Autism Blog - Jenny McCarthy needs to learn: autistic is not psychotic or crazy

06 Aug 2009

Author: Sullivan
Comments: 102

Jenny McCarthy needs to learn: autistic is not psychotic or crazy

Last year Amanda Peet had a story in Cookie Magazine. She came out very pro-vaccine. Jenny McCarthy “jumped” on the story (delayed to be coincidental with Jenny McCarthy’s need for publicity).

This year, Cookie Magazine has a story with Jenny McCarthy. There is a lot bad in there. I am saving the worst for last (you can skip to the bottom if you want).

As to be expected in a magazine article about a celebrity, Ms. McCarthy is pushing her own business interests. In this case, her educational DVD collection:

“Through a series of entertaining vignettes featuring a cast of kids (including Evan), puppets, and dolls, the DVDs model correct social behavior and tackle everything from sharing and patience to maintaining conversations with friends to sibling rivalry. “Any parent will tell you that her kid watches a show and imitates it,” McCarthy says of her inspiration for the idea.”

I find that statement really strange for educational videos targeting autistic kids. I can think of a number of parents of autistic kids who would disagree with “Any parent will tell you that her kid watches a show and imitates it” From the book “Educating Children with Autism” by the National Academies Press:

Studies over longer periods of time have documented that joint attention, early language skills, and imitation are core deficits that are the hallmarks of the disorder.

Another quote from the Cookie Magazine story:

McCarthy’s widely publicized journey began in 2004, when her son had a seven-hour seizure and went into cardiac arrest. When he got home from the hospital, Evan was put on a heavy dose of antiseizure medication, which kept him awake for four days and induced hallucinations that made him not recognize his mom and bang his head against the wall until he bled. “I ran out of my house and into my driveway and screamed at the top of my lungs to God to just take him away, because I loved him so much and he was in so much pain,” McCarthy says of the period she describes as her “second rock-bottom” (the first being the moment Evan’s heart stopped momentarily).

A couple of observations.

First, I wish Cookie Magazine had clarified the point as to how long after his vaccination the seizure came. His MMR was at 14 months, his first seizure was after he was 2.

Now for the second. Did Jenny McCarthy really write that she had wished her child would be taken by god?

I didn’t want to blog this story. Why give Jenny McCarthy more publicity? Well, here’s the paragraph that made me want to blog:

McCarthy is leading a more normal life now, too, after having felt very alone in her first marriage, to Evan’s dad, and suffering what she calls a “breakdown” two years after Evan went into cardiac arrest and suffered those terrifying seizures. “When your kid is psychotic or crazy, you go into this place of shock so you can remain calm,” she says. “A problem a lot of moms [of autistic children] have is that they need to get out all [their emotions] later. I kept mine bottled up for two years, and then I finally released all this pent up fear, sadness, and anger. I just cried and cried and cried and cried and cried.”

“When your kid is psychotic or crazy, you go into this place of shock so you can remain calm”

I just don’t know what to say. Autism is not “crazy” or “psychotic”. Why is this woman chosen by the press to represent autism?

Maybe next year Cookie Magazine could interview a mother who is autistic or, at least, has an autistic child.

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Comments

102 Responses to “Jenny McCarthy needs to learn: autistic is not psychotic or crazy”

Karen Delaney
August 6th, 2009
23:59:13

I so agree; In McCarthy’s book she also recounted an episode in the school’s parent waiting area where she noticed that the mom’s were physically and emotionally divided between those that would “do anything” to help their kids and those that just sat there and looked defeated. Perhaps the ones that were not on her side of the room recognized the wild claims and unproven methods that she was promoting. It’s clear that McCarthy is looking at autism from a different lens than I; one in which there isn’t this perfect cure that will make my child typical. I also feel that in her next book she may want to have a medical consultant review her facts as many were simply not believable.
Sullivan
August 7th, 2009
00:04:56

Thanks for the comment, Karen.

There is a big gap between “do anything” and “do anything that makes sense”.
Socrates
August 7th, 2009
00:09:37

Facts need not enter into the debate:

Indeed, McCarthy is so universally appealing, striking that elusive combo of unapologetically attractive and wickedly funny,

‘Nuff said. We’re all doomed unless Kev’s going to get his boobies out and tell a cracking joke.
Sullivan
August 7th, 2009
00:22:10

Echoing the testimonials of many parents she spoke to, McCarthy says Evan’s language doubled within two weeks of her having first eliminated wheat and dairy from his diet. (Prior to that, he spoke only a few two-word phrases.)

I hate the vague “doubled language” sorts of comments that get used in testimonials. I’m glad her kid made a jump, but “double” means very different things when a child has “only a few two-word phrases” than when a child has much more language.
David N. Andrews M. Ed. (Distinction)
August 7th, 2009
00:25:48

“We’re all doomed unless Kev’s going to get his boobies out and tell a cracking joke.”

Well, then, Kevin…. up to you mate…

Your audience wants nipples! Well, THEIR audience wants nipples because they’re easier to fucking visualise than actual bleeding facts!
Leila
August 7th, 2009
00:45:17

I disagree that autistic kids don’t imitate TV shows. They do – the ones they really like, and then go on to script and act out the scenes repeatedly. The problem with the DVD (I’ve seen the one for pretend play) is that not all kids will get especially excited about those scenes to the point of playing them out, and even more, to the point of generalizing those pretend play skills.

As for the story, I’m sad that when we are bracing for a really scary flu season, people will be discouraged from vaccinating because of McCarthy and her followers.
Sullivan
August 7th, 2009
00:49:07

Leila,

I’d say that some ASD kids would imitate. But some don’t. I don’t know what fraction, but imitation is considered a big enough topic that it appears in the NAP’s book (and many other places).
Leila
August 7th, 2009
01:21:59

Sullivan, I think their imitation skills are impaired, mainly due to a lack of intrinsic motivation to imitate/reciprocate. It depends on what they “choose” to imitate, and what they are physically able to imitate.
Maddy
August 7th, 2009
01:29:19

It is indeed most unfortunate. I think DVD’s are a good idea for some children, there are already quite a few on the market. I don’t know if she’s really trying to exploit the situation but I doubt it, she doesn’t seem a malicious type, it’s more an opportunity and people listen to her and she wants to help.

