Oh, for fuck's sake.

[rivka]

Ninety-nine percent of the time, when I'm offensive, (a) I know that I'm being offensive, (b) I'm doing it on purpose, and (c) I'm willing to acknowledge it. This may not be much of a virtue, but sometimes it's all I've got.

In another journal to which I shall not link, a commenter presented the opinion that "autism and ADD are 'massively overdiagnosed.' " When I asked if she had any evidence for this claim, she posted a long set of justifications involving lazy teachers, parents with no discipline skills, venal psychologists, and suggestive idiots who see symptom lists on the internet and become convinced that their child is autistic. Here's the money quote:

what is often diagnosed as autism is more likely a lack of parenting skills combined with a therapist's interest in creating a lucrative "treatment" plan - one that involves "specialists" "drugs" and "group therapy" - all of which line someone's pockets.

My response, I acknowledge, was not at all kind or temperate. I regretted, afterwards, not making the same points in slightly more temperate language. But I am not amused, today, to discover that she made a long self-pitying post in her own journal about how victimized she was by my horrible attack. Because she is never one to make a point offensively, herself. She's very gentle.

If the bit I quoted above is not unbelievably offensive to parents of autistic children and to mental health treatment providers, then I need a new definition for the word. Yes, when I fired back, I was harsh. But I'll be damned if I'm going to accept a version of events in which I am supposed to have fired the first shot.

Comments

[casperflea.livejournal.com]

Um, no, it wasn't. I work at a library reference desk - we like to wallow in information.

I wonder what, if any, cross-cultural studies of diagnoses of ADHD and high-functioning autism reveal. Are they as commonly diagnosed in the poor, the non-white, in foreign countries? Because certainly the media picture of these illnesses is that they affect white males of the upper middle class in American suburbs. The biological tendency to affect males seems fairly obvious, but the rest, not so much. Or is there (as is of course likely given our medical system) just massive underdiagnosis in the poor and non-white?

[casperflea.livejournal.com]

I realize you have partly answered this with your UK reference above.

[rivka.livejournal.com]

Because certainly the media picture of these illnesses is that they affect white males of the upper middle class in American suburbs.

It's interesting that this is your perception, because I think I'm more likely to hear that poor black kids are being drugged into submission.

I don't know for sure, but in scouting around I found this (http://www.futureofchildren.org/information2827/information_show.htm?doc_id=256825):

According to the hyperactivity subscale of the Strengths and Difficulties Questionnaire of the National Health Interview Survey, 4.19 percent of boys and 1.77 percent of girls have “clinically significant” ADHD symptoms. Among boys, the prevalence is highest among blacks, at 5.65 percent, as against 4.33 percent for whites and 3.06 percent for Hispanics. Prevalence is also higher (6.52 percent) in families with incomes less than $20,000 than in families with higher incomes (3.85 percent). When gender, race, age, income, and parental education are taken into account, the effect of income remains statistically significant, but there is no difference in prevalence between blacks and whites.

But that's survey results, not diagnoses. This review article about epidemiology of ADHD (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12216060&dopt=Citation) concludes, "basic information about how the prevalence of ADHD varies by race/ethnicity, sex, age, and socio-economic status remains poorly described."

[enid-niniane.livejournal.com]

I'm not expert, but I took a course in this a couple of months ago, so I have to add this: "Differing cultural standards might also influence prevalence. Ratings in the United Kingdom and China showed that almost three times as many Chinese boys were identified [as showing symptoms of ADHD]. On closer examination, it was revealed that the Chinese boys were actually more attentive and less active than the U.K. boys." (Behavior Disorders of Childhood, p. 245, 2003)

Speaking entirely anectdotally, I think some of the differences in perception about these disorders may depend on where one lives. I grew up in a small Canadian town, and in a very white/Chinese/Iranian part of Toronto, and the majority of kids I knew who were on Ritalin were white males - because there were perhaps 5 black males at the school. And I did wonder about the diagnoses that led to the prescriptions - it wasn't like this when I was in elementary school, but by the time my brother got there, half the boys in his grade were on Ritalin, along with a few of the girls (that's about 10 of 60 students); if there are a lot of cases like my brother's class, that could certainly make many people wonder whether or not ADHD is overdiagnosed.

That said, blaming parenting when there's no evidence that it has anything to do with ADHD or autism is a horrible thing for anyone to do.

[kiya]

I have a friend who had a tough time getting an ADHD diagnosis and treatment because she's female; I have a cousin who had neither his ADHD nor his dyslexia diagnosed before his late teens because he was categorised as "disruptive black kid" rather than evaluated for medical problems.

That's my anecdotal stuff.