Diagnosis of autism: Current epidemic has social context

doi:10.1136/bmj.328.7433.226-a

BMJ 2004;328:226 (24 January), doi:10.1136/bmj.328.7433.226-a

Letter

Diagnosis of autism

Current epidemic has social context

The first 150 words of the full text of this article appear below.

EDITOR—In their article on the diagnosis of autism Bairdet al completely ignore context.¹ They focus on an explanationwithin the child for the rapid rise in rates of diagnosis, implyingthat the only cultural factor affecting this has been low ratesof recognition in the past.

The immaturity of children may be a fact of biology, but themeaning ascribed to this immaturity is a fact of culture. Withoutany tangible evidence of organic pathology and any biologicaltests to substantiate our hypothesis of a neurological dysfunction,the boundaries of the disorder can expand endlessly and aredependent on the subjective opinion of the person making thediagnosis.²

Our notions of child development are culture bound and too oftencreate a blueprint of age dependent expectations that ordinaryparents fear our children cannot meet, rather than a set ofrequired behaviours that our children must master if . . . [Full text of this article]

Sami Timimi, consultant child and adolescent psychiatrist

Ash Villa, Sleaford, Lincolnshire NG34 8QA stimimi@talk21.com