DSM5 Autism Do-Over Raises Concerns Down Under, Yeah?

Concerns have been raised in Australia over the DSM-5 Autism Do-Over, the new Autism Spectrum Disorder.  The fears echo those held by many in North America where studies have suggested a loss of autism diagnoses under the new DSM-5 diagostic criteria for autism with a possible loss of funding for autism treatment and services.

ABC (Australian Broadcasting Corporation) News reports the concerns expressed by Autism Awareness Australia:

"Vicki Gibbs from Autism Spectrum Australia's diagnostic service said Australian research has found a significant number of autistic children would fail to meet the new criteria. "What our study found was of the 120-odd children that we assessed, about 23 per cent of those children who would have got a diagnosis under the existing DSM 4, we would not have been able to give a diagnosis under DSM 5, just because they didn't have enough of the symptoms," the clinical psychologist said."

As the parent of a 16 year old son with severe autistic disorder I learned long ago that unanticipated changes can have immediate repercussions for my son.  Meltdowns have been prompted by unanticipated and, sometimes, unnecessary changes in my son's routines and expectations.

Change itself can be very disruptive. It does not appear to be a lesson learned by the autism experts on the DSM5 committees ... yeah?

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Experienced Clinical Child Psychologist On Increases in Autism Diagnoses, Importance of ABA Treatment



From the Medicare for Autism Now! web site:

Dr. Glen Davies is a clinical child psychologist who has practiced in the Vancouver area for over 25 years. Today, over two-thirds of the children seen in his clinic are on the autism spectrum. In his 16 minute interview, Dr. Davies comments upon the dramatic increase in autism diagnosis over the last two decades. He discusses the transformational impact of ABA treatment, as well as the relative costs of not providing treatment – to autistic children, their families and society at large.

Dr. Davies is a clinical psychologist with actual experience working with children with autism. There are lots of purely academic, research psychologists working solely with abstractions and epidemiological statistics. It is important to listen to  experienced clinical psychologists like Dr. Davies, psychologists who understand the realities and challenges of autism disorders and the best known way to address those challenges ... ABA treatment.

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Autism Research Community's Failing Grades: Vocational Interventions Research


"In the end, the researchers found only five studies that focused on vocational interventions. While this handful of studies looked at certain on-the-job programs designed to support young adults with autism and suggest these "interventions" can improve quality of life and reduce symptoms of autism, the study authors concluded, "all studies were of poor quality." They say these studies had serious flaws including the randomization or comparison groups, which makes it difficult to draw any conclusions. Lack of follow-up and the fact that most studies were small also contributed to the researchers' deeming the quality of the research as poor. The study was published Monday in the medical journal Pediatrics. 

Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, says she finds it remarkable that only five studies that address vocation skills were published in the last three decades and all were of poor quality. "There is a tremendous knowledge gap regarding how to help young people with autism be successful in the work environment," Dawson says."

Evidence weak that vocational programs help young adults with autism, CNN, August 28, 2012




This information does not indicate that vocational interventions are not effective. What it indicates is that the autism research community has not bothered to conduct any serious research to evaluate those interventions. The autism research community has its obsessions and it pursues them doggedly even when the results don't support their particular obsessions. But those obsessions do not necessarily result in quality autism research. 

We all know that within the next couple of years the "Mottron group" will publish more studies telling us how autism is just a different, in some ways superior, type of intelligence, one that can not, and should not, be cured. There will be more studies about the genetic bases of autism without ever pinpointing specific genes or genetic groupings that explain the diverse types of autism disorders as they manifest in so many individuals. The environmental side of the autism equation will be ignored. No new treatments or cures will be explored. 

The autism research community has done little to advance our understanding of what autism disorders are, how they are caused, how to treat or cure autism disorders or even, since Lovaas, how to assess or evalute interventions. The review of vocational autism research is just one more failing grade for the autism community that puts up lots of posters and makes grand speeches at IMFAR conventions in hotels around the world but really does little to help the lives of those who actually suffer from autism disorders. 

