False Dx: Up to 70% of dx'd may not actually be autistic?

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autisticelders
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14 Apr 2024, 1:35 pm

https://kosmospublishers.com/dr-david-rowland/ oh my. no actual credentials listed. see that???? but he wrote a book and writes articles on the internet and gets publicity wherever he can. Who benefits? Do your homework, beware of false prophets (fake doctors) and watch out for pseudoscience or opinion based woo-woo.


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autisticelders
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14 Apr 2024, 1:40 pm

https://www.thriftbooks.com/a/david-rowland/669196/ author of many other pseudo science books about all sorts of "crackpot" "information". Anything for a buck. Pay no attention to the man behind the curtain.


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IsabellaLinton
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14 Apr 2024, 2:07 pm

autisticelders wrote:
https://kosmospublishers.com/dr-david-rowland/ oh my. no actual credentials listed. see that???? but he wrote a book and writes articles on the internet and gets publicity wherever he can. Who benefits? Do your homework, beware of false prophets (fake doctors) and watch out for pseudoscience or opinion based woo-woo.



I searched for him in the College of Psychologists in every Canadian province including New Brunswick, where he seemingly resides.


His name isn't listed in any Canadian College of Psychologists or Neuroscientists.


I dug a bit more and found this article about him on a site called "Quackwatch":



https://quackwatch.org/11ind/rowland/



Excerpts:


Image

Image

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There's also a reference to him being a fraud, on Reddit:



https://www.reddit.com/r/autism/comment ... se_spread/


Excerpts:



Image


...


Image



As someone who was evaluated by a Canadian PhD Neuropsychologist and "Autism Expert", I'm pretty skeptical that this bloke exists.

I've never even heard of the Rowland Institute.

My partner is doing provincial licensing exams right now and he's never heard of him either.


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ASPartOfMe
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14 Apr 2024, 2:15 pm

I agree that one can be mis or undiagnosed and be actually autistic. I agree that one could have a professional autism diagnoses be allistic.

The growth in autism diagnosis since the ‘90s IMHO is the constantly mentioned expansion of diagnostic criteria, but also awareness due to the internet. It is a lot people seeing a list of traits seeing it fits them or their kids and obtaining a diagnosis. Up until the last 15 or 20 years this was difficult to obtain for everybody due to lack of clinicians with knowledge of autism and difficulty obtaining insurance. This is still true to some degree especially for older adults and females.

It is an imperfect science, a lot of basics are unknown. A diagnosis is based on observable and self reported traits. That is subjective which means too many misdiagnosis.

Opinion=mine
That said in 2024 there is decently good idea of what the traits are and if a person is impaired by them. 70 percent misdiagnosis is way overblown.

The belief in massive over-diagnosis does a lot more harm than good. It conveys the message to those wondering if they might be autistic to stop wasting their time, they are a fuck-up end of story. I have seen a lot people here on WP who have spent so much time, money and effort to obtain a diagnosis still doubting themselves. Even those who are starting to accept the idea they are autistic get doubts from friends and loved ones setting them back. If imposter syndrome is a fire the belief in massive over-diagnosis is the equivalent of pouring gasoline on it.

Healthy skepticism is a necessary thing. In 2024 what we have is the assumption of nefarious intent. That is a toxic thing.


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IsabellaLinton
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14 Apr 2024, 2:26 pm

ASPartOfMe wrote:
Opinion=mine
That said in 2024 there is decently good idea of what the traits are and if a person is impaired by them. 70 percent misdiagnosis is way overblown.

The belief in massive over-diagnosis does a lot more harm than good. It conveys the message to those wondering if they might be autistic to stop wasting their time, they are a fuck-up end of story. I have seen a lot people here on WP who have spent so much time, money and effort to obtain a diagnosis still doubting themselves. Even those who are starting to accept the idea they are autistic get doubts from friends and loved ones setting them back. If imposter syndrome is a fire the belief in massive over-diagnosis is the equivalent of pouring gasoline on it.




