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“We don’t do autism”

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Re: “We don’t do autism”

#71

> Which is to say that it’s clear whatever condition the strident, proud autistics have, it’s not quite the same condition as one that leaves you epileptic, mute, and generally unable to care for yourself. I can understand the anger here, but please understand that the problem goes both ways. Some high-functioning autistics don't seem to get that the condition can be absolutely crippling, but their belligerence stems…

The author is being a bit prejudiced by saying her severe examples are somehow not acceptable while more high functioning ones are. Most people are unable to care for themselves. We depend on others to help provide food and water for us, accommodation, etc. Most of us won't stay alive if we're isolated from the support of other people we depend on. Some autistic people with more extreme cases not only can't provide their own food, but also can't put on their own clothes. That's just a tighter dependency but not distinctly bad.

I've heard similar arguments about Downs syndrome. Some people want to prevent it, but others say let's embrace it and recognize that the patients are still people who still get to experience life just like the rest of us. They might not be capable of some things we are, but hey, we're not capable of some things a superhuman AGI robot would be either. We wouldn't want to sterilize all humans just because intelligent robots appear and we feel our life has become relatively worthless.

Re: “We don’t do autism”

#72
post #63

Earlier quoted context omitted.

It seems that Dandy-Walker Syndrome is a known cause of some of the symptoms that show up in people on the Spectrum. i.e - there is an overlap. http://ghr.nlm.nih.gov/condition/dandy-walker-syndrome And Dandy-Walker syndrome appears to be directly linked to Cyst growth and hence at least diagnosiable via MRI.

Dandy-Walker Syndrome is rare, though. MRI scanning all people diagnosed with autism just to check for it would be not be justified.

I imagine a study would be warranted, if one does not already exist. If a statistically significant link could be established, why not run tests? How much does it cost to have an MRI performed? How does it compare to the lifetime medical (and social) costs of an autism sufferer?

Re: “We don’t do autism”

#73
The author is getting at one of the most important things that people don't seem to understand about autism research affecting everything from cause diagnosis to potential treatments: because of the variations, getting control groups together is virtually impossible.

My wife used to offer one of the programs that's been around for about 20 years (Sensory Learning Program - aka The Bolles Method) that people can pay for out of pocket but insurance won't cover. In some patients we saw no benefit at all. In others the results were near miraculous. For example, in the span of 2 weeks (the length of the program) one 4 year old child who had never spoken went from zero to 50 words. His mother was in tears.

The people who developed the program in Colorado had numerous pieces of coverage, Wired even did an 8 part story on them but couldn't ever get an autism study together. Eventually they did manage to get a complete study through regarding PTSD because you could get a control group together for PTSD and it showed statistically significant changes (part of the program affects the amygdala and there was some crossover benefit).

The whole thing was both fascinating and shocking. When I found out about the program at first, I was an absolute skeptic too. Looks completely hokey, but for SOME people it works.

The problem is that they haven't been able to find a way to identify the type of people who will benefit significantly...and that is because of the difficulties of getting together a control group. I know there is one doctor in Indiana trying to classify the symptom patterns across the spectrum. He's worked hard to reduce them down...to about 4,000. Prior to the categorization and reduction he was sitting at closer to 200,000.

And the problem is that the second that you know that and you start reading headlines about a study "disproving X" regarding autism you click the link and realize that 9/10 times it's just a rehashed study on general public diagnostics...because nobody can get together a friggin control group.

Re: “We don’t do autism”

#74

Earlier quoted context omitted.

What disturbs me the most is: are we really not taking MRIs of most autistic patients? How come we don't have enough data to draw clear correlations? I'm not a physician either, but it seems a perfectly valid, testable hypothesis that a cerebellar cyst is the cause of the author's brother condition, and this kind of malformation bears an impact on those conditions at large.

Definitely not. Ask most doctors if an MRI is warranted for an autism diagnosis and they'll laugh at you.

I don't see why laughter would be warranted for such a question. Yeah, MRIs are expensive, but wouldn't measurement of the brain's internals among those with autism be helpful in identifying the contributing factors and - maybe someday - a proper treatment?

Re: “We don’t do autism”

#75
I've worked with a range of children, some of them have been marked with interesting psychological conditions.

This was in the states, and I don't really believe that it would have happened in the UK.

A child in my care was presented to me as a "manic depressive" Said child was 7[1]. I Accepted the diagnosis unconditionally, I looked forward to interacting with a intelligent, communicative, but somewhat inhibited, or slothlike child (depending on phase and drugs)

This child had none of these traits. He had poor language skills, the inability to share, bugged by external stimulus, Terrible social skills, poor empathy and a few other things.