I realize how pessimistic this comment is. My son was diagnosed 14 years ago at age 2. I have seen many hopes raised and false starts made but I have seen little lasting progress in the past 14 years. Instead of progress we have a new definition of autism disorders scheduled to arrive in the DSM5 that will do nothing to improve the lives of those with autism and will not advance diagnosis, treatment or cure for autism disorders. The world autism research community has been talking in circles since my son was diagnosed studiously avoiding the tough research issues but achieving nothing. 

Yes my comment is pessimistic. I would love to be wrong about this. I would love to see some substantial breakthrough in understanding autism, how it is caused, how to ameliorate its challenges for my son and others, breakthroughs in treatments and cures. I do believe that progress must be achieved through research but as my son grows older I do not see the qualitative results, beyond the work of Lovaas and those who followed his lead, of any such research to date. Perhaps a review like this will help those at the IACC and other autism research leaders face some autism reality and improve the direction and quality of autism research.

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Guilty! Autism Blame from Cold Moms to Old Dads


Breaking Science News: Guilty! Old Dads convicted of causing children's autism disorders, all charges dropped against environmental toxins!

Once upon a time the medical community accepted without critical analysis the speculation that aloof, cold "refrigerator" moms caused their children's autism disorders. Eventually that so called theory was exposed as a medical establishment fraud, a very harmful one.  In recent years the old dads theory has gained ground and it is the old sperm of dads, including this dad, that is responsible.  The recent "study" which purports to "link" older dads to the autism of their children is the attack du jour on autism parents who MUST be blamed for what has happened to our children. The medical establishment, still at war with McCarthy, Wakefield and parents who observe regression in their children immediately after vaccinations is giddy and giggling with glee over the opportunity to once again blame parents, Dads' turn this time,  for their children's autism disorders.  

None of the environmental toxins to which our children, and we, are exposed in utero, or in our air, water, toys, jewelry, living room window blinds, foods, gasoline, house paint, pharmaceuticals, vaccines or vaccine ingredients including those administered to pregnant women will be considered. Corporate profits will be immunized from the disorder known as Irrational Autism Parents Disease.  Even more funds can be diverted from environmental autism research into "genetic" autism research no matter how genetics is defined at the time.  Many parents do not trust the researchers and medical authorities who accept any piece of speculation as long as fault for autism can be laid at the feet of parents.  And all the smart people of the medical establishment will wonder why many of those same parents do not and will not trust them.

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12 Years Later: Environmental Causes of Autism Still Unexplored

"The Environment as an etiologic factor in autism: a new direction for research"  by EA London was published online by ehp, Environmental Health Perspectives, in 2000. Today, 12 years later, it remains the direction not taken as "autism research" continues down the road of genetic obsession and largely ignores environmental autism research.

Although public health authorities have paid lip service to the idea that autism appears to result from gene environment interaction funding has been overwhelmingly directed towards the gene side of the equation. The people who are much smarter than most of us, who understand things we can not possibly understand, who do not need our input as unwashed, unthinking parents of autistic children simply keep on keepin' on with their religious like belief that autism is primarily genetic.  Following is the abstract and the suggestion for new lines of investigation into environmental exposures which the US IACC, the Canadian Institutes for Health Research and other agencies involved with setting directions for autism research do not appear to have accepted. Of course the genetic obsession research has brought us a better understanding of autism causes .... hasn't it?

Abstract

Autism is one of a group of developmental disorders that have devastating lifelong effects on its victims. Despite the severity of the disease and the fact that it is relatively common (15 in 10,000), there is still little understanding of its etiology. Although believed to be highly genetic, no abnormal genes have been found. Recent findings in autism and in related disorders point to the possibility that the disease is caused by a gene-environment interaction. Epidemiologic studies indicate that the number of cases of autism is increasing dramatically each year. It is not clear whether this is due to a real increase in the disease or whether this is an artifact of ascertainment. A new theory regarding the etiology of autism suggests that it may be a disease of very early fetal development (approximately day 20-24 of gestation). This theory has initiated new lines of investigation into developmental genes. Environmental exposures during pregnancy could cause or contribute to autism based on the neurobiology of these genes.

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Autism Reality Check: Where Are The IACC Results?

