Autism rates have soared. This doctor says he knows part of the reason why : NPR

Juana Summers, host:

There was a title of the New York Times that drew our attention this week – “Autism rates increased by 60 times. I played a role on this subject.” This is an opinion article written by Dr. Allen Frances. Dr. Frances, psychiatrist, directed the working group which created the fourth edition of the diagnostic and statistical manual of mental disorders. The DSM is in a way a Bible for mental health professionals who seek to diagnose and treat a wide variety of mental illnesses and neurological disorders. Dr. Allen Frances joins me now.

Welcome to everything considered.

Allen Frances: Thank you.

Summers: I am curious about timing. In your article in Times, you have written that the explosion of autism rates has become fodder, as you called, for Robert F. Kennedy Jr. – The theories of the conspiracy of the Secretary of Health. Is that why you decided to express themselves now?

Frances: Exactly. When – I think if you are looking for the whole world, you cannot find a person less appropriate to direct health efforts in the United States or in the world. And when he started to redirect resources in an extreme way for research on the causes of autism and the best way to treat it to try to find a means, a ploy, a misleading method to prove the theory of the vaccine, I thought it was necessary to speak. And this has become even worse when he dismissed people from the CDC’s advisory committee for the CDC and hired hacks to try to continue the theory of the vaccine conspiracy that has been the passion for his life for 20 years.

Summers: I will simply note that Kennedy’s assertion that vaccines repeatedly cause autism. There have been a multitude of studies that prove that they don’t. But the fact remains that there is still no clear answer on what causes autism. Can you say that the largest factor stimulating the explosion of autism rates is motivated by means of modifying the definition?

Frances: You know, what happened is that in 1994, we added a condition which was called Asperger’s disorder which was a very soft form of some of the same symptoms that occur in classic autism. Classic autism is absolutely undoubtedly. The beginning is before the age of 3 years. Severity and disabilities are tragic and for life, and you cannot confuse classic autism with something else.

Asperger is a very light version of classic autism and therefore much more common and much more easily confused with other mental disorders or for normal eccentricity and social removal. The 60-time increase was therefore widely launched by the change of definition in the DSM-IV, then it was promoted by several factors. First and foremost, originally, it was the fact that educational services were intended to obtain the diagnosis. And whenever there is an advantage linked to a psychiatric diagnosis, rates – rates jump enormously.

Second, the Internet has spread the idea of ​​autism as forest fires. And many people have self-diagnosed with autism. In some places, it has almost become a badge of shine. And therefore the differences in the definition and the differences in the application of the definition and the fact that the educational advantages were associated with it – this is what caused the increase of 60 times – not vaccines. We know in very conclusive studies that vaccines do not cause autism.

Summers: While we are talking, I can’t help but think of some of the countless people who have fought all their lives who get a diagnosis of autism in adulthood, and it’s like a whip of them. Everything suddenly has a meaning. How can it be a bad thing?

Frances: You know, I think it is certainly true that human distress is looking for an explanation, and different periods of time offer different explanations which are suddenly very popular. Everyone jumps on the train. This helps to explain to the individual the problems they have. So, the – I am in favor of people who believe that autism is an explanation of their problems. And sometimes it is, and then it is worth it. Some people were therefore identified who were reportedly missed. And for them, it can be very useful. But for the vast majority of people who carry the diagnosis now, it is questionable and the second and third opinions would be useful.

Summers: Doctor Frances, in your opinion, what is the best way to follow for people who, as you describe them, may be socially awkward, who believe that they could suffer from an autism spectrum disorder?

Frances: Do not diagnose it and do not accept what can be an overdiagnosis of others. Very often, a diagnosis of autism made early in life does not remain stable throughout life. And meet a good friend, fall in love – many life experiences help social clumsiness, and that disappears and improves with age. I would therefore not be limited by the fact that I have an autistic diagnosis by thinking that I cannot have a better future.

Summers: It was Dr. Allen Frances, a psychiatrist who led the working group that created the fourth edition of the diagnostic and statistical manual of mental disorders. Dr Frances, thank you.

Frances: Thank you very much – and always a pleasure that listens to you.

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