Savage on Autism

[Tsukasa Buddha]

Another thing I see this as similar to is the whole "depressed people just need to get over it, stop whining, and move on" or "people with anxiety 'disorders' are just people who like to worry".

 

[Gazpacho]

Why Asperger's specifically?

Because of the number of social misfits who diagnose themselves with it or whose parents shop around for a diagnosis.

Psychiatric diagnosis is heavily politicized in the US education system. In some jurisdictions it's the only legally safe means of dealing with disruptive children.

There is a clear tendency in certain areas to ascribe any social failing in children- or indeed in adults- to one "syndrome" or other.

Drunks are no longer drunks, they have alcoholism.

Lazy people have fatigue syndrome.

Thieves have "kleptomania".

These are all terrible examples.

 

[lionking]

Without supporting Savage's hyperbole, ADHD does seem to be over diagnosed in Australia at least, where challenging childhood behaviour can be treated easily with Ritalin rather than the expensive and time-consuming serach for underlying causes of the behaviour. When Ritalin was put on the Pharmaceutical Benefits Scheme (meaning it became cheap) prescriptions went from just over 500 a month to nearly 6,000. Perhaps reflective of a real need for this drug, or perhaps an easy cure to a complex problem.

 

[skeptifem]

Never heard of Mr.Savage. He certainly seems like a bit of a twit, but occasionally there's a weak signal discernible in the noise of the emptiest vessel.


There is a clear tendency in certain areas to ascribe any social failing in children- or indeed in adults- to one "syndrome" or other.

Drunks are no longer drunks, they have alcoholism.

oh yeah because no one says 'alcoholic' in an insulting manner. please.

Lazy people have fatigue syndrome.

you are pretty ignorant if you think chronic fatigue syndrome is laziness.

Thieves have "kleptomania".

again, I dont think anyone feels better about having kleptomania. Being a chronic theif is implied by the name.

Some of the time

, this view is justified and helpful.
If treating behaviour X as illness "I(X)" gets people over it, fine and dandy- whether I(X) actually exists or not.

The label isnt helpful by itself, its finding appropriate treatment for the problem. identifying the problem isnt a bad thing ever. I dont know how someone could seriously have a problem with medical definitions like 'alcoholic' being used when they mean the same thing as 'drunk'. Medical everything has its own name, there are courses in medical terminology for this exact reason.

But if it merely provides an excuse to persist in behaviour X, then it is a useless strategy.

simply diagnosing someone with anything isnt a strategy at all.

Pretending every badly behaved brat has ADHD or autism will not help either the brat or the people who genuinely DO have those conditions. Indeed it harms both and adds insult to the injury of those who do have the condition. (I don't have the slightest doubt autism exists as a spectrum of neurological problems. I'm less convinced by M.E. and I don't believe in alcoholism at all. (I do believe in drunks. I know several)).

Where the problem is not medical, but attitudinal, then what needs adjusted is attitude. That can't be done by indulgence, or by pretending the cause is not what it is.
The trick is knowing which case is which- and thatcan be genuinely hard.

It is made even harder when any departure from the default, "syndrome" view is seen as unhelpful because unsympathetic.

Sometimes, being unsympathetic is the kindest way to be. We need to separate those cases and handle them appropriately.

yeah because psychological treatment doesnt try to deal with attitudes at all, they just give you a dx and send you on your way.... ???what planet are you living on?

 

[skeptifem]

Without supporting Savage's hyperbole, ADHD does seem to be over diagnosed in Australia at least, where challenging childhood behaviour can be treated easily with Ritalin rather than the expensive and time-consuming serach for underlying causes of the behaviour. When Ritalin was put on the Pharmaceutical Benefits Scheme (meaning it became cheap) prescriptions went from just over 500 a month to nearly 6,000. Perhaps reflective of a real need for this drug, or perhaps an easy cure to a complex problem.

part of the reason for the over diagnosis is gender bias in the dsm. the criteria for add/adhd was based almost entirely on male children who were more likely to act out in certain ways for cultural reasons. so a lot of girls were underdiagnosed. I certainly was. I made it all the way through school without anyone mentioning it, despite truancy meetings and other problems that resulted in teachers meeting with me and my parents, and that was only a couple of years ago so i made it through the add diagnosis boom without anyone even considering that i had it. Pretty much everyone I knew diagnosed with it was a guy, and a lot of them were not taking their ritalin at all and didnt need it. the criteria for add is being changed for the next version of the DSM though so it may make a positive difference.

but really giving children who act out and dont have an attention problem ritalin does not work. its basically speed. so if its a 'solution' to problem children its a crappy one.

 

[Skeptic Ginger]

Michael Savage is a right leaning demagogue.
He is relatively intelligent but his beliefs blind him to his idiocy. He isn't far off from Rush Limbaugh on many issues.

