The Syndrome That Became an Epidemic: David Boyle Asks Whether Autism, Diagnosed 1,000 per Cent More Than a Decade Ago, Has Become a New Term for Naughty Children and Wonders If the Drug Companies Are Behind It All
Boyle, David, New Statesman (1996)
"Don't call me that word!" says a furious six-year-old, sitting between worried parents and NHS psychologists in a drab, suburban family centre. She is in the middle of what is becoming a familiar scene in modern Britain: the ritual of the official diagnosis of Asperger's syndrome, or mild autism. It's the word Asperger's that has been whispered between her parents and professionals in her hearing once too often. Some specialists in this complex area of paediatrics believe that, if a child challenges the diagnosis, it is wrong by definition.
Non-professionals might also wonder why a child communicative and intuitive enough to recognise the word might ever be thought autistic, or anything like it. But in this case the diagnosis stood, as it does in so many others now--maybe not fully fledged autism, but "Asperger's" or "autistic spectrum".
Autism was first diagnosed in 1943; the word itself, coined in 1908, was used to describe children who were self-absorbed and unable to interact socially. The field has become particularly complex and controversial over the past decade, partly following the translation into English of work by Hans Asperger, who linked clumsiness in children to autism in the 1940s, and partly because autism has been linked to other questions, including the hotly disputed claim that the childhood jabs against measles, mumps and rubella (known as MMR) might trigger the condition.
The figures are certainly frightening. There are now half a million people in the UK said to be suffering from autism, up 1,000 per cent among children in the space of ten years. That's one in 86 primary schoolchildren in England and Wales, and one in 121 in Scotland--enough to prompt a column in the Guardian by an agonised mother and a series of TV documentaries.
You can terrify people with percentages, and in the United States you will find claims on the internet of staggering 62,000 per cent rises in Illinois over the same period, and credulity testing four-figure percentage rises in states such as Ohio and Nebraska. Actually, 1992-93 was the first time researchers collected figures in the US, so they are open to challenge. None the less, such figures appear on campaign websites, fanning the flames of a global autism panic. A recent study by the Royal Free Hospital in London cast doubt on whether there has been ally rise at all, suggesting that the statistics simply reflect wider medical recognition of autism. Following publication of the study, Professor Priscilla Alderson, an expert in childhood studies at London's Institute of Education, claimed that the rise was about psychologists trying to "make a quick buck", and that symptoms would disappear if children were allowed out of the house a little more.
This may be true, yet perhaps what is most interesting is what the enthusiasm for diagnosing autism says of our fears about child behaviour. Why has a condition, so distressing for parents that doctors, until recently, might delay using the dreaded word for years, suddenly become so overwhelmingly "popular"? Why are parents so keen to have the diagnosis and psychologists and doctors so keen to oblige?
The question is behind not just the MMR debate, but also the deployment of scarce education resources, with the education authorities under pressure to provide for growing numbers of the mildly autistic. One answer may be our inability to deal with what was once called naughtiness--or even mild oddness. This is not to say that MMR jabs are necessarily innocent, or that autism isn't immensely distressing. It can tear a family apart when children shut down and withdraw from the world. Previous generations struggled over this mystery malfunction, but there is still neither a foolproof solution nor a clear cause.
Yet an afternoon at a family centre--with professionals fresh from courses on autism, doling diagnoses out to grateful and worried parents--might also make you wonder about the way we love to label and count the things we fear most. …