Is self-diagnosis reliable?

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It is, since most children with AS have glaringly obvious deficits in especially the areas of self-help skills and adaptive behaviour for reasons other than their special interest, but that's again another topic than the original one. Also, impaired imaginative play that is a symptom of autistic disorder is also often present in children with AS.

Anyway, changing topic ever so slightly is confusing if it only relates to the original topic in a different context. Or is that a post that is addressed at no one and not relating to the recent discussion?

Sora: You said "AS as defined by DSM-IV-TR and AS is not arbitrary in how it relates to classical autism. I'm trying to figure out how anyone who met criteria for classical autism can now meet criteria for AS and I can come up with no plausible possibility actually. "

I was trying to explain that not only is it a plausible possibility, it is a regularly occurring issue. The creation of the Asperger Syndrome designation has lead to it being applied to anybody autistic-like who has speech. Kids designated classical autistic because of late speech are later developing speech and having the classical autism label dropped and be replaced by an Asperger Syndrome label. The doctor that originally promoted the exploration of Hans Asperger's research to clinicians in 1981 has always argued that they were one and the same condition and the separation was arbitrary to begin with. She, Wing is her name, has gone on to explain that the creation of this artificial divide always has and continues to cloud and block the furtherance of understanding and treatment.

The article I referenced in particular concludes that post adolescent support needs of the two groups are defined more by the intellectual level of the individuals than by diagnosis, yet the decision on whether or not support services are qualified for depends on autistic versus asperger diagnosis, with asperger diagnosis being grounds to deny the support services.

I see. You're talking about how AS should defined, but I was talking about current definitions as a response that you said that you would be diagnosed with AS today.

AS as defined by the criteria of both the current versions of DSM and ICD (since we do not have definition by cause right now) isn't arbitrary because either you meet it or you don't and may meet criteria of classical autism. There's a very clear explanation on when to apply which label.

I didn't go into whether that's a sensible line drawn between the two or not and whether current AS and classical autism are valid or correct or arbitrarily defined.

About that then, whether it's AS as well as classical/HFA are arbitrary definitions because the group that receive these diagnoses is so heterogeneous -

yes, I agree the current definition lacks in preciseness and should be changed as soon as there's a more precise definition by which to diagnose those with such PDDs!

I'm totally affected by this imprecise and incorrect classification myself, it's horrible.

Sounds like me. I appear mostly quite normal and I had only ever read about basic autism and although I recognized a lot of myself in that, I knew that I wasn't autistic to the degree it was explained so I dismissed the idea. It was shocking for me to read about Asperger's Syndrome and see myself on the spectrum. Horrid.

You had previously made it very difficult to know exactly what that point is, despite my asking several times. You have now given an answer. It seems that you took the discussion in a completely different direction but didn't bother to check to see if I followed along.


I am neither attacking your person nor your writing style. I am questioning your debating style.
The "spouting rhetoric" comment was targeted to what I perceived as you engaging in a straw man argument to bolster your position. The "spouting" part refers to what I perceived to be completely irrelevant comments and/or truisms unrelated to the point I thought you were making. It appears, however, that you were making a completely different point.

Let's back up here pre-rabbit hole and go back to my original point:


I believe you then made the point that the label itself isn't the problem, and that the world's perception of the label is the problem (I am paraphrasing here; feel free to correct). So let me clarify the context in which I was imagining this statement to be applicable.

I was mostly referring to children being diagnosed with an ASD when it was not at all certain they needed professional help with coping and adapting. You have indicated that the spectrum butts up against NT, and I agree with that. So then, technically someone who is on the spectrum very mildly may not need this help at all. If they don't need help, I'm arguing that in fact they have been misdiagnosed with a disorder (that's the D in ASD, after all).

How you make the determination about when a child needs professional help is going to be an individual call, one that the parents need to make. It's going to have to do with their perception of their child's overall well being over a period of time. There is no hard-and-fast rule about when it is appropriate. However, once a person has been diagnosed, it is hard reality that the world is generally neither understanding nor accepting of ASDs. Let's work to change that in whatever way possible, but it will take time.

