New York Magazine article on over diagnosis from 2014

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I came across this article today and was wondering what people thought about it?
http://nymag.com/news/features/autism-spectrum-2012-11/ (sorry it is quite long).

I have got to admit the articles claims about how many 'false positive' diagnosis there are, and the very skeptical view of self diagnosis, it made me doubt myself and my own self and then formal diagnosis. I know I have it more mildly than some people (though it has still caused me significant problems) and that at the time the criteria for aspergers was initially developed I would probably not have been considered impaired enough to be diagnosed.

However, I think it is wrong of the article to imply this broadening of the category is invalid, as if the the clinicians who originally uncovered and developed the diagnosis somehow had a complete understanding and that others have corrupted it. Seems to me an organic process whereby recognition of less extreme expressions of the same underlying pathology is exactly how these things should develop.

I know what I have has always been there and so is likely to be neurological, I difficulties in the same areas as those with 'genuine aspergers' i.e social and communication, I have the sensory over sensitivity as people with autism, and I have been impaired by these things. But articles like this seem to suggest unless you are extremely impaired then it is not autism, and as I have a job and can live independently I would probably be considered a false positive.

I just don't see the logic in this, that some people think that it is all or nothing and that you need the same level of impairment as those that the original diagnosis was based on to suffer from the same condition, rather than believe that some people can just have a less severe expression.

Articles like this really annoy me, they try and make out something very real does not exist.

Your article isn't clickable. As of this post, you still have time to edit YOUR post, and make it clickable.....

sorry it worked for me but maybe that was my browser recognising a weblink, i've edited it now. hopefully it should work for everyone

Great article. So true. The pop culture following of ASD is embarrassing. I was in denile about my diagnosis early on because of this hysteria. Now after accepting I am acctually autistic it's harder to talk to people about it. I think people who defend the wider spectrum feel threatened that their self diagnosis may be false.

I didn't like it. It had some good points, but I think it buried them in smug self-satisfaction. ASD does seem to be the designer disorder of the moment, and I certainly remember how everyone suddenly had ADD a few years ago when that was popular. One of the main points of the article seems to be that everyone nowadays, whether they have any training in the area or not, is making flippant comments about public figures possibly having Asperger's without having given them an examination. Diagnosis of ASD requires a professional with specialized training in autism and many hours of examination; diagnosis can't be made through a TV!! ! I agree that this is a problem, as it lessens the struggle that those of us who ARE on the spectrum go though. When people think that Obama and Jerry Seinfeld and Mark Zuckerberg have Asperger's, they start thinking it's a fun thing that makes people creative, interesting and successful. No wonder people who don't have it think they want it. There are benefits to Asperger's, but it is far more problematic than beneficial, and it is not something that anyone who has it would want to have. The most we can be is happy to be the people we are, but we won't pretend it's a breezy life to live.
The article does, in my opinion, highlight the need for specific diagnostic procedures and/or a physical indication of the disorder that can be used to make a diagnosis. Asperger's is well publicized, but it is not well understood even in the professional psychological community. Unless a psychologist specializes in autism/Asperger's or has specific experience and training on it, they are simply not qualified to make a diagnosis. Simon Baron-Cohen's AQ test is a good start, but it is far from able to indicate diagnosis. Psychologists who are underequipped in this area need a reliable way of making a correct diagnosis. Unfortunately, such a thing doesn't currently exist.
I don't want to sound like a jerk here, but this article also illustrates the caution we should be taking with self-diagnosis. Self-diagnosis can be a great thing, but it can also be too easy to come by. If you read symptoms on the Internet, it's fairly easy to convince yourself you have any number of fatal diseases. If you are self-diagnosed, I am NOT telling you that you don't have Asperger's. But there are those fakers out there who wear ASD as a hipster fashion choice along with their geek glasses and their lumberjack beards, and these are the people we need to be careful of. I would daresay that the people on this website are not likely to be fakers; it seems to me that the fakers wouldn't need to visit this website. Unless they're REALLY good at faking it.
I really hate that Bryna Siegel woman. She might be the head of some autism clinic, but that doesn't mean she knows a d*mn thing about it. She can't know anything about autism to make the comments she made. She actually said adults who pursue a diagnosis see it as a lunch ticket. Exactly where is there supposed to be a free meal in ASD? My ASD has never gotten me a dime in any way, shape or form. Most Aspies are not savants who make millions from their amazing talents; most of us are unemployed, underemployed, struggling to make some kind of living for ourselves. A diagnosis of ASD is likely to come with a sentencing of permanent poverty. Where is the lunch ticket, Bryna? If there is one, I sure as hell didn't get it.
Then she has the audacity to say, "Anyone who has a secretary doesn't have Asperger's." If she really knew about autism, she would know that blanket statements can't be made about it. It manifests in many different, kaleidoscopic ways. It varies in symptom manifestation as well as severity, and by adulthood, many Aspies have learned masking techniques to hide their ASD traits and appear more normal. Some do it so well that they very well could be successful enough to have a secretary. Granted, I don't. I can't even keep a minimum wage job. But others can, and that doesn't mean they don't struggle. What a b*tch.
And to you specifically, something_, I can't tell you whether you do or do not have Asperger's, but I can tell you this: You have had struggles your whole life, so that means you aren't making it up. You may not be as severe as others, but if Asperger's fits for you, than don't let anyone tell you otherwise. I diagnosed myself with Asperger's two years before I got an official diagnosis. I read up on it and it made a lot of sense. I pursued a professional diagnosis because I wanted to be sure, and because I wanted something I could defend myself with against the doubters and naysayers. My psychologist specializes in autism and Asperger's, so I trust her judgment. But even after she told me the diagnosis, I STILL doubted whether she and I got it right. But the more I talk to people in this group and in another Asperger's group I belong to, and the more I see we have in common, the more I understand that my psychologist gave me a correct diagnosis. Things I struggle with, things I don't understand, things I couldn't explain, are the same things that people here struggle with and don't understand. We are similar because we all fall somewhere on the spectrum.

