Clinic Notes: Symptoms, Syndromes, and the Autism Spectrum

If you spent a few hours in the waiting room at The Children’s Treatment Center where I treat children, most of whom have Autism or Asperger’s diagnosis, you would be confused. Children on the Autism Spectrum are different—very different. At the lower end of the Spectrum we have children who are low functioning and often have a comorbid diagnosis of Mental Retardation, and are in special education classes at school. At the high end of the Spectrum we have children with high functioning autism and/or Asperger’s, who usually mainstreamed in school, but have more than their share of social problems. To add to the confusion you would also see kids with a dual diagnosis such as ADHD and Autism or Autism and ADHD, which even confuses me. Of course, part of the problem is there is no biological marker for Autism. But part of the problems is a carelessness among clinicians in diagnosing a syndrome, which is a collection of symptoms, and then adding a syndrome such as ADHD, which is a symptom often that makes up the syndrome Autism. In my view, this is a recklessness among clinicians that confuses parents, teachers, and other caregivers.