What Is Wrong with My Three Year Old?

I am distressed by how many parents of preschool boys worry that their sons are autistic when their sons' behavior would never have been considered autistic even ten years ago. The autistic spectrum seems to become ever wider, capturing many more children in its diagnostic net. I have known, am related to, men who would now be diagnosed along the autistic spectrum. Yes, they are eccentric; yes, they are not the most stimulating conversationalists; yes , they don't have a huge number of friends. But they can be good sons, brothers, husbands, and fathers. If you can relate to your computer, you can have a successful career. Is the alarming epidemic of autism, along with the similar epidemic of childhood bipolar disorder, created by greatly expanding the criteria for diagnosis? Are we losing tolerance for divergent thinkers to maintain a society hostile to children and families?

When my kids were young, 25-30 years ago, even in therapy-obsessed Manhattan, preschool kids weren't frequently diagnosed, weren't taking psychiatric medications, so I am skeptical about this epidemic of very young children with serious problems requiring psychiatric drugs. If our kids were having problems in nursery school, we might decide to wait another year and find a better school. What is going wrong with the way we are raising children? Why do we look in children's brains for the answers to be found in social reform? Are we being encouraged to worry needlessly about our own kids that we don't have any time or energy for political activism on behalf of all children?

Who is blowing the whistle? Who is questioning the wisdom of babies and toddlers being cared for by strangers? Who is wondering whether group care is appropriate for most children under three or four? Thirty-five years ago, children were five before they were expected to adapt to group standards of behavior. Who is crusading for a shorter work week and greatly increased parental leaves? Who is is dedicated to make caring for preschoolers a viable career path for college graduates, comparable to teaching in salary and benefits?

Who is demanding the economic changes required to enable parents to care for their babies and toddlers themselves? Who is comparing our rate of childhood mental illness with rates in the rest of the Western world? Who is outraged about preschoolers taking multiple psychiatric drugs that have never been tested on children? Who is fighting to outlaw drugs ads in magazines and on TV? Why are we teaching our kids that drugs are the solution to every problem? Thirty years ago we felt like bad parents if we let our kids have caffeine.

The aggressive drug treatment of mental illness in the last 30 years hasn't been a success story. When yesterday's wonder drug becomes generic, its ineffectiveness is suddenly discovered and its dangerous side effects are no longer covered up. Today's expensive wonder drug will save your life after being tested for a shockingly short time on shockingly few people who don't share your diagnoses. Witness the latest advertising blitz to treat bipolars with antipsychotics; all the tried and true mood stabilizers are becoming generic, so they obviously can't help.

Preschoolers are so unformed, so in process. This year's four year old can seem like a different creature than last year's three year old. These diagnoses of autism, bipolar disorder, ADHD imply lifelong, incurable brain disorders for which there are no medical tests, no verifiable proof of their existence. How do we know that today's experts on autism are any more correct than the world acclaimed psychiatrist who attributed autism to "icebox mothers" 40 years ago? Why do we expect little boys to adapt to schools better suited to girls? Why don't we train and recruit more male teachers in preschools, who might be better role models for little boys and help create more welcoming schools?

It is politically correct to be very tolerant and open-minded about emotional problems, but that enlightenment is only surface deep. I mourn for the three year old already cursed with a lifelong diagnosis. Loner, loser, geek, and nerd seem far kinder labels. In this fall's TV season, geeks are the new Prince Charmings. The confidentiality of medical records is a myth. Many adults not diagnosed along the autistic spectrum have successful careers in math, science, engineering, computer programming. Would that have happened if they had been diagnosed and stigmatized as preschoolers? What special services would you have prescribed for Bill Gates?

I am not questioning that some preschoolers will benefit from early intervention to cope with their idiosyncratic learning styles or developmental delays. I am not questioning that some children with severe problems require evaluation and treatment from infancy. But preschool services should not necessitate a lifelong diagnosis.

Why would you accept that your young child has a permanently broken brain? Why not take him out of day care, find a different nanny, change nursery schools, reduce your working hours, live more frugally, borrow money and take a leave of absence from work, ask your parents and relatives for help, search out books and activities about his particular obsessions, learn the recommended interventions yourself?

Does your child need more relaxed time with his overscheduled parents rather than tense sessions with experts comfortable with diagnosing him after a few testing sessions?Why not wait until the picture becomes clearer? Why it is so urgent to find the answer when he is 2 or 3? We are not dealing with meningitis or childhood leukemia. here Are we doing far more harm than good? When I hear a 7 year old rattle off all his psychiatric labels, it breaks my heart and makes me want to man the barricades. I would love to find some comrades.