They plan to delete Asperger from DSM 5

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Whilst disturbing in principle, I wouldn't be too concerned about this. To me it is unfathomable that a guide controlled by the mental health profession would agree to a classification scheme that results in thousands of practitioners being cut off from insurance money? Even if there were incontrovertible scientific proof that AS could be eliminated effortlessly, the profession would still fight to keep it in the DSM as there are so many stakeholders. The natural trend is to include more people, not exclude. Judging by the overall tendency of the DSM to expand the number of qualifying patients, it appears that the mental health lobbies are more influential than the insurance lobbies.

There will also be this amazing, inexplicable trend for more and more people to be diagnosed with HFA, because even though they talked "on time", there was something irregular about the nature of their communication (or whatever reason is offered.)

How weird that AS, atypical and Rett's don't have their own code in the DSM! They have in the ICD-10 after all:

ICD-10 F84 Pervasive developmental disorders
F84.0 Childhood autism
F84.1 Atypical autism
F84.2 Rett's syndrome
F84.3 Other childhood disintegrative disorder
F84.4 Overactive disorder associated with mental retardation and stereotyped movements
F84.5 Asperger's syndrome
F84.8 Other pervasive developmental disorders
F84.9 Pervasive developmental disorder, unspecified

http://www.psychnet-uk.com/dsm_iv/_misc ... tables.htm

296.90 Mood Disorder NOS
297.1 Delusional Disorder
297.3 Shared Psychotic Disorder
298.8 Brief Psychotic Disorder
298.9 Psychotic Disorder NOS
299.00 Autistic Disorder
299.10 Childhood Disintegrative Disorder
299.80 Rett's Disorder
299.80 Asperger's Disorder
299.80 Pervasive Developmental Disorder NOS
300.00 Anxiety Disorder NOS
300.01 Panic Disorder Without Agoraphobia
300.02 Generalized Anxiety Disorder

Last edited by sinsboldly on 10 Sep 2009, 9:12 pm, edited 1 time in total.

long before my diagnosis, I took a mandatory written test (psychometric) to determine mental illness. Without the diagnosis of asperger's, I could be misdiagnosed as a mixture of OCD, Histrionic, Bipolar, Borderline, and Schizotypal Personality disorder.

We need a clinical diagnosis for Asperger's, else we certainly will not receive the correct support.

I know about the coding now, I meant with the new DSM-V.

Obviously, if they remove all of the labels that are there now (AD, AS, PDD-NOS), it'll get a new form of code. I can see either 2 codes (ASD clinical and subclinical) or five under the proposed changes (the severity levels and the two subclinical ones).

what does subclinical actually mean as far as diagnosing on the spectrum?

Subclinical would mean V code, not serious enough to apply for disability. These are listed under childhood disorders in the DSM, so, it would be used to diagnose Asperger's in children. The child would be refered to counseling. It would make it more like ADHD and less like autism.

oh, good! then if my diagnosis is considered a childhood disorder I should be cured any day now!

The only difference between regular autism and Asperger's is that kids who look higher functioning get diagnosed with Asperger's. Other than that, there's really no huge qualitative difference between the two groups. There's no gap between them, no obvious distinguishing trait that's present in one group and not the other. Even "speech delay" is crazy vague. What do you do with the kid who speaks at three years; is that late or on time? Two years eleven months? What about the kid who speaks entirely in memorized phrases? The kid who learns sign readily but doesn't speak until five? There's no gap, no easy way to distinguish them--just a spectrum, with each feature present in strengths anywhere from near-absent to preeminent. They just artificially took the cases that had the particular feature of unusual speech development in a milder form and called them Asperger's... So yes. We are basically a kind of autism. There's never been much reason to differentiate Asperger's from any other kind of autism; it's about time they figured that out.

They need to get it through their heads that autism is just diverse by its very nature. That over half of cases today are the catch-all PDD-NOS should speak for itself, shouldn't it?

To be a clinical condition, there needs to be a level of impairment/distress arising as a result of the symptom traits.