Intelligent? That's a stretch unless his persona is just a money making act.

 

[Skeptic Ginger]

Without supporting Savage's hyperbole, ADHD does seem to be over diagnosed in Australia at least, where challenging childhood behaviour can be treated easily with Ritalin rather than the expensive and time-consuming serach for underlying causes of the behaviour. When Ritalin was put on the Pharmaceutical Benefits Scheme (meaning it became cheap) prescriptions went from just over 500 a month to nearly 6,000. Perhaps reflective of a real need for this drug, or perhaps an easy cure to a complex problem.

While all sorts of illnesses are misdiagnosed both over and under, the anti-drug-your-kids group in ADHD is similar to the anti-vaxers. They are on a mission and it often gets in the way of their objectivity.

If you stick to the evidence based treatments which hopefully the majority of physicians do, the idea incompetent parents are just getting docs to medicate their children's behavior problems is a myth. There are differences in prescribing practices between countries. That is worth looking at. But the diagnosis is real and the treatment effective. It is a harder diagnosis to make since there isn't an easy objective test like a blood test. But the subjective criteria are specific and not made in a single visit with a parent taking their child in and complaining.

 

[mrbaracuda]

But yeah, even my conservatives family members think Savage is nuts.

That would be the racist ones? You know, the ones besides you.

 

[lionking]

While all sorts of illnesses are misdiagnosed both over and under, the anti-drug-your-kids group in ADHD is similar to the anti-vaxers. They are on a mission and it often gets in the way of their objectivity.

If you stick to the evidence based treatments which hopefully the majority of physicians do, the idea incompetent parents are just getting docs to medicate their children's behavior problems is a myth. There are differences in prescribing practices between countries. That is worth looking at. But the diagnosis is real and the treatment effective. It is a harder diagnosis to make since there isn't an easy objective test like a blood test. But the subjective criteria are specific and not made in a single visit with a parent taking their child in and complaining.

I can't really argue with this, but am still puzzled that some parts of Australia (in the large cities) have some of the highest rates of ADHD diagnosis in the world and in regional areas it is quite rare.

 

[Gazpacho]

the idea incompetent parents are just getting docs to medicate their children's behavior problems is a myth.

The idea that parents and teachers use psychiatric diagnoses as legal fictions so they can invoke some section of school policy isn't a myth. I've seen the paperwork. It happens.

 

[Soapy Sam]

Grenme- No, I don't think you're wrong.

(Aside-steel helmets were a feature of European war for centuries. US troops in WW1 were generally equipped with British ones, as the US army evidently did not, as you say, use them as standard. They did afterwards. On the other hand, miners' safety lamps really did kill miners, but that's another story...)

But I don't think I am wrong either.

I'm saying very simply that there are medical conditions typically defined by asocial , or anti social behaviour and there is behaviour (on the part of people who do not have those medical conditions) , which can be confused with those conditions. And we must be able to tell the difference. If a child spits on someone because he has a neural problem, he needs help. If he does so because he's rude, he needs something else.
If we "treat" him for a condition he does not have, we help nobody.

In the past, I think society too often erred on the side of assuming that all " asocial behaviour" X (of whatever sort) was a failing of character- of parental discipline or of self discipline in many cases.
Today I believe we may err the other way- by assuming all such problems are medical / organic as the default position.
(Of course we may have it 100% right. But I'm sceptical).

In some cases, the organic default is the wiser and more humane position to take- especially with problems like childhood autism which are developmental (ie time dependent) and take time to pin down, often at critical stages in a child's life. (In the specific case of childhood autism, I think Savage is dead wrong. And if I appeared to confuse / conflate ADHD with autism, that's poor writing on my part, for which I beg your pardon. I'm aware they are quite different. I'm not sure if Savage is.)

My point is simple- Some cases of these "social illnesses" for want of a better group term) are misdiagnosed due to the change in default assumption. " Playing safe", if you like. That may be 1 % or a fraction of 1%. I don't know. I doubt anyone knows. I certainly don't credit the 99% Savage claims, but I'd guess the figure may be significant.
(I read some more of Savage's stuff last night. My opinion stands; he is indeed a twit.)

But for every dollar spent on those who are not suffering an actual organic condition, a dollar less is spent on those who are. (Coming from the UK, where most medical costs come from a central pool, this probably influences my attitude). I have friends in the NHS who tell me stories of immense waste of resources coddling people who have nothing clinically wrong with them , but who persistently take up resources and time which could be better applied elsewhere. In the US, where patients are likely to be charged up front, perhaps that is less of a problem.

And that is the whole of my argument: We need to be objective (and yes, sceptical) about the default position- We have finite resources and they should be applied to the best advantage of the truly needful. That certainly includes more research into the actual cause of conditions like autism.

