Children with autism may receive 1:1 classroom support - or placement in a smaller classroom with a higher teacher to student ratio. They may have their curriculum specially modified, and be tested with accommodations made for their difficulty with language processing. They may be included in "lunch bunch" social clubs, offered adaptive PE, and more.
But what if a child has many of the same disabilities as a child who's officially diagnosed on the autism spectrum - but doesn't quite fit the criteria for an autism spectrum diagnosis? In theory, schools should provide services based on need rather than diagnosis, but as often as not, things don't quite work out that way. And so the child with the autism spectrum diagnosis receives many more supports than a similar child who doesn't have the official diagnosis appended to his file.
In some cases, doctors have been known to diagnose a child with autism spectrum disorders when he doesn't quite fit the criteria - because he or she knows full well that the diagnosis will make all the difference in terms of the supports, treatments and options available to that child and his family.
Is it acceptable for a doctor to provide a child with "borderline" symptoms with an autism spectrum diagnosis?
In my opinion, given that the doctor explains his reasoning to the parents - who agree - it often makes good sense to lean toward diagnosis when considering patients with borderline symptoms. By providing the diagnosis, the doctor can ensure that the child will receive the support and accommodations he needs to move forward. By denying the diagnosis, the doctor may make it impossible for the child to build the skills and confidence he needs to succeed.
My opinion, however, is by no means universal. Laura, commenting on a prior blog post, says:
Diagnosing for services should not be condoned, for many reasons, including:What's your opinion? Vote in the poll!
- 1) It’s intellectually dishonest.
- 2) It causes unnecessary alarm.
- 3) Resources are not unlimited.
Actually, the schools assessment and a medical diagnosis are two different things. The child would have to qualify for the schools/ state criteria regardless of the medical diagnosis. Those who state their child is HF, this is where you see this. Sure, they may have a diagnosis but yet that child wont qualify for the schools special ed services. So, it works both ways.
As for borderling autism, that’s a tough one. Some kids just don’t display all the aspects of autism. If doctors are diagnosing autism when the child doesn’t meet the full criteria, what does that do to those rates?
Diagnosing is another way for the medical community to make money. My son is 19 and Autistic and for every service that he is entitled to he has to get rediagnosed. That is ridiculous! It appears to me that there is no accountability out there to protect children and their families. They become victims of abuse and get taken advantage of around every corner. Re-diagnosing is expensive, time consuming and emotionally draining on families. I am trying to get IHSS from our state and they require my son to be rediagnosed. My son hasn’t seen a doctor in years. As a parent who is convinced my son was damaged by “environmental” factors I stay away from doctors unless it is mandatory such as an accident or something like that. Plus they had my son on many drugs for which were more harm than good.
I am tired of our children being used as guinea pigs and experiments to see what works and what doesn’t. To have a doctor that doesn’t know my son or what our history has been is irritating to me to make his opinion the deciding factor as to whether or not my son qualifies for the measly amount they give for these services. It is not right and this needs to change. Once the person is with a regional center they should be considered disabled and given what they are entitled to.
I have not one, not two, but three sons on the autism spectrum. I’ve had each child diagnosed at least two times each. The schools insist that a child be diagnosed before entering preschool and again before entering kindergarten to determine if he qualified for placement in an autistic support classroom. As if the child was magically “cured” between preschool and kindergarten! Kudos to Jenny McCarthy for finding a solution to her son’s autism but it doesn’t work that way for all of us. Each of my sons are on the spectrum but none of them have the exact same symptoms. The autistic support classrooms have been a blessing. They really have made a difference. If your child is disgnosed with ASD, fight for any and every service your child is eligible for. Believe me it will help your child and it will help you too.
Hmmm. I’ve had my son rediagnosed twice so far, and by my choice and I’m sure I’ll have this done again in 5 years. Where I live and in many states, once your child is diagnososed you don’t need another to qualify later on except for depending on county service, they come out yearly. The schools are suppose to re-evaluate every 3 years.
“our children being used as guinea pigs” It drives me nuts when people include ‘our’ children when they really should only be speaking about their own. Maybe your’s is, but my child is NOT a guinea pig, nor part of any experiments except well, not one certain thing ever works for all kids does it?
I’m not sure why any one wouldn’t want to reassess to see what improvements, if any are measurable on paper, and doctors should not be to blame for this.
Gee sandy, I am so sorry to insult you. You sound very thin skinned. Your children must not be that old. How lucky for you to have had the red carpet laid out for you. I have not been so lucky. If you read what I was saying I said “I don’t like when our kids are used as guinea pigs”…I didn’t call your kid a guinea pig…my god. I was talking about my own children…do I know you? No…relax and get yourself some decaf tea or something.
I’ve been around the block a while, and the comment is made quite often. So is the comment diagnosing is another way for the medical community to make money. Since you stay away from doctors and your child hasn’t seen one in years, one could then assume you weren’t meaning your own. Most times if the diagnosis was recent, they wouldn’t ask for another to be done. Services are in fact based on a diagnosis and since many kids do improve, many times they want it updated every 3 to 5 years. Services most times are based on how severe the disability effects the person, and an eval is the only as to know this.
And again, I’m not sure why any one wouldn’t want to reassess to see what improvements, if any are measurable on paper, and doctors should not be to blame for this. As for a red carpet, no such thing. You deal with regional centers, they don’t have them where I live so we don’t deal with that red tape as you do.
