Gerrymander for the Cure

Gerrymander for the Cure

Presently one child in fifty-nine is diagnosed with autism. This an increase from only two years ago when one child in sixty-eight was identified as being on the spectrum.

Not to worry, the incidence of autism is going to go down dramatically. Don’t get confused.   The number of children exhibiting signs of autism may not change and, in fact, could go up, but the incidence will go down.

Thoroughly confused now?   Let me explain.  In 2013, the American Psychiatric Association released the latest version of its Diagnostic and Statistical Manual, affectionally known as DSM-5.   In this new version, Asperger’s Syndrom was no more. Childhood disintegrative disorder, pervasive developmental disorder and not otherwise specified also got the ax. All of these categories were bundled under a very broad autism spectrum disorder.  The new criteria were in some ways more restrictive than the former ones were.  HOWEVER, if you were considered one of the previous categories under the old DSM, you can keep your diagnosis even if you would not qualify under the current DSM 5.

These are the criteria that are used by mental health professionals, e.g. psychiatrists, psychologists and social workers to determine a person's disability and, therefore, eligibility for many services.

But it is the Centers for Disease Control that issues the official definition that is used for tracking prevalence.  Change the definition and you change the number of kids who make the cut.

The Center for Disease Control has evaluated the new definition and it believes that if the Center should switch to the new definition the number of children with autism would drop by 18%!   How great is that!   Think of all those children who will be cured by the stroke of a pen.  Won’t  their parents be relieved.  Going forward, the CDC will be using the new definition for its next evaluation of prevalence.   They will release their results in about two years.

One CDC staff member opined the expectation that clinicians will adjust their evaluations of children to fit the new definitions so the new prevalence numbers might not be adjusted that much.

The Director for the Center for Autism and The Developing Brain at Cornell University said she expects the prevalence of autism to continue to rise even with the new definition.  

This whole situation reminds me of when I was the Director of Special Education at a local school system.  Our Board of Education was concerned that too many children were being diagnosed as having learning disabilities.  In those days, a child was considered to have a learning disability if there were particular discrepancy between achievement scores and ability test scores.  The Board increased the required discrepancy causing many children who had previously had a learning disability to be declared cured.   It fell to me to notify parents.   Parental reaction ranged by total relief that their child was now all better to comments such as, “how dumb do you think I am, my kid still can’t read.”

It is good to know that old habits die hard and we can still define our way out of an exploding increase in a disability.  

It will be a great fundraising slogan-“ let’s gerrymander our way to the cure.”