Diagnosis of Autism
Autism Rates By Allen Frances Dr. Frances is a psychiatrist. He led the American Psychiatric Association’s task force charged with creating the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Robert F. Kennedy Jr., secretary of health and human services, is correct that reported autism rates have exploded in the last 30 years — they’ve increased roughly 60-fold — but he is dead wrong about the causes. I should know, because I am partly responsible for the explosion in rates. The rapid rise in autism cases is not because of vaccines or environmental toxins, but rather is the result of changes in the way that autism is defined and assessed — changes that I helped put into place. In the late 1980s and early 1990s, I was the chair of the task force charged with creating the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, or the D.S.M.-IV. Sometimes called the “bible of psychiatry,” the D.S.M. influences medical practice, insur...