Guest Opinion: The Really Big Lie About Autism

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Mnemosyne
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18 Jan 2007, 10:50 pm

squaretail wrote:
Is it true, that before 1994, one had to have an assessed IQ in the MR range in order to receive a diagnosis of autism?


I looked up the DSM-III criteria for autism, and this is what I found. Section B talks about "qualitative impairment in verbal and nonverbal communication" so I would assume that that would generally typically occur if one was labeled mentally ret*d. I guess there were exceptions, but that seems the most likely case. Anyway, the criteria:

Includes at least two items from item A, one from item B, and one from item C:

A. qualitative impairment in reciprocal social interaction (the examples within parentheses are arranged so that those first listed are more likely to apply to younger ormore disabled, and the later ones, to older or less disabled) as manifested by the following:

(1) marked lack of awareness of the existence or feelings of others (for example, treats a person as if that person were a piece of furniture; does not notice another person's distress; apparently has no concept of the need of others for privacy);


(2) no or abnormal seeking of comfort at times of distress (for example, does not come for comfort even when ill, hurt, or tired; seeks comfort in a stereotyped way, for example, says "cheese, cheese, cheese" whenever hurt);

(3) no or impaired imitation (for example, does not wave bye-bye; does not copy parent's domestic activities; mechanical imitation of others' actions out of context);

(4) no or abnormal social play (for example, does not actively participate in simple games; prefers solitary play activities; involves other children in play only as mechanical aids); and

(5) gross impairment in ability to make peer friendships (for example, no interest in making peer friendships; despite interest in making friends, demonstrates lack of understanding of conventions of social interaction, for example, reads phone book to uninterested peer);

B. qualitative impairment in verbal and nonverbal communication and in imaginative activity, (the numbered items are arranged so that those first listed as more likely to apply to younger or more disabled, and the later ones, to older or less disabled) as manifested by the following:

(1) no mode of communication, such as communicative babbling, facial expression, gesture, mime, or spoken language;

(2) markedly abnormal nonverbal communication, as in the use of eye-to-eye gaze, facial expression, body posture, or gestures to initiate or modulate social interaction (for example, does not anticipate being held, stiffens when held, does not look at the person or smile when making a social approach, does not greet parents or visitors, has a fixed stare in social situations);

(3) absence of imaginative activity, such as play-acting of adult roles, fantasy characters, or animals; lack of interest in stories about imaginary events;

(4) marked abnormalities in the production of speech, including volume, pitch, stress, rate, rhythm, and intonation (for example, monotonous tone, question-like melody,or high pitch);

(5) marked abnormalities in the form or content of speech, including stereotyped and repetitive use of speech (for example, immediate echolalia or mechanical repetition of a television commercial); use of "you" when "I" is meant (for example, using "You want cookie?" to mean "I want a cookie"); idiosyncratic use of words or phrases (for example, "Go on green riding" to mean "I want to go on the swing"); or frequent irrelevant remarks (for example, starts talking about train schedules during a conversation about sports); and

(6) marked impairment in the ability to initiate or sustain a conversation with others, despite adequate speech (for example, indulging in lengthy monologues on one subjectregardless of interjections from others);
C. markedly restricted repertoire of activities and interests, as manifested by the following:

(1) stereotyped body movements (for example, handflicking or twisting, spinning, head-banging, complex whole-body movements);

(2) persistent preoccupation with parts of objects (for example, sniffing or smelling objects, repetitive feeling of texture of materials, spinning wheels of toy cars) or attachment to unusual objects (for example, insists on carrying around a piece of string);

(3) marked distress over changes in trivial aspects of environment (for example, when a vase is moved from usual position);
(4) unreasonable insistence on following routines in precise detail (for example, insisting that exactly the same route always be followed when shopping);

(5) markedly restricted range of interests and a preoccupation with one narrow interest (for example, interested only in lining up objects, in amassing facts about meteorology, or in pretending to be a fantasy character);