Sub clinical refers to the same kind of traits being present, but without the manifestation of clinically significant levels of impairment/distress (usually because the intensity of the traits is lower).

The clinical significance of sub clinical Autistic traits relates to instances like this:

While the quoted poster actually has a clinical manifestation (diagnosable), people with sub clinical autistic traits are also at risk of this kind of thing happening. They might seek treatment for garden variety circumstantial depression when a parent dies (for instance) and be misdiagnoses with any number of clinical conditions they do not have due to atypical traits and expressions that are explained by sub clinical Autistic traits.

Another example would be someone who has difficulty interpreting “feed back” from their body and cannot pin point the location of pain they are experiencing. In my experience when you cannot be more specific about the pain caused by a broken collar bone, than to point to your knees, sweep you hand to up above you head, and claim the pain in “there” (from your knees to over the top of your head on that side of your body), physicians tend to find this odd and difficult to believe. A label of "sub clinical autistic traits including sensory integration irregularity" would be useful for effected people so that both they and health practitioners understand the atypical way they experience bodily sensations.

A sub clinical label would also have applications in learning environments and work places, and in the domain of self understanding and self directed development.

I don't think Asperger's will come under subclinical. It'll come under less severe ASD along with "good" HFA, with what's commonly seen as "bad" HFA and "mild" LFA coming under moderately severe, and "bad" LFA coming under severe. "Mild" AS will be the subclinical form I'm betting, with BAP equating to normal variant personality.

I agree, I think AS is a form of autism too, but there's so many people who want to change things around because so many are so mild. They are accommodating all these border line AS cases that can almost pass for NT. I don't understand why they don't go ahead and classify themselves as NT if it's so easy for them to blend in and act like one? They don't have any problems so why single themselves out from the rest? Some NTs are intellectual, too.

I personally think that asperger's is just a teen and adult manifestation of a mild form of autism.

I was a typical autistic toddler and preschooler, giving my parents all sorts of grief. I now diagnose as aspergers.

Aspergers is recognized because of the work of Dr. Asperger of course. Autism was not understood either, at the time he conducted his research. And no one has really integrated the two since then.

Again with the autistic spectrum disorder: aspergers is on one end (and it too has many shades), and LFA on the other. It is all autism.

Well, because those people have to spend more effort than most to "pass", and they're sick of having to do it when they could just be themselves if only people accepted them that way. Even on the borderline of autism, being different can be difficult. It would feel very invalidating to them, I think, if they were basically told, "You're neurotypical; stop whining about being different; you've got no right to be weird; but these poor disabled autistics over here, they have the REAL problems..." which of course invalidates both their own difficulties and their ability to speak up for the rights of autistic people in general.

A lot of the non-disabled people with the autistic or near-autistic phenotype share one of the biggest issues that the very obviously autistic people also face: How can we get the world to see that it is acceptable to be odd, that we shouldn't have to try to fit in to be accepted? That is why I think it is very important to keep the Spectrum unified, as far as that's possible, because if we are all in little groups according to whether we're disabled or whether we've got special talents or whether they can diagnose us or what particular diagnosis we've got, then we'll just end up falling victim to divide-and-conquer, or maybe even unknowingly stomping on another group to get our particular group's rights upheld.

But, doesn't it seem like some people with AS have more in common with neurotypicals than they do others with AS? Like, for instance, they like being social, they have lots of friends, they know how to interact, they scoff at those of us who have issues in these areas...just like NTs do...it seems, to them, having the issues socializing and not wanting to be social are not AS problems...because they like to socialize themselves.
What are the differences between such persons and NTs?

Well, sure, there's always going to be a point on a continuum where one starts having more in common with neurotypicals than with the bulk of autistics. That doesn't mean such a person won't still be significantly different from NTs, though. Autism's a very wide spectrum indeed and it's probably possible to be only a little autistic but still different enough from typical that you don't really fit in there either. Of course you could end up in the best of both worlds, acting as an interpreter, taking advantage of both sorts of traits, but it might be a bit awkward if you were determined to belong to one group or the other.