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MrXxx
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05 Apr 2012, 4:00 pm

alongfortheride wrote:
I never said he was diagnosed AS. He was diagnosed PDD-NOS.


Oh, sorry. :oops:

That is different. The comparison of those two wouldn't apply then.

Yeah, there probably will be some PDD-NOS diagnoses that will not qualify for ASD. That's because there is no criteria list for PDD-NOS, and the profession and the public have long had a problem with that.

Quote:
Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism)

This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction associated with impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behavior, interests, and activities, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes “atypical autism”—presentations that do not meet the criteria for Autistic Disorder because of late age at onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

LINK


Basically all this means is that if the doctor strongly feels it's Autism, but it doesn't fit into any of the other Autistic categories, this is what they can use. It leaves the door wide open to very opinionated diagnoses without any specific criteria.

A lot of professionals have had a problem with the existence of PDD-NOS because there really isn't any clear definition or guidelines for it.

"I think it's Autism, but it doesn't fit all the criteria for any of these, so let's just say it's PDD-NOS," is pretty much all it takes right now to apply it. That is a problem.


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05 Apr 2012, 4:01 pm

MrXxx wrote:
I very curious about something. There is quite a lot of negative talk about what will happen once DSM-V becomes affective. I'm wondering how many of the nay-sayers that are so dead set against it have actually spoken to a professional about it to see if they agree.

All the professionals I've talked to about it so far, feel that DSM-V will include pretty much everyone that now qualifies for Asperger Syndrome. They're the ones doing the diagnoses. It seems to me to stand to reason that if they think it's not going to change much of anything but the actual labels, that's probably true.

I guess this was my point in posting in the first place. I felt relieved after talking with a professional who I trust and hearing his positive opinion. He is a staunch advocate for autistic people. I can understand why it is scary because we don't KNOW what effects the outcome will have but I feel better now than I have since I first learned that the criteria were going to be changed.



MrXxx
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05 Apr 2012, 4:03 pm

MomofThree1975 wrote:
I thought the diff with Asperger's and Autism is that Aperger has normal or early language development?


That is the major and most obvious difference, yes. DSM-V does away with that. Delayed or early language development will both qualify for ASD, but I believe that criteria may come into the severity levels. There are severity levels in DSM-V, rather than different diagnoses.


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MMJMOM
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05 Apr 2012, 5:09 pm

YEP! Aspergers criteria is also average to above ave intelligence, autism and PDD-NOS dont have to meet that criteria either. Of course many kids with Autism and PDD-NOS are ave to above ave intelligence, but that criteria doesnt have to be met for their diagnosis as it does in Aspergers!

For the speech criteria, a case like my son ,born with a cleft lip and palate, who was speech impaired due to the cleft, it raises a good point that not all kids who are speech delayed cant be Aspergers diagnosed. I LOVE that the speech before 2 criteria is taken out of the DSM-V. My son DID have speech all along, just a bit delayed due to cleft issues. He cought up brilliantly with therapy and surgeries to repair his cleft.


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M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


MMJMOM
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05 Apr 2012, 5:15 pm

OddDuckNash99 wrote:
The DSM-V is going to be an utter abomination of practically every neuropsych disorder/category. Removing AS before we properly study it is just shameful. I feel that DSM-V is going to make ASDs even more overdiagnosed than they are right now. Everyone says the criteria is going to be more stringent, but I highly doubt that the diagnoses will decrease. The criteria are going to be such a broad, unspecific bunch of nonsense, and this seems to be the trend with ALL categories of disorders in the DSM-V.

I'm also greatly unhappy about them categorizing ASDs as "neurodevelopmental disorders" in the DSM-V. EVERY single DSM diagnosis is a result of some sort of improper neurological development. This new label is making it look like ASDs and Tourette's and ADHD are there from birth and other psych disorders are not. It's going to create more stigma for disorders that don't fully show up until young adulthood, such as schizophrenia. It's just going to make it look like it's not someone's "fault" for having an ASD, but it IS someone's fault for having bipolar disorder or schizophrenia or another "mental illness."

Finally, doing away with the distinction of HFA vs. AS is a terrible idea at this point in time. I am a strong believer that there is not enough evidence that AS is TRULY a form of autism and not a form of NVLD. And even if AS is a form of autism, why is there no speech delay in AS? A speech delay in one but not the other says that SOMETHING is different about AS and HFA brains, and the fact that these differences aren't being looked at before AS will be thrown away is a travesty, in my opinion.


In AS there is a pragmatic speech defecit, so there is a speech issue it is just in pragmatics.


