Whatever happened to Donald?

September 24, 2010 1:07 PM

Donald was the first child ever diagnosed with autism.

Identified in the annals of autism as “Case 1 … Donald T,” he is the initial subject described in a 1943 medical article that announced the discovery of a condition unlike “anything reported so far,” the complex neurological ailment now most often called an autism spectrum disorder, or ASD.

posted by magstheaxe (37 comments total)

These descriptions of Donald would seem to do a great job of capturing the implications, challenges and mysteries of classical autism.

Perhaps the doctors who have identified so many of my acquaintance's children -- misbehaving, petulant children, but children who nevertheless display all signs of normal human emotion, motor control and cognitive understanding -- as autistic should read this so they can actually know what autism is. Then, perhaps, they'll only give the strong amphetamines and antipsychotics to those kids who really, truly need it, rather than blunting a generation in the name of the pharmaceutical industry.
posted by I EAT TAPAS at 1:22 PM on September 24, 2010

I EAT TAPAS: "These descriptions of Donald would seem to do a great job of capturing the implications, challenges and mysteries of classical autism.

Perhaps the doctors who have identified so many of my acquaintance's children -- misbehaving, petulant children, but children who nevertheless display all signs of normal human emotion, motor control and cognitive understanding -- as autistic should read this so they can actually know what autism is. Then, perhaps, they'll only give the strong amphetamines and antipsychotics to those kids who really, truly need it, rather than blunting a generation in the name of the pharmaceutical industry."

Wow, that is pretty crass. Why not just come out and accuse autistic people of faking it too, while you're at it? Or dispense with the fig leaf of "true autism" and saying "OH, I don't think it's a real thing".
posted by ShawnStruck at 1:25 PM on September 24, 2010

Why not just come out and accuse autistic people of faking it too, while you're at it? Or dispense with the fig leaf of "true autism" and saying "OH, I don't think it's a real thing".

I think you missed TAPAS' point, which was almost the exact opposite of what you're reacting against - not that it doesn't exist, but rather that Autism Spectrum Disorder" seem to be somewhat over-diagnosed these days. Its become somewhat fashionable for parents to ID their child as "autistic" (perhaps because it gets them extra services, perhaps because being "on the spectrum" also implies that your socially-maladjusted child is also smart) when the child's actual issues should perhaps not be treated through hardcore medication.
posted by anastasiav at 1:30 PM on September 24, 2010 [8 favorites]

There have always been autistics. I think, though, that a fast-moving, clamor-filled society is far more disabling to autistics than any previous time in our history. That’s why I think autistic children–who, in a previous decade or century, might have been the oddballs who eschewed “society”, the eccentric scholars–are now spinning, rocking, head-banging, melting down and shutting down at younger and younger ages.

I don’t think there has ever been such a sensory *onslaught* before as now exists in almost every workplace, business, mode of transportation–and most homes. There’s also the *pace* of modern life, and all the “activities” that many families engage in, especially if they have several children–drop off that one for practice, that one for lessons, go to the store, pick up the dry-cleaning. I also think–perhaps with good reason–that parents now are loathe to leave their young children alone and will pack them in the car and take them on errands. What does all that speed and rapid, repeated change in environments and situations do to an autistic child?
posted by ShawnStruck at 1:46 PM on September 24, 2010 [5 favorites]

hen, perhaps, they'll only give the strong amphetamines and antipsychotics to those kids who really, truly need it, rather than blunting a generation in the name of the pharmaceutical industry.

Since when do they give amphetamines to kids with Autistic spectrum disorders?

Attention disorders with hyperactivity must be treated with caution in the autistic, because amphetamines often cause severe exacerbation of autistic symptoms. The standard therapy here is methylphenidate and dextroamphetamine (Burg; Tonge).

So my guess is that you don't know WTF you're talking about.

_{Also from that page:}

_{Other novel pharmacological approaches to characteristic autistic symptoms are ascorbic acid, propanolol, naltrexone, fenfluramine, and LSD. LSD, which of course works on the serotonin system, has been shown to increase the autistic’s response to their environment, but is still accompanied by hallucinations (Cook).}

posted by delmoi at 1:46 PM on September 24, 2010 [1 favorite]

delmoi... your quoted text says the standard therapy for ADHD in autistic patients is stimulants.
posted by polyhedron at 1:54 PM on September 24, 2010 [1 favorite]

delmoi, I've spoken to a substantial number of parents whose children have been diagnosed with ASD, often combined with ADHD, and prescribed Ritalin or Adderall. Simply Google autism + adderall or autism + ritalin, and I'm confident that you'll find that this isn't particularly uncommon, or something I'm making up.

