Called Diagnosing autism spectrum disorders in elderly people, (HERE) it tells about the difficulties involved in recognizing ASD in older people. In it we learn about three elderly men who received an autism diagnosis later in life.
The paper concludes that “the three case studies show that in clinical practice ASD can easily be missed in elderly individuals presenting with comorbid psychiatric disorders, potentially causing iatrogenic damage. Although further research on phenotyping and diagnosing ASD in older people is warranted, the most important step at this point is to create a greater awareness of the possibility of ASD in old age among health-care professionals working with people in this age group.”
In the 11 page report, we’re told that older people were never diagnosed correctly because it’s only been in the last thirty years that we’ve been fully aware of what autism is. (And remember that Asperger’s Syndrome was only added in 1994.)
The paper describes the diagnostic tools, the questionnaire and observation methods used, and we’re presented with three cases of individuals now found to have autism:
Mr H, age 72, Mr. B. age 78, and Mr. W. age 83. All three were married and had children. All had identifiable idiosyncrasies and mental problems like depression, OCD, and rigid behaviors. The possibility of an Asperger’s diagnosis was presented in all three cases.
It won’t work
Studies like this prove nothing. Making claims of high functioning or Asperger’s in elderly people does not demonstrate that autism has always been around. These men are so old that there are no reliable witnesses to tell us what their childhoods were like. Why couldn’t researchers find people in their 30s, 40s, or 50s whose parents are still alive and can provide the background on their early development? Why couldn’t they find adults with classic autism, people whose symptoms are so easily recognized that the diagnosis would obvious to all?
I can drive to the local middle school and high school in my small town and show you hand flapping, nonverbal, rocking kids in special education classes who are diagnosed with autism. I work with these kids. Why can’t I go to a nearby nursing home and observe elderly residents doing the same thing? I work with older teenagers who will never marry and whose symptoms show no signs of disappearing.
This is a lot like the news from Britain last year about the questionnaire done in 2007 (HERE) in which researchers claimed that they identified 19 undiagnosed adults with autism. These findings were used to support the claim that the MMR vaccine isn't linked to autism since these adults wouldn't have received the vaccine which was introduced in 1990 in Britain.
Here’s how one critical report described the survey: “Survey Authors Couldn't Find Enough Adult Autistics.” (HERE) “There were early rumours in 2008 the authors could not find numbers of adult ASC cases matching numbers in children.
"The survey failed to find a single case of an adult with ‘typical’ or ‘classic’ autism, found in approximately 30% of ASC children. 'Typical' or 'classic' autism is a type of ASC controversially claimed in 1998 might be associated with the MMR vaccine.
"The authors also failed to find sufficient adult ASC cases overall - just 19 in 7,451 adults, being ‘higher functioning’ ASCs - mainly Asperger's Syndrome. This represents an overall rate of just under 1 in 300 potential adult cases and not the officially claimed 1 in 100 for children”.
John Stone wrote about it for Age of Autism (HERE) and his opinion still holds true today.
I posted this comment on John’s story:
The BBC reported on the adult autism study and described autism like this:
“People with autism spectrum disorder may suffer a range of problems, including difficulty interacting with other people and communicating their feelings." The survey reported, "ASD is known to be strongly associated with the presence of learning disabilities and it has been estimated that 7.5%of adults with a learning disability may also have ASD."
What's implied here of course is that adults who have been labeled LD, may actually be autistic. If we just identify them, we'd find the same rate that we see in children everywhere.
Anyone really thinking about this has got to see the flaws in this proposal. I have yet to see experts like Baron-Cohen and Brugha actually show us the autistic adults displaying the same characteristics of classic autism we see in our children. Where are the adults whose autism symptoms are undeniable? Where are the adults in their 40s, 50s, and 60s who don't talk, are in diapers, bang holes in walls, and stim and scream for hours on end?
I know lots of severely autistic kids just around here who would never be able to respond to either set of survey questions:
I would rather go to a library than a party --or-- I would rather go to a party than a library
I don't particularly enjoy reading fiction --or-- I particularly enjoy reading fiction
I find it hard to make new friends --or-- I find it easy to make new friends
Their autism would require constant care and supervision. These autistic people would be institutions somewhere as 40, 50, and 60 year olds because their parents are no longer able to care for them.
These are the people I'm waiting to see. These are the people no one ever shows us.
Anne Dachel, Media Editor.