No, if a child doesn’t fully fit the criteria they shouldn’t be diagnosed. If doctors are doing this, then those rates are way out of whack.
This is the thing that irritates me Sandy is that like the “Spectrum” we all have our own experience of the autism situation…if you want to sit there and split hairs go right ahead but as far as I am concerned there is not enough people trying to understand others people’s experience! There seems to be a lot of arguing about “what is right” “who is right”…who knows maybe it is the election but it really saddens me when someone like you takes something I said and turns it into something else. You completely missed my point in the first email. I am talking about my experience!
I’m not spitting hairs. Sorry, that’s the way I read it. You weren’t only talking about your family anyway. You missed the point of the article. A diagnoses often means services, and often service require updated diagnosis. Kids that are border line or even display all the signs, often docs still wont diagnose. Even for SSI, they request a updated diagnosis every few years. It’s not a money maker, it’s a scam preventative.
Again, I’m not sure why any one wouldn’t want to reassess to see what improvements, if any are measurable on paper, and doctors should not be to blame for this.
In some cases, doctors have been known to diagnose a child with autism spectrum disorders when he doesn’t quite fit the criteria – because he or she knows full well that the diagnosis will make all the difference in terms of the supports, treatments and options available to that child and his family.
Administrative diagnoses are more often made by social service agencies. That’s how Evan was first diagnosed. It’s not clear if Evan really is autistic – he no longer qualifies for services. That’s not unusual.
AutismNB, you said:
“Administrative diagnoses are more often made by social service agencies. That’s how Evan was first diagnosed. It’s not clear if Evan really is autistic – he no longer qualifies for services. That’s not unusual.”
Could you explain this more fully? Do you mean that Evan was diagnosed by a doctor and/or set of therapists employed by a social service agency as opposed to a hospital or autism center? Or was he diagnosed by non-experts because he appeared to meet certain guidelines under which he could receive services?
And when you say he no longer qualifies for services but may or may not be officially “autistic” – how is that determined? Is he tested and found to be at or above normal functioning in specific areas, but never given a full diagnostic battery of tests?
I ask because the idea of an “administrative diagnosis” is new to me, and I’m not quite sure what it means. I looked it up, but couldn’t find a definition.
Thanks,
Lisa (autism guide)
Evan’s first medical diagnosis was epilepsy. Later, he was given an autism diagnosis by the Calif Regional Center. A reasonable case can be made that Evan’s diagnosis was a result of his young age, and that he lived in an area where there is money to spend on services. In short, the CRC is simply looking for ‘autistic like symptoms’ – not the same thing as “autism”.
The diagnosis was observational, and not necessarily made by an MD. More likely somebody working from a checklist, followed by a brief meeting with a psychologist. The role for these centers is to qualify disabled children for services. Whatever it takes.
Jenny says that the Center took the diagnosis ‘away’ – that’s her “proof” that the diet and vitamin regimen cured Evan’s autism. Had it not been for the center, who knows if ‘autism’ would even have been brought up.
The fact is, we really don’t know what the truth is about Evan, because nobody is holding Jenny McCarthy accountable for her claims. She says the things that some parents want to believe, then counts her money.
When I need my car fixed, I go to a real mechanic. When my plumbing leaks, I call a real plumber. Why on earth would anybody trust their childrens’ future to a D-list actress whose story changes week to week?
sorry – didn’t realize you were describing Jenny’s son (the name Evan didn’t ring a bell for me). thought you were referring to someone in your own life whom you’d seen diagnosed as you described.
I haven’t dug deeply into jenny’s materials to determine who, precisely, did what testing to come up with what diagnosis for Evan – or under what circumstances the diagnosis “was taken away.”
But to be fair, Jenny’s not suggesting that she’s a doctor. And she certainly isn’t the only one saying that a change in diet had a huge impact on her child.
In researching the subject of GFCF diets and autism, I found quite a few studies that support the idea that makes a real difference in some (not all) cases. I found some studies that showed no change. I found NO studies that say “GFCF diets cure autism.”
Lisa (autism guide)
What’s interesting is how California works with those regional centers, and who they decide needs the most services and who doesn’t. Just because they took services away does not mean the child wouldn’t have autism. I know many from CA and the regional center takes away their services all the time if the child does not present severely enough for their criteria.
There is a certain percentage with epilepsy or seizure disorder’s along with autism however there is no way to know what part of the brain the epilepsy is effecting to know if that would account for the autism-like behaviors.
Some one who spends 20 minutes with a child, obsrving only, is not a true diagnosis. A ‘diagnosis’ from a school has never been an acceptable diagnosis unless of course, you’re dealing with regional centers.
But to be fair, Jenny’s not suggesting that she’s a doctor. And she certainly isn’t the only one saying that a change in diet had a huge impact on her child.
No, Jenny is suggesting that her grasp of pediatric neurology, immunology, toxicology, and epidemiology is more reliable than a doctor’s. What’s fair about that?
Those who state their child is HF, this is where you see this. Sure, they may have a diagnosis but yet that child wont qualify for the schools special ed services.
Hi , my son was diagnosed HF (by the school district at almost 3 years old) and does qualify for school special ed services. I don’t believe that HF needs less therapies and help that those diagnosed with typical Autism or Aspergers. It all depends what the weak areas are within the childs development and not what label is being put on them. we have now 3 labels PDD-NOS, Autism and HFA in a period of 6 months.