Brilliant. I agree with you. Of course there are misdiagnoses both ways, but I don't believe the number of overdiagnosed autistics is anywhere near 70% assuming they have a comprehensive assessment from an accredited and experienced evaluator.

It's problematic that many people who are diagnosed develop imposter syndrome because of propaganda claiming neurodiversity is just a hot new trend.


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14 Apr 2024, 2:29 pm

MushroomPrincess wrote:
Fenn wrote:
If “has autism” doesn’t mean “has a diagnosis of autism” what, exactly does it mean? Can anyone answer that?

A communication disorder stemming from a malformed or deficient frontal lobe, usually characterized by clinically significant delay in language development and difficulty with non-verbal cues.

I thought everyone on here knew what autism was; it's an autism website and this is the autism board. If there was ever any doubt that this condition is overdiagnosed, we needn't look much farther than the legions of confused gen-Xers who can't even give a meaningful definition for the disorder which they swear they have.


The general scientific consensus is that autism is indeed a communication disorder, but the idea that it is from a malformed or deficient frontal lobe is not at all a common belief amongst mainstream scientists. If you can give me a few sources where this idea has stemmed from - I would imagine they are from lesser known sources, not anybody or any place serious about autism research.

The causes of autism are known to be 'unknown', as of present. Whilst the frontal lobe might be implicated in autism, in the same way that the pre-frontal cortex is implicated in adhd - that is by no means the only cause of autism and I have never seen any evidence in favour of that idea, from any mainstream or reliable source.



Last edited by blitzkrieg on 14 Apr 2024, 2:38 pm, edited 1 time in total.

IsabellaLinton
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14 Apr 2024, 2:35 pm

I agree.

If it were that simple, brain scans would be the gold standard for diagnosis.
It seems brain differences are often found post-mortem, but not on scans of live patients.


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__Elijahahahaho
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14 Apr 2024, 2:36 pm

blitzkrieg wrote:

But even for people with less severe cases, the disorder can still be disabling in an NT society and so I think things have gotten better, not worse, in terms of diagnostic frequency.


I agree with blitzkrieg here.

I think it depends how you use the diagnosis. I see it as a way to help explain problems ive had and design
ways around it. No model will be perfect for anyone, so its just another tool to help.



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14 Apr 2024, 2:42 pm

IsabellaLinton wrote:
I agree.

If it were that simple, brain scans would be the gold standard for diagnosis.
It seems brain differences are often found post-mortem, but not on scans of live patients.


Right?

Brains scans aren't used in the diagnosis of autism because there has never been a conclusive or reliable, physical brain abnormality (or abnormalities) associated with autism.

Most of the parts of the brain that have been identified that are linked in some way to autism/brain dysfunction are described as "may" be associated with autism and even when those brain abnormalities are associated with autism, that doesn't mean that everybody with autism has that same source of dysfunction.



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14 Apr 2024, 2:44 pm

__Elijahahahaho wrote:
blitzkrieg wrote:

But even for people with less severe cases, the disorder can still be disabling in an NT society and so I think things have gotten better, not worse, in terms of diagnostic frequency.


I agree with blitzkrieg here.

I think it depends how you use the diagnosis. I see it as a way to help explain problems ive had and design
ways around it. No model will be perfect for anyone, so its just another tool to help.


I think that diagnostic procedures have improved a lot in recent years.

I think that autism may be under-diagnosed if anything, not over-diagnosed, personally.



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14 Apr 2024, 2:50 pm

It's a neurodevelopmental disorder, meaning the brain is affected somehow in development, but I agree it might be an aspect of neural /nervous system function rather than brain physiology itself.

I should also mention, even though I have brain abnormalities on MRI and EEGs, my brain scans weren't conducted as part of the diagnostic process. My doctor did say they were relevant though, at least in my own case.


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blitzkrieg
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14 Apr 2024, 2:55 pm

IsabellaLinton wrote:
It's a neurodevelopmental disorder, meaning the brain is affected somehow in development, but I agree it might be an aspect of neural /nervous system function rather than brain physiology itself.

