We say that autism is diagnosed, but the word diagnosis rests on a shaky foundation, the danger of which is never more apparent than when we promote early diagnosis for young children.
To employ the word diagnosis means to accept the assumption that autism is a medical condition or a mental illness, but this is precisely the assumption most in doubt. The medical community, which on one hand acts with unbridled certainty that autism is indeed a mental disorder, a brain-based illness, on the other hand admits the cause of autism remains entirely unknown and there is no known effective cure. So where does the certainty come from in the first place?
What if autism were not a medical condition, not a mental illness? Would we be able to discern that possibility, given that we have put the blinders on?
Those who speak favorably of early diagnosis for young children inevitably follow with the phrase early intervention. But how can early intervention be considered safe and effective if there is no known cause? How can early intervention be deemed appropriate if we remain uncertain of what autism is? The treatment of a non-existent illness is not necessarily benign.
Not that long ago the diagnosis of autism was an extremely rare event. Are we certain that those who went undiagnosed—and who therefore went untreated—are we certain their outcomes were inevitably tragic?
The correct word is recognition. We now know enough about autism to recognize it in certain individuals, including some who are very young. But recognition is all we have.