ShawnStruck, this WSJ article (if the paywall doesn't block me) does a good job of explaining the skyrocketing rate of autism diagnoses in California and how local researchers believe that this increase is based primarily on social factors or the level of the parent's education, and not environmental factors.

I do believe there are plenty of individuals out there with honest to goodness autism, and that medical therapy for those who have it is important. But something's screwy with the increased rate of diagnosis, and the levels of reliance on prescription drugs that I've seen among my peers is horrifying.

(Also, thanks anastasiav.)
posted by I EAT TAPAS at 1:58 PM on September 24, 2010 [2 favorites]

ADHD and ASD are not even close to the same thing. Their only similarity is that armchair doctors think that both are over-diagnosed.
posted by muddgirl at 2:02 PM on September 24, 2010 [4 favorites]

Perhaps I should be a bit less forceful. Sometimes, a person may have symptoms of ADD or ADHD that turn out to be secondary symptoms of an ASD. Perhaps even vice-versa. But it seems really inappropriate to me to start talking about each disorder interchangeably. Before my father was diagnosed with a disorder, there was speculation that he could have anything from AIDS to lupus to Eppstein-Barr. This does not imply that AIDS and lupus require the same treatment.
posted by muddgirl at 2:09 PM on September 24, 2010

I read this article earlier this week and really loved it. Donald seems like a great dude who's led a really interesting life so far.
posted by iamkimiam at 2:19 PM on September 24, 2010 [1 favorite]

This was a fantastic article that my wife and I read a few days ago. It gave us a little bit more hope that our autistic son could lead a fulfilling life long after we're gone. I'm thinking of trying to teach him the fundamentals of a golf swing, so perhaps he can be a little bit like Donald.

Perhaps the doctors who have identified so many of my acquaintance's children

You mean the one's with degrees on the wall? Just like yours? Oh wait...

Its become somewhat fashionable for parents to ID their child as "autistic"

Dude, you're lucky this is the Internet and I can only think about throwing a punch.

perhaps because it gets them extra services

Actually, yes. Getting a label is a significant milestone, because it means eligibility for the pittance of services offered in this country, which you still have to wrestle out of (well-meaning) budget-minded bureaucrats.

Fun fact: There's an entire business model centered on providing advocacy to parents of special needs children. The bureaucracy sucks so bad, you need a professional just to figure it out.

perhaps because being "on the spectrum" also implies that your socially-maladjusted child is also smart

I'm thinking a right cross to the mouth oughta do it...

when the child's actual issues should perhaps not be treated through hardcore medication.

... but now I think you might have be one of the misbehaving, petulant children that had an experience with medication.

Do us all a favor. Up the dosage.
posted by Cool Papa Bell at 2:24 PM on September 24, 2010 [19 favorites]

Go back and read I EAT TAPAS' comments again, Cool Papa Bell.

I do believe there are plenty of individuals out there with honest to goodness autism, and that medical therapy for those who have it is important.

And what anastasiav said:

not that it doesn't exist, but rather that Autism Spectrum Disorder" seem to be somewhat over-diagnosed these days.

Holy shit, it looks like they're saying that you kid's problem is legitimate...they're dissing on all the other parents who are abusing the system and drawing ire on your kid's condition! It looks like they're on your fucking side if you weren't waiting so eagerly to be offended.
posted by Jimbob at 2:32 PM on September 24, 2010 [10 favorites]

What does all that speed and rapid, repeated change in environments and situations do to an autistic child?

I am fortunate because my son is highly functioning asperger's. When he gets in a rapidly-changing situation, like cruising about in the car from place to place, he'll withdraw into his Nintendo DS. He's also "gifted." This can be a problem because gifted programs rarely accomodate aspie kids. Also, he gets really, really bored with his 90-minute social skills class and is begging me to not have to sit through it any longer.

I have mixed feelings about over-diagnosis. Is overdiagnosis happening from trained psychiatrists, or just the family doctor/pez dispenser?
posted by mecran01 at 2:40 PM on September 24, 2010

Dude, you're lucky this is the Internet and I can only think about throwing a punch.