The terminology certainly appeals to those she is most trying to reach which is also understandable and even more unfortunate.
Sullivan
August 7th, 2009
01:34:26

I have to add, I have heard from one parent whose opinion I trust that the DVD’s were actually good for some kids (not specific to ASD). I just find the idea of the parent of a non-autistic child pushing DVD’s on the autism community with a viewpoint that is basically flawed (all kids imitate) to be distasteful.
Clay
August 7th, 2009
08:54:28

@Maddy – I haven’t read any of her books, none of her writings anywhere, so I can’t characterize her as “malicious”. I do think she’s exploiting the situation and would use the word “avaricious” instead. She gave up on the “Indigo Child” nonsense because it was just a passing fad. She found something that, (whether it actually applied to her child or not), was NOT going to fade away. She makes Money off this, and incidentally, keeps her name and face in public view, playing the “martyr mom”. Despicable, I think.
Shannon
August 7th, 2009
12:58:22

There is evidence that video modeling (as opposed to “watching TV”) can help kids with autism learn, e.g., http://tr.im/vRx7. But to apply what “any kid” does to kids with autism is yet another example of the sloshy, shallow thinking Ms. McCarthy uses in so many of her writings and proclamations about autism.
Dana
August 7th, 2009
16:02:48

Please, please, please Cookie Magazine, interview me.
Amber Smith
August 7th, 2009
17:30:44

My autistic child loves to imitate things she sees in videos. These would work well for her—as long as the people she is interacting with don’t attempt to vary the script in any way.
Twitted by lydiatusson
August 7th, 2009
18:41:44

[...] This post was Twitted by lydiatusson [...]
Is Jenny McCarthy Out Of Line For Calling Autism “Crazy” And “Psychotic”?
August 7th, 2009
20:43:50

[...] sadness, and anger. I just cried and cried and cried and cried and cried.” UK based autism blog leftbrainrightbrain.co.uk has a history of criticizing McCarthy for her emotional responses in the autism community, and [...]
Patrick
August 7th, 2009
21:58:24

Nice persona to promote correct social behavior example, no? Like running over to the playboy house for a debauchery inspired party? Or hollering Bullshit at opponents of ones viewpoint on TV in order to try and win the debate with emotion instead of facts.

Kiss my assets lady.
janet
August 8th, 2009
00:05:34

I have never read any of Jenny’s books, simply because I don’t think that she is very credible. To say that children with autism is “psychotic” is the most absurd thing that I have ever heard. She has made having autism out to be the worse thing in the world. My son is autistic and I would not change him, he is wonderful. She is not nor should ever be considered a spokesperson for the autistic community.
Sullivan
August 8th, 2009
00:33:18

Janet,

take a look at Jenny McCarthy sporting her “Tired of Autism” bracelet.

This from a woman who, if we take her at her word, had an autistic child for 2 years or so? And that was a couple of years ago? She is tired of autism?

I really don’t understand how she can be taken by the media as a representative of an autism community.
Nicky
August 8th, 2009
01:54:51

She may genuinely be trying to help with her dvd, but unless the kids find something that interests them, then it won’t work. And most of them would just repeat a very small section over and over again, rather than watching the whole thing. Generalising ASD kids simply won’t help them. Anyway, I wouldn’t buy a dvd from someone who is “Tired of Autism”, I would much rather buy another Thomas the Tank Engine one instead (if I could find one that we don’t have :))

I thought that keeping your feelings bottled up for years was simply being a parent and putting your kids first, no matter what needs they have. No medals there, even for teenagers, when we totally deserve one :)

Psychotic and crazy kids eh? What a fantastic description about autism. (Thanks Jenny but I would much rather you come to terms with your own son and his needs, rather than recovering your own mental health on a wave of desperate parents who have placed you on a pedestal).

My autistic son is many things, but the description of crazy and psychotic is very derogatory. Its a pity that some have appointed JM as their crusader, b/c she will be the increasing catalyst to more and more polarised opinions in the future.
AutismNostrum
August 8th, 2009
06:37:26

My son prefers Blue’s Clues. And hey, BC is actually pretty good for overtly teaching social and life skills. My son has started talking a lot more after watching it, but it’s not like he watches videos in a vacuum. We’ve been reading to him, sending him to preschool, and otherwise interacting with him.

I’d try the JMc videos too, but I hear they’re made by an anti-vaccine whackaloon, and I’d prefer not to give her money.
Sullivan
August 8th, 2009
14:39:44

I am probably just a selfish jerk, but if the videos would really help my kid I’d buy them. I figure that $1 from me isn’t going to advance her cause when she has access tovs. Jim Carrey’s millions…
NightStorm
August 8th, 2009
14:56:47

QUICK! Someone hire a big breasted dumb woman that can market Neuro-D!

Thats my thoughts on Jenny, she nothing to be feared, she just bilboard with huge silacon tatas. It’s been theorized that Evan isn’t even autistic. She founds something to market herself in after being a wash-up it’s pathetic. Why do you go back to selling your vag and let real parents advocate for autism Jenny
Grendel
August 9th, 2009
14:56:01

I worry quite a lot whenever I see anything that attempts to capture the entire ‘autism kid market’.

I watched my own son score a goal in soccer today playing a team sport that a doctor once told us he would never play because he ‘has autism’.

I am rapidly learning not to under (or over) estimate any child who has autism and in my admittedly limited experience once of the most typical features of autism is its atypical presentation from child to child – there are some shared behavioural features but at the level of capability there is great variation, as with any child.

