The Autism Mountain

 The so-called autism epidemic has been sold to the public as an unprecedented surge in children afflicted with a mysterious condition. In reality, it is an epidemic created by psychiatry itself. The numbers rose not because millions of children suddenly lost the ability to function in society, but because diagnostic boundaries were quietly expanded.

Dr Allen Frances, the psychiatrist who chaired the DSM-IV task force, has been unusually candid. He later said his “biggest DSM-IV regret” was that “our broadening the autism definition … led to such massive, careless over-diagnosis” (Allen Frances, Twitter, April 2023). In another interview he admitted he was “very sorry for helping to lower the diagnosis bar” (New York Post, April 24 2023). When the architect of the system admits diagnostic inflation—not hidden disease—is to blame, the foundations of the narrative begin to collapse.

Families have been trapped in this narrative for decades. They were not villains. They were misled. A child with sensitivities to sound, difficulty sitting still, or trouble making friends was suddenly said to be “on the spectrum.” Parents were encouraged to accept the label as scientific truth. And once that label was applied, an industry stood ready to sell services, interventions, and treatments. Applied Behaviour Analysis (ABA) became the flagship product. Marketed as the “only evidence-based treatment,” ABA was funded by governments, written into policy, and enforced in schools. Behind the slogans, it taught compliance, extinguished individuality, and often left lasting harm. Many autistic self-advocates have described ABA as abusive.

At the same time, it is crucial not to deny that real learning disabilities exist. Conditions such as dyspraxia, apraxia, dysphagia, dyscalculia, dyslexia, and other developmental challenges are genuine and can create serious difficulties in daily life. These conditions need recognition and support. But they require tailored responses—speech therapy, occupational therapy, physical therapy—not a blanket autism label. Folding every difference into “autism” blurs the reality of those struggles and dilutes the help people actually need.

This is how a market sustains itself. Once a diagnosis becomes currency, schools need it to justify funding, providers need it to secure contracts, and pharmaceutical companies need it to sell drugs. Psychiatry’s initial misjudgment metastasized into a self-sustaining economy.

The pattern is familiar. We have seen diagnostic inflation before. Homosexuality was once classified as a mental illness. Multiple Personality Disorder filled clinics in the 1980s before collapsing under the weight of its own excesses. “Recovered memory” therapy destroyed lives before being discredited in court. Even the chemical imbalance theory of depression, once repeated as fact, has been quietly abandoned by researchers who now admit the evidence was never there.

Frances himself warned during the DSM-5 debates that the process risked creating “false epidemics” through “soaring ambition and weak methodology” (Allen Frances, DSM-5 commentary, 2010). He has continued to describe the current surge in autism as a “false epidemic.”

The autism bubble is held up by the same scaffolding. And the resistance to questioning it will be fierce.

First, the money. ABA providers, diagnostic services, and pharmaceutical companies have billions invested in keeping the label alive. They will lobby, fund awareness campaigns, and publish friendly research.

Second, the shield of compassion. Critics will be accused of cruelty: “You are invalidating autistic people’s lived experience.” It is a rhetorical trap. The real question is whether the label itself helps or harms.

Simple preferences, sensitivities and or trauma are not autism- so very many things are simply not.  The authorities do know this. 

Third, the inertia of academia. Universities trained a generation of professionals in the autism framework. Few professors will admit they spent careers teaching a mistake. Counter-articles will appear, wrapped in jargon, to protect reputations.

Fourth, the emotional hold on parents. For some families, walking away from the diagnosis feels like admitting they were duped. Service providers know this, and they will weaponize it: “Don’t let anyone shame you for seeking help.”

Fifth, diagnostic creep. Even if autism diagnoses decline, new categories will appear: sensory processing disorder, social communication disorder, pragmatic language impairment. The system does not shrink; it morphs.

Finally, the law. In courts and tribunals, lawyers will argue that withholding a label or therapy is negligence. Councils and schools, fearing liability, will keep pressing for diagnoses.

These defenses are predictable. They can be pre-empted. The financial motive must be named first: this is not about children, it is about an industry. The compassion shield must be pierced: no one denies that people struggle, but struggle does not equal autism. Parent guilt must be lifted: the guilt belongs to the sellers, not the buyers. Diagnostic creep must be exposed as a shell game. And the legal fear must be inverted: what is truly negligent is forcing children into unproven and harmful interventions.

History suggests how this ends. Manias collapse not when insiders whisper doubts, but when the public hears them. Once the mainstream hears that the “autism epidemic” was built on expanded criteria, and that the man who wrote the manual admits it, the authority of psychiatry is punctured. Media outlets love the story of a lie exposed. Politicians, wary of wasting money, begin to retreat. And what once looked like settled science becomes yesterday’s scandal.

This is not to say there are no children in need. There are, and always will be. But their struggles are varied: learning disabilities, sensory differences, trauma, attention problems, immune issues. To funnel all of this into a single word—and then build an empire on it—is not medicine. It is commerce.

The collapse will not happen all at once. It will follow the familiar arc. At first, resistance. Then doubt. Then scandal. And then silence, as the industry moves on to its next invention.

The autism epidemic is not a surge in broken children. It is a surge in broken diagnostics, amplified by money, fear, and misplaced trust. The sooner we see it for what it is, the sooner families can be freed from a system that was never designed to heal them.

Liz Lucy Robillard