Joanne Gerenser Ph.D Executive Director of the Eden II Autism Expert
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Male1: I went back to some of the charts in my practice, going back 25—I have practicing over 30 years, and I believe, I do not look that old, but we saw kids who just said that they were tired. They did not function. They did not speak. They even had some repetitive gyrations so we did not call them autistic. So the question in my head is what bothers me the most. A severely retarded child with a very low IQ, is what those kids will be labeled—autistic today or can we say, they are autistic. How do you differentiate it, is there any way? Female: Clearly, the kids that have severe or profound mental retardation and have autism, there is no reason why they cannot co-exist. In fact they do co-exist. Male: Because the reason I say that—I would like to add another criteria potential. The kid has no potential of communicating. No potential of functioning verbally. I do not know what I want to call that. I think we should call it 1A, 1B because when we talk about the word autism, there are studies that say, we found autistic rates are increased because a father over 40 has a greater risk, what are they talking about—a little smidget of a speck—a severely retarded kid that is labeled autistic because he has the things that I have mentioned. That bothers me because how do you make progress if you do not label what Female: Well, I think that first of all, I have never met a child that does not have some potential ever. Regardless of their functioning level, you just have to change the vision of what potential it is in some cases, but I think that the really important question here is if you have a profoundly retarded child who has autism, the way I would intervene to get to whatever potential that child has will be different that if I had a child who was profoundly retarded without autism and I know that sounds very ambiguous because how do you explain— Male1: We appreciate what you are saying, I understand that. That bothers me because when I hear autistic rates going up, have we taken kids from one category that we can normally do 25 or 30 years ago and put them in here so that the rates may not be increasing, we just add more to the definition if there is really an increasing rate of autism. Because I would like to know what the real labels are. Female: Well, I think the epidemiological studies as well as the people who are really looking at that would say that there is no one reason why the rates are going up. The rates are going up. Male: That is a little bit of it. Female: Well, clearly, we are better at diagnosing, so people are better at identifying cancer today quicker because we are identifying people who have autism that 20 years ago probably would have been called mentally retarded or called speech language impaired or called emotionally disturbed and today, they are being called as having an autism spectrum disorder. That is part of it. The second part of it is we broadened our classification system, so prior to 1994, we did have Asperger’s disorder in our classification system. So all of those kids, those kids— Male: Not that they did not exist, we just labeled it. Female: Clearly, it existed. I mean, if you read the literature they would argue that autism clearly does exist and since—absolutely. There are descriptions of children who would be defined as having autism. Male: There is some term, congenital schizophrenia, they are probably autistic, are they not? Female: Probably, I mean, remember in the 60s and 70s, it was believed that these children were psychiatrically impaired so a lot of the young adults, the people in my adult program who are in their 30s and 40s, when I go back to their records, they do not have a classification of autism or a diagnosis of autism. They were diagnosed as childhood schizophrenic.