I figure I just need to love him, provide the support he needs along with any therapy and ignore any advice that comes from McCarthy or her ilk.
dr treg
August 9th, 2009
20:51:25

“Autism is not “crazy” or “psychotic”.”
Some element of denial?
Clay
August 9th, 2009
23:55:37

@dr treg – No denial, just statement of fact. I’ve never been crazy nor psychotic in my 63 years, although for the first 53 of them, before I was Dxd, I didn’t know what to think about my differentness. Not crazy, not psychotic, just different. Thank you very much.
hammie
August 10th, 2009
00:57:52

I hereby trademark the phrase “neural otherness is awesome’
(as given to me by one of my non-autistic blog commenters who appreciates our world)

I can be funny, I can hold my own when interviewed. But I have small boobs and a moveable expressive face. (mostly laughlines from my kids)

So if someone can sub me some breast aug and about a litre of botox – I will go on the US talk show circuit and sell our message.

xx
passionlessDrone
August 10th, 2009
13:25:44

Hello friends –
I don’t have this DVD, but I have seen one with her and one of her son’s therapists in them. (I think). Anyways, my son didn’t go for them, but I bet other kids might. As far as autism therapy videos go, if your kid likes it, the fathers are going to find these easier on the eyes than most. Hah.

As far as crazy or psychotic; the fact is, that is how some children with autism present behaviorally, especially when you are at the beginning of the ride. My son used to smack infants that cried, or anyone that sneezed. He broke two windows in our home banging his head before he was three years old. He was obsessed with making sure that things colored orange and green were put together. He was stone cold silent for six full months; except in his room in the dark, when he would laugh out loud again and again. Putting the word ‘autism’ or ‘autistic’ in front of this type of behavior doesn’t make it appear any less crazy or psychotic.

– pD
Sullivan
August 10th, 2009
18:52:35

pD-

with all due respect, acting strangely, even very strangely, is not the same as acting psychotically.

Psychotic (and crazy) implies a lack of connection with reality. I realize this is somewhat of a catch-22 when dealing with nonverbal people, but without an understanding of why someone does something, you can’t say it is psychotic. Banging ones head, even into windows, is not being out of touch with reality. Putting orange and green items together is not being out of touch with reality.

Using an example not from your child: lining up cars. Lining up cars because one has an over riding need to do so is one thing. One could say it is a common trait to autistics, or those with OCD. Lining up cars because voices tell you to do so—that is psychotic.

I would say that parents of children who are truly psychotic don’t need Jenny McCarthy using the “crazy” word either.

A simple mental test: Had Amanda Peet made a comment that autistic kids are psychotic, would there be outrage? I would be very comfortable betting money on that. I would even bet a large sum on the exact person who would write the blog post at a certain blog I know.
dr treg
August 10th, 2009
19:27:11

Wasnt autism initially originally described as childhood schizophrenia and schizophrenia is one of the psychoses?
Clay
August 10th, 2009
20:24:12

@ dr treg – What are you, a dentist? Didn’t people used to think the world was flat? Ya gotta catch up with the times, man.
dr treg
August 10th, 2009
23:06:53

Another denial?
Clay
August 10th, 2009
23:28:06

Statement of fact. Autism is Not childhood schizophrenia, although it was considered as such in a past generation. We now know better. You’re WAY behind the times.
dr treg
August 11th, 2009
00:03:57

Autism was originally described as childhood schizophrenia as stated above.
bensmyson
August 11th, 2009
12:22:56

I am extremely sorry that the type of bigotry that prevails on this site will more than likely add to the ever increasing epidemic of autism.

By definition hallucinating is a psychotic event.

And by the way, God is spelled with a capital “G”

Autism sucks!
Sullivan
August 11th, 2009
15:41:23

bensmyson,

thanks for your input.

Autism is not a state of hallucinating.
KWombles
August 11th, 2009
16:52:39

bensmyson,

I’m extremely sorry that a certain other site you frequent will do nothing to further understanding of what autism is and is sponsored by businesses out to make a buck off of desperate parents.

Your god may be spelled with a capital g, but that doesn’t make everyone else’s god(s) or goddesses, for that matter, spelled with a capital.

Gosh, way to signal to all autistic persons that they suck. I’m sure Ben will appreciate seeing that when he grows up.

And to agree with Sullivan, autism and hallucination have nothing to do with each other.
dr treg
August 11th, 2009
17:13:48

Hallucinations are not necessary for the diagnosis of psychosis.
Clay
August 11th, 2009
20:04:21

@ dr dreg – True, there are many manifestations of psychosis. Which ones do you have?
Sullivan
August 11th, 2009
20:29:36

Clay,

Dr. Treg is trolling to get exactly this sort of comment out of people.
Joseph
August 11th, 2009
23:44:04

Wasnt autism initially originally described as childhood schizophrenia and schizophrenia is one of the psychoses?

In Kanner (1943)? It wasn’t. Kanner noted that the children might have been viewed as feeble-minded or schizophrenic, but that’s different. In fact, Kanner said the specific syndrome of autism was a novel concept, quite unlike anything previously reported. He added:

This is not, as in schizophrenic children or adults, a departure from an initially present relationship; it is not a “withdrawal” from formerly existing participation.

Granted, later autism was considered a type of childhood schizophrenia. According to Kanner’s view in 1943, what we call “regressive autism” now is childhood schizophrenia. Childhood schizophrenia is clearly a category that is rarely if ever used anymore.
dr treg
August 12th, 2009
09:25:36

It is interesting that this site is usually quite rational but when certain valid comments are made re
1. Autism was described as childhood schizophrenia in the past.
2. Hallucinations are not necessary for diagnosing psychoses.
instead of just being taken as normal entries certain individuals become personally offensive as they have made mistakes in their entries possibly due to lack of insight and denial.
McCarthy seems to affect people`s judgement. Not everything she says is wrong and not everything she says is right as with most people.
Why was risperidone, an anti-psychotic, given a licence by the FDA for the treatment of autism?
Sullivan
August 12th, 2009
14:46:35

dr treg,

perhaps because some of use know that the definition of psychosis has changed over time. At one time, yes, autistic people were labeled as “psychotic”. Given the modern definition, this is no longer the case:

http://www2.merriam-webster.co.....=psychosis

“a serious mental disorder (as schizophrenia) characterized by defective or lost contact with reality often with hallucinations or delusions”

“McCarthy seems to affect people`s judgement”. Very true. There is an entire organization currently built around affecting people’s judgment using Jenny McCarthy.

