Are the messages about autism compromised?

There have been lots of conflicting claims about the prevalence of autism over the past year. I wonder which messages the Government and health professionals are listening to, and whether the ones sent out by NAS are being countermanded by other claims.

The latest claim in the British Medical Journal is that the increase in diagnosis in the 1990s has levelled off since 2000, and that the yearly diagnosis rate is 3.8 per thousand (compared to popularly held views that it is greater than 10 per thousand, possibly 13).

The study was based on diagnoses each year by the age of 8, but that could be to do with the effectiveness of diagnosis, especially as with recession, and the evidence of parents trying to get their children diagnosed or statemented, whereby there might be a deliberate policy to reduce diagnosis to fudge the statistics. Another study in America suggests a 78% rise between 2002 and 2008, and why wouldn't it surprise me if the UK was trying to pretend things again? 

Who do you believe? And more importantly who do the Government and Health Professionals believe?

Another claim made a year ago in the Journal of Child Psychology and Psychiatry believes children can grow out of autism.  Well we know many GPs hold that view, and it seems to be reinforced from somewhere. The evidence is supposedly that groups receiving strong support show marked improvement in social interaction skills, but that's been known as a short term response to coaching for some time.

Funnily enough you can always get a daft wee bit of research done in the UK, if the money's the right colour, but spend £0.5m on developing training and awareness packages and there's no apparent outcome!

The puzzle with the "grow out of it" research is it has the usual problem with eye contact. It thinks that if conspicuous gaze aversion stops the problem has gone away.

I truly dispair. The two most obvious and persistent factors are poor use of eye contact, preventing assimilation of a wide range of non-verbal cues, and sensory issues/sensory overload. Both are pushed to the back of scientists' minds, the eye contact if it isn't obvious. No-one seems to have explored whether these are key causal factors. That might better explain short-term improvements.

But NAS needs to weigh up whether the messages it is putting out are compromised by contradictory messages coming from sources the professionals, and Government, hold in better respect. Like the British Medical Journal and the Journal of Child Psychology and Psychiatry.

Parents
  • The trouble is our experiences don't get reported back to the medical world, or anyone else that influences outcomes.

    Medical Journals are mostly published by professional bodies - that's what funds them. Members, whether they read all the content, or no more than skim read it, which is worse, apparently want the best in internationally refereed research to be published by them.

    Our concerns just wouldn't make the grade even as a footnote in such journals.

    If professionals don't willingly read the stuff produced, they probably have to go to professional discussions where they work, that review current developments.

    More worryingly too, journaslists read and review these articles, and pick up on the hot stories, which will be things like dietary choices or claimed cures etc that will appeal to newspaper and magazine readers. For example the person found naked recently at a care home for people with autism.

    The trouble is most of these papers are written by research teams in very tiny research areas. Universities have to produce a lot of internationally refereed published papers to stay high in the league tables. The actual subject matter may only be read by the members of one or two competing research teams internationally. To read most academic papers you need to be a regular reader of that line of research, otherwise you wont know the context or the jargon.

    The people who published a research paper on children growing out of autism, there may not be any other teams researching that. To challenge the claims another research team has to set up another data set, either existing data used a different way, or fresh measurements, which may take years. Even if another research team has researched this area and can contradict, they have to write a paper to the required standards, get it past international referees who may force several rewrites, and it may be months or years before a counterclaim gets into the same journal. 

    Know I don't suppose the publishers or the readers or the contributors to the Journal of Child Psychology and Psychiatry care a jot about the impact of that paper on people with autism and how they get treated.

    That paper has set back years of effort by organisations like NAS to fight such myths. And the claims made in that paper will be used to reinforce old established myths about autism. 

    The professional bodies who print this junk - and it is often junk (as for all the refereeing the quality of research and its reliability is often lost in procedure), are quite devoid of ethical responsibility. They couldn't care less.

    And as for the paper in the British Medical Journal, same applies. Whatever anyone says, there's an authoratative paper that says autism is now on the downturn. It backs the drive to reduce diagnoses and cut back on services to people with autism on economic grounds.

    And does the British Medical Journal care? I doubt if morals and ethics come into it. Its about publishing papers that look good that's all.

Reply
  • The trouble is our experiences don't get reported back to the medical world, or anyone else that influences outcomes.

    Medical Journals are mostly published by professional bodies - that's what funds them. Members, whether they read all the content, or no more than skim read it, which is worse, apparently want the best in internationally refereed research to be published by them.

    Our concerns just wouldn't make the grade even as a footnote in such journals.

    If professionals don't willingly read the stuff produced, they probably have to go to professional discussions where they work, that review current developments.

    More worryingly too, journaslists read and review these articles, and pick up on the hot stories, which will be things like dietary choices or claimed cures etc that will appeal to newspaper and magazine readers. For example the person found naked recently at a care home for people with autism.

    The trouble is most of these papers are written by research teams in very tiny research areas. Universities have to produce a lot of internationally refereed published papers to stay high in the league tables. The actual subject matter may only be read by the members of one or two competing research teams internationally. To read most academic papers you need to be a regular reader of that line of research, otherwise you wont know the context or the jargon.

    The people who published a research paper on children growing out of autism, there may not be any other teams researching that. To challenge the claims another research team has to set up another data set, either existing data used a different way, or fresh measurements, which may take years. Even if another research team has researched this area and can contradict, they have to write a paper to the required standards, get it past international referees who may force several rewrites, and it may be months or years before a counterclaim gets into the same journal. 

    Know I don't suppose the publishers or the readers or the contributors to the Journal of Child Psychology and Psychiatry care a jot about the impact of that paper on people with autism and how they get treated.

    That paper has set back years of effort by organisations like NAS to fight such myths. And the claims made in that paper will be used to reinforce old established myths about autism. 

    The professional bodies who print this junk - and it is often junk (as for all the refereeing the quality of research and its reliability is often lost in procedure), are quite devoid of ethical responsibility. They couldn't care less.

    And as for the paper in the British Medical Journal, same applies. Whatever anyone says, there's an authoratative paper that says autism is now on the downturn. It backs the drive to reduce diagnoses and cut back on services to people with autism on economic grounds.

    And does the British Medical Journal care? I doubt if morals and ethics come into it. Its about publishing papers that look good that's all.

Children
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