Autism is not shameful, regardless of how it impacts an individual's functional capacity. There is no doubt that autism is an incredibly broad diagnosis, including the most vulnerable, intellectually disabled members of our society, as well as some of our most articulate and gifted individuals.
There has been much attention in Australia about the early intervention study that reduced the number of children meeting diagnostic criteria for ASD when they reached three years of age.
This has not helped society's misunderstandings about autism as a neurodevelopmental, life-long condition.
Many people within the autism community have argued that being autistic is part of their identity, and although some individuals develop effective masking / camouflaging skills, it does not change the fact they find social interactions confusing, or sensory stimuli overwhelming, or experience mental health challenges as a result of their neurodivergence.
For carers supporting autistic people who can not advocate for themselves, having a diagnosis is often critical in accessing sufficient funded supports.
So is it right to celebrate an intervention that may cause a delay to diagnosis? After all, it is easier to provide effective early intensive behavioural intervention to infants when guiding them with physical prompts is age-appropriate, and when there are less advanced skills to teach to be part of the 'typically-developing' demographic.
If an autistic child was taught to respond to their name, return a smile, imitate certain 'normal' play skills, and then was not considered in need of support - what happens when they go to school and do not receive the social, communication and behaviour support they need? What happens when their 'poor behaviour' is attributed to 'poor parenting'? That does not seem like a good outcome for any member of their community. That child will be at risk of being unfairly judged and isolated and educators will not be able to access the professional development that they need to make reasonable adjustments in their classroom.
In Australia, most children do not receive a diagnosis until they are over the age of four, despite experts advising that the 'wait and see' approach could be harmful. Evidence tends to support that the earlier a diagnosis is received, the better the outcomes.
For children who have very significant support needs and will need round the clock care as they age, surely the measure of success is not in what test they are taught to pass by age 3, but should be about the range of functional skills that increase their independence?
Having support, when needed, as early as possible, for as long as needed? Absolutely.
Implying a therapy could prevent autism, which is how some media outlets are interpreting this story? Irresponsible.
Some of the children involved in the study would not have been autistic in the first place, but were included because their siblings had diagnoses. For the children who did not meet criteria at age three, how many of them end up with a diagnosis years later when their parents had been led to believe they were neuro-typical? For those individuals, what challenges would they experience growing up feeling lonely and different, as many autistic young people disclose?
There is nothing shameful about receiving a diagnosis of ASD.
It is celebratory to increase functional capacity for an individual, to reduce the disabling features of someone's autism, and support the development of happiness and independence.
The success criteria of an intervention is not hiding a permanent condition or disability, it is about improving the quality of life for an individual and their loved ones. It would be great to increase the sample size of this study and identify the support needs of the children long term, which are hopefully the researchers' intentions too!