I should also mention, even though I have brain abnormalities on MRI and EEGs, my brain scans weren't conducted as part of the diagnostic process. My doctor did say they were relevant though, at least in my own case.


Yeah, the 'wiring' of the brain during a persons brain development can culminate in what results as autistic traits - enough to warrant a subjective diagnosis from an autism specialist/specialists. I didn't mean to neglect or discount that reality in anything that I said.

My previous post was partly in response to the idea that autism has been definitively linked to a modular part of the brain which is what MushroomPrincess asserted.



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15 Apr 2024, 3:59 am

I also thought - what does it matter.
If you look at the actual accommodations people will need - these should be available to anyone
anyway, if they say they feel pain otherwise, since most of them are at very little cost to an employer or friend.



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15 Apr 2024, 6:40 am

__Elijahahahaho wrote:
I also thought - what does it matter.
If you look at the actual accommodations people will need - these should be available to anyone
anyway, if they say they feel pain otherwise, since most of them are at very little cost to an employer or friend.


Accommodations for disabilities, whilst perhaps technically available to anyone, are actually very difficult to obtain, at least in the UK - many employers don't want to be 'bothered' with someone who has extra needs.



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15 Apr 2024, 7:07 am

blitzkrieg wrote:
Personally I think that the increase in diagnosis frequency, is due to better screening methods and a broadening of who might be considered autistic, now, versus say, a couple of decades ago and beyond.

I would say when incidences of clinical diagnosis were a lot lower, the threshold for qualifying as being autistic would be a lot higher, i.e, only the more severe cases would be labelled.

But even for people with less severe cases, the disorder can still be disabling in an NT society and so I think things have gotten better, not worse, in terms of diagnostic frequency.

Yes, it's also worth noting that whenever you have a new diagnosis added to the DSM or there is a significant change to how the diagnosis is used, it often results in Baader-Meinhoff kicking in.

Even if we accept the premise that ASD is legitimately overdiagnosed, we're still stuck with the reality that there are an awful lot of people that wouldn't qualify for any other diagnosis and so clearly have a developmental disorder.

A major issue I have with the DSM 5 is that ASD is essentially now just pervasive developmental disorder when there isn't a more specific disorder that's applicable, as long as you don't fall into one of the gaps that they opened up when they created the criteria and get nothing at all. I'm personally arguably in the gap they created between the autistic spectrum and the schizophrenia spectrum that they created by nuking AS. Too autistic to be schizophrenia spectrum and too se schizophrenic to properly fit with the autistic spectrum. Just a bunch of BS created because they couldn't be bothered to properly address the inconsistencies of diagnosis.



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15 Apr 2024, 7:11 am

The_Walrus wrote:
MushroomPrincess wrote:

I don't want to get too political (this isn't P&P after all), but I suspect that the wave of new diagnoses in the 80's and 90's was brought on by market pressures, to feed a burgeoning "troubled teen industry". Incidentally, the autism "epidemic" seems to be localized entirely within these countries where it can be profited from.

JamesW has already posted a nice rebuttal of the "science".

I don't buy into your conspiracy theory for a second, either. Autism rates have been going up around the world, including in countries where healthcare is provided for by the government. I was diagnosed by an NHS child psychiatrist - this diagnosis placed a burden upon the NHS.

Furthermore, while it's true that Aspergers is no longer a recognised diagnosis, that isn't because it "doesn't exist". The two conditions have simply been merged. Yes, it's fair to say that changing diagnostic practices are responsible for the increase in diagnoses, but that doesn't mean the diagnostic processes in the past were therefore right and current ones are wrong - we're just getting better at identifying autism now.

Now that I think about it, what's particularly interesting is that this is happening even as the lead in the environment has reduced substantially due to leaded gas being banned and even the lead nitrate that used to be used for those nice yellow lines on the roads has been discontinued. I do wonder how much of this is because the kids have less lead poisoning screwing with the diagnostic criteria. Even at the currently assumed rates, ASD isn't that common, even a slight shift due to something like that could be significant.