How do you feel about AS being abolished in the DSM-V?

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now see, that differentiation is something i will be glad to see gone, because for my family, the experience is opposite of yours. my son is also high functioning and highly verbal, but when i say he is classically autistic, the image people get of my son is not accurate. people either, if they havent met him, assume he has issues that he doesnt, or if they have met him, they often refuse to accept that he has classic autism (and sometimes any autism at all). a lot of people ive met have a hard time understanding that a child with a tested IQ that classifies him as smarter than 95% of the population can also be the same child with almost every diagnostic criteria of classic autism and who isnt potty trained at 6 weeks before his 5th birthday.

maybe i am dreaming, but i really do hope this change in the diagnoses will move us towards a time when i dont have to say "but" every time i tell someone about my sons autism. when i dont have to correct peoples false assumptions about my son. when maybe they will try to figure out who he is instead of automatically assigning issues to him because of his autism.

If your son is diagnosed as autistic...which is under ASD, how does removing AS from the DSM impact that?

Concerning verbal abilities, people with AS tend to have high verbal IQ's. There is more to that than talking a lot. However that is not part of the AS diagnostic criteria in the DSM-IV. The DSM-IV requires no clinically significant language delays.

If your son did not meet this then that is probably why he was classified under ASD instead. Some children drift from the lower end of the spectrum to the upper end of the spectrum with age and the right therapy, however I still believe AS is significantly different from HFA neurologically.

as i said in my first post on this thread, my son is officially (and incorrectly) diagnosed AS. and no, overall the change in wording of the diagnosis wont change anything for him, except to remove obstacles at his current school.

his verbal IQ was tested at only 108 while his performance IQ tested at 129. this is opposite of what a lot of AS see and indicative of a language impairment. he does have a severe language impairment, but it is with intelligibility; his expressive and receptive language are fine. the psych who did his testing notated that his lower VIQ is probably impacted by his impairment and that the score will likely raise as his impairment is corrected. he has undergone more testing last month with a neuropsych who thinks he is classically autistic as well, however we havent gotten her diagnosis yet so he is technically still AS at this point. she did some more IQ testing also, and his understanding of language (meanings of words, interpretations, etc) was extremely high, and yet i still had to interpret a lot of his speech for her due to his impairment.

my son does meet the AS criteria of no significant language delay, which i feel is the primary reason he was misdiagnosed AS. he was a little slow in using spoken language, but not significantly so, and it had more to do with his willingness to use them than his ability to do so. i dont think his impairment tho has much of anything to do with autism. i am NT and had an impairment, both of his brothers have/had speech therapy, one for a lisp and the other a severe intelligibility impairment worse than my asd sons.

i dont see a significant difference neurologically between AS and my son. there is probably a bigger difference between most HFA individuals and AS, though. i am very interested in research into the cause of autism, as i think that will tell us so much about the varieties we see on the spectrum. ive been told my son and SO both are rare creatures given their combination of IQ, high functioning, and observable diagnostic criteria, but i have no idea how accurate that is. how rare can that be, i live with two of them every day.

what i want to see is an end to the assumptions that my son should be potty trained because he is officially diagnosed AS, or the assumption that he is cognitively impaired because he is actually classic autism. i dont want to hear that my SO should just go out and get a job and cant be autistic because he is smart enough to have compensated for so many things to have made it 39 years without being diagnosed.

im hoping those things go away. i want them to be seen as individual people, not just as some list of common traits that they dont fulfill anyway. its still going to take decades to rid people of the assumptions based on the old diagnoses, but i hope to see it someday.

I hear what you are saying - but I think the DSM really is about the clinical approach for people who deal with autism. The awareness in the general public is always going to be a struggle, precisely because every person on the spectrum is different (you would think the word "spectrum" would convey this concept.) While I think there is some cause-and-effect between the DSM and the general public (and schools) I think it's not predictable or constant.

However, there is a clear relationship between the DSM criteria and clinical response, which directly affects our kids. Whether this will be for the better or the worse, it's hard to say.

I just wanted to say that I was just speculating when I said that those already diagnosed with AS would have to go and get rediagnosed. What I was thinking was that if a person had a diagnosis of AS and was not receiving services, if there came a point when they needed services, would they have to get a diagnosis of Autism?

Maybe they can come up with something like they have for Diabetes. Maybe there can be a Type 1, Type 2, Type 3 Autism?

This is an interesting point. I really hope this does not happen. It would be a huge step backwards.

My sons are both dxed Aspergers. At school they attend social skills classes with kids who are diagnosed classic autism. Aspergers and autism are already lumped together for the purpose of providing certain services in my community. The humbling thing is, that although my sons are by far the most "normal" in appearance, communication and mannerisms and out of all the boys in their SS group they are the only 2 who have not qualified for funding from the school district for EA's because they are too high functioning, there are many times where they may have the most difficulty with a new concept taught in the social skills class. This is specifically what I meant about it not mattering much to us. The help that they are receiving is already accessed under the autism umbrella and is of similar benefit to them as it is to the other autistic kids. These other children are all high functioning to varying degrees...meaning verbal and attending regular classes with their NT peers. I don't think anyone would advocate for lumping Aspies and HFA kids with LFA kids when it comes to dispensing services, that just wouldn't help anyone, and there is going to have to be some way of distinguishing with the new diagnostic criteria.