I get that this is a flash point for you, but take a step back and hear me out.

Ever see someone over in AskMe labeled as having ASD based just on a short description? Ever meet a nerdy adult who says "Oh, yeah, I'm probably Aspergers" as a sort of Get Out of Jail card for all their social ills? Ever meet a parent who tells your their basically normal child is autistic based on their own armchair diagnosis? Or a parent who comes into the classroom and demands special treatment for their child because "she's probably got Aspergers and you need to make allowances for her?".

This is what I'm talking about. Not kids (and adults) with a genuine diagnosis.

Society -- and yes, some doctors and teachers too -- tend to throw the Aspergers/ASD label on more and more things based simply on casual observation or reported behavior, not true diagnosis, sometimes even to the point of treating children with medication because their parents come in waving internet articles and demand that the doctor "fix it" when the core problem is not really anything having to do with ASD.

And, honestly? Violence and insults don't solve anything.
posted by anastasiav at 2:47 PM on September 24, 2010 [9 favorites]

Donald lives next door to where my great-grandmother lived. My mother (who is a little older than Donald) remembers him being "on the fringes" when playing with her friends and that he was odd but not outcast. At my grandmother's funeral, my mother saw him for the first time in almost 40 years and he not only remembered her, but her birthday and my and my sisters' names and birthdays (and I can't remember ever having met him when visiting my grandparents).

I'm guessing that his family's having the money to get the best medical advice coupled with the fact that Forest is a very small town where everybody knows everybody else's business has a great deal to do with his good life.
posted by skyscraper at 2:51 PM on September 24, 2010 [8 favorites]

Doctors don't actually diagnose these nerdy self-proclaimed "Aspies" as having ASD.

Please, for the love of god, if you don't have proper training and experience in mental health, stop forming ridiculous opinions like "the majority of condition X is made up because I say so".

People with mental and neurological conditions are stigmatized enough as it is, without every armchair theoretician whose expertise is derived from reruns of House telling them they're faking it.
posted by unigolyn at 3:05 PM on September 24, 2010 [4 favorites]

Also, he gets really, really bored with his 90-minute social skills class and is begging me to not have to sit through it any longer.

Please, please, please talk him into sticking it out. I would kill to have had the opportunity to be taught basic social skills as a kid. It would have saved me tons of grief in junior high and high school.
posted by Mr. Bad Example at 3:14 PM on September 24, 2010 [1 favorite]

I'm guessing that his family's having the money to get the best medical advice coupled with the fact that Forest is a very small town where everybody knows everybody else's business has a great deal to do with his good life.

It's also due to another factor--someone in the article stated something like (I read the print edition and don't have it front of me for the exact attribution): "Odd poor people are crazy. Odd rich people are eccentric." This may also factor in to the relative increased diagnostic rates among the educated and well-off.
posted by availablelight at 3:31 PM on September 24, 2010 [2 favorites]

I would like someone to show me evidence for over-diagnosis on a system-wide level. The evidence I know of shows that it's under-diagnosed in girls. Here are some examples of what not-evidence looks like:

I know someone who knows someone who knows a lot of kids who are over-medicated!

Plenty of kids I barely know don't seem autistic--what would their parents and developmental pediatricians know about it that I can't determine from a short encounter with a child who is already on medication? There's no way their medication could actually be HELPING them behave normally--all meds do is drain souls!

There are so many more diagnoses of autism now and there is no way that could be due to greater awareness, different diagnostic procedures, or shifting diagnostic criteria! It must be over-diagnosis!

A lot of people think that having Asperger's makes them seem smart or special. That is the equivalent of an actual medical diagnosis, and it happens enough to be a significant, systemic problem, not just something that occasionally annoys me on the internet!

People use autism as an excuse when they want special treatment/services for their kids! I have no direct experience with the services that are available for autistic children. Nor do I know that people generally cannot receive services simply by claiming that their obviously normal child is autistic.(this is a new one, so good job).

Seriously, I would be interested in any kind of article or evidence you could provide.

There are people here on Metafilter who have autism, some of whom might be reading this (and who read your comment.) There are people whose loved ones have autism. There are people who don't know much about the disorder, who will go on to spread the information that you're putting out there.