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J- 8, diagnosed Aspergers and ADHD possible learning disability due to porcessing speed, born with a cleft lip and palate.
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M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


OddDuckNash99
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06 Apr 2012, 6:57 am

MMJMOM wrote:
In AS there is a pragmatic speech defecit, so there is a speech issue it is just in pragmatics.

I am well aware of this, but it still doesn't explain the obvious neurological differences between why AS children speak on time (and often precociously) and why HFA children do not speak until age 3 or later. Pragmatics of speech is not the same in the brain as actually producing speech.


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MMJMOM
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06 Apr 2012, 9:05 am

I guess if we knew that we would be rich...lol. I also know plenty of PDD NOS and HFA kids that did speak as toddlers. I think more then having speech, is using it socailly and to get needs and wants met.

Also, thats probably why they are getting rid of the age and just saying early childhood speech development.


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Dara, mom to my beautiful kids:
J- 8, diagnosed Aspergers and ADHD possible learning disability due to porcessing speed, born with a cleft lip and palate.
M- 5
M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


zette
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06 Apr 2012, 12:27 pm

OddDuckNash99 wrote:
MMJMOM wrote:
In AS there is a pragmatic speech defecit, so there is a speech issue it is just in pragmatics.

I am well aware of this, but it still doesn't explain the obvious neurological differences between why AS children speak on time (and often precociously) and why HFA children do not speak until age 3 or later. Pragmatics of speech is not the same in the brain as actually producing speech.


There isn't that clear of a dividing line between where HFA ends and AS starts. For instance, how do you classify the language delay of my son, who had two word combos at 25 months, but then did not move beyond 3 word combos until we payed for speech therapy at 32 months? Technically this is classified as "not clinically significant". He had at least a hundred words and was able and interested in communicating his desires (such as to see the workings of the toilet.) At age 6 it seems his thoughts run far too fast for his speech to catch up -- it's often painful to wait for him to get through a sentence as he keeps repeating part of a phrase, trying to get the words to come out.

DS also has mild delays in motor skills, mild sensory issues, social delays, and ADHD/executive function issues. He definitely fits better with the current AS criteria than classic autism, although the fixed interests and repetitive behaviors were a bit of a stretch. I'm not sure under the new criteria whether he will be able to meet two items for "repetitive behaviors and restricted interests" required for Austism 1. At the same time, Social Communication Disorder + ADHD does not capture the motor, sensory, and speech production issues.



MrXxx
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06 Apr 2012, 7:58 pm

Bombaloo wrote:
MrXxx wrote:
I very curious about something. There is quite a lot of negative talk about what will happen once DSM-V becomes affective. I'm wondering how many of the nay-sayers that are so dead set against it have actually spoken to a professional about it to see if they agree.

All the professionals I've talked to about it so far, feel that DSM-V will include pretty much everyone that now qualifies for Asperger Syndrome. They're the ones doing the diagnoses. It seems to me to stand to reason that if they think it's not going to change much of anything but the actual labels, that's probably true.

I guess this was my point in posting in the first place. I felt relieved after talking with a professional who I trust and hearing his positive opinion. He is a staunch advocate for autistic people. I can understand why it is scary because we don't KNOW what effects the outcome will have but I feel better now than I have since I first learned that the criteria were going to be changed.


This is interesting, because there is a recent post in General Autism forum right now that tells a very different story, but it's from a user in Australia. The OP in that thread says they've spoken to several professionals who all feel the opposite. I've got to wonder if it's because there is something very different going on there.


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DenvrDave
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07 Apr 2012, 12:09 am

This:

MomofThree1975 wrote:
The only label I care about is the label that gives me the most services.



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07 Apr 2012, 6:42 am

and here in NY, that is the district classifying your child with AUTISM. My district flat out refused to classify my son with Autism, despite his psychiatrist stating it is medically necessary due to his Aspergers and the isues that comes along with it. The district can decide what classification to give your child. Basically, they told me that my son is way too high functioning to get the Autism classification. Amongst a slew of other rediculous reasons, such as, I dont want people to read the IEP and think my child is Autistic, yep they said that ot me! Other then a diagnosis of classic Autism, they dont have to classify Aspergers or PDD-NOS as Autism either. We have numerous freinds in all different districts with the same issues, they are usually classified Other Health Impaierd(OHI). My son is classified Speech Impaired right now casue he gets speech due to his cleft, butt he Chairperson wanted to change the classification to OHI when he got diagnosed Aspergers. Autism diagnosis guarantees your child a certain amount of speech per week, as well as Autism consultant and parent trainer. It costs the districts MORE $ and they dont want to give it. SO, those of us with Aspergers kids or PDD NOS, they dont HAVE to classify them with Autism, which gives the most services.