“1. Autism was described as childhood schizophrenia in the past.
2. Hallucinations are not necessary for diagnosing psychoses.”

We are not in the past. Autism is not characterized by hallucinations.
Sullivan
August 12th, 2009
14:49:04

Just a note, dr treg,

you are demonstrating two facts here

1) you work from a position of profound ignorance as to the current understanding of autism
2) even Jenny McCarthy’s followers see her statement in Cookie Magazine as considering autism to be a psychosis.
dr treg
August 12th, 2009
21:05:06

re. “a serious mental disorder (as schizophrenia) characterized by defective or lost contact with reality often with hallucinations or delusions”
Excluding the hallucinations, which you seem to be preoccupied with, the other parts of the definition of lost contact with reality and delusions seem to apply to autism which can also be treated with risperidone an anti-psychotic drug.
Seems like splitting hairs.
Sullivan
August 12th, 2009
21:20:13

Clay,

sorry to slow you down there bud. You had him pegged. Clearly not in touch with reality, this one.
Sullivan
August 12th, 2009
21:21:37

dr treg,

I am going to ask a sincere question:

Are you trolling?

From where I sit you are either

a) trolling and exceptionally rude

or

b) completely out of touch with what autism is

Seriously.
daedalus2u
August 12th, 2009
21:31:38

There is a pretty good case that psychosis and autism are the opposite ends of a continuum of social behaviors.

http://www.ncbi.nlm.nih.gov/pubmed/18578904

I think their ideas about paternal imprinting of genes leading to one or the other are not quite correct, but some of the ideas in this paper are compelling. What this means is that a touch of autism may actually make psychosis more difficult to happen. The literal brains of people on the spectrum are more resistant to delusions than the less literal brains of people who are NT.

To make a crude analogy, people with autism have trouble understanding communication that NTs can understand. People with psychosis have no trouble understanding communication that NTs can’t understand (i.e. people with psychosis can hear communication that isn’t there).
i've a headache now
August 12th, 2009
22:05:43

“Why was risperidone, an anti-psychotic, given a licence by the FDA for the treatment of autism?”

Anti-Ps are also used to treat migraines, per the FDA. Don’t take the drug-to-market name so blasted literally, Dr Treg.
dr treg
August 12th, 2009
22:39:12

Both autism and schizophrenia increasingly appear to be neuro-inflammatory psychiatric diseases which share
1. Abnormal T helper cell responses
http://www.sciencedirect.com/s.....871418e032
http://jleuk.highwire.org/cgi/.....act/80/1/1
2. Genetic factors
http://www.ncbi.nlm.nih.gov/pubmed/19135727
3. Dendritic spines abnormalities
http://www.abc.net.au/science/.....964387.htm
http://www.eurekalert.org/pub_.....081009.php
4. Clinical features
Patients with autism may have delusions, hallucinations and reduced connectivity with reality.
5. Treatments
Risperidone is used for the psychotic features of both diseases. (Not headaches as stated above)

To say that patients with autism cannot be psychotic is splitting hairs. Once again it is all about current psychiatric nosology which is rapidly becoming outdated with advances in neuroscience.
Sullivan
August 12th, 2009
22:57:36

To say that patients with autism cannot be psychotic is splitting hairs. Once again it is all about current psychiatric nosology which is rapidly becoming outdated with advances in neuroscience.

Has anyone said this? No one says that autism is some sort of shield against being psychotic. The point is that autism is not a psychosis.

While “Patients with autism may have delusions, hallucinations and reduced connectivity with reality”, that is a very different thing from saying, “autism is a lack of connectivity with reality”.

Are you saying that Risperidone is effective in treating autism? Unless you want to grant that point, your Risperidone argument is obviously a troll.
Sullivan
August 12th, 2009
23:01:05

Risperidone is used for the psychotic features of both diseases. (Not headaches as stated above)

That is a false statement.

Risperidol is approved for “irritability associated with autistic disorder”

RISPERDAL is approved for the treatment of irritability associated with autistic disorder in children and adolescents (ages 5-16 years), including symptoms of aggression, self-injury, tantrums, and quickly changing moods. It is the first and only prescription medication approved by the FDA for this purpose.
dr treg
August 12th, 2009
23:08:30

“Has anyone said this? No one says that autism is some sort of shield against being psychotic.”
You said this in the opening post:
“Autism is not “crazy” or “psychotic”.”
Sullivan
August 12th, 2009
23:11:27

Yes, Dr. Treg,

Autism is not psychotic.

That is a very different statement, logically, from “patients with autism can not be psychotic”.

Once again, do you misunderstand or are you trolling?

(edited to add “autism” into the quote)
dr treg
August 13th, 2009
00:13:49

So what is the diagnosis in a patient with autism who develops “psychosis” i.e. hallucinations and delusions?
Sullivan
August 13th, 2009
00:27:31

dr treg,

I would guess a dual diagnosis of autism and whatever fits the other symptoms.
i've a headache now
August 13th, 2009
00:43:09

Dr Treg. Darling. You misquoted me. I.do.not.like. I said: “Anti-P’s”. Please re-read what I wrote. Since the 1950s, if one shows up at an ER with a migraine there is a good chance they’ll be given an Anti-P.
Dedj
August 13th, 2009
00:45:29

All such clients that I’ve met clinically that have autism and psychosis have been diagnosed as ‘autistic’ and ‘schizophrenic/name of psychosis’.