I'm not saying that you have to be positive about people who incorrectly medicate children or abuse services that are meant for others. What I am asking is that you wait to talk about these people until you have actual knowledge of them, and that you do not assume that these people make up a significant portion of people who are or have family members who are autistic unless you have actual evidence that it's true.
posted by the young rope-rider at 3:37 PM on September 24, 2010 [12 favorites]

I'm heartened to see what is the first occasion in my memory of a story posted to Metafilter about a small Mississippi town pulling together in doing something decent.
posted by Countess Elena at 3:44 PM on September 24, 2010 [5 favorites]

delmoi... your quoted text says the standard therapy for ADHD in autistic patients is stimulants.

I EAT TAPAS said amphetamines, which is not only incorrect but backwards.
posted by delmoi at 4:06 PM on September 24, 2010

"Holy shit, it looks like they're saying that you kid's problem is legitimate...they're dissing on all the other parents who are abusing the system and drawing ire on your kid's condition!"

You're not talking to me, but I'll respond--I'm not going to jump up and cheer just because the arrogant ignorance isn't directed at me--at least not this time. I'm not going to join in when someone judges random people they (and I don't even know), while perpetuating harmful stereotypes about people with autism and their families.

And no, it's not just the "bad" parents/family members/caregivers who have to deal with this.

Everyone who has ever spent a significant amount of time with an autistic child has been told that that child doesn't need treatment, just [structure, discipline, organic food, freedom, understanding].

Or that autism is made up by big pharma or people who want to create zombie children (bonus points if they're saying this with a straight face while watching the child in question hit themselves in the head, rock back and forth, and recite lines from last night's episode of Nature)

Also fun is when someone tells you after 2 minutes of meeting him that "he seems okay...are you sure he has autism? Maybe he was mis-diagnosed. You should get him checked out again."

The most fun is when someone watches you interact with the child in a way that significantly improves their behavior, and then proceeds to tell you that you have no idea how to treat a child, and that is probably why he has autism.
posted by the young rope-rider at 4:08 PM on September 24, 2010 [9 favorites]

delmoi, what people call amphetamines are a kind of stimulant (example: Adderall, aka mixed amphetamine salts).

They need to be used with caution because of the potential side-effects, but they're definitely used to treat autism. Adderall is approved for that specific use, if I remember correctly.

Google is not really working for you right now.
posted by the young rope-rider at 4:15 PM on September 24, 2010

I EAT TAPAS said amphetamines, which is not only incorrect but backwards.

Is dextroamphetamine not an amphetamine?
posted by rtha at 4:17 PM on September 24, 2010 [1 favorite]

I just read the entire piece on Donald, and it is a wonderful portrait of a man who grew up autistic and is now 77 years old and living independently.

One of the takeaway quotes from the piece is a Forest local that says something to the effect of "if you're poor and strange, you're a weirdo; if you're rich and strange, you're just eccentric." Donald's parents were rich; his father was an attorney (the article seems to hint he was mildly autistic as well) and his mother was from a wealthy family that ran the town's Bank of Forest.

The pleasant thing about this article is that people with autism are not lost causes. They are good and interesting people who, while eccentric, and perhaps sometimes frustrating to deal with, are worth knowing and worth making part of the community. It is not a disease to be feared, per se, but a condition that need only be understood to be accepted.

Donald likes to travel. He has travelled to something like 38 countries and 28 states, including Istanbul 5 times. He does this because he likes to take actual photographs of places he's seen in books, so that he can catalog them.

And Donald is not mildly autistic, or what I would determine (in my uneducated layman's understanding) to be a "high functioning" autistic person. He doesn't appreciate human interaction, doesn't show affection, can't process social cues, had no emotional reaction to his parents' deaths, and can also multiply large numbers in the blink of an eye and remember remote details of everybody he knows.

The social conditioning we undergo throughout our entire lives causes us to disregard people who act strangely. I tell you, I'd love to play a round of golf with the guy (he golfs everyday, and is in all likelihood much better than me). I'd love to be identified by a number by him.

It's worth reading the article as it is instead of debating how crazy both sides of the current hot-button autism debate can be. It seems to me that Donald leads a pretty rich and fulfilling life. Not something that I can 100% comprehend, but something that Donald can comprehend. And this makes me happy, and it makes me hopeful.
posted by jabberjaw at 4:36 PM on September 24, 2010 [8 favorites]

The evidence I know of shows that it's under-diagnosed in girls.

Based on this previous post and my own experience working with individuals with autism, I agree.