In the mean time, the effect on a developing child's self-confidence can be very detrimental. Instead of accepting themselves for being the way they are, they are given subtle cues from society around them to lower their expectations for achievement. Also, given an ASD diagnosis in school means that some programs or teachers may apply teaching techniques inappropriate to the child, and that can be very detrimental to the child's well being. There are many here that can describe this situation better than I can. Again, this isn't a problem with the label itself; it's the current fallout from having a label.

To clarify, my point has little to do with self-diagnosis vs. professional diagnosis. Please let me know if I misrepresented you in any way.

I always knew about AS virtually all my friends have it! I found out alot more about is though when we read a book on it in English, and was surprised about the predudeces some people have against those who have it. And through reading lots of stuff, doing many online tests, everything pointed to me having AS, quite mildly though. Another thing I have noticed about AS is that alot of the people with it that I have seen seem to be obsessive compulsive, I know I am, and I notice numerous instances of drumming on the table etc. and when I inquired about OC and autism and he confessed about strange rituals he used to do when he was younger. I apologise for the inordiantly long post, but as you can see I'm getting carried away and am now "Rabbiting on" as my dad endearingly calls it, or not...

This sums up my experience completely.

What criteria were unlikely to be met given a strict interpretation and what does a strict interpretation entail?

I believe our best diagnosis is made by ourselves.

A very good way of doing it is reading what we write at the wrong planet, you will feel if you are one of us or not.

By the other way, a medical diagnosis sounds as ... a kind of revealling... or a veredictum... we won't, probably, be strong enough, or mature enough, to deny the sacred words of a specialist, even if he knows much less than us about the subject.

Well, I am sure you will soon have no doubt about being, or not, one of us.

Welcome!

This is getting plain ridiculous. The argument that has been put forward by Wing for nearly 30 years is that Autism is Autism is Autism, PDD is PDD, they are ONE, SINGULAR medical condition that has a RANGE of impacts on individuals relating to the individual. She based this argument on the study of the work of Kanner and Asperger which was published in 1943 and 1944, and the inclusion of studies of the work of Emanuel Miller who was a third phychiatrist in the same time frame as Kanner and Asperger who recognized the same autistic traits in children and adults supports this view as well.

fMRI and EEG studies have continued to support this view. A major criticism of the DSM criteria introduced in version IV in 1994 was that, strictly followed, an individual should ALWAYS be diagnosed with autism and not asperger because asperger syndrome requires the individual meet the description of autism first, and no further diagnosis beyond that is useful or necessary. This is not MY argument, this is the driving argument behind the next set of changes expected to be incorporated into DSM V. If you have access to a medical lit search, I could suggest six different articles referenced in support of this idea and the years they were published range from 1995 to 2001.

The argument that has been put forward by Wing and colleagues, which I agree with based on my understanding of the evidence as presented, is that this continued separation has been a prime motivating factor in the ongoing misunderstanding of what Autism is and what it means to those diagnosed as within the spectrum. Wing suggests that the first step to resolving some of these problems is to recognize that which is medically true and always has been, that autism is one medical condition with a spectrum representing the range of possible patient outcomes.

If clinicians refuse to recognize a medical fact, then as the ones that live and breathe that medical fact we have a responsibilty to self-advocate and self-diagnosis in a proper manner. If politics are holding back proper medical treatment, we can establish good science practices on our own and encourage professionals to pull their heads out of the sand and catch up with modern knowledge. Recent studies suggest there are more than five hundred thousand children with autism in the united states, and there are even more adults. They have a clear, medically demonstrated physiological condition that causes extreme stress throughout their lives because they might appear outwardly intelligent but they have a language disorder that leads to confusions in communication without either party being aware.