Personally, I like the term Aspergers. I can relate to it. The diagnostic criteria fits my sons (and myself as a child) very well. I also really appreciate the Aspie community and sense of identity. I will be sad to see it go.

But like I said, as far as my sons are concerned, I do not think it will make much difference (at least I am hoping it doesn't).

Your son may have an auditory processing disorder in which he can't tell he is not pronouncing his words correctly. Speech therapy usually resolves it.

Will not the new Autism spectrum involve a literal "scale"?

Why would this result in higher-functioning indiviuals being grouped in with lower functioning ones clinically?

Here is what I have seen on the issue.

There is a big push in the DSM to tighten and eleminate diagnosises that do not have alot of drugs to treat it like AS. However digagnoses like bipolar, ocd, Adhd, schizophrenia, and depression which have alot of drugs and new drugs to treat them, the criteria is being loosened, and expanded because alot of those who vote in the DSM panel are influenced by the drug companies with incentives.

Just because they eliminated AS from the new DSM, does not mean that you or your loved one does not have it. It is like a panel decides that the earth is no longer round, that it is flat. This does not make it true. I have AS whether or not they say it is there.

Consider though that the drug companies don't benefit from anything being eliminated from the DSM. With respect to the drug companies, they would theoretically benefit from more things being in the DSM, because there would be more things they could potentially treat.

Still. It's frightening we have to consider corporate motivations at all when discussing revisions of clinical terminology.

Would kids really be expected to go through the whole diagnosis assessments all over again if they had already been diagnosed with AS? Are people aware of how much stress the kids go through for these assessments and how much it affects their confidence every time some so-called professional makes them go through hoops? Understand the schools need to justify the expenditure for extra support but get fed up with constant requests for updated reports that result in hours of assessments and reports.

The DSM is written by the APA which gets 99% of its funding from drug companies. Whether the drugs actually treat the condition is totally irrelevent, all that matters to them is the perception of reality. The amount of high level APA executives serving prision sentaces for research fraud is huge. Most of the research they base the drugs on have been proven in court to have been falisifed and they are often serving very heavy prison sentences for it. There is no research anywhere that can show that any mental illess is caused by a chemical imbalance in the brain and I and many other people are more than willing to be shown some that does. The APA, NAMI and the rest will all tell the truth about that, what they say is that they are still doing research to find the chemicals involved!! They have had these medications in use for over 50 years and still they cannot come up with any research that shows any form of chemical imblance. In fact research shows that people who have brain scans BEFORE they are medicated show NO differences at all to so called "normal" people. Sure medications may help to allevaite some of the symptoms, but they relieve some of the symptoms of the spectrum disorders too. THey do not treat anything as they have nothing to treat.

The difference is many of those on the spectrum do not want to be fixed or cured or the like. That does not mean that they do not need help and suppor to do some things, would not benefit from different therapies and the like but that they are who they are, and want to be loved and accepted for just that, being non typical people. People on the spectrum have been able to vocalise and organise themselves in a way that meets there needs, which many of those in the psychiatric survivor movement have not.

The other reality is that they are just proposals and they do have to be supported by the field trails, but they will design them to say whatever they really want them to say, so it means nothing really. It is a proposal and many people are already acting like it will happen.

I have recently had social workers in the disability sector tell me I cannot be autistic and I must have aspergers because I can speak and am not intellectually disabled!! I cannot expect the average person walking down the street to understand if disability workers cannot!! The other reality is that regardless of diagnosis of any condition every single person is different and every single person requires individualised services and responses. Even if you want to believe in the chemical imbalances for mental illnesses and that the drugs will fix it, WHY does each condition have so many different drugs, all acting on different parts of the brain, all with different chemical combinations in them. The fact is they have so many and some people respond to some, some to all, some to none!! People are different and it is no different no matter what the disorder. Everybody simply needs to be able to have any additional neends met and supported, based on their individual needs, not on a diagnostic label. A label does not and nor will it ever determine what I do or do not need, etc. For some children with autism applied behaviour analysis may be brillant for others it is totaly useless. Speech therapy is useful for some and not for others. We all need to be seen as individuals and for a team of people to support us and the people who love and care for us to work out the best things that are needed for our individual needs. The best social skills training groups and therapies in the world have not been able to teach me any more social skills than I already have, and yet I cannot cope in social situations. It may appear to be the social skills that are lucking as on the surface it is, but if you look underneath at the underlying problems you discover that that is not what I need at all. Unfortunately finding people to support you to look at the real issues and to provide the supports really needed is difficult, people just want to group us into boxes, to tick a box, and say this person needs this, this will fix them, make them normal, more normal or whatever. But the fact is NO human, regardless of condition is that simple. We are all complicated individuals and anything that involves the brain is even more complicated.

