I have been taken aback by how many mothers of preschool boys worry that their sons are autistic. In 62 years, I have not encountered seriously autistic children, though I suspect I have known, even been related to, men who would now be diagnosed along the autistic spectrum. They all are scientists, mathematicians, and computer programmers. Sure they are weird; surely they are not the most stimulating conversationalists,; sure they don't have a huge number of friends. But they can be great sons, brothers, husbands, and fathers with successful careers. Is the alarming epidemic of autism partially created by greatly expanding the criteria for diagnosis? Are we losing all tolerance for divergent thinkers to maintain a society hostile to children and families?
When my kids were young, 25-30 years ago, even in therapy-obsessed Manhattan, preschool kids weren't frequently diagnosed, weren't taking psychiatric medications, so it is very hard to get my mind around this epidemic of very young children with serious problems. Is something going very wrong with the way we are raising children? What has happened to social criticism and reform? Are we being encouraged to worry needlessly about our own kids that we don't have any time or energy for political activism on behalf of all children?
Who is blowing the whistle? Who is questioning the wisdom of babies and toddlers being cared for by strangers? Who is wondering whether group care is appropriate for most children under three? Who is crusading for a shorter work week and greatly increased parental leave? Who is crusading to make caring for preschoolers a viable career path for college graduates, comparable to teaching? What changes are required to enable parents to care for their babies and toddlers themselves? Who is comparing our rate of childhood mental illness with rates in the rest of the Western world? Who is outraged about preschoolers taking new medications that have never been tested on children and inadequately tested on adults? Who is working to outlaw drug ads in magazines and on TV?
The aggressive drug treatment of mental illness in the last 30 years hasn't been very successful. When yesterday's wonder drug becomes generic, its ineffectiveness is suddenly discovered, and today's expensive wonder drug will save your life after being tested for a shocking short time on shockingly few people who don't share your diagnoses. Witness the latest advertising blitz to treat bipolars with antipsychotics; all the tried and true mood stabilizers are becoming generic so they obviously can't help.
Preschoolers so unformed, so in process. This years's four year old can seem like a different creature than last year's three year old. These diagnoses of autism, bipolar disorder, ADHD imply lifelong incurable brain disorders for which there are no medical tests, no verifiable proof of their existence. How do we know that today's experts on autism are any more correct than the monsters who attributed autism to "icebox mothers" 40 years ago?
It is politically correct to be very tolerant and open-minded about emotional problems, but that enlightenment is only surface deep. I have experienced that brutal reality in 22 years of being open about my manic depression in the mental health field. I mourn for the three year old already cursed with a lifelong diagnosis. Loner, loser, geek, and nerd seem far kinder labels. In this fall's TV season, geeks are the new Prince Charmings. The confidentiality of medical records is a myth. Many adults not diagnosed along the autistic spectrum have successful careers in math, science, computer programming. Would that have happened if they had been diagnosed as preschoolers?
I am not questioning that some preschoolers will benefit from early intervention to cope with their idiosyncratic learning styles or developmental delays. But preschool services should not necessitate a lifelong diagnosis. Why would you accept that your young child has a broken brain? Why not take him out of day care, find a different nanny, change nursery schools, reduce your working hours, live more frugally, borrow money and take a leave of absence, ask your parents and relatives for help, search out books and activities about his particular obsessions, learn the recommended interventions yourself? Why not wait until the picture becomes clearer ? What is the urgency to find the answer? This isn't meningitis. What is the point of early diagnosis if there are no safe, effective, time-tested treatments. Are we doing far more harm than good? When I hear a 7 year old rattle off all his psychiatric labels, it breaks my heart and makes me want to man the barricades. I would love to find some comrades.
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