We have identified useful ways to help these individuals cope, but that outward intelligence continues to result in disenfranchisement because it is assumed they should know better and are just being lazy. People get all bent out of shape because they think people are self-diagnosing with Autism all willy-nilly but the studies suggest a rate in my country of 1 in 150 being born autistic if not more. The average class size in our schools is about 35 kids, meaning in every 5 classrooms in america, there is one autistic child. Most of those children are being told they are just normal kids who have a discipline problem. That they are just lazy, inconsiderate, have no empathy, that they are jerks. Autistic individuals have likely been told these things since the first one was born. There was a time when you could just move away from society when it became too much, but where do you go today? The system is too large for us to just go hide from, so we have to take a stand and be recognized as humans with human rights like any other.

I cannot speak for everyone, but we were pretty accurate with self-diagnoses here. Now we have the best diagnoses that money can buy .... and I miss the money.

http://www.springerlink.com/content/l15514241h4p3602/

Appeal to authority is: You don't have AS because you don't have {some symptom that isn't a part of the disorder}, and if you question me, you're wrong because I'm the expert!

An analogy, you would assume that a pilot who has his piloting license will be qualified to fly the planes he is approved to fly? It's a given, as probability stipulates that the pilot with the qualifications will know how to fly that which he is qualified for. We rely on experts to know more than "us" in their field, for we can't know everything and we don't go through the training they do.

I'd much rather a person qualified to fly fly me somewhere than someone who claims to know how to fly; probability, you see? Hence, a given.

(Naturally, nothing is certain. And people need to prove that they are experts in their field if they state they are.)

O, and yes, you can say that my analogy is a fallacy, but it only is without questioning the validity of someone's expertise; one should always question the claims people make.

That only applies to children who were three years old or less at the time of the diagnosis (The onset of the conditions in section B. of the DSM-IV section on autism) or those who had a diagnosis based on recording video of their interactions at that age, which is certainly something that should be addressed, but not exactly a huge sample of the spectrum as a whole. Children and adults who did not exhibit the behavior in section B. of the autism diagnostic criteria would almost certainly be classified as having asperger's regardless of the language impairments mentioned in the abstract. While I think it'd be a good idea to clean up and further refine the diagnostic criteria, that may not be possible at this time, and for now it may simply depend on whether or not a child exhibited the behavior described in section B. before three years of age.

Daniel: Medical profesionals are assumed to have knowledge of medicine. They have authority there. To claim that they are right because they are regarded as an authority, rather then to demonstrate the rightness of what they claim to demonstrate how they are an authority, is an argument from authority or appeal to authority. You didn't argue the merits of my specific instances in which I was disagreeing with the common stance of the authority, you simply said well they are professionals, clearly they would know the way in which it physically manifests. I have presented specific evidence from the same authoritative professional group demonstrating that there is clearly contention within the group, and I presented specific evidence I feel supports one side over the other.

yesplease: The point of the study I linked and the 5 other studies it makes reference to in the abstract is that the diagnostic criteria creates a divide based on criteria that does not fit the progression of actual patients, and it has lead to a situation where no two doctors are applying the criteria in the same way, because they are all actually autistic individuals and there is no clinical basis for an Asperger Syndrome designation. What stage they are at in development at the time they are first diagnosed is what is setting the tone for how far they are expected to develop because it is preventing them from being given proper support if they are seen as "too high functioning".

What special factor are you saying changes this if you only look at a group that was diagnosed after the age of three?

I didn't read your instances, as that's not related to my argument; it doesn't matter what disorder or professional we're speaking of. It needs to be taken case by case with the individual (which is out of the scope of this discussion if you don't name a certain individual who will assess you); there's no point in discussing the merits of the DSM-IV-TR if the professional in question uses Gilberg's Criteria for AS, for example. My point is, with some critical thinking over the merits of the professional in question and their expertise in their domain, one can safely conclude that they're reasonably able to do what they say they can. An appeal to authority wouldn't include this, it'd just say to trust someone who holds authority blindly, which I recommend against, no matter the person.

Still, in my experience (anecdote), professionals have known far more about how AS and AD manifest without me questioning their expertise than anyone I've seen on a forum state. Which probability will say is most likely to happen.