In otherwords he was in my view was on the autistic spectrum. (Other people more experienced, who dealt with him agreed with me)

The reason why it was so concerning was the drugs he was put on to combat his "depression". He was on lithium and other such lucrative expensive drugs. The problem with lithium is that withdrawal has a 30% risk of suicide.

The problem for me was that anyone with a tiny bit of medical training, could see he wasn't manic. Because the Psychiatrist was being paid by the hour, and prescription, his diagnosis wasn't going to change.

[1]Manic depression in prepubecents, is vanishingly rare. http://www.rcpsych.ac.uk/healthadvice/parentsandyouthinfo/pa...

Re: “We don’t do autism”

#76
The this I don't understand is why the author thinks a draining spinal fluid would improve things. A cyst is normally an enclosed sack of fluid, so draining spinal fluid is unlikely to do anything.

I would say its more likely to temporarily enlarge the cyst as the relative pressure would change.

Re: “We don’t do autism”

#77

I've worked with a range of children, some of them have been marked with interesting psychological conditions. This was in the states, and I don't really believe that it would have happened in the UK. A child in my care was presented to me as a "manic depressive" Said child was 7[1]. I Accepted the diagnosis unconditionally, I looked forward to interacting with a intelligent, communicative, but somewhat inhibited, or…

I agree this child was misdiagnosed and was receiving the wrong, dangerous, treatment.

But lithium is not expensive. Lithium is dirt cheap.

http://www.coventrywarksapc.nhs.uk/mf.ashx?ID=425e5245-157c-...

> Cost: For 800mg/day lithium carbonate or equivalent, at April 2015 dm+d prices, one year’s treatment costs

> Priadel® 400mg tablets £25

> Camcolit® 400mg tablets £31

> Priadel® liquid £273

Re: “We don’t do autism”

#78
post #77

I've worked with a range of children, some of them have been marked with interesting psychological conditions. This was in the states, and I don't really believe that it would have happened in the UK. A child in my care was presented to me as a "manic depressive" Said child was 7[1]. I Accepted the diagnosis unconditionally, I looked forward to interacting with a intelligent, communicative, but somewhat inhibited, or…

I agree this child was misdiagnosed and was receiving the wrong, dangerous, treatment. But lithium is not expensive. Lithium is dirt cheap. http://www.coventrywarksapc.nhs.uk/mf.ashx?ID=425e5245-157c-... > Cost: For 800mg/day lithium carbonate or equivalent, at April 2015 dm+d prices, one year’s treatment costs > Priadel® 400mg tablets £25 > Camcolit® 400mg tablets £31 > Priadel® liquid £273

I stand corrected.

I wonder if NHS prices, which are normally quite good translate into American prices?

Re: “We don’t do autism”

#79

Earlier quoted context omitted.

Definitely not. Ask most doctors if an MRI is warranted for an autism diagnosis and they'll laugh at you.

I don't see why laughter would be warranted for such a question. Yeah, MRIs are expensive, but wouldn't measurement of the brain's internals among those with autism be helpful in identifying the contributing factors and - maybe someday - a proper treatment?

You've proposed the reasonable step of using MRI to scan the brains of people with ASD diagnoses. That's already happening. We could probably do more of it. http://www.nhs.uk/news/2010/12December/Pages/new-brain-scan-...

http://autism-center.ucsd.edu/what-causes-autism/Pages/fmri....

Parent post is talking about scanning an individual. That's less useful. The second link I provide gives some reasoning: ASD is often suspected early. Many parents recognise somethings are different at about two years of age. You can't put an awake two year old in an MRI machine because you need the scanned person to stay still.

Re: “We don’t do autism”

#80
post #77

Earlier quoted context omitted.

I agree this child was misdiagnosed and was receiving the wrong, dangerous, treatment. But lithium is not expensive. Lithium is dirt cheap. http://www.coventrywarksapc.nhs.uk/mf.ashx?ID=425e5245-157c-... > Cost: For 800mg/day lithium carbonate or equivalent, at April 2015 dm+d prices, one year’s treatment costs > Priadel® 400mg tablets £25 > Camcolit® 400mg tablets £31 > Priadel® liquid £273

I stand corrected. I wonder if NHS prices, which are normally quite good translate into American prices?

Lithium (carbonate) is a very old drug, cheap to manufacture, and non-patentable. It is essentially the lithium (metal) salt of carbonate (bubbling water). It is super cheap everywhere.

While you might think so, I don't think it's a fact that the psychiatrist would run out of patients without this child being diagnosed with bipolar.

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