I have previously written about the importance of the IACC and in a 2009 blog comment expressly thanked the IACC for its role in advancing autism research.  With the passage of 3 years though I have  become a less enthusiastic IACC booster.  Both the Canary Party and the Elizabeth Birt Center for Autism Law and Advocacy (EBCALA) have called for an accounting from the IACC and its leadership. I support their calls for accountability.  

Autism advocate representatives on the committee have been anti-cure ideologues while autistic persons seeking cure like Jonathan Mitchell are ignored in every sense of the word.  The IACC, despite paying lip service to gene environment interaction has for the most part continued to subscribe to the "it's gotta be genetic" belief system for explaining what causes autism. 

During the IACC existence, and during the 14 years since my son's autistic disorder diagnosis,  autism diagnosis rates have literally exploded. Yet the IACC makes no serious effort to address this burgeoning rate and allows the public to believe the tired, repetitive, and unsubstantiated excuses that every single reported increase in autism is due entirely to mid 90's diagnostic definition changes, enhanced awareness and diagnostic substitution motivated by parental desire to obtain all those wonderful autism services that apparently exist in every school district in the US.

I am not anti-IACC but I do believe there should be some accounting provided.  As the Autism Gadfly Jonathan Mitchell has said non-Americans, including Canadians like me, have no right to DEMAND anything from an American taxpayer funded institution but the IACC has an important role to play in autism research and, like many US institutions, has a world wide impact.  As a Canadian autism dad I ask the IACC to provide a real world accounting of its efforts.  Are we any closer to understanding autism causes? Will the IACC continue to politely ignore the environment side of the gene environment base of autism disorders?  Will we actively direct our research towards cures and treatments?

If I have been too one sided I invite anyone reading this blog, including the academics and researchers who occasionally humor this autism dad with a visit to my blog, to please provide examples of real world results achieved by the IACC or indicate where the IACC is going and whether it still hopes to find causes, cures and treatments for the increasingly diagnosed autism disorders.

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What you don't know about me.


I have recently been inspired by several posts by other parents who are raising the veil off of how we parents feel.

So here is mine derived from those I have read (including some published nationally in places like the Huffington Post) . I do not take full credit as I have copied some sentences and others I have just added what sums up my experience.


What you may not know about me:

1. I am tired.
Parenting is already an exhausting endeavor.
But this is a whole other level of fatigue.
Even if I've gotten a good night's sleep, or have had some time off, there is a level of emotional and physical tiredness that is always there, that simply comes from the weight of tending to special needs.
Doctors and specialists visits are not just a few times a year,
they are several times a month.
Paperwork stacks up,
spare time is spent researching new treatments,
positioning them to sit and speak a certain way,
advocating for them in the medical and educational system.
This is not to mention the emotional toll of raising a special needs child, since the peaks and valleys seem so much more extreme for us.
 I am always appreciative of any amount of grace or help from friends to make my life easier,
no matter how small,
including arranging plans around my schedule and location...
And bringing me a Tim Horton's Butter Caramel Ice Cap Supreme .

2. I am jealous.
This is a hard one for me to come out and say, but it's true.
 When I see a child do what my son can't... I feel a pang of jealousy.
It hurts when I see my son struggling so hard to learn to do something that comes naturally to a typical kid,
 like making friends or sitting still.
It can be hard to hear about the accomplishments of my friend's kids. Sometimes, I just mourn inside for my boys,
"It's not fair."
Weirdly enough, I can even feel jealous of other special needs kids who seem to have an easier time than my boys.
 It sounds petty, and it doesn't diminish all my joy and pride in my boys' accomplishments.
But often it's very hard for me to be around typical kids with them.
Which leads me to the next point...

3. I feel alone.
It's lonely parenting a child on the spectrum.
Especially when the child is non - verbal (and those days are never far from my memory).
 I can feel like an outsider around moms of typical kids.
While I want to be happy for them, I feel terrible hearing them brag about how their 2-year-old has 100 words, or already knows their ABCs .
Good for them,
 but it's not what my world looks like.
 I stopped reading sites about development milestones years ago
 (my favorite used to be babycenter.com)
because I got tired of comparing and falling short.
 It has been a sanity saver to connect with other special needs moms,
with whom it's not uncomfortable or shocking to swap stories about behavior therapies,
 food restrictions,
 communication devices
 and coping methods.
Even within this community, though, there is such variation in how every child is affected.
Only I fully understand Colin and Avery's unique makeup and challenges.
 With this honor of caring for them comes the solitude of the role.
I often feel really lonely in raising them.