This is not entirely true. The APA gets roughly 16.9% of it's funding from membership dues and fees, 27.7% from journal subscriptions, 15% from licensing and royalties, 11.5% from direct sales, and 23% from other sources which seems to be interest from bonds. If they were receiving 99% of their funding from drug companies, it would be through these venues and not directly. The APA and drug companies used to offer joint scholarships and grants to students, which isn't unusual in academia. They also used to allow drug companies to sponsor dinners and continuing education events, which also isn't unusual in academia, but no longer allow them to do so.Their financial information in available online and they typically have non zero net losses.



I can't find any sources for this. Can you please post them?



I can't find much on this either. Most of the breach of ethics I know of surrounding psych drugs is concerning coverup of Paxil withdrawl, and SSRI's causing emotional instability in children and teenagers.



I partially disagree. How we think and feel and perceive is ultimately controlled by the structure, composition, and biochemistry of our brain. Perhaps chemical "imbalance" is not the best term or concept to represent mental illness, however you will certainly find different chemical concentrations and usage in the brain of someone who is bi-polar as opposed to the brain of someone who is not. But the chemical "imbalance" is not the root cause. The root cause is likely structural or metabolic or both.

The brain is not an enigma that operates by magic.



There are certainly studies that show differences in brain structure and functioning for disorders such as OCD, schizophrenia and bi-polar disorders.Can you prove that all of the individuals in these studies have been medicated at some point in their lives? I've not seen much mentioning either way, unless the person was on medication at the time of the study.

They are doing research to form a better understood model of the brain and the various disorders of it, and much of this research was only able to commence very recently with the advent of technology. You must remember that as early as the 1950's there was very in the way of means of examining a functioning brain, and the development of medication hinges on technology that helps researchers better understand how the brain works. Much of today's imaging technology relies heavily on software to improve on that which hardware technology cannot. This generally centers around better filtering and rendering algorithms which I can promise get incredibly complex and otherworldly to even some of the people who work on them.



If they alleviate symptoms of something with positive outcomes, they are treating it.



But I can promise you most people with OCD, bi-polar disorder, clinical depression, schizophrenia, and tourette's do want to be cured.



This is quite common I'm afraid and I have certainly run into my fair share of mental health workers who were not properly educated on certain issues. You must understand, in academics, a person may only be introduced to certain subjects in a topical manner, without any deep study. The subject may have been chapter 5.6 and composed of no more than a page and a half of the book they were learning from, for example. Frequently, descriptions will be narrow, and the person will go out into the field with little real life experience with individuals with such disorders.

You may have seen me rant about mental health workers...psychologists and counselors, not being able to differentiate OCD from perfectionism or irksome quarks. I occasionally come across someone who has been told they have OCD, when on further investigation, all they had was a mental health worker who was not qualified to tell them whether or not they had OCD because the person clearly didn't know what OCD was.



Yes, but some individuals are different in very specific like ways because they share similar unusual aspects of neurological anatomy.

This is why people with OCD generally focus on the same categories of things. This is why people with Williams Syndrome like music. This is why people with AS are often called "little professors" as children and so on.

Even if you want to believe in the chemical imbalances for mental illnesses and that the drugs will fix it, WHY does each condition have so many different drugs, all acting on different parts of the brain, all with different chemical combinations in them. The fact is they have so many and some people respond to some, some to all, some to none!! [/quote]

Most drugs of the same class effect the brain in very similar ways to eachother. But you are correct in that everyone is slightly different. Different people metabolize things in slightly different ways. Different people have different types of cell docking cites. Different people will have variations in wiring. But this is no different than drugs for anything else. There are different blood pressure drugs, different cholesterol drugs, tylenol, aspirin, advil and so on.





Yep. The brain is very complicated, so it's actually quite amazing that there are drugs that are at least partially successful at treating neuropsychiatric disorders at all.

My son is diagnosed with both AS and a Disorder of Written Expression, both of which are diagnoses proposed to be subsumed into less-precise blanket diagnoses ("Autism Spectrum Disorder" and "Learning Disabilities", respectively). I am deeply concerned about this, as I believe that the purpose of obtaining a diagnosis should be to guide intervention and treatment, and I fail to see how eliminating the diagnostic distinctions between these disorders will do anything to increase our ability to accurately target interventions and guide treatment decisions.

It appears that rather than being driven by an assessment of what makes sense from a clinical and therapeutic perspective, the revision may be, in these particular instances, driven by the ways in which the Federal laws governing special education services are written and applied. I don't think it is coincidental that two of the thirteen categories under which children can be determined to be eligible for special education services are "Autism" and "Learning Disabilities", and that for purposes of eligibility (and therefore funding), no further differentiation is required. This seems to me to be case of the tail wagging the dog, aligning diagnostic standards with legal eligibility standards, instead of doing it the other way around.