Children misdiagnosed with autism
[This is the print version of story http://www.abc.net.au/pm/content/2008/s2418004.htm]
PM – Wednesday, 12 November , 2008 18:38:00
Reporter: Annie Guest
Experts say diagnosis of the condition in Australia is patchy, because doctors here don’t apply the internationally accepted diagnostic criteria. Some patients are diagnosed as autistic when they don’t have the disorder, others with all the symptoms are turned away.
In Queensland today, there are fresh accusations that doctors are misdiagnosing children so they qualify for help in the classroom. But with a new Federal Government support package being rolled out, there’s fresh hope of a more uniform approach.
Annie Guest reports from Brisbane.
ANNIE GUEST: About 125,000 Australian children are known to have autism spectrum disorder. Many of their families describe stress, worry and hard work. They’re dealing with an array of symptoms that seem as complex as the terminology.
ANTHONY WARREN: Autism spectrum disorder is a somewhat misleading term.
ANNIE GUEST: Anthony Warren is from the advocacy group, Autism Spectrum Australia.
He says the label is an umbrella term, and the problems communicating and repetitive behaviours often described as autism fall into one of three disorders.
ANTHONY WARREN: The groups are autistic disorder, Asperger’s disorder and the third groups is atypical autism.
ANNIE GUEST: And more children are being diagnosed with these problems. In some areas, there’s been a 20-fold increase in two decades.
Last year, Australia’s first autism prevalence study found one in 160 young people have autism spectrum disorder. That’s consistent internationally, as is the rise in diagnoses.
In Queensland, politicians are blaming paediatricians and psychiatrists. The Education Minister Rod Welford told ABC Radio, he supports claims by his predecessor, that doctors are intentionally misdiagnosing children so they can qualify for support in the classroom.
ROD WELFORD: It’s a disgraceful state of affairs and I agree with him. There does appear to be an over-diagnosis of children with ASD or autism and there’s just no rational explanation for it.
And certainly if that evidence is extreme or substantial then it’s something that you would refer to the relevant medical authorities.
ANNIE GUEST: Similar concerns about diagnoses linked to funding have been voiced over the years in other states.
Autism Spectrum Australia’s Anthony Warren says it is a problem, but the big rise in the disorder is primarily because of better awareness.
ANTHONY WARREN: That’s because we’re better able to recognise the autism spectrum disorders and I mean that’s a very positive thing. On the other hand, there is a risk that of over-diagnoses.
ANNIE GUEST: And how prevalent is that over-diagnosis or misdiagnosis in Australia?
ANTHONY WARREN: Look I think that’s really impossible to know. I would have thought that, look, my experience in New South Wales is that may be a few misdiagnoses. If anything, there’s an under-diagnosis.
ANNIE GUEST: But with an internationally agreed classification system, that should not be happening.
Brisbane paediatrician Dr Neil Wigg describes the process of diagnosing a child.
NEIL WIGG: If I am suspicious that a child might have autism spectrum disorder, I work with clinical psychologists, speech pathologists, occupational therapists, a range of other people and when we then sit down and we do some quite specific assessments of children in order to be quite confident in the diagnosis.
Now that’s a lengthy and expensive process and that process is not available to all paediatricians and it’s certainly not available to all children in Queensland.
ANNIE GUEST: What are you saying there, are you saying that it’s possible that they’ve got it wrong?
NEIL WIGG: I’m saying that they are doing it on the basis of less evidence than other people who do more exhaustive testing.
ANNIE GUEST: But there’s hope that a new Federal Government program will force practitioners to adopt the internationally accepted criteria for diagnosis.
The $190-million package is currently being rolled out and Autism Spectrum Australia says children will not be able to access the early intervention programs unless they have been diagnosed in this way.
But for those already working in schools, all children labelled with these problems need their help.
Penny Beeston is the chief executive of Autism Queensland.
PENNY BEESTON: We actually never see children come through our doors with a diagnosis of autism who don’t have clear, clear traits of autism.
ANNIE GUEST: The five-year Federal Government packaged includes help education, support and early intervention services for children up to the age of six.
ASHLEY HALL: Annie Guest with that report.