Autism diagnoses and parenting problems
Bookworm on Jul 21 2008 at 6:00 pm | Filed under: Parenting
Back in November 2007, I wrote a long post talking about the fact that I see a lot of children who are labeled as having Asperger’s (a subset of autism) but who seem instead (or also) to be the victims of profoundly bad parenting. I noted that I have known over the years children who are actually profoundly disabled, and whose disability has been given the Asperger’s/autism label. These correctly diagnosed children are quite different from the problem kids I identified in my earlier post. The children I identified in my post, the ones I thought were victims of diagnostic overkill rather than an actual disability, weren’t kids who lack language skills, or control over their bodies, or who have obsessive interests that impair their ability to function, or who fail to recognize ordinary human emotions. The kids I know who fall into those latter categories of genuine disability are, frankly, doing wonderfully well and working vigorously to maximize all of their strengths.
Instead, in my November post, I was talking about the children who are prone to chronic tantruming and who get slapped with an Aspergers label as a sop to the parents. Here is how I described these children, all of whom have on their “permanent records” labels that place them within the autism spectrum:
Where I’m about to get controversial is my sense that, in some cases, Aspergers is the diagnosis given to children whose parents are not parenting. I know three — count ‘em, three — children who are nightmarish behavior problems. What characterizes all three of them is the uncontrollable temper tantrums they have. And I’m not talking about 2 or 3 year olds lying on the floor hollering “No!” I’m talking about kids who are 7 or 8 or even 11 or 12 and who regularly engage in scenes that involve uncontrolled screaming, hurling insults and, often, physical violence against other adults or children. Because of the scenes — and only because of these scenes — each set of parents eventually took the child to a psychiatrist. That is, the parents did not take their kids to the psychiatrists because they weren’t socializing well or because they were obsessed with a single subject at school. They took them because of those off-the-charts tantrums. In all three of the cases I know, the psychiatrists diagnosed the kids with Asbergers.
But here’s what I didn’t tell you about those three children: In each of the three cases, the parents (in my humble estimation) earn an “F” for structure and discipline. The common pattern in each of those households is that one or both of the parents feels an almost excessive sympathy for the kid when he (or she) is frustrated or unhappy. What the child wants, the child gets. One of the children I’m thinking of ruled the whole household. She dictated what was eaten, what wasn’t eaten, where people went, what they did, what bed time was, what toys and games were bought and rejected, etc. The parents thought that they were making her happy, but to an objective observer, the child was miserable. It was way too heavy a burden to place on a 10 year old, and she was a frenzied, hysterical tyrant who was unable to cope if anything didn’t go her way.
What also characterizes all of these parents is that, when the child has a tantrum, regardless of how awful it is, and what havoc it creates, the parents respond, not with discipline, but with sympathy: “The poor little thing. He couldn’t control himself. He was so upset I didn’t have the heart to punish him.” And in each case, this sympathetic response to the child’s tantrums worsens after the diagnosis. Now the parent is not only sorry for the child, but he’s convinced that the child is “sick” and must be handled with ever greater care.
Apparently I’m not the only one who has noticed this diagnostic trend — that is, to reach a psychiatric conclusion that all tantruming little children have a disease — although I pointed it out tactfully and to a small audience. Radio host Michael Savage apparently made the same point, but did so in way that managed to offend everyone:
Radio talk show host Michael Savage, who described 99 percent of children with autism as brats, said Monday he was trying to “boldly awaken” parents to his view that many people are being wrongly diagnosed.
Some parents of autistic children have called for Savage’s firing after he described autism as a racket last week. “In 99 percent of the cases, it’s a brat who hasn’t been told to cut the act out,” Savage said on his radio program last Wednesday.
Savage offered no apology in a message posted Monday on his Web site. He said greedy doctors and drug companies were creating a “national panic” by overdiagnosing autism, a mental disorder that inhibits a person’s ability to communicate.
On his radio show last week, he said: “What do you mean they scream and they’re silent? They don’t have a father around to tell them, `Don’t act like a moron. You’ll get nowhere in life. Stop acting like a putz. Straighten up. Act like a man. Don’t sit there crying and screaming, you idiot.’”
As I already demonstrated months ago, I think Savage is on to something. While all of us recognize that there are genuinely disabled kids out there, kids whose behaviors span the spectrum from severe autism to geeky Aspergers, those of us who are honest recognize that there is also a major epidemic of bad, weak, inconsistent parenting out there, and that it is creating thousands of damaged kids who are treated, not with good parenting, but with bad medicine. I’m only sorry that it was Savage who made this point, because you can count on him being so spectacularly tactless and inflammatory that the message gets lost in the ruckus.
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Autism is real, Asbergers is real, and Lousy Parenting is definitely real, and getting worse. Before I go any further, there is NO SUCH THING AS QUALITY TIME if by that you mean you can pretend that an hour spending some allegedly special time with your kid so you don’t feel guilty about dumping him/her on nannies, day care, this program, and that class while you go sell Real Estate.
