Autism after 18: not in Latvia?

The parents of several children on the autism spectrum have encountered a situation that when the child comes of age, the diagnosis is changed. Parents raised the alarm over this because it makes it difficult to receive help, which is already very limited for such people, Latvian Television reported on July 30.

Lilija noticed early on that the behavior of the youngest of her two children was different. At the age of three, the boy was diagnosed with autism spectrum disorder outside Latvia.

“Then, as a teenager he passed a special test ADOS with a certified psychologist who confirmed the autism spectrum disorder [...] But reaching the age of 18, that diagnosis vanished. At first, 'mental retardation' appeared. Now a different one,” Lilija said.

The son is currently 25 years old. In contact with other parents whose children also have autism, Lilija discovered that the situation was identical: coming of age, the autism spectrum disorder is transformed into schizophrenia or other diagnoses.

It was also confirmed by Diāna Mekša, head of the association “Solis augšup” (Step Up). The problem crystallized at a time when Diāna, along with other parents, tried looking for ways to create a service for assistance for adults with autism. 

The president of the Association of Psychiatrists, Māris Taube, pointed out that such a diagnosis is also applicable to adults, and should not simply disappear or change without justification.

“In Soviet times, it was thought that autism, when [the person] grows up, was turning into schizophrenia frequently. Now the beliefs are changing. Psychiatry is a dynamic thing, we have congresses, conferences, classifications change,” Taube said.

He stressed that if someone changes the diagnosis of autism, it should be rare, rather an exceptional case, but it should not happen as often as he has learned at the moment, prompted by LTV.

The autism association has stated that in some cases, the diagnosis is also changed by parental pressure, since for example, patients with other diagnoses may have higher state reimbursement for purchasing medicines. However, such a situation cannot be accepted.

Taube promised to talk to doctors again about the fact that autism in adults remains and this diagnosis cannot be lost anywhere: “Yes, we will talk or hold a separate conference as an association, let us stress again, we will do it.”

Lilija said that she would not mind adding to her son's diagnosis if other issues developed during his life, but it is important not to remove the existing ones – it changes the treatment plan, but inappropriate treatment makes the patient feel worse.

The Ministry of Health declined to comment on the situation in person, but said in a written response that the diagnosis should also be maintained in adults. The ministry added that pay conditions are currently being improved to pay for psychological health measures for adult patients with a diagnosis of autism spectrum disorders.

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