Montreal researcher denounces the growing overdiagnosis of autism

The diagnosis of autism has so drifted for 50 years that it is now based on signs of less and less marked, warns Wednesday a Montreal researcher in the pages of the prestigious JAMA Psychiatry.
In other words, says the meta-meta-analysis of Dr. Laurent Mottron, the autistic who are studied are less and less different from the general population of non-autistics.

“Autistic people who are being tested now are less and less different from typical people,” psychiatrist Rivière-des-Prairies psychiatrist told The Canadian Press. But really less and less, to the point that if the trend continues, we would not be able to find any difference within five to ten years. We think it’s because the criteria have opened up beyond common sense, to the point that what is called autism today, the difference with typical people is impalpable. ”

He says his meta-meta-analysis takes the results of virtually every autistic patient who has been tested in the world for 50 years in the field of cognitive neuroscience and covers just about everything a human can do when it deals with information.

“Our paper shows a fact and a fact that can not be wrong because it brings together all the global research on the brain of autistic, he assured. The fact we found is concrete. ”

The number of people diagnosed with autism is expected to increase significantly around the world. In the United States, the prevalence of this developmental disorder would have increased, between 1966 and today, from 0.05 per cent to over 2 per cent. In Quebec, the reported rate is close to 2 per cent. In comparison, there is no increase in the prevalence of schizophrenia over the years.

Multiple managers

Doctors who agree to sign a diagnosis of autism are not the only ones responsible for this drift, says Dr. Mottron.

“Currently, a diagnosis of autism is what makes it possible to have services in schools,” he said. When you have a diagnosis of autism, you are much more likely to have a lot of extra stuff, compared to another condition, which is total nonsense, because the need for services is independent of the diagnosis. You can have a fuzzy diagnosis and have very big needs, you can be 200 percent autistic and have almost no need. ”

More and more people have an interest, simply for the exercise of their profession, to have as many autists as possible, he continues.

Schools would pressure doctors to get the diagnosis of autism that will unlock the budgets they would need to provide services to this “autistic” child. Parents, they, “cry when we remove a diagnosis of autism”.

“They tell us that they have watched and that their child has all the criteria,” said Dr. Mottron. This is because the criteria have become so trivial! It is said that he is an autistic because he does not have many friends, or he does not like to have his hair cut, or the labels annoy him, he is an autistic. If they are trivial criteria like “do not have not a lot of friends” and “is bothered by the labels of shirt”, we will find a package. That’s what happens. ”

Autism is now something that is identified by criteria, whereas at the beginning it was something that was recognized, he said; it is “fundamental” that criteria-based diagnosis is associated with diagnostic recognition.

The situation is complicated by the fact that there are mild forms of autism. That being said, says the researcher, having autistic traits is not the same as having autism.

Multiple consequences

“People who are diagnosed with autism when they are not, often have problems, but they are not the same,” said Dr. Mottron. Services for autistics, special classes for example where there is a ratio of one teacher per six students, is something very, very expensive. We give them a level of services immediately: it’s like having a flu and being sent to the intensive care unit. It’s more a question of modulating services. ”

Dr. Mottron evokes double prejudice.

“If you are told that you are autistic when you are not, it gives a completely crazy thing about the understanding of oneself,” he said. There is also harm to hard-core autistic people, who in some cases need very dense services, and these services are diluted to people who do not need them. ”

He asks to stop “a kind of crazy machine on the diagnosis of autism”.

Dr. Mottron expects his meta-meta-analysis to change the criteria for autism in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

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