Note that hallucinations and delusions are not neccisarily sufficient to qualify a client for a diagnosis of a psychotic condition.
Joseph
August 13th, 2009
01:04:11

Let me quote from the Volkmar & Cohen (1991) abstract:

CONCLUSIONS: If the present study group is taken to be representative, it appears that the frequency of schizophrenia among autistic patients (0.6%) is roughly comparable to the frequency of schizophrenia in the general population. It does not appear that the two conditions are more commonly observed together than would be expected on a chance basis; therefore, the current (DSM-III-R) approach to dual diagnosis of these conditions appears reasonable.

This is in contrast with the fact that the most common misdiagnosis of autistic adults is schizophrenia. There’s no contradiction necessarily, however.

In a chapter by Frith & Frith of a book titled “Social Psychiatry,” they state:

Delusions and hallucinations commonly occur in schizophrenia, but are an exclusion criteria for the diagnosis of autism.

If delusions and hallucinations were part of autism, they would just be. There would be no need to deny it. But they aren’t. Why suggest they are, except to troll and to try to bother people? This is not something that only Dr. Treg does. RAJ is also known to do this much of the time.

It makes no sense to compare autism with X condition, on the basis that both have genetic factors, for example. You could compare autism with virtually anything that way.
i've a headache now
August 13th, 2009
01:04:24

“[...] a patient with autism who develops “psychosis” i.e. hallucinations and delusions?”

My dear Dr Treg—of course you know to discontinue the autistic client’s prescribed use of Risperidone immediately under such circumstances.
Sullivan
August 13th, 2009
01:11:46

@i’ve a headache now

I could be wrong, but I don’t believe dr treg is a doctor of the sort who could prescribe meds to autistics.
i've a headache now
August 13th, 2009
01:23:17

Ah, but he/she’s vastly interested in Regulatory T Cells.
Clay
August 13th, 2009
01:29:59

If delusions and hallucinations were part of autism, they would just be. There would be no need to deny it. But they aren’t.

Ah, we can always trust Joseph to come up with the definitive answer!

Why suggest they are, except to troll and to try to bother people?

And he nailed that one too. (But so did I).

This is not something that only Dr. Treg does. RAJ is also known to do this much of the time.

Right, and they can both kiss my big red rosy …

:-)
dr treg
August 13th, 2009
01:50:40

So when a patient with autism thinks that a noisy car is a monster that will eat him/her, or when the patient has an imaginary friend that they talk to you are saying that these are not delusions or hallucinations affecting the patient with autism?
Dedj
August 13th, 2009
03:30:54

No one has said anything remotely like that Dr Treg.

Hallucinations and delusions are not part of the diagnosis of autism.

This does not mean that one cannot be autistic and have hallucinations or delusions.

What is does mean is that autism and psychosis (as you imply it) are co-morbid. Psychosis is not intrinsic to autism.

Aside from your examples being rather poorly explained (has anyone ever explained what a car is? Does the person know the friend is imaginary? Are they confusing sub-vocalisation with another person talking?), a person who is psychotic and autistic would (in a perfect world where autism and psychosis are both fully understood and competantly diagnosed) receive a dual diagnosis, as have all of my previous autism+psychosis clients.
i've a headache now
August 13th, 2009
04:40:01

Dr Treg: Is it the same individual re: both items (car and imag. friends)? What age?
Chris
August 13th, 2009
05:07:11

The question about the age is very important.

The illusions, including imaginary friends, is very common among NT children. Up to the time my younger NT son was almost eleven years old the mirror in his room had to be covered because the reflections frightened him. When my daughter was a preschooler, and up through age five she had a fascination with Disney’s 101 Dalmatians. When we went anywhere we had to hold the car door open to let all the imaginary puppies in or out of the car. My disabled son did see UFOs in the sky often (due to watching silly programs on certain cable channels), but he grew out of that by the time he was in middle school.

Compare that to a shirt-tail relative who was perfectly normal up until her late thirties. That is when she saw things that were not there, and had a paranoid delusional break-down that put her into a hospital. After treatment and finding appropriate medication (over about a ten year period of ups and downs), she is doing quite well now.

There is a vast difference between the imagination of normally developing children, and those children with developmental issues who also have imagination but grow out of them a bit later and the very real mental illness of an adult.

I suspect that “dr treg” has not dealt with real children, nor read any kind of literature on child development.
Liz Ditz
August 13th, 2009
05:26:58

Yanking the conversation back to the starting point, re Jenny McCarthy:

“When your kid is [in a painful place—her words were “psychotic or crazy”] you go into this place of shock so you can remain calm,” she says.

I don’t think that McCarthy is far off.

I actually have had the experience of not my kid, but my mother in a psychotic episode, and indeed, I “went into this place of calm”. Not shock, but a sort of “I can’t afford to feel about this now, I have to do the thinking and deciding.”

