Tag: early signs of autism

Misdiagnosis of Kids with Autism and Vaccine Injury

Awareness of autism has greatly increased in recent years.

Some people are even suggesting that we have gotten to the point where autism is being over-diagnosed.

Remember when folks got upset because Seinfeld said that he might be on the autism spectrum?

Misdiagnosis of Kids with Autism and Vaccine Injury

Although autism might be over-diagnosed in some situations, it is just as likely to be under-diagnosed in others. That’s especially true when you hear about misdiagnosed autistic adults. No, not adults who were misdiagnosed with autism, but adults who are actually autistic, but were misdiagnosed with other conditions, like schizophrenia, anxiety, or personality disorders.

It is also probable that autism is actually sometimes misdiagnosed. That’s right, there are some other conditions that can be confused or misdiagnosed as autism.

“Generation Rescue believes that childhood neurological disorders such as autism, Asperger’s, ADHD/ADD, speech delay, sensory integration disorder, and many other developmental delays are all misdiagnoses for mercury poisoning.”

When Generation Rescue, Jenny McCarthy‘s autism organization, was founded, they believed that autism was caused by mercury poisoning. Actually, not just caused by, but that autism actually was a “misdiagnosis for mercury poisoning.”

No one really seems to believe that anymore, but there are some other conditions that can legitimately be misdiagnosed as autism.

Many people see Jenny McCarthy battling doctors to save or recover her son as being anti-autism.
Some people say that Jenny McCarthy’s son might have been misdiagnosed with autism and might actually have LKS instead.

Consider Landau-Kleffner syndrome (LKS), which is also known as Progressive Epileptic Aphasia or Aphasia with Convulsive Disorder. Children with LKS develop normally, but then have:

  • a severe regression in language functioning, with a progressive loss of speech, especially receptive speech or understanding what other people say
  • seizures, including focal motor seizures, focal seizures that become tonic-clonic seizures, atypical absence seizures, and atonic seizures.
  • behavioral problems, including having poor attention, being hyperactive and aggressive, and having anxiety

LKS can be difficult to diagnose because the seizures can be subclinical (only recognized on an EEG) at first, so the child may have already regressed by the time they have obvious seizures. And they might improve as the seizures are treated.

“After 35 years as a speech pathologist, I’ve seen many children with a diagnosis of autism that turned out to be a combination of language delay, sensory issues and apraxia.”

What If the Diagnosis of Autism Is Wrong?

Other conditions can have signs and symptoms that overlap with autism too (although they also sometimes occur with autism), making a misdiagnosis possible, including:

  • anxiety
  • childhood apraxia of speech – children with this motor speech disorder have a hard time talking
  • language delays
  • selective mutism – only affects children in some situations, like at school, but they talk well at home with close family
  • sensory issues
  • 22q11.2 deletion syndrome – a chromosomal disorder that causes many signs and symptoms, including some that resemble autism

But how can a child be misdiagnosed with autism?

“…inexperienced professionals, with narrow, preconceived notions of what ASD is, may place too much weight on symptoms that although associated with ASD, are not necessarily definitive of ASD. In other cases, and as noted above, problems in social relatedness and social interaction observed during the diagnostic process, may be artifacts of the unfamiliarity and artificiality of the setting itself.”

Barry M. Prizant On the Diagnosis and Misdiagnosis of Autism Spectrum Disorder

It shouldn’t be hard to imagine that a child could be misdiagnosed with autism, especially as there are more children with suspected autism, including children getting screened at an earlier age, meaning that there is a big demand for autism evaluations.

“Ideally, the definitive diagnosis of an ASD should be made by a team of child specialists with expertise in ASDs.”

AAP on the Identification and Evaluation of Children With Autism Spectrum Disorders

Unfortunately, that can mean that some of those evaluations are being done by health care providers without any added expertise in formally diagnosing autism, including some pediatricians, neurologists, counselors, and social workers, etc.

While many health care providers can evaluate and diagnose autism, from a child neurologist, developmental pediatrician, and child psychiatrist to a child psychologist, speech-language pathologist, pediatric occupational therapist, and social worker, they should all have expertise in autism spectrum disorders (ASDs).

Getting the Diagnosis Right

Why is it so important to get the diagnosis right?

Most importantly, a correct diagnosis means that a child will get the right treatment as early as possible. Also though, in an age when some parents still try to associate vaccines with autism, a misdiagnosis can be especially problematic, perhaps leading to a vaccine injury story.

Remember back in the 1970s when many parents blamed the DPT vaccine for causing their kids to have seizures and brain damage? We now know that some, if not many, of them had Dravet syndrome, a genetic condition (SCN1A mutation) in which children develop severe, fever-related seizures before their first birthday.

