PARENT ASKS: Are there any real psychiatric disorders? What is autism?
D Z wrote: I've been reading several of the articles regarding what you call ADHD fraud. I have an 11 year old son who takes Adderall. I will discontinue the drug immediately. I know that ADHD is not a disease in your opinion but do you have any explanation for what is referred to as ADHD? My son has a very hard time understanding what he reads, expressing himself, etc. He goes to public school. He has had some lanuage/speech tharapy and small group teaching in elemantary school. I'm trying to help him with organization, studying and note taking. I have often been thankful that there was an explanation and a name for his learning style. It's hard to know what to do as a parent of a child who doesn't learn in the standard way. Are there any real psychiatric disorders? What is autism?
[Fred A. Baughman Jr., MD:
there are
absolutely no psychiatric disorders that are diseases, that is, that are
due to an abnormality within the child/person. Autism is a
"wastebasket" term referring to infants, children who, almost always are
behind, usually moreso language-wise than physically, i.e., in age of
walking and in general coordination. Being conclusively late and then
behind in speech is almost always due to a diffuse insult/abnormality of
the brain and is neurological and not psychiatric. To further clarify
"autism" see the piece appended.
Briefly regarding your son's reading problems, this is almost always due
to inept, misguided, "whole language" instruction and instructional
materials to the exclusion of phonics. Get an explicit phonics
instructional program, stick with it, and you will, no doubt see
improvement, even catching up and surpassing age-, grade- mates.
(disclaimer: no prof. relationship here) Best of luck. By the way,
psychology, psychiatry and psychiatric drugs are not legitimate
components of an education. If an alternative to public education
becomes a possibility, grab it. FB
]
S G (family physician writing re 2 year old patient, son
of J) wrote:
Dear Fred,
J has a son who is non-verbal as a two year old. His mom brought
him to Children's and they decided it was a form of autism. The child
loves hugs and seems to be socially normal. I was wondering if it could
be an input - deafness - or an output - mute - problem. How would she
know?
S G
[Fred A. Baughman Jr., MD:
S G, the word autism is the same sort of wastebasket term as cerebral
palsy, but
worse yet. The question, more simply and understandably is whether not
being verbal,
having words at 2--24 mo is an abnormality, a brain abnormality. Yes,
hearing loss is
to be ruled out, and probably has been ruled out, both by parent
observation and by
folks at Children's Hosp. I am presuming he walked on time. Some who
do, then fail
at the timely acquisition of verbaliozing, of speech and by 2 one would
expect plenty
of trying to speak and short sentences, frequently with sentences much
more simple
coming from boys than girls, they should be 2,3 and 4 word sentences I
would think,
having none at all is of concern suggesting not a pure expressive
problem as we see in
acquired focal lesions in adults, almost non-existent in children, but
diffuse
encephalopathy. This would be a strong suspicion at this point but not
a certainty.
Nor is brain scanning or other technology likely to give a quick
definite answer.
Continue normal life including language all around, from all family
members, speaking
to him, and if the brain is OK language, will emerge, if not it will
confirm at 2 1/2
and 3, 3 1/2, 4 and 5 that the brain is not OK, language may well come,
the problem
not being all or none, and then the question will be how far behind, how
subnormal?
And here then question becomes: At 4 what age is his speech like (like
2, like 3)? At
5 what age is his speech like. And this, his language level will become
perhaps the
best indicator of how far behind he is and what developmental trajectory
he is likely
to remain on. Once assuredly "like 3" when 5, "like 6" when ten, he is
40% behind and
that is his trajectory, one not "grown out of". These are the sort of
descriptive
terms their physicians ought to be using if parent understanding is the
aim. Etiology
is often no known or knowable but once developmental dx. is pinned down,
then cause
can be sought. As I mentioned above, some little ones, boys more than
girls seem
mute, disinclined to say a word and then all of a sudden surprise and
delight. Odds
are against this, further observation, 2- to 3 and perhaps beyond,
needed. Best,
Fred.
]