And I’ve had the experience of my kids experiencing what we call “bleedy injuries” in my family, and my experience has been similar.”I can’t afford to feel about this now, I have to do the thinking, deciding, and acting.”
i've a headache now
August 13th, 2009
09:25:20

I think her son was actually coming out of a major epileptic seizure for which he was hospitalized…so clearly psychotic and crazy are inappropriate terms and…autistic did not even apply at the time. Ms McCarthy going into a “place of shock…[to] remain calm” is not what I see as ‘calm’. She, admittedly, went from screaming (at the top of her lungs) for God to “take him away”, to then “bottling” up her emotions and then next ‘releasing’ her “pent-up fear, sadness and anger”—whereupon she “cried and cried and cried.” None of that seems very calming. Meanwhile, she was also busy shilling for Indigo then TACA and then onto GR. In reality, she may have been in such a state of ‘shock’ that many of her statements/decisions/choices were, well, perhaps not…the best.
David N. Brown
August 13th, 2009
09:47:10

I suspect that autistics hallucinate (in terms of sensory perception) more often than the general population. A thought I have had is that a hallucinating individual can remain rational, if he a) rejects them as unreal or b) accepts them as real and responds to perceived reality in a logical and organized way. I’ve created a hypothetical description of “delusional aspie” based on my own experiences and a fictional character of mine named Zaratustra.
As far as the general description of psychotic, I think it can apply well enough, all too often. But, I am sure such behavior is mostly brought on by frustration, stress and abuse by “normals”. I have summarized the issue with an essay title: “vicious when poked with a stick”.
dr treg
August 13th, 2009
09:47:51

So if a 4 year old with the diagnosis of autism has
1. Loss of connectivity to reality.
2. Thinks cars are monsters after explanation.
3. Has an imaginary friend who they talk to
it is worth seeking another opinion for the dual diagnosis of autism-psychosis and not autism alone as these psychotic features do not appear in autism.
David N. Brown
August 13th, 2009
09:59:49

“Psychosis” isn’t a useful psychological term. If schizophrenia is being argued, I think the key question is the capacity for “rational delusion” (see above). A less appreciated aspect of schizophrenics is that the actions often don’t make much sense even in the context of their delusions.
dr treg
August 13th, 2009
10:08:53

Whether the delusions are primary or secondary they are still delusions and by their nature irrational. Is there an element of denial in the field of autism and no-one accepts that it may just be another type of “psychosis”?
Dawn
August 13th, 2009
12:59:44

@Dr Treg: DO you have any children? You say
“So if a 4 year old with the diagnosis of autism has
1. Loss of connectivity to reality.
2. Thinks cars are monsters after explanation.
3. Has an imaginary friend who they talk to it is worth
seeking another opinion for the dual diagnosis of autism-psychosis and not autism alone as these psychotic features do not appear in autism.”

My answers as a parent: 1. Yes, probably needs to be reviewed
2. No. Many children are scared of loud noises and will take more than 1 explanation to accept that a car is not a monster (if the child has not been exposed to a car on a regular basis). My eldest hated the vacuum cleaner for many years and would scream and cry if I used it when she was around. Took some time to get across to her that it wasn’t a monster, since it a) made very loud noises and b)sucked up things and you would not see them again.
3. Many children have imaginary friends that they talk to for YEARS. If pushed, normal children will admit that their friends are “just pretend”, psychotic people cannot do this. So the imaginary friend is not the problem. The problem is if this friend is seen to be real or not.

I hope this helps…
passionlessDrone
August 13th, 2009
13:29:29

Hello friends –
This discussion strikes me as absurd, and seems like a perfect illustration of why so many parents, when initially exposed to sites like this come away thinking you (or perhaps just your ideas) are damaging to their children, or at the least, your experiences are so far from theirs, that ‘your autism’ can’t be anything like ‘their autism’.

The parent watching their child injure themselves, spin for hours on end, or refuse to look them in the eye doesn’t give half a shit as towards the clinical minutia between psychotic, autism, schizophrenia, or just plain crazy. Further, the notion that these are the salient points to debate seems like a massive waste of energy, time, and indeed, displays a fundamental difference in prioritization.

Now here comes Jenny who who claims to have experienced the same feelings they have and seems concerned with finding concrete ways to help children; poorly defended or not.

Parents of newly diagnosed children coming across this thread likely aren’t going to leave with the message you’d like them to.

Ironically, this study came across pubmed for me this morning.

Comparison of social cognitive functioning in schizophrenia and high functioning autism: more convergence than divergence

– pD
Clay
August 13th, 2009
13:37:05

So says another of our persistent trolls. If you don’t like it here, why do keep coming back? Just so you can act out being the (!) you are, I’d say.
Joseph
August 13th, 2009
14:02:17

So if a child has an imaginary friend, that means they are delusional and hallucinating?

Pure crap.
dr treg
August 13th, 2009
14:03:46

It seems that when patients with autism develop hallucinations referral for exclusion of schizophrenia or psychotic depression is suggested.
http://abcnews.go.com/Health/A.....id=5387923
However it is quite clear that autism and schizophrenia have many overlapping symptoms/behaviors with hallucinations, delusions and loss of connectivity less frequent or not typical in autism – but they do occur.
Following on from this why isnt autism a psychosis?
As PD says who cares as long as research into genetics, the immune system and structural changes in the brain especially the dendritic spines is pursued in order to try to improve the quality of life of the patient.
This thread has demonstrated the amount of energy wasted on
1. Current outdated psychiatric nosology
2. Arguing about whether McCarthy is completely right or completely wrong again.
It is highly possible that in 100 years the terms “autism”, “psychosis” and “schizophrenia” will be obsolete.

“The moment we want to believe something, we suddenly see all the arguments for it, and become blind to the arguments against it.”
GB Shaw.
Sullivan
August 13th, 2009
16:31:24

pD—
if people do’t give “half a shit” about the minutia between psychotic, autism, schizophrenia, or just plain crazy:

I would ask that they use terms which don’t stigmatize my kid. With apologies to those with true psychoses, those terms carry the stigma of being a potential danger to others.

Since they don’t give “half a shit”, they shouldn’t give “half a shit” about changing the terms they misuse. Otherwise they are showing that they don’t give “half a shit” about the other autistics in the world.
dr treg
August 13th, 2009
16:58:48

You seem to be showing your true colors i.e. you dont want the stigma of “psychosis” being attached to a loved one, but unfortunately you further stigmatise schizophrenia which is only associated with a small increase in the relative risk of “being a potntial danger to others”.
http://www.ncbi.nlm.nih.gov/pu.....rom=pubmed
Your selfish ignorant comment is on a par with McCarthy`s. It is unfortunate that in 2009 all psychiatric diagnostic terms are stigmatising.
Sullivan
August 13th, 2009
17:47:32

dr treg,

I don’t want the stigma of psychosis being attached—since it is unwarranted.

