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Parenting for Children with Suspected Autism: Navigating Overdiagnosis

Trigger alert: *Let me start by apologizing, as always, this post may be triggering and annoying for some of you, but it is still important that you read it, even if you strongly disagree.


"We're ordering in from the DSM-5, Do you want anything?"


Introduction

Imagine my surprise when five of my best friends recently (Last 3 months!) shared that their children had been diagnosed with Autism Spectrum Disorder (ASD). This sparked my curiosity, so I decided to take the Autism Spectrum Quotient (AQ) test myself. The results? I’m quite advanced on the spectrum. Yet, as a child, I received no special assistance, managed to get decent grades, and enjoyed a relatively good social life (even if I wasn’t the most popular kid in school).


Autism on the Rise

Indeed, the incidence of autism diagnoses has been rising steadily. A study published in Brain Sciences indicates that the prevalence of ASD has increased from 1 in 150 children in 2000 to 1 in 54 children in 2020, representing a 178% increase over two decades (reference[here]). But is this rise an accurate reflection of reality, or are we, as some suggest, overdiagnosing?


The False Positive Conundrum

One of the key issues we face today is the high rate of false positives in ASD diagnoses, especially when anxiety is present. Anxiety is rampant in our modern world, and its symptoms can often mimic or exacerbate those of ASD. A study published in Clinical Neuropsychologist found that false-positive rates for ASD can be as high as 50% when anxiety disorders are also present (reference [here]). This overlap can lead to misdiagnosis, causing unnecessary stress for both the child and the parents.


A Race to Diagnose

We seem to be in a frenzied race to diagnose our children with a myriad of conditions — be it mental health disorders, allergies, or other peculiar ailments. The Pediatrics journal reported a 400% increase in food allergies in children between 1997 and 2011 (reference [here]). While the intention is often to help, the implications of this overzealous approach can be counterproductive.


The Impact on Self-Esteem

Frequent mental health screenings, while well-intentioned, can significantly impact a child’s self-esteem. Children may begin to internalize these diagnoses, viewing themselves through a negative lens, which in turn affects their social and emotional development. A study in Frontiers in Psychology showed that children who are frequently labeled with mental health issues have a 30% higher likelihood of experiencing low self-esteem (reference [here]). Over-protective parenting, driven by these diagnoses, can also contribute to lower self-esteem and poorer mental health outcomes for children, with a reported 25% increase in anxiety and depression rates among these children (reference [here]).


What’s Next? A Call to Action

So, what should we do next? Here are a few steps to consider:

1. Seek Help for Yourself: It’s possible that your own anxiety is driving a compulsive need to diagnose and “over-assist” your child. Addressing your own mental health can have a profound impact on how you perceive and respond to your child’s needs. Studies have shown that parental anxiety can significantly influence a child’s mental health, with children of anxious parents being twice as likely to develop anxiety disorders themselves.


2.Question the Necessity: Ask yourself if what you’re noticing is truly debilitating for your child within their social environment. Are other kids displaying similar behaviors? Could you be projecting your own biases?


3. Consider Preventative Interventions: Instead of jumping straight to a diagnosis, consider short cycles of Cognitive Behavioral Therapy (CBT) to help with behavioral challenges and anxiety. Research has found that preventative CBT can reduce the onset of anxiety disorders in children by up to 50% (reference [here]).


The Final Thought

Remember, most parents act with the best intentions, striving to help their children in every possible way. However, parenting is arguably the toughest job you will ever have. Ensure that your anxieties related to parenting are managed. Take a moment to help yourself first, much like the advice given in airplane safety videos: “Put the mask on yourself before helping your child.”

By balancing our approach to diagnosis and intervention, we can better support our children’s development without inadvertently causing harm. After all, isn’t the goal to raise happy, healthy, and well-adjusted individuals?


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In this era of overdiagnosis, a bit of caution and a lot of love can go a long way.

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