Overdiagnosing Asperger's

Two recent NY Times pieces discuss the overdiagnosis of Asperger's.

This op ed is written by someone who was mistakenly diagnosed with Asperger's as a teenager by his psychologist mother who (surprise!) specialized in Asperger's.  He eventually outgrew his social awkwardness, but wonders if he would have if he had been diagnosed younger, or would he have withdrawn even more in a sort of self-fulfilling prophecy:


I wonder: If I had been born five years later and given the diagnosis at the more impressionable age of 12, what would have happened? I might never have tried to write about social interaction, having been told that I was hard-wired to find social interaction baffling.

The authors of the next edition of the diagnostic manual, the D.S.M.-5, are considering a narrower definition of the autism spectrum. This may reverse the drastic increase in Asperger diagnoses that has taken place over the last 10 to 15 years. Many prominent psychologists have reacted to this news with dismay. They protest that children and teenagers on the mild side of the autism spectrum will be denied the services they need if they’re unable to meet the new, more exclusive criteria.

But my experience can’t be unique. Under the rules in place today, any nerd, any withdrawn, bookish kid, can have Asperger syndrome.

The definition should be narrowed. I don’t want a kid with mild autism to go untreated. But I don’t want a school psychologist to give a clumsy, lonely teenager a description of his mind that isn’t true.


Under the headline: "Asperger's History of Over Diagnosis,"we get a shout out as the only people who might not eventually be labeled as being a bit of an Aspie:


For better or worse, though, Asperger syndrome has become a part of our cultural landscape. Comments about a person’s having “a touch of Asperger’s” seem to be part of everyday conversations. Even an episode of “South Park” last year was devoted to Asperger syndrome. We can only hope that better physiological markers distinguishing between the autism-spectrum disorders and pure social disabilities can stem this tide of ever more pathologizing.

But, as Martha Denckla, a pediatric neurologist at Johns Hopkins University, has lamented, the only Americans in the future who will perhaps not be labeled as having a touch of Asperger syndrome will be politicians and lobbyists. Members of the political establishment may have other kinds of psychopathology; but, unlike the rest of us, they at least cannot be thought of as Aspies.


Of course we can all be glad that we will never be diagnosed as having Asperger's (which doesn't mean that I won't sometimes throw out that I am also a little bit Aspie to get sympathy and leeway). I guess we can also be happy that people seem so reluctant to diagnosis anyone who isn't a murderer a sociopath (and categorically exclude children).  In my mind, though, I don't see anything wrong with labeling people a little bit Aspie or a little bit sociopathic, unless it's an issue of prescribing medication or other radically different treatment.  But if there are no meds and there is no treatment, then what is wrong with slapping a label on someone as long as it helps others understand them (and helps them understand themselves) better?