As you ignore—I noted with apologies that there is a stigma.

You are a troll and uneducated and you have a big axe to grind. Your science is unsound.

You may join Harold Doherty and John Best soon.
David N. Brown
August 13th, 2009
17:55:12

To Dr. Treg,
When I say “rational”, I mean mainly the ability to respond to PERCEIVED reality in an organized way. As far as “social cognitive functioning”, one element of my “delusional aspie” profile (for whatever it is worth) is that the subject can remain communicative and intelligible, where a schizophrenic likely would not. Also, your example of “cars as monsters” does not involve any abnormal sensory perception. If the car is really there, and is perceived as a car, there is no “hallucination”. The problem is better described as a phobia.
Stephanie Lynn Keil
August 13th, 2009
18:07:08

I love that when some people don’t agree with a rational point of view or a fact (always something negative) that they don’t like a person automatically gets labeled as a “troll.”

To Harold Doherty and other parents of severely autistic children who need intensive treatment your rhetoric is nothing but a waste of time and a “troll” to them.

Perhaps people should learn to listen from both sides and not slap every person and opinion they disagree with as being a “troll.”
Clay
August 13th, 2009
18:32:42

It seems this post is a troll magnet.
Joseph
August 13th, 2009
18:35:04

If people don’t give “half a shit” about the minutia between psychotic, autism, schizophrenia, or just plain crazy, why have multiple labels at all? Why not just use “crazy” as an umbrella term and study “crazyness” as one entity? In the old days, it was kind of like that.

That’s a surprisingly naive observation by pD.
dr treg
August 13th, 2009
18:38:20

Rational is defined as “having or exercising the ability to reason”.
The belief that the car is a monster and will eat people is a delusion not a hallucination.There seems to be uncertainty in your entry about the clinical features of schizophrenia.
As mentioned above the main reason why the opening post doesnt want to accept the fact that autism patients may have psychotic features is
1. Denial
2. The stigma of the word psychosis.
3. Hatred of McCarthy.
It is easy to start entering offensive comments when someone disagrees with your viewpoint.
Which part of the science of autism do you need information on?
Dedj
August 13th, 2009
19:04:29

SLK - Dr Treg is not getting slapped with ‘troll’ for his disagreement. He is getting labelled a ‘troll’ because he continues to disagree with a statement that has not been made, that he continues to disagree with strawman arguements he has made from commentors posts, and that he continues to assert some form of maliciousness or ill-will is motivating the OP and the commentators, rather than the actual ICD/DSM diagnostic criteria.

As an aside, I have witnessed Harold:

Dismissing Kristina Chew as ‘anti-treatment’ because of her criticism of ABA, despite the fact that she has discussed several treatments on her website.
Dismissing a director of a national autism charity as being ‘a know-nothing and do-nothing’ depite this persons involvement in researching video as a treatment tool and involvement in several advocacy agencies.
Dismissing a advocate and lecturer on autism (and published authour) as a ‘biased know-nothing’ because of her criticism of ABA, despite her research record in ABA extending into the 90’s.
Dismissing research as worthless purely because it disagrees with his own perception of his sons abilities.
I’m not even going to mention his treatment of Michelle Dawson, suffice to say she has handed him his ass on a plate multiple times. He does not need to be embarrased further.

In short, Harold doesn’t meet the strict defintion of ‘troll’, but that doesn’t mean his overall behaviour isn’t disagreeable.
Sullivan
August 13th, 2009
19:06:44

Stephanie Lynn Keil,

There are many people I disagree with. Very few get labeled “troll”. There are some people I agree with whom I have called “troll”.

dr treg meets the criteria. His comments most often do not offer actual information.

You, for example, I have just disagreed with. However, your comment added something new to the conversation, and you took the time to flesh out your assertions.

I made a mistake by bringing up Mr. Doherty. He is unable to partake in discussions on this forum, so for the most part I consider it bad form to discuss him here. However, he has moved beyond troll in some of his recent activities.
Clay
August 13th, 2009
19:26:52

I say that “being a troll” is a state of mind. If a person’s intent is trollery, s/he can be a troll even on his own blog. Such is the case with the other exiled bestard, who’s a troll 24/7, wherever he happens to be!
David N. Brown
August 13th, 2009
19:30:43

To Dr. Treg,
I consider the core diagnostic criteria of schizophrenia (at least as “classically” defined) to be (sensory) hallucination, delusion and disordered thought processes and actions. To the extent that “psychotic” is diagnostically useful, I think it suggests violent, frenzied and/or disordered behavior. Overall, subjects with the same or different mental abnormalities differ in degree and kind as to how their perceptions and reasoning depart from a common framework of logic and reality. It can be taken as a rule of thumb that “intermediate” cases, where a highly deluded subject is able to carry out complex and effective plans based on his delusion, represent the greatest danger.
i've a headache now
August 13th, 2009
19:49:27

My dear Dr Treg: It’s not ‘delusional’ for a four year old to have a monster fear. Period. Moreover, the opening post had to do, in part, with Ms McCarthy’s imprecise use of language and its effect. One hardly thinks her use of ‘breakdown’, ‘psychotic’ and ‘crazy’ were meant clinically. However, Ms McCarthy, as putting herself forward as as spokesperson, could really do with being more responsible in how she uses language. Announcing to the whole world that you screamed for God to ‘take’ your child, because he had a [successful!] stay in the hospital due to an epileptic seizure, is, well…I shall simply refrain from elaborating….
Sullivan
August 13th, 2009
20:24:19

In short, Harold doesn’t meet the strict defintion of ‘troll’, but that doesn’t mean his overall behaviour isn’t disagreeable.

Just to be clear—I wasn’t bringing up Mr. Doherty as a “troll” but, rather, as a person who has lost his privilege to comment on this blog.