“We present here the cases of 5 children who presented for epilepsy care with presumed parental diagnoses of alleged vaccine encephalopathy caused by pertussis vaccinations in infancy. Their conditions were all rediagnosed years later, with the support of genetic testing, as Dravet syndrome.”

Reyes et al on Alleged cases of vaccine encephalopathy rediagnosed years later as Dravet syndrome

In addition to the seizures, these children have developmental delays and autism-like characteristics. They don’t have a “vaccine encephalopathy.” Just like autistic kids don’t have mercury poisoning or any kind of vaccine damage.

What to Know About the Misdiagnosis of Kids with Autism and Vaccine Injury

To help avoid a misdiagnosis, if possible, a team of child specialists with expertise in evaluating kids with autism spectrum disorders should see your child with suspected autism.

More on Misdiagnosis of Kids with Autism and Vaccine Injury

Explaining the Correlation of Autism After Vaccines

Vaccines have nothing to do with autism.

It’s not the MMR vaccine. It’s not thimerosal. It’s not anything else about vaccines.

It has been proven time and again.

“The parental focus on vaccines as a possible cause of autism has been encouraged by the recent growth in popularity of ‘unorthodox biomedical’ theories and therapies in autism…”

Fitzpatrick on MMR: risk, choice, chance

Not surprisingly, that hasn’t stopped some parents from continuing to blame vaccines, mostly because they didn’t notice any symptoms of autism until after their child got their routine vaccines as a toddler.

Recognizing the Early Signs of Autism

In 2007, the American Academy of Pediatrics issued guidelines for universal screening of all children for autism at 18 and 24 months. Since then, many kids are getting diagnosed at an earlier age.

That’s good news, as an earlier diagnosis should mean that more kids will be able to benefit from earlier supports and accommodations.

“…the average age of diagnosis for those born before 2005 was just under four years old; for those born during during or after 2005, it was roughly two-and-a-half years old.”

AAP on Children are Diagnosed with Autism at Younger Ages Since Push for Universal Screening

Looking at the early signs and symptoms of autism, it is easy to see why autism isn’t always recognized that early, even with a screening tool, like the M-CHAT-R:

  • What if you don’t recognize that your child isn’t really speaking single words because he or she is simply parroting or echoing what you are saying without knowing what the words mean?
  • What if you don’t recognize that your child isn’t responding to his name being called because he responds to other noises, so sometimes coincidentally turns when you call his name?
  • What if you don’t recognize that your child isn’t bringing objects to share with you (as an interest), because he or she sometimes will bring them to you to have you help open or use them?

And if your child is eventually diagnosed with autism, will you recognize that those were early signs that were just difficult to detect, or just think that your child didn’t have any developmental differences and then lost those skills?

Explaining the Correlation of Autism After Vaccines

Many people understand the idea that “correlation doesn’t imply causation.”

So just because your child was vaccinated and you soon noticed signs and symptoms of autism, that doesn’t mean that it is really linked to vaccines.

Temporal binding is a phenomenon that reinforces that assumption of cause and effect once we have linked two events causally in our minds. The effect biases our memory so that we remember the apparent cause and effect occurring closer together in time. In experiments we tend to remember the cause as happening later and the effect happening earlier.”

Steven Novella

Of course, a phrase about correlation and causation isn’t going to be enough of an explanation for most parents, especially if they have already heard a bunch of vaccine scare stories.

Fortunately, there is plenty of evidence to back up that idea, including that:

  • many studies have shown that there is no link between vaccines and autism
  • unvaccinated kids develop signs and symptoms of autism at the same time as children who were vaccinated
  • some studies have shown that even when parents think that their child’s first signs and symptoms of autism didn’t occur until right after a specific vaccine, like the 12 month MMR shot, when experts looked at the child’s home movies, they could detect subtle signs at a much earlier age, well before the child got those vaccines
  • while regressive autism is real and some kids with autism regress significantly in their development, losing many of the early skills they had picked up, even then, these children often had some subtle, early developmental delays. They don’t usually have a sudden regressive type of autism.

What about package inserts? Don’t they say vaccines cause autism? No, they do not.

And all of the studies that anti-vax folks say support a link between vaccines and autism? They aren’t what you think they are.

Mostly remember that the scientific evidence overwhelming supports the fact that vaccines have absolutely nothing to do with autism!

What to Know About the Correlation of Autism After Vaccines

Vaccines having nothing to do with autism, even though it might sometimes seem to you that your child’s signs and symptoms of autism are correlated with recently getting vaccinated.

More About Explaining the Correlation of Autism After Vaccines