase in ASD. Most importantly, I believe that it has further been cemented in my brain the amount of unique information available to families and how a diagnosis can seem so much more overwhelming when you read such extremities.

Works Cited
Buron, D.B., Wolfberg, P. (2008). Learners on the Autism Spectrum. Kansas: Autism Asperger
Publishing Co.

Gnaulati, E. (2013, September 21). That’s not autism it’s simply a brainy introverted boy.
Salon.com. Retrieved: September 30, 2013 from http://www.salon.com/2013/09/21/thats_not_autism_its_simply_a_brainy_introverted_boy/