On the general disagreement with my position, I can only say I'm always open to information. Boo's link on autism is a fine example. On ME, those studies I have read seem inconclusive- many UK doctors do not believe such a condition exists. They may be wrong, but the fact there is widespread doubt suggests it's hard to pin down. But convince me, by all means. I still think some people use it as an excuse, just as they use "bad backs".

As for alcoholism, sorry, I do not see this as a disease. It's self poisoning. That the underlying reasons may benefit from being treated as an ailment is another argument entirely and if it works, great. But that's a side issue to the OP and I probably should never have raised it.

Now give me a minute to get my shields up before you all start again with the brickbats.

 

[Ivor the Engineer]

Perhaps it will be discovered Mr. Savage has a mental illness, which can be used as a label (and possibly an excuse) for his behaviour. Then all of those who condemn him will have to feel guilty for persecuting a mentally ill person who couldn't help himself.

 

[Soapy Sam]

For those who haven't seen it, there's an interesting link in this thread
http://www.internationalskeptics.com/forums/showthread.php?t=115527
to a new book on autism.

 

[Dancing David]

Michael Savage is a right leaning demagogue.
He is relatively intelligent but his beliefs blind him to his idiocy. He isn't far off from Rush Limbaugh on many issues.

I would guess his show is more of entertainment from some people than informational.

 

[Dancing David]

The idea that parents and teachers use psychiatric diagnoses as legal fictions so they can invoke some section of school policy isn't a myth. I've seen the paperwork. It happens.

This is an interesting point, and has some truth from an anecdotal basis. I agree, there are kids whose parents doctor shop for a diagnosis. however in all the cases i can think of , it is a search for a palatable diagnosis, more appealing to the parent.

For example a child who has a parent who displays some classics psychosis (affective flattening) and features of bipolar disorder with narcissistic qualites. there child has been a pain in the booty since kindergarten, meets the fcriteria for conduct disorder and bipolar disorder. the schools would like to address the disruptive behaviors as 'emotional disability' (and I mean extremely disruptive, like dumping desks and screamin). This however does not make the parent happy, as they would NOT want the child to be labeled as having a mental illness. So they shop around until they find a doctor who gives a diagnosis that the parent prefers, but is still labled as bipolar later in the dianosis. the parent comes to the schools and say 'They have Aspergers' which is allowed for special ed under "Other health Impairment" (same as ADHD).

However the child is not getting the ED services that they really need.

this is very common especialy with Aspergers and Tourette's syndrome (both of which are real) , parents wil shop around to explain away the problems that the child has. the main issue is that often the diagnosis is incorrect, especialy Tourettes when Intermittent Explosive DO is more likely.

This is also more of an issue for middle class parents than lower income parents.

 

[Dancing David]

Perhaps it will be discovered Mr. Savage has a mental illness, which can be used as a label (and possibly an excuse) for his behaviour. Then all of those who condemn him will have to feel guilty for persecuting a mentally ill person who couldn't help himself.

Autism is not a mental illness, it is a developemental disorder.

 

[Dancing David]

Made the Yahoo News:
http://news.yahoo.com/s/ap/20080722/ap_en_ot/savage_autism;_ylt=AllApgxTILweJOsZIMRqL7Cs0NUE

 

[Fronzel]

I saw a show on CNN about Autism for some awareness day they were using. One of the producers had an autistic child. They listed the symptoms he had.
There were things like Difficulty in social situations, Liked math and science, very few friends, introverted and a few others and it made me realize that being a weird nerdy kid in school is now autistic.

you are pretty ignorant if you think chronic fatigue syndrome is laziness.

I'll admit to being ignorant about it, but It doesn't seem to occur on the farm too much.

I don't think Doctors normally invent diseases just because they are bored, but it does seem like everybody has to have something.

 

[Billdave2]

