At this pace, it can feel as though nearly everyone could be described as “on the spectrum” within the next two decades.
That was the striking takeaway after reviewing a recent report examining the sharp rise in autism diagnoses. Researchers in Europe found that between 2001 and 2020, the number of people identified as having some form of autism increased dramatically.
But the most important detail may be what did not change: the study found no corresponding increase in severe autism, defined as autism accompanied by intellectual disability.
Over the 20-year period, diagnoses of autism with intellectual disability remained essentially unchanged. By contrast, autism diagnoses among people without intellectual disability surged, climbing by 1,800% from 2001 to 2020.
Put simply, for every one person diagnosed with autism without intellectual disability in 2001, 18 people received that diagnosis in 2020.
Professor Uta Frith at University College London has been studying autism for 60 years. Commenting on this study, she expressed concern about “diagnostic inflation,” which has the effect of “pathologizing normal human variations.”
That’s a fancy way of saying that Professor Frith is skeptical about whether all these people with autism truly have autism. They may just be normal people who are being diagnosed with autism because they have issues with social interaction.
I have been a family physician for more than 30 years, and I think Professor Frith has a point.
Social media is part of the problem. One popular TikTok video, with more than 11 million views, presents a series of statements. If you agree with the statement, then you may be on the spectrum. One of the statements in that TikTok video is “You don’t like talking on the phone because phone conversations are stressful.”
OK, I’m a family doctor, and I can tell you with confidence that about half of the adults I see would agree with that statement.
American researchers recently studied 100 popular TikTok videos about autism and found those videos to be “unsatisfactory” and “often misleading.”
Researchers have also documented that it’s much easier to be diagnosed with autism today compared with 20 years ago: clinicians will make the diagnosis on the basis of many fewer symptoms.
RELATED: ICE Detainer Filed for Migrant in Crash That Killed Maryland Mom, Daughter
But it feels good!
Professor Frith notes that teenagers and adults newly diagnosed with autism “often report overwhelmingly positive effects. They state that the diagnosis explains their lifelong struggles and liberates them from self-blame. In this way, the label itself can be therapeutic without any formal treatment.”
So what’s not to like? Where’s the harm? Why is this a problem?
It’s a problem because it turns normal human variation into a diagnostic label.
“I’m on the spectrum” is so much cooler than “I have trouble making friends; I feel myself to be awkward socially.” It also shifts responsibility.
If I say “I have trouble making friends,” then maybe I should do something about that. Maybe I should make more of an effort. But if I say “I’m on the spectrum,” then it’s not a problem anymore. It’s just who I am. It’s not going to change. “Neurodivergent” is now part of my identity.
In the new edition of my book “Boys Adrift: The Six Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men,” I explore the rise in psychiatric diagnoses in the United States. I cite a report from the CDC showing that 23% of 17-year-old American boys have now been diagnosed with ADHD, and the great majority of these boys are on medication.
As recently as 1987, the official estimate of the American Psychiatric Association was that ADHD “may occur in as many as 3% of children.”
So we’ve gone from 3 out of 100, to nearly 1 in 4, in 40 years.
Resist the temptation to medicalize, to pathologize, to put a diagnostic label on who you are.
If you feel uncomfortable talking on the phone, if you have trouble making friends, don’t label yourself as being “on the spectrum.” Find the courage to try, to make an effort, to be more human. You can change. I’ve seen it happen.
Leonard Sax, MD, PhD, is the author of “Boys Adrift: The Six Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men.”