These parents are fully complicit in getting to the doctor who will diagnose the KID with the problem. “See! It’s not ME! My poor, poor child has this terribly exotic disorder.” And thus the kid is marked for life, and will act out even more, and more dramatically and catastrophically, until that parent starts BEING a parent, who demonstrates actual caring by getting into it with the kid. Sadly, an older child may be too far gone.
In short, kids spell “love” T I M E. They want YOU, and lots of YOU regularly, predictably, and reliably, not some series of hired caretakers, and wardens with you dropping in now and again.
Or, if you’re helicopter cream puff mom who caters to your kid’s every whim, every want — have you noticed that EVERYTHING, ALL the time, ALWAYS is not enough? That’s because kids CANNOT control themselves, and CANNOT be satisfied by giving them everything they “want.”
Kids don’t want stuff. They don’t want their whims, regardless of what they say. What they want is to feel SAFE, WANTED, and LOVED, and they get none of those things when they are allowed to spin out of control. SAFE means that an adult will protect them from themselves. Kids are programmed to need parental control. When they don’t get it, alarm bells go off, and they start demanding it — and I’m not talking conscious, aware, verbal demands here — until they get it.
Lest you think I’m some benighted dolt, I repeat: Yes, Autism is real, Asbergers is real. I am close to a young person who has Autism Spectrum, and it’s real. We don’t know the cause.
But so is this rash of hideously bad parenting, all — apparently — in the name of not “traumatizing” the kid, or just due to plain old self centered parents.
Sorry for this poorly organized post, but I’m steamed. I’ve seen both, and the cause of too many is plain to see, and just deprives kids who really do need the help from getting all they need.
I read a certain blog where the mother has posted much about her daughter. The daughter was recently diagnosed Asberger’s, which any fool reading the mother’s blog would know is wrong. I believe Asberger’s is real (I’ve wondered if I had it, but determined I’m just plain weird), but Asberger’s is the new ADHD - a catch-all for corporal punishment/structure-free parenting. This is terrible for the parents of Asberger’s kids, just like the ADHD catch-all diagnosis is bad for parents of true ADHD kids. I often hesitate to tell someone our son is ADHD because the false positives have given the diagnosis such a bad rep. And the horrible education system has given people the idea that our dyslexic and dysgraphic daughter must be illiterate. Nevermind that she’s twelve and currently reading the Iliad. Sigh.
Michael Savage is an easy target for some who hate the message and see shooting the messenger as the best option.
I listen to Savage’s radio show. His on-air personality and behavior can lead some people to believe that he uses a shotgun to discuss topics ifor which a pistol would be better.
All-in-all, though, American society will be paying the price - in the cost of misdiagnosed autism/Aspergers/whatever - for the fatherless family created by the 1960s welfare mindset.
Savage is a gem of tact and soft-speaking compared to many of the conversations about it that go on within the profession, lemme tell ya!
His only error is that he misspoke, it seems to me, and it’s a not uncommon mistake. He didn’t mean autism. He meant the rest of the BS: ADD, HD, ADHD, etc. As a shrink myself I’ll go along without hesitation with the idea that ALL of that stuff is crap. All of it. Every bit of it. And 80% of the time so is a diagnosis of AS, and autism is probably 60% over-diagnosed.
In this society we are beset with parents who do not know how (our generation has proved pathetic parents); teachers who do not know how; zealots who do not know how - like Hillary Clinton, who have successfully made it illegal for a parent to whop a kid one when needed (and despite all you’ve read in “Modern Mumbo-Jumbo” or wherever else you’ve heard it, an occasional whop remains the answer to many an issue - just as it has been for the last 2,000,000 years); shrinks who don’t know how (a psychiatrist is the absolute worst place to take a kid; they don’t know how to work with people and they’re not interested in finding out: they dispense drugs); and a society that thinks it’s helping kids by making it illegal for Bookworm, where she lives, to glare crossly at one of her offspring.
So all of that kind of alphabet soup nonsense is precisely that: nonsense, to which Savage’s remarks are totally applicable. But, though Autism is insanely over-diagnosed, it is quite real, and when it is profound it is devastating.
As far as the rest of it’s concerned, you’ve probably noticed on the goggle-box: the “Dog Whisperer” mostly ignores the damn dogs, and tries to train the owners to make sense. This is not much different. Kids in the state of nature are not much different than the dogs, and aren’t successfully trained in ways fundamentally differently than the dog, either; IF - you can train the parents to do it. (It’s a big “if.” Huge “if.” Gigantic “if.”)
But a psychiatrist isn”t going to do it: they don’t know how. A clinical psychologist (me) is better, but not best. You’re best off with a well-schooled male clinical social worker, and next best off with a female - if you can find one who doesn’t need to lose half her body weight. (We don’t know what it is with female social workers [and this isn't random cruelty: it does get talked about], but you have to figure that anyone who’s most rewarding relationship in life is with a bag of Chips Ahoy or a pint of Haggen-Dazs is probably not a good bet to help you get your life re-oriented.)
But Savage’s main point is a simple one, and he’s not wrong: if the human offspring was as screwed up as the current numbers would have you believe, one is left to wonder how the hell the human race prevailed over the last several million years.