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J- 8, diagnosed Aspergers and ADHD possible learning disability due to porcessing speed, born with a cleft lip and palate.
M- 5
M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


alongfortheride
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07 Apr 2012, 8:04 am

MMJMOM -- We had the same issue. Our son, with PDD-NOS diagnosed privately in January, qualified for nothing at all other than accommodations. He is too successful. Carries a 3.8 GPA so flat out denied an IEP for no academic need. Not considered autistic by their check lists. He passed their speech tests easily, but cannot initiate a social conversation 90% of the time and does not ask social questions of others at all. They ignored my bringing in a social communications list that showed his areas of clear deficits. I was able to check of 2/3 of them as applying to him. We will have to do it privately. He hadn't gotten together with his only friend in 8-9 months, but he sits with other kids at lunch so they considered him okay. He is too high functioning for the AS high functioning social skills group in the schools so that is another thing we pay for and do privately since he needs it. Finally got a 504 last week and a school counselor willing to listen and work with him a bit (1-2x a month), but the social worker who is more experienced with ASD kids will give him no help since he doesn't qualify for an IEP. Very frustrating. HIgh functioning kids can and do get shoved under the rug.



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07 Apr 2012, 9:14 am

alongforthe ride:

Agreed, this is partly why I hoomeschool my son. The district DID give social skills group casue I was causing a stink about the classificaton, and the chairperson asked what services I felt he needed that he would get under the Autism classification, so I said soial skills group, and he gave it to us. 2x a week. WELL day one of group, the social worker came to me and said she absolutely didnt see aspergers in my son, she saidthis BECASUE he walked into the group room, and took over the group. She told me he practically ran the group and this was the first time he was with any of these kids. There were 3 other kids, and him and the social worker. Consequently, she reccomended a stopping social group for him next year as she stated he has no issues socailly in that group room. That is all they care about.

First of all, he walked in and ran the group, can you say contorl issues? That is a HUGE part of our problems. My son is fine if he is in control, calling the shots, etc...but not all of life can you take over.

They also told me becasue my sons academic scores were, in some areas in the superior range, he absolutely wouldnt qualify for anything. The only reason he has an IEP is becasue of his cleft palate issues with articulation, he gets speech.

So yes, the high functioning kids already get swept under the rug. I hear this same scenario for HF kids with PDD NOS as well.


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Dara, mom to my beautiful kids:
J- 8, diagnosed Aspergers and ADHD possible learning disability due to porcessing speed, born with a cleft lip and palate.
M- 5
M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


zette
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07 Apr 2012, 9:45 am

I wonder if these school districts and govt groups will start saying that autism 1 doesn't get services, only autism 2 and 3?



MMJMOM
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07 Apr 2012, 10:28 am

that is possible, I am sure they will have a way around that. Although it says with support...but I guess the term "support" is subjective. How much support?


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Dara, mom to my beautiful kids:
J- 8, diagnosed Aspergers and ADHD possible learning disability due to porcessing speed, born with a cleft lip and palate.
M- 5
M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


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07 Apr 2012, 3:07 pm

The speech impairment is a delay in spoken language for communication without compensation using gesture or mime for communication. The key is for communication. In autism, both Asperger's and Kanner's, there is a general communication delay that goes from total lack of verbal+non-verbal communication to not enough communication to meet basic needs like mommy I need to go to the bathroom to not enough communication to meet social demands, like a conversation with parents. For children of a certain age, say five, there is a spectrum of communication impairments within the autism spectrum, and children diagnosed with Asperger's often have communication problems, such as not being to have a simple back and forth conversation that is natural for NT children or not being able to tell what happened at school or not being to initiate communicate spontaneously without very specific questioning, even if these particular autistic children spoke single non-echoed words like "bye-bye" by age two and used communicative phrases like "I eat cake" by age three.

In Kanner's, the speech delay is not as clear cut as no spoken words at all by a certain age or the totally non-verbal child. A child might be able to speak words just fine, but can only do it as echolalia, which you can do for animal noises or words, it doesn't matter, you're just making the noises that you hear, not communicating. Or once you learn to put single words into sentences, you might only be able to say a sentence for communication when you really need to, as in a crisis situation, but be non-verbal almost all the time. That would be because the idear of communication does not occur to you regularly, so you can only think of it when you really need to communicate something, at which time you are suddenly able to speak in a way that people thought that you couldn't speak, and you go back to normal-for-you afterwards. For some children, it is clear that they cannot speak words. For some children, it is not clear whether they cannot or donot speak words, cannot or donot speak words without echoing, cannot or donot speak words for communication, cannot or donot put words together into phrases for communication, or donot speak or gesture at all due to lacking a communication instinct and not knowing what own or others' speaking or gesturing means. What you see on the outside is a non-verbal child, but it is unclear what is going on inside, and not being able to make speech is not the whole story.