The Handbook of Language and Speech Disorders. Группа авторов. Читать онлайн. Newlib. NEWLIB.NET

Автор: Группа авторов
Издательство: John Wiley & Sons Limited
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Жанр произведения: Языкознание
Год издания: 0
isbn: 9781119606994
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& Tuma, 1988; Scott, 1990). Given recent claims for significant increases in the incidence of autism in the United States, an example for how social construction influences the process of legitimatization in autism and how this very process creates the perception of an “autism epidemic” is especially illustrative (Baker, 2008; Gernsbacher et al., 2005).

      Given these changes to the diagnostic criteria between DSM‐III and DSM‐IV‐R, it is not surprising that there appear to be many more diagnoses of autism over the time span discussed. Indeed, the new and milder categories or variants of autism appear to account for 75% of the new diagnoses (Chakrabarti & Fombonne, 2001), and when other socially driven changes (e.g., establishment of threshold and sub‐threshold symptoms, a decision to co‐diagnose, attempts to identify children at progressively younger ages) are also considered, it is no wonder there appear to be significant increases in incidence that necessitated the change in categories in DSM‐5. The point, however, is that led by advocacy groups championing more relaxed and inclusive criteria, the reality of autism has changed according to social considerations. Discussions on the role of social variables in reconceptualizing autism, its causes, and its incidence may be found in the work of various researchers in the history and epidemiology of autism (e.g., Baker, 2008; Fombonne, 2003; Gernsbacher et al., 2005; Silverman, 2004; Waterhouse, 2013; Worley & Matson, 2012).

      The use of diagnostic terms like language disorder, childhood apraxia, dementia, learning disability, specific language impairment (now usually referred to as developmental language disorder), autism, ADHD, auditory processing disorder, and many others, as labels for individuals and their impairments is not always objective or valid and, as a result, there are many possible consequences inherent in the diagnostic process that can have an impact on the diagnosed individual. If the label or diagnostic category appears valid and is correctly attached to an individual, positive consequences may accrue. However, there may also be problems. For example, some diagnostic categories themselves are suspect and merely function as mechanisms of current societal values, power or control (e.g., Abberley, 1987; Conrad, 1992; Mehan, 1996; O’Connor & Fernandez, 2006). If the label or category is invalid or if the individual is misdiagnosed, the resulting consequences are frequently negative.

       1.4.1 Positive Consequences

      In line with the first consequence, once a valid and accurate label is obtained it can also lead to opportunities and extra resources that are not available without a diagnostic label (Gillman, Heyman, & Swain, 2000; Sutcliffe & Simons, 1993). As previously stated, many governmental regulatory bodies, educational remedial guidelines, and insurance providers require a standard diagnosis before treatment is provided. Federal and state special education regulations, for example, require official diagnoses before intervention is even planned. In the ADHD study just reported (Damico & Augustine, 1995), school systems did not tend to orient to the needs of the students studied until a formal diagnosis was obtained. When the formal label was delivered to the schools, however, it acted as a catalyst. Various accommodations and services not previously offered to the child and parents now were provided. The label, therefore, had a reactive power over the schools, the parents, and even the children. This need to employ diagnostic labels to achieve such ends is not