Check out John Rosemond at Rosemond.com. He has been a common sense advocating child psychologist who once called the alarm on the ADHD “epidemic” and now calls the alarm on the latest “epidemic” of children with “bipolar” - I think this autism business is along the same lines. I have 3 sons who have never been easy - all 3 have had teachers tell me they needed to be medicated for ADHD. I think they are just boys with “ants in their pants”. they spent a lot of time on “house arrest” living in their rooms sometimes for weekends at a time (with no TVs or computers in there either). The first one is an honors student at a great university. The second and third are turning into pretty decent teenage boys.
[...] Bookworm Room Autism diagnoses and parenting problems Just a quick reference on autism. Autism is the new diagnosis by doctors who dont know what else to do. Kind of like ADHD use to be. It does have alot to do with parenting and allowing kids to get away with anything and everything. I am not saying that all cases are like that but a large percentage are. __________________ “Get out there and nail everything you can!” [...]
I wrote a post on this very issue Sunday here
http://thehillchronicles.com/?p=1431
I do not believe that children with Autism or Aspergers Syndrome are being over-diagnosed. However, I do believe it is being confused with ADD/ADHD unfortunately, which is widely used.
Wonderfully sensible comments, and kudos to you for enduring the fiery headwind into which you’ve been flying, the flames of which I’ll just assume you have been sharing with me. We’re in the minority here. Maybe it’s a verbal minority and not a nose-count minority, but we’re certainly outgunned.
Personally, I think “Kidzmom” and I have both been wonderful parents to our own falsely-diagnosed son — but diagnosed he is, because nowadays, as you put it, “all tantruming little children have a disease.” (FWIW, our little darling didn’t even tantrum, he just put more emphasis on his personal little projects than on jibber-jabbering with people, just like his Dad — in other words, he is what used to be called a “nerd.”)
I have to run now, but for now, I’ll just block-copy my five points from Dr. Mel’s place as I see no reason to revise them at all. I think all five are critically important, and as people quibble back and forth about this, we’ve shown a persistent and unfortunate tendency to miss all five. You have been far more insightful here. Well done.
1. How come people use horror stories about genuinely autistic kids, to argue with Dr. Savage? You should be able to answer that; it’s what you just did. Here’s what you’re not seeing: I read stories like that and my thought is, well, in case there are further doubts, I’ll have to file this story — My child isn’t doing those things. I think (partly because of the indelicacy of Savage’s remark) folks like you have lost sight of what the debate is. We aren’t debating whether autism exists; we’re debating whether it’s being over-diagnosed. And it is. Wretchedly. For government money.
2. I see parents of autistic children are not taking offense at me for agreeing with Dr. Savage, or coming to his defense. My position is that he is guilty of mixing his “doctor” gig with his “shock jock” gig, failing to clarify in what capacity he’s speaking. So it isn’t as if I’m really defending him; I’m saying he’s got a good point and he’s right about some things, which is slightly different. So the parents of autistic kids are really getting offended at anyone who won’t join the witch hunt and string Dr. Savage up by his short hairs. Which answers your question: The kids may not be sacred cows, but this disorder certainly is one. Why do the parents who personally live with these challenges every single day, seem to be incapable of digesting answers that aren’t simple and black-n-white?
3. On that note — how are their (your) children diminished just because the parent of ANOTHER child wants to show some skepticism about whether his child is part of the autism crowd? How does this impact the first kid? Seems to me a more logical reaction would be “Thank you for questioning the system, to ensure the finite resources are available to help the kids who really need help, like mine.” Doesn’t that make sense? The time and expense needed to accommodate the special needs of kids who have this disorder, are not trivial, as you’re aware.
4. Autism is unique in being treated as a “spectrum” of disorders, which I think is an abominable and reprehensible practice and I’ll tell you why. Some of these are real disabilities, with physical definition. Neurological damage which can be verified by means of simple tests. Others are behavioral, and are matters of opinion. Kids with PDD-NOS who are extreme cases, it’s a pretty much settled thing. But with the borderline cases that could just be quirky personalities and nothing more exotic than that, this causes real problems. The “laymen” hear their children have been “diagnosed” and they think it’s lesions on the brain stem, or something that can be validated — in fact, it’s nothing more concrete than a doc going through a checklist and saying “yeah, I think he acts that way.” Completely subjective. As I’ve said before, there are valid reasons for continuing to evaluate both types of disorder here and continuing to refine what we know, and learning about what we don’t know. But mixing them together in the same bag? That’s terrible. It causes confusion, damaging, predictable confusion, and I don’t see anybody working to alleviate the confusion. I think they’re in it for the money.
5. I’ve used the terms “disorder” and “disability” somewhat interchangeably here because I’ve noticed that’s what the behavioral health profession has a tendency to do. When discussing these borderline cases, these terms should not be intermixed. A disorder is something that is out of the ordinary; we all have disorders of some kind or another. But as I continue to tell people, and I’ve been sounding like a broken record for many years now: A disability is not something you drop when you go visit your Dad, and he expects you to not have it.