D. onset during infancy or early childhood;

E. other symptoms that may occur with the syndrome:

(1) sensory disturbances as evidenced by atypical responses to stimuli (for example, touch, sound, light, movement, smell, taste). Responses may include overreaction, indifference, or withdrawal; and

(2) uneven acquisition of skills, and/or difficulty in integrating and generalizing acquired skills; and

F. the pupil's need for instruction and services mustbe supported by at least one documented systematic observation in the pupil's daily routine setting by an appropriate professional and verify the criteria categories in items A to D. In addition, corroboration of developmental or medical information with a developmental history and at least one other assessment procedure that is conducted on a different day must be included. Other documentation should include parent reports, functional skills assessments, adaptive behavior scales, intelligence tests, criterion-referenced instruments, language concepts, developmental checklists, or an autism checklist.



squaretail
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18 Jan 2007, 10:54 pm

Thanks! Do you know if that's the DSM-III or DSM-IIIR?

Anyways, it's not vastly different than the DSM-IV, but the 'examples' that are given for each trait are missing from the IV, and thus allow much more subtle behaviors to be considered as meeting the criteria.



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18 Jan 2007, 11:00 pm

didn't they disprove the mercury-vaccine thing?

she is apparently not aware that "correlation does not equal causation"..................


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SteveK
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18 Jan 2007, 11:12 pm

Mnemosyne,

That is ODD! I KNOW I saw a reference to IQ<70. I did look a few times in Google since Squaretail stated the question here, and didn't find it.

Steve



Mnemosyne
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18 Jan 2007, 11:57 pm

squaretail wrote:
Thanks! Do you know if that's the DSM-III or DSM-IIIR?

Anyways, it's not vastly different than the DSM-IV, but the 'examples' that are given for each trait are missing from the IV, and thus allow much more subtle behaviors to be considered as meeting the criteria.


That's the DSM-III R. I actually found the diagnostic criteria taken from EVERY version of the DSM here:
http://unstrange.com/dsm1.html

Pretty interesting reading.

I really wish I could eavesdrop on the conversations about ASDs when the APA meets. I'm so intensely curious about what the next DSM is going to say!

EDIT: There's a link at the bottom of the page for general PDD diagnostic criteria. I find it really interesting that previous version of the DSM mention sensory sensitivity for both autism and PDD, but they were removed for the DSM IV.



SteveK
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19 Jan 2007, 12:23 am

Interesting!

Quote:
DSM I (1952)

000-x28 Schizophrenic reaction, childhood type

Here will be classified those schizophrenic reactions occurring before puberty. The clinical picture may differ from schizophrenic reactions occurring in other age periods because of the immaturity and plasticity of the patient at the time of onset of the reaction. Psychotic reactions in children, manifesting primarily autism, will be classified here.

DSM II (1968)
[autism was not mentioned; the word appears only under the following category]

295.8 Schizophrenia, childhood type

This category is for cases in which schizophrenic symptoms appear before puberty. The condition may be manifested by autistic, atypical and withdrawn behavior; failure to develop identity separate from the mother's; and general unevenness, gross immaturity and inadequacy of development. These developmental defects may result in mental retardation, which should also be diagnosed.


DSM III (1980)

Diagnostic criteria for Infantile Autism

A. Onset before 30 months of age

B. Pervasive lack of responsiveness to other people (autism)

C. Gross deficits in language development

D. If speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, pronominal reversal.

E. Bizarre responses to various aspects of the environment, e.g., resistance to change, peculiar interest in or attachments to animate or inanimate objects.

F. Absence of delusions, hallucinations, loosening of associations, and incoherence as in Schizophrenia.


INTERESTING! This implies that autism didn't exist there prior to 1980, and nobody here would qualify in 1980!(Nobody here has B, and probably not C Many don't have D, and some might even say they don't have E!) That would mean diagnosis of anyone here couldn't be made under the DSM until 1987 when autism started looking similar to how it does today. So it is STILL reduced to 20 years ago! So the oldest diagnosed at 3 would be 23. That's STILL close to 18. WOW, I guess I couldn't have been diagnosed with autism after all. I went to the psychiatrist in the late 60s.

Steve