I think the assumption that there is "over diagnosis" may be rather ignorant in itself. The advance of medicine means we get better at recognizing illnesses and disorders for what they are.

Even though Hans Asperger first began to classify kids with HFA in 1947, it wasn't until after he died in 1980 that the term "Asperger Syndrome" even came into existence (which is coincidentally the same time I saw TV reports on kids with low functioning autism and realized I had something similar). AS wasn't added to the DSM until 1994, and only after that, did professional psychologists, psychiatrists and therapists begin to pay attention to the symptoms and realize how many cases there actually were.

What seems to be coming to light is not that High Functioning Autism isn't real or serious, but that its the more common form of autism and the previously recognized Kanner's or Low Functioning type is relatively rare (thank goodness). What these smug knowitalls are calling "over diagnosis" or the "diagnosis de jour" is simply the Mental Health profession in general coming to terms with a disorder that until this point in history has been callously ignored, while its victims suffered through their entire existences being told they were just incompetent at life.

As far as some Aspergians becoming successful, I don't believe that has anything to do with "mildness" (gods, I get sick of that myth - there's no "mild autism," just better coping skills) - I think the degree to which most autistics are able to succeed professionally and materially has as much to do with blind luck as anything else - being in the right place at the right time. If you fall into a career that aligns with one of your special interests, and your coping skills are good enough, you can get lucky.

I grew up obsessed with pop music, radio and voice mimicry, but it was a pure set of domino-falling coincidences that led to a new friend dragging me without my prior knowledge, into a local radio station and introducing me to the Program Director just as they had a rare opening available. I didn't plan it, nor would I have known how, or been brave enough to seek it out. It fell in my lap and I made a 30 year career out of it (not that I was materially successful, I was still poor as a church mouse, but I kept getting jobs because I was so obsessive that I excelled at it, and kept getting fired because I had high anxiety and poor social skills). Its a matter of finding a niche and holding on to it.

I digress. In any case, maybe there is some degree of over diagnosis, but I think its prejudicial to assume that - its that same old litany of "you look too normal to have a disability" and that's just the attitude of a bigot who knows nothing about the human brain and has no compassion for something they haven't experienced for themselves.

Its amazing to me how people accept an invisible handicap like dyslexia without question - you never hear anyone claim that dyslexia is "over diagnosed" - but because autism is more complicated to wrap one's head around and the Low-Functioning type was implanted in the cultural consciousness first, every blockhead with a keyboard thinks they're an expert on who can and cannot be autistic.

Being a scientist, I personally know several fellow scientists (men and women) that would likely fall within the spectrum. Science tends to be an attractive force for those with Aspergers, myself included.

As one of the commenters beneath this fatuous and puerile article wrote:


"This article is insulting. in a few short paragraphs the author manages to demean and insult an entire spectrum of people. The author chose to ignore the actual autistics in favor of the so-called self-important experts. If the author bothered to really look into the issues in the autism community he would have found that some of the biggest issues those on the spectrum face is within the psychiatric community itself. Many have come to the conclusion that the autistics biggest enemy is the doctors who are supposed to help them succeed. You include erroneous data and ignorant conclusions based upon some outdated and warped theories perpetuated by those who deride and denigrate the very people they are supposed to help and support."

Based on posting in the last year and half I expected the article to be largely agreed with. Heartening to see the article called out in thoughtful ways. Probably too much to hope for but maybe just maybe the trend here at WP will FINALLY start to reverse. Being an outlier I'm used to. Being an outlier to actually fighting these prejudices seemingly alone in my own community sucks and made me have doubts it was my community.