Autism diagnoses and parenting problems

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.