(note: comment edited shortly after published)
Joseph
August 13th, 2009
21:52:23

Harold is not a troll? Nonsense. Read the comments of this post, starting at #4.
Dedj
August 13th, 2009
22:25:31

I’m well aware of Harolds habit of taking sentences out of context, or of misattributing offensive intentions and arguements to his opponents .

I remain firmly convinced that Harold totally believes in his interpretations (even after repeated corrections) and is motivated to respond due to his self-image as a serious advocate.

Typical troll behaviour is to respond to rebuttals with further troll like behaviour. Harolds typical response to rebuttals is to demean his opponents (always by comparing them disfavourably to his apparently unvalidated self-image), provide a quote that doesn;t say what he thinks it does, and then co-incidentally disappear when his rebuttals are shown to be ill-informed or easily refuted (as they were with his dismissal of Larry Arnold).

Harolds intent is not to disrupt or ‘troll’, but to act as an advocate for autistic children (does anyone have any evidence of Harolds actual offline contribution to autism advocacy? If so I’d like to see it).

The fact that he does this through inaccurate, often irrelevant, statements heavily influenced by his experiences with his son and in a condecending manner does not neccisarily qualify him as a ‘troll’.

He certianly isn’t very well informed, and is quite possibly a nicer person in real life than he comes across on the blogs he infests, but he certianly isn’t worthy of disrupting this thread.
MJ
August 14th, 2009
02:02:13

Very apropos –
Pervasive developmental disorders and psychosis.

Pervasive developmental disorders (PDDs) and infantile schizophrenia were initially thought to be the same condition, but distinct differences were described in later research. However, attempts to identify psychosis in individuals with PDDs continue to be challenging and controversial. The two disorders share many similar features, including perceptual abnormalities, thought disorder, catatonia, and deficiencies in reality testing…

http://www.ncbi.nlm.nih.gov/pu.....t=Abstract
dr treg
August 14th, 2009
19:28:19

It seems that from recent entries
1. Many do not know that much about psychotic delusions and hallucinations
e.g. not agreeing that a child with autism who believes that a car is a monster that will eat people is delusional and not aqgreeing that a child with autism who talks to an imaginary person is hallucinating.
2. Many do not accept that autism can be associated with psychotic symptoms e.g. delusions and hallucinations.
As the reference in the last entry confirms the prevalence of psychosis in autism is difficult to assess.
The fear of the opening post is that their child will be called psychotic and be perceived as being a danger to others. This fear renders the opening post closed minded.
Sullivan
August 15th, 2009
00:59:12

Dismissing Kristina Chew as ‘anti-treatment’ because of her criticism of ABA, despite the fact that she has discussed several treatments on her website.

The “anti-treatment” argument is a major straw man in online discussions. A common example—if you side with actual toxicologists and say “I think chelation challenge testing and chelation as a treatment for autism is unwarranted given the science” you can expect a response of “you are anti treatment”.
Dedj
August 15th, 2009
02:27:47

“1. Many do not know that much about psychotic delusions and hallucinations”

Including you it seem. You did not provide sufficient context for your original scenerio – i.e. that the belief was irrational, non-cultural and absolute – that is, the belief does not go away with rational explanation from a trusted authourity. Mistaken beliefs are not delusions.

Try reading what is actually written. It’s the polite thing to do.

“Many do not accept that autism can be associated with psychotic symptoms e.g. delusions and hallucinations”

Indeed not, for this wasn’t the actual arguement – nor has anyone actually made it – that psychosis is not an essential criteria for autism.

It is not, as per the DSM and ICD.

Case closed, move along now.
Dedj
August 15th, 2009
02:32:17

Indeed Sullivan, you will find many people in the ‘ND movement’ who opposed many biomed and ABA type interventions, yet are not anti-treatment.

How can you tell? Well, there are many people in the ND movement who have researched, delivered, advocated for or otherwise help support autism therapies. Many got into ND through their work in autism services.

Strange how these people never get a mention from anti-ND bloggers. Strange how pro-ND professionals never get a mention. Strange how anti-ND people stick almost exclusively to what is on the bloggosphere.

It’s almost as if they don’t actually know about the offline ND world at all.
David N. Brown
August 15th, 2009
06:32:52

To Dr. Treg,
As far as your examples, I think you have a fair point as far as “cars as monsters” qualifying as a delusion (though I think it’s a strong term to use). Imaginary friends is another matter. A child may act out interactions with an imaginary friend, without sensory hallucination or a belief that the “friend” is real. Probably only a thorough and trained clinical observer would have much chance of distinguishing very effective “play-acting” from actual hallucination and delusion. Incidentally, even if the latter is the case, it’s most likely to have started as play acting. In any event, the fundamental question is not whether autistics are subject to hallucination and delusion, but whether they are at unusual risk. As I have mentioned, I consider this a strong possibility, but something that must be considered is whether such behavior simply draws more attention when the individual is known to be autistic.
NightStorm
August 15th, 2009
18:02:50

Indeed Sullivan, you will find many people in the ‘ND movement’ who opposed many biomed and ABA type interventions, yet are not anti-treatment.

and there are those like me who thinks ABA has some merit but needs to be remastered to suit the needs of the autist than the parent.
James Gavin
November 8th, 2010
17:33:57

@ dr treg

Here’s a good basic reference for you try. It should hopefully clear up some of your confusion about what actually constitutes a delusion or hallucination.

http://books.google.com/books?.....38;f=false

Clearly an autistic child can also experience psychotic symptoms (in the same way that a child with a broken limb can experience such symptoms…)

http://content.karger.com/prod.....=000255958

A systematic review in 2009 (looking at psychiatric co-morbidity with autistic spectrum disorders) found that the strongest association was between ASD and anxiety disorders. Depression also appeared common but the evidence regarding psychotic co-morbidity was contradictory.