Also, I think that one of the issues with prescribing traditional ADHD drugs like Adderall, Ritalin, amphetamines, etc. (and that etc. includes a huge spectrum of meds) is that they are not necessarily being prescribed for ADHD at all (in fact, all of the psychologists that I've worked with have noted that technically a kid shouldn't have a diagnosis of both autism and ADHD), but instead for symptoms of autism. Since no one really knows what is causing the symptoms, it's honestly kind of a trial and error procedure. Some kids respond really well to X drug, while another kid with autism shows no behavioral changes whatsoever with the same drug.

Autism is an emerging field. Doctors are trying different things (I'm not advocating randomly handing out drugs to see what they do, but the truth is no one knows what the best treatment will be). Parents are trying different things too. When I worked in homes as a consultant, not a day went by when I didn't get a request for or asked my opinion on some "new" treatment like music therapy, chelation, sensory integration therapy, "the diet", and many other techniques that people are trying, basically for lack of research and data on their effectiveness and abundance of anecdotal evidence from other parents or people in the field of autism. One I found particularly interesting: using marijuana to relieve some symptoms of autism. Although I am not a huge fan of these treatments that are often just given new names to market them, I can't say I wouldn't do the same thing if I had a child with autism.
posted by chela at 5:05 PM on September 24, 2010 [2 favorites]

My dad sent me this article last week (and I considered doing my first FPP on it!) becuase my brother has autism. And I think the important message that the general public should get from this article is that CHILDREN WITH AUTISM GROW UP TO BE ADULTS WITH AUTISM! I get so frustrated when the focus of the disorder is solely on children rather than people.

My brother lived at home until after my father remarried after my mother's death. I think in a lot of ways, her death forced him (and my dad) to let him be a more independent person. My brother will be 50 this year. He worked for 15 years as a janitor at a vet clinic, but for the past five years (after vet's office was bought out by a national chain) he has worked in a supportive workshop. He's happy with this, although he could be fine in another job as well. My brother drives himself to work across the Dumbarton Bridge (in Bay Area rush hour traffic!) to work every day. He buys his own groceries and pays his own (thankfully subsidized!) rent. He flys across country to go on vacation. He drives all over California for vacation. Sure, he gets help from a life skills coach and my dad because there are people who will take advantage of him (asshole car repair shops for example.)

So, like jabberjaw I urge to read the article becuase it is not about autism, it's about Donald, a person with autism.
posted by vespabelle at 5:10 PM on September 24, 2010 [12 favorites]

Everyone who has ever spent a significant amount of time with an autistic child has been told that that child doesn't need treatment, just [structure, discipline, organic food, freedom, understanding].

Or that autism is made up by big pharma or people who want to create zombie children (bonus points if they're saying this with a straight face while watching the child in question hit themselves in the head, rock back and forth, and recite lines from last night's episode of Nature)

Oh my good grief yes. Please let's not do that here. I get enough of it from my in-laws.
posted by Daily Alice at 6:26 PM on September 24, 2010

From the article:

Alternatively, we can dispense with the layers of sorrow, and interpret autism as but one more wrinkle in the fabric of humanity. Practically speaking, this does not mean pretending that adults with autism do not need help. But it does mean replacing pity toward them with ambition for them. The key to this view is a recognition that “they” are part of “us,” so that those who don’t have autism are actively rooting for those who do.

Wow. Beautiful. Sorry for participating in the derail, and thanks for posting.
posted by the young rope-rider at 7:08 PM on September 24, 2010 [2 favorites]

after watching the movie MOZART AND THE WHALE, i think the off syndromes apply also in this movie.
posted by tustinrick at 8:17 PM on September 24, 2010

it would be very cool if people could discuss autism without some cynic insisting that much of it is made up - it always seems like there's one person who's just got to express their disgust and skepticism about whether some people are actually autistic

as if it could possibly really matter to them - it's a cheap opinion, cheaply given and tiresome as hell

on medication - my daughter is currently taking risperidone for irritability associated with her autism - it seems to be working pretty well; she hasn't had the major blowups in school she was having 6 months ago
posted by pyramid termite at 8:45 PM on September 24, 2010 [1 favorite]

When the focus is just on giving out pills and labels and there is no accompanying movement towards social change and access to support systems and flexibility in employment/education and all those things? That's bad. Medication isn't bad, mind. But it doesn't fix things. You can't build a house with just nails and no hammers or wood or drywall or whatever. If you're trying to fix the problem with just a tiny subset of the necessary tools, you're going to end up with something deeply broken. There needs to be social support. Flexibility in our education and employment opportunities. Available medical care, available counseling, yes, available medication, for both those who are worst off and those who are only "borderline".