4. I am scared.
 I worry that I'm not doing enough.
What if I missed a treatment or a diagnosis and that window of optimal time to treat it has passed?
 I worry about their futures ,
whether they will ever drive a car,
or get married,
or live independently.
I am scared thinking of the hurts they will experience being "different" in what's often a harsh world
 (not to mention that I fear for the physical safety of the person who ever inflicts any hurt upon my child)
 I am scared about finances.
 Finally,
I fear what will happen to them if anything were to happen to me.
 In spite of this, my fears have subsided greatly over the years because of my faith, and because of exposure to other kids, teenagers, and adults affected with Autism Spectrum disorder.
When I meet these people , the sadness and despair that I was projecting onto Colin and Avery's future lives (because it was so unknown) melted away when I saw the love and thriving that was a reality in their lives.

The fear of emotional pain is the one that remains the most.

5. I wish you would stop saying,
"retarded,"
"short bus,"
 "He's just slow" or
 "as long as he is healthy... "
 I know people usually don't mean to be rude by these comments,
 and I probably made them myself before I had my boys.
 But now whenever I hear them, I feel a pang of hurt.
 Please stop saying these things.
It's disrespectful and hurtful to those who love and raise the kids you're mocking (not to mention the kids themselves).
As for the last comment, "as long as he is healthy,"
I hear a lot of pregnant women say this.
Don't get me wrong,
 I understand and share their wishes for healthy babies in every birth,
but it's become such a thoughtless mantra during pregnancy that it can feel like a wish against what my son is.
"And what if he is not healthy?" I want to ask.
(My response: you will be just fine! You and your child will still have a wonderful life.)

6. I am human.
 I have been challenged and pushed beyond my limits in raising my children.
 I've grown tremendously as a person, and developed a soft heart and empathy for others in a way I never would have without them.
But I'm just like the next mom in some ways.
I get really cranky,
my children irritate me,
and sometimes I just want to flee to the spa or go shopping
(or further away ).
 I still have dreams and aspirations of my own.
 I travel,
 I sing,
I am working on a novel,
I love good food ,
I scrapbook and
I play the flute.
 Sometimes it's nice to escape and talk about all these other things.
And if it seems that the rest of my life is all I talk about sometimes, it's because it can be hard to talk about my son.
Which leads me to the final point...

7. I want to talk about my children / It's hard to talk about my children. They are the most awe-inspiring thing to happen in my life.
Some days I want to shout about how great they are!
Sometimes, when I'm having a rough day, or have been made aware of yet another health or developmental issue,
I might not say much.

I don't often share with others, even close friends and family, the depths of what I go through when it comes to Avery and Colin .
But it doesn't mean that I don't want to learn how to share our life with others.
 One thing I always appreciate is whenever people ask me a more specific question about them,
like "How did He like the zoo?" or
"how is Music Therapy going?"
rather than a more generalized "How is Avery?"
which can make me feel so overwhelmed that I usually just respond, "Good."
Starting with the small things gives me a chance to start sharing.
And if I'm not sharing, don't think that there isn't a lot going on underneath, or that I don't want to.

Raising a special needs child has changed my life.
I was raised in a family that valued appearance above all else,
and unconsciously I'd come to judge myself and others through this lens. Nothing breaks this lens more than having a sweet, innocent child who is born with impairments that make ordinary living and ordinary performance difficult
or even impossible.
It has helped me understand that true love is meeting someone
(child or adult, special needs or not)
exactly where he or she is --
no matter how they stack up against what "should be."
 Raising a special needs child shatters all the "should bes" that we idolize and build our lives around,
and puts something else at the core:
 love and understanding.


the last thing you may not know about me ...

I do have it tough some days, but I feel really blessed.

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