We should keep the separate Asperger's category

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OK, I have to say I disagree with this. "Terrible", no. They are much better than before. I would say, more like... "Okay."

They have to. They have to be based on observable things, or it won't be a usable set of diagnostic criteria. You can't interview a two-year-old child about his thoughts and perceptions unless he's awfully precocious; and until we can test those things, there'd be no good in defining it in terms of mental processes. They're not defining autism as a set of behaviors so much as providing a set of behaviors that are the most likely to represent someone with the cognitive traits of autism. It's the best they can do, under the circumstances, without a way to detect the underlying cognitive traits directly.

They're lumping it in with the social criteria, on the basis that speech is basically a social behavior, I think--i.e., "Marked deficits in nonverbal and verbal communication used for social interaction". If you don't have communication, you'd probably be automatically in the severe part of the communication criteria, and be diagnosed autistic if you met the others. If you had speech but used it very clumsily; or had communication but not speech, it'd probably be in the moderate range. (I am guessing here because they have not yet given out much information on the proposed severity levels.)

They are probably trying to distinguish it from simply having a speech/language disorder rather than autism proper. Someone whose only problem is not developing speech cannot properly be called autistic because they will have the ability to make friends and the ability to respond to and interact with others in a back-and-forth sort of way, and will have none of the repetitive-behavior traits. This looks to me more like they are merging social and communication, rather than dropping communication. If they had dropped communication, then yes, it would have been pretty much ridiculous.

I agree that if they don't take environment into account, they're going to be overlooking things. However, that the social criteria do mention "appropriate to developmental level", rather than just peer relationships period. That would mean that if you can only make friends under some circumstances, but not most, then a decent shrink would probably realize that this isn't a lack of autism, but an autistic person in an environment practically tailored exactly to their needs. It's a similar situation to the ADHD child in a highly structured environment--still ADHD, but not obviously so.

I wonder about the theory of mirror neurons and whether an EEG would be a fairly simple way to detect autism. For those who don't know and If I'm describing it correctly, when a person hooked up to an EEG grasps something, the "mu" wave is suppressed. This also happens when the subject observes someone else grasping something. Now an autistic will not have the mu wave suppress when observing someone else grasping something. I just think they need to work on finding neurological indicators because behavior is a consequence of both neurology and environment.

I absolutely believe that there should be seperate diagnoses, what ever they want to call them. There is an absolut difference in functionality, which has nothing to do with snobbiness! It's about giving granular help to granular issues. You don't treat every cancer the same way, as there are various types and various means for treating each. Same with Autism, lumping everything together I believe is a huge opening for the educational and medical communities to start lumping together the treatment, which may severly and adversly affect the special needs across the scale.

In theory, yes, and wouldn't it be nice to just wire yourself up to an EEG and get an answer! But what exactly is "suppressed"? Where's the threshold? How do you differentiate from other causes that might do the same thing? What do you do if you see that pattern in someone without any of the behavioral traits? What if they've manually learned how to read faces; do they still have the same effect? What if you see autistic behavioral traits but don't see that pattern? What if the person you're measuring has an unusual EEG to begin with (as many autistics do, due to comorbid epilepsy)? Etc.

I mean, there's lots of ways that the brains of autistic people and non-autistic people can be shown to be physically/electrically/chemically different; but there's a big difference between proving that they are statistically different and being able to use the difference as a diagnostic test. Most likely, all the differences so far are just less useful for the purpose of diagnosis than observing behavioral traits, because they throw too many false positives or false negatives, or because they're simply not a good idea as a diagnostic test (brain biopsy, anyone?... thought not).

Good point, but I think assessing by behavior is subject to just as many variables.

Which makes the question: Which is subject to fewer variables? 'Cause there's no such thing as a perfect diagnostic test, whatever it happens to be based on.

Re-writing the criteria is something that needed to happen in any case. We were throwing most cases into the PDD-NOS catch-all, and that's a surefire sign of a bad definition.

Agreed, and they would do well to ask some questions and learn a few things.