Olmsted on Newsweek: Diagnosis, Epidemic & 1985
This week’s Newsweek cover story on autism and adulthood “fails to confront a key issue, one that bedevils mainstream publications every time they write about autism,” according to Dan Olmsted in The Age of Autism: What Newsweek Missed. And what is that key issue? Olmsted writes:
Is it really increasing? Or are we just doing a better job of diagnosing the disorder?
Olmsted takes Newsweek to task for failing to “connect the dots” between the lead story’s attributing the rising prevalence of autism to better diagnosis and a quote in an accompanying article regarding Thomas Insel, director of the National Institute of Mental Health: “In 1985, curiosity sent him searching; it took several phone calls to find a single patient.” Olmsted asks:
Does today’s “more sophisticated epidemiology” really square with Insel’s experience? I don’t believe it does; 1985 was hardly the dark ages of medical diagnosis.
But if we are currently living in the Age of Autism Enlightenment—-in which the standard figure for autism diagnosis is every 1 in 166 children—then 1985 might be something more like the Early Modern Period of autism understanding, when various of the treatments (such as ABA) for autistic children were developing. Temple Grandin’s first book, Emergence, was published in 1986, while 1987 saw the publication of the DSM-III-R, in which the category of “Atypical Pervasive Developmental Disorder” was changed to “Pervasive Developmental Disorder Not Otherwise Specified (including Atypical Autism)” (Grinker 2007: 136-7).
In other words, what gets classified—identified—diagnosed as autism today may not have been what medical professionals were seeing in 1985. The one individual with autism that Olmsted refers to is Donald T, ” first child in the landmark 1943 study identifying autism,” who is is now 73 years old; he does not refer to any autistic persons diagnosed in 1985 or, indeed, today. Thus Olmsted can make sweeping statements like the following:
Because it doesn’t connect the dots, Newsweek misses the point: We’re in an epidemic, which is why the future of this generation is a crisis. The article’s whole premise, however, inadvertently suggests the truth: There are now so many kids with autism — “as many as 500,000 Americans under 21,” the magazine says — that caring for them as adults must be urgently addressed.
First, in reference to the final sentence in this passage, we need to “urgently” address how to care for autistic adults who need more services not because there are “now so many” autistic persons, but because autistic persons ought to have the best care and services possible, regardless of their numbers. Second, Olmsted moves swiftly from making the case for an autism epidemic—which, as I have written earlier, need not be thought of as simply negative—to announcing that the “future of this generation is a crisis.” Olmsted is suggesting that, because of an unprecedented and large increase in autism diagnoses, a crisis is ahead of us due to a severe lack of services and programs for autistic adults.
Olmsted’s argument for not only an epidemic of autism but also a looming crisis for autistic persons and their families rests on the claim that the numbers of children diagnosed with autism has increased dramatically since, say, 1985. Are there really more autistic persons; is there some “hidden hoard” of autistic adults who have yet to be accounted for—who might be hiding in plain sight?
Olmsted ends his article by stating that “until we stop ignoring the obvious, we’re never going to stop this epidemic — and find new and better treatments for people already afflicted.” Perhaps there are a few more dots that Olmsted himself has to connect, to find what is obvious, that there are indeed more than a few autistic adults out there, ready, undiagnosed, and able.
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POSTED IN: Adulthood, Autism Lit, Books, Diagnosis, Education, Environment, Health, History, Psychology, Science, Treatment
2 opinions for Olmsted on Newsweek: Diagnosis, Epidemic & 1985
Roy Grinker
Nov 21, 2006 at 9:22 am
My wife, a psychiatrist, was trained at Mass. General Hospital, and she (like Insel), never saw a case of autism. Why? There was no one in the dept. with a specialization in developmental disorders. So people with autism were treated at other centers, or, at Mass. General, by neurology. The reason she didn’t see any cases was because they never came to psychiatry. We have to recall just how young a field child psychiatry is.
Autism Vox » Epitasis and Aposiopesis in Dan Olmsted
Jan 10, 2007 at 1:17 am
[…] Figaro of Figures of Speech served fresh notes that epitasis “supplements a point with a sentence that adds emphasis rather than meaning.” Indeed, Olmsted’s Age of Autism series returns again and again to the same topics: He has continually called for investigation into an autism-vaccine link, stated that there is an epidemic of autism, and noted that earlier evidence suggests that autism and “a rare and mysterious autoimmune disorder,” Still’s disease, may be connected. Epitasis thus serves Olmsted well as, by “stretching out” what one sentence, and one article, are saying into the next and by adding on phrases of similar meaning but different wording (”…..disorders on the autism “spectrum” now afflict as many as 1 in 166 children. Note: children. Where are the 1 in 166 autistic adults?”), Olmsted is able to continue to make the same points about autism—namely, that autism is an epidemic affecting today’s children that has potentially been caused by vaccines or by mercury or by some environmental agent, and that the truth about all this is not being revealed by some institution or agency (of the government). […]
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