Every "they" is a part of "us", and as a community we can do so much to help other people, whether they're poor or uneducated or non-neurotypical or physically/mentally disabled or just strange or odd or awkward. If we wanted to. Sadly, I'm not sure much of the world does.
posted by gracedissolved at 9:32 AM on September 25, 2010

I'd just like to point out that the Atlantic article is fascinating, beautifully written, detailed, and rather long. It paints a really gorgeous journalistic portrait of a very interesting and unusual person, and it also brings up several excellent and oft-overlooked insights about people with autism (that it is not only a problem which affects children, that community perception and acceptance can have huge positive effects for the long-term outcome of those with ASDs, etc). It is a very good read, very nuanced and obviously well researched, worth taking a little time with in order to fully appreciate. I enjoyed it immensely, and I am thankful to magstheaxe for bringing it to my attention and to the attention of the community here in general.

It does not touch upon the (fraught, sensitive, and tiresomely over-discussed) issues of medication and overdiagnosis in any way whatsoever. Unfortunately, I EAT TAPAS's first comment (delivered a scant fifteen minutes after the posting of the article – maybe I'm just a slow reader) pretty much ruined our chances of having any substantive discussion about anything else. Thanks for that.

If I may liken a front page post to a seed, and the conversation that comes afterward in the thread to the delicate flower which with care and love might grow from it, that comment was essentially the conversational equivalent of coming upon the pale, yellow-green tip of spring's first crocus poking up from beneath the thin blanket of winter's last, melting snow – and then dropping one's trousers, squatting down one one's haunches, and depositing a huge, steaming, lurid pile of of putrid shit right on top of it.
posted by Scientist at 12:42 PM on September 25, 2010 [1 favorite]

Thanks for posting this.
posted by LobsterMitten at 9:39 PM on September 25, 2010

From the article:
Autism is a highly individualized condition. The amount of room the brain makes available for growth and adaptation differs, often dramatically, from one person to the next. One can’t presume that duplicating Donald’s circumstances for others with autism would have the effect of duplicating his results.

Aside from just bringing to light the fact that children with autism grow up, this quote shows another important point of the article, and one that it is crucial that people understand. There is so little information available about autism and its implications (well I guess there is some available, but not necessarily that the general public is aware of) that people hear of one case and think that it is or can be true for all people with autism. Jenny McCarthy's son was cured of autism- mine can be too! (Don't get me started.) Rain man could count toothpicks in a few seconds- all individuals with autism must have a cool special gift probably related to math!, etc.

Sorry, getting off track- anyway, my point in quoting the above text is that Donald's story is beautiful, heartening, encouraging- but it is not the case for all adults with autism. It's this fact that makes it impossible to answer a parent who asks me earnestly, "will my son go to college?" I love that guy Gerhardt (the one that taught them the credit card trick) in the article whose career is "based on people not wanting my job". As someone who works with mostly children and adolescents with autism, it makes me want his job.
posted by chela at 8:14 PM on September 26, 2010

This thread totally has asperger's
posted by tehloki at 4:45 AM on September 27, 2010

...it looks like they're saying that you kid's problem is legitimate...they're dissing on all the other parents who are abusing the system and drawing ire on your kid's condition!
This!
is seriously the Problem with what you are saying. Whoever you are referring to has zero business assessing legitimacy of anything here.

Its become somewhat fashionable for parents to ID their child as "autistic" (perhaps because it gets them extra services, perhaps because being "on the spectrum" also implies that your socially-maladjusted child is also smart) when the child's actual issues should perhaps not be treated through hardcore medication.

-in the world of parents trying to actually get services for their child, a "parental diagnosis"... is not something that is accepted ever; generally diagnoses which get people services require testing that can often run into the thousands of dollars (ESPECIALLY so if the child 'passes' through early years, or is not noticed as a 'problem' early on, or is gifted and coasts through elementary school, or is female).
Getting 'services' is very much not as easy as people seem to often portray it (and again, 'services' does not solely mean medication.
posted by infinite intimation at 3:17 PM on October 1, 2010 [1 favorite]