I can throw at least some personal anecdotal evidence in this conversation. My wife works in the genetics field. Her job is to schedule genetics testing for children that have been refered by the state department of disabilities and special needs because they have some form of developmental delay. She gets a family history and then is present during the examination by one of the clinical geneticists (these doctors are also pediatricians by training). The goal is to determine if there are any genetic anomalies present to explain the delays. They see lots of kids on the autism spectrum and all the data they get is used to further there research in to what is causing it. All of this knowledge my wife has gained came in very handy after our son started daycare. After a the second week, one of the "teachers" (it is church daycare, only the director has a degree) told my wife we needed to look into moving our son into the public school for kids with special needs. They said they "believed" he was autistic. There reasons for believing this? He didn't play with the other children as much as they thought he should and he tended to wander off when they had the kids in circle learning songs (by the way he was three and had kept by my parents up until then and not around other children much). They had already filled out paperwork for us to take to the special needs school describing my son's behavior. My wife told them to hold off while she got a second opinion. She asked the doctors she works with, who have known our son since literally the day he was born (one of them examined him 20 minutes after his birth). They told her there was no way he was anywhere on th eautism scale. Taking it one step further she contacted the developmental pediatric doctors that that tehy worked with when they do big clinics for another opinion. We took him in to see them and they looked over the paperwork and then interacted with him, had him play games, asked him questions etc. There opinion was if he did not have autism, but if anything may have a slight case of ADHD, but not major. He also said that the paperwork the daycare had filled out showed that he had every single syptom of autism, and they had rated those symptoms as all being 10 ona scale of 1-10 with 10 being the highest. He said any child that truly had those type scores would be so profoundly autistic that there would be absolutly no doubt. My wife went back and told the daycare we would give it a few weeks and see how it went. After a couple of more weeks, my son was playing with the other kids like "normal", he had apparantly just been a little shy at first. He still didn't sit in circle well, but the teachers soon realized that the reason he got and went to do something else was because after going over the song once, he knew it and got bored sitting there. My wife asked the developmental pediatrician what would have happened if we hadn't questioned the daycare and just went to the special needs school. He said that based on the paperwork the daycare had filled out he most likely would have been admited without further testing. They would have realized fairly quickly that he didn't belong but that it would be on his permanent record and he would probably have to go through lots of testing when he got to elementary school to be put in regular classes. The moral of this story is that there are kids who definatly get misdiagnosed an dmost parents don't have the knowledge or resources that we did to be able to question the system.

 

[GreNME]

Soapy Sam: thanks for not getting bent out of shape. I was hoping that I didn't go too far in the hyperbole of my first sentence.

Grenme- No, I don't think you're wrong.

(Aside-steel helmets were a feature of European war for centuries. US troops in WW1 were generally equipped with British ones, as the US army evidently did not, as you say, use them as standard. They did afterwards. On the other hand, miners' safety lamps really did kill miners, but that's another story...)

But I don't think I am wrong either.

I'm not saying you're necessarily wrong, I'm saying that there is very likely less of what you describe than you think, and that autism is definitely not similar to those other conditions you mention.

I'm saying very simply that there are medical conditions typically defined by asocial , or anti social behaviour and there is behaviour (on the part of people who do not have those medical conditions) , which can be confused with those conditions. And we must be able to tell the difference. If a child spits on someone because he has a neural problem, he needs help. If he does so because he's rude, he needs something else.
If we "treat" him for a condition he does not have, we help nobody.

That's all well and good, but the trick is refining diagnoses so one doesn't get confused with the other. You'd agree that modern medical science is regularly working to improve diagnosis, yes?

In the past, I think society too often erred on the side of assuming that all " asocial behaviour" X (of whatever sort) was a failing of character- of parental discipline or of self discipline in many cases.
Today I believe we may err the other way- by assuming all such problems are medical / organic as the default position.
(Of course we may have it 100% right. But I'm sceptical).

As am I, but I've learned that diet and overall general health from a very young age plays a lot into the development of the brain and all its chemicals. As such, (lately) I've been coming to the conclusion that we've passed the point of the pendulum swing you mention there and that more and more people are becoming aware that it isn't just parenting, it isn't just medicating, it's that many kids are being deluged in environments where several factors may be turning what could be considered behavioral problems into actual medical conditions.The problem is that I don't think any person or agency is sure what the optimal balance is for avoiding this, nor do I think that balance is going to be the same for everyone.

In some cases, the organic default is the wiser and more humane position to take- especially with problems like childhood autism which are developmental (ie time dependent) and take time to pin down, often at critical stages in a child's life. (In the specific case of childhood autism, I think Savage is dead wrong. And if I appeared to confuse / conflate ADHD with autism, that's poor writing on my part, for which I beg your pardon. I'm aware they are quite different. I'm not sure if Savage is.)

No, I don't think you conflated the two. At least, I didn't take what you said as doing so. You seemed to be clear in your distinction, I am just suggesting that perhaps our differences are more a matter of extremes rather than opposition.

I do somewhat disagree about the other things you mention, though. The reason I only somewhat disagree is because I think there are cases where genuine illness diagnoses are used to treat what would otherwise be a case where someone needs to change behavior and habits and medicine (or treatment, or operations) won't necessarily do that for them. I think that alcoholism might be one such case, where in some areas a diagnosis of alcoholism might be attributed to someone who simply needs to stop being such an irresponsible binge drinker. I would disagree that alcoholism isn't an actual condition, though, because there are definitely symptoms attributable to alcoholism that are very much the same as chemical addiction. Still, that's a whole other conversation and I'm not necessarily convinced that all people who are called alcoholics share those physical criteria that are attributable to an actual chemical addiction (but there are some who do).