Autism diagnosis often divides parents and experts: parents helplessly watch as their children tragically suffer lifelong impairment while autism experts claim the condition is permanent and hopeless. Many parents concede hopelessness, observing aging children who do not demonstrate improved skills and who often regress over time. Lately, however, the hopeless are becoming hopeful. Parents of autistic children are sharing heartwarming, even miraculous, stories of recovery.

Stories of autism recovery are sparking controversy, prompting experts to question the validity of such assertions. Skeptics commonly state that autistic individuals cannot experience recovery and argue that autistic children manifesting indications of rehabilitation were misdiagnosed from the outset. Considering autism has existed some sixty years and so little progress has been made in treating the condition, skepticism regarding recovery is understandable. After all, recovery is not an experience often enjoyed by those suffering a chronic illness, particularly a brain disorder of unknown origin believed incurable. Still, some autistic children appear to be recovering from this baffling infirmity. Are these children truly experiencing rehabilitation or were they originally misdiagnosed? With national autism expenditures totaling $20-60 billion annually, and with autism incidence on the rise, the question bears investigation. To determine whether autism rehabilitation is possible or merely the result of misdiagnosis, we must first confirm the validity of diagnosis by examining the diagnostic process.

Since autism cannot be determined by a blood test, the diagnostic process for determining autism is behavioral. Specifically, autism diagnosis relies on the application of standardized testing criteria that measure a child's ability to communicate, engage in reciprocal social interaction, and engage in unrestricted patterns of behavior, interest, or activity. Diagnostic criteria are applied in the presence of at least one medical doctor or psychiatrist during a lengthy observation session in which the child is asked to perform a number of age-appropriate tests. The child's responses are noted. At the end of the diagnostic session, the parent is informed whether or not his child has autism.

While using the best medical facilities, highly skilled professionals, and standardized diagnostic criteria does not eliminate the possibility of misdiagnosis, misdiagnosis is unlikely for several reasons. First, the observation process by which a child is determined autistic is not a casual one. A team of professionals headed by either a medical doctor or psychiatrist observes the child for a lengthy period of time, usually several hours. Observation of this duration allows the diagnostic team to accurately analyze a child's behavior in accordance with standardized testing criteria.

Second, standardized testing criteria refer to a codified list of behavioral deviations typical of autistic children that is utilized by diagnosticians to determine which children belong in the autistic classification. Using standardized criteria, children tested in the United States are subject to the same codified guidelines, such that a diagnosis, and the criteria on which it is based, does not deviate from location to location. Thus, a child diagnosed with autism in Wichita, Kansas, would receive the same classification in New York City.

Finally, the amount of diagnostic criteria that a child must meet is not random. For example, to be diagnosed with autism, a child must indicate at least one type of qualitative impairment in reciprocal social interaction, one type of qualitative impairment in communication, one restricted, repetitive, and stereotyped pattern of behavior, interest, or activity. Furthermore, he must exhibit six indicators overall. Thus, although behaviorally based, every precaution is taken to ensure that the process leading to an autism diagnosis is accurate, trustworthy, and medically sound.

If autistic children experiencing recovery were accurately diagnosed from the outset and autism is considered an incurable brain disorder, how do we attempt to explain parents' stories of rehabilitation? Moreover, why are rehabilitative stories offered by parents and not by experts who persist in the belief that autism is an incurable brain disorder? Ironically, the research process may have buried the one ingredient necessary for creating recovery: desire.

The research process is a scientific one, demanding objectivity be the measure of truth. Additionally, the research process requires detachment and focuses on differences. As researchers observe and record myriad disparate symptoms manifesting among autistic individuals, they focus on those differences and search for root cause, assuming root cause leads to cure. Additionally, research is conducted using a hypothesis that human behavior, including the bizarre and antisocial behavior displayed by autistic individuals, is controlled by brain function. While the number of individuals afflicted with autism increases, the research pool increases proportionately, but the hypothesis and research method remain the same. Believing autistic manifestations related to disordered brain function, studying greater numbers of autistic individuals does not flesh out root cause or result in cure. Thus, the explanation for autism remains the same and parents sharing stories of autism recovery are dismissed as anecdotal.

Elsewhere, a different group of dedicated individuals emerges and begins looking at autism through different eyes. Rather than seeing autism under a microscope, or as a collection of bizarre and antisocial symptoms, they see autism in the eyes of their sons and daughters. Theirs is not an objective mission to find autism's root cause. Theirs is a cause so personal, heartfelt, and urgent that it becomes a mission: restore their children's lives that have been irrevocably transformed by autism and assist other parents in accomplishing the same. Focusing intention, action, and resources on the goal of recovery, pioneers in autism rehabilitation are lighting the way for thousands of hopeful parents who hope to relate to their children for the first time.

If we can place our faith in the credibility of the American autism diagnostic process and its ability to provide accurate assessment, we must also believe that autism recovery is possible. If autism recovery is indeed possible, afflicted individuals may experience rehabilitation. Stories of autism recovery do not yet abound but are becoming more common. How many cases of autism recovery will be required before experts admit the reality of recovery and embrace the paradigm on which it depends? Perhaps that number depends on the amount of experts who also become parents of autistic children.

Grossman, Lee, President of the Autism Society of America, written congressional testimony presented to the U.S. House of Representatives, April 18, 2002.
The Diagnostic and Statistical Manual, 4th Edition, American Psychiatric Association, 1994.
Ibid.
Op ed.