Do you prefer the DSM-5 classification of ASD?

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I agree--even the most high functioning of us still have autistic traits--though some of use are fortunate enough to be in low stress situations where they are rarely evident--we know they are still there. It is important for anyone we are in a relationship with to understand this fact.

I think it is very simple and cut into 3 levels, based on severity I can associate with like level 1=HFA, level 2=MFA, and level 3=LFA. Kind of like the Saffair-Simpson Scale for Hurricanes (I live in Florida, the hurricane hotspot) like Category 1 Hurricane, being the mildest, and Category 5, like Katrina being most servere. But however, I kind of find it discramatory. First, they grouped up all of the disorders, eliminating Aspergers, PDD-NOS, Rett, and CDD. That means in a society where people think Autism is a robber for a normal typical life, that means high functioning indiciduals, like me, are more likely to be discriminated from that type of life. Also, since the population of autistic adults is increasing dramatically, they base levels of needing support: Cat 1=Requires Support, Cat 2=Requiring Substantial Support Cat 3=requiring Very Substantial support. That means DSM-V assumes that ALL autistic people need support regardless of severity. Being that I am for autistics having the same equal rights of nuerotypicals, I see that DSM-V might pose a threat to that autistic self advocacy (ie it assumes that everyone Autistic needs a gaurdian, which strips civil liberties). I like DSM-IV better it helped people understood autism's wide spectrum but doctors, pople, and authorities see it as this Aspergers=HFA, PDD-NOS=HFA, Kanner Autism/Rett/CDD=LFA, its misrepresented. This is probably why I was misdiagnosed as Aspergers despite the fact I did not speak until I was 4 (The golden rule of an Asperger's diagnosis is nos speech delay), and still carry the offical diagnosis to this day. In actuality, PDD-NOS (refers to incomplete Aspegers or Autism criteria) and Kanner Autism (Kanner autism diagnostic criteria says nothing about cognitive or self help deficits, however, 75% of Kanner type people are intellectually challanged) can both widely range from LFA to HFA. Aspergers is most correct, but because it is too similar to autism, it was considered a High Functioning type of Autism just as how Rett Syndrome and CDD, which are also non autistic disorders too similar to autsim are considered to be servere low functioning types of autism. I got my own Idea for an Autism Spectrum Disorder, PDD-NOS returns to the Spectrum, High functioning Autism (diffrent from Aspergers) is a newcomer to the spectrum, and Autism gets remaned Classic Autism again. But this is how this should be: Basic High Functioning Autism= Criteria IQ of 85 and above, Golden Rule of no Cognitive Delay, has better self help skills, Has Social Deficits BUT Must want to make friends and be part of society. Classic Autism- IQ less than 85, Cognitive deficit, problems with self care, has social deficits and must not want to be part of society. PDD-NOS-Has autistic characteristic but meets an incomplete criteria for Classic autism or High Functioning Autism. Aspergers comes back to mental books but as a seperate diagnosis from my suggested ASD? What do you think about that?

Umm, that's because we do require support. It doesn't define what type of support you receive, just that you need it. If you don't need support, then you probably have no need for the diagnosis in the first place. I've yet to hear of someone needing the diagnosis but not requiring some type of support that someone wouldn't "normally" need. I consider myself to be pretty high on the spectrum, but that doesn't mean I don't need support. For example, I used to not be able to attend a brick and mortar school throughout high school, so I was online schooled. Now that I'm in college, I can attend in person classes, but I would get emotionally drained if they were all in person and with a lot of people. So one of my "supports" means I need to take online classes or in person classes that are small (such as honors ones).

You're taking it to imply something that's not being implied - "support" doesn't mean you require a guardian. It means that you require some type of support. What type that is is likely going to be determined by those who are apart of your support team. For some people, it may mean a combination of therapies, medications, and other things (headphones for sensory issues, weighted blankets, IEP plans, being able to take exams in a quiet space, etc...). These things aren't needed "normally" speaking. That's one reason why educational supports require a documented diagnosis. (In my case, normally speaking, students don't HAVE to take online classes or small in-person classes. Only people with specific disorders and diagnoses, including, but not limited to autism, social anxiety, ADHD, may have an actual "need" to take classes like that or receive other disability services, hence it being a "support.")

What you're proposing won't happen. As you said, the diagnoses were removed because they were too similar. There never was a real difference between autistic disorder and Asperger's Syndrome. The only differences displayed between people with the disorders involve the severity of symptoms, hence why the DSM-V uses the "spectrum" idea that there is one diagnosis with multiple symptoms that are displayed with different severity levels by different people. The idea is to bring people together for more accurate diagnoses, not split them apart with inaccurate ones (like they were under the DSM-IV). The same thing happened to the schizophrenia subtypes for the same reason - there's no need to keep labels that separate people when they're virtually useless in the first place.

This i very much agree with this

No. I have a problem with the DSM and the way it has been used in the past to reify non-existent "mental diseases" such as homosexuality. The assumption that the DSM no longer reifies anything in these wonderful modern times is a dangerous one, as is the wholesale belief that the DSM and all its pronouncements are automatically and objectively scientifically valid, with no hint of vested interests, cultural bias and the like.

As to its application to ASD - given that the general public equates anything in the DSM with "mental illness slash disease" then I would prefer that ASD was not even there, as its inclusion perpetuates stigma.

Who benefits from it being there most? That needs to be carefully considered, I think. There are other ways of establishing common criteria listings for syndromes that are not psychiatric disorders.

A critique that cites some general concerns with the DSM 5, which I tend to share:

http://www.academia.edu/2766051/The_ris ... tic_bubble

Probably one of the most enlightening posts I have read in a while.

Appreciated. I think there is a real parallel here that we need to be very mindful of:

1) homosexuality was a difference, not a disease just as ASD is a difference not a disease
2) the inclusion of homosexuality as a "disease" in the DSM helped to not only justify the stigma but
also contributed to the cultural acceptance of violence that many gay men experienced in their families,
communities and society as a whole. They were "fair game" (horrifically so in many cases).
3) the inclusion of ASD as a disease will also reinforce and perpetuate the stigma and contribute to
the social acceptance of the child murder of autistic children and the cultural prejudice adults on
the spectrum contend with every day - in employment, in the media, in their families, in their lives.

If we don't learn from history we help its re-enactment. Some members on WP seem to really admire the
DSM, without any critical analysis. It is a disturbing trend, at least from my perspective.

I agonized for months over the DSM-5, because I couldn't understand why it was 5 instead of V.
The DSM people really have no consideration for people like me, who are tortured by the above kind of issues.

B19 for American Psychiatric Association Board of Trustees! I amn’t sure, can a person even campaign for such a position?

This deserves more love.



Most people thought very differently about homosexuality even just 50 years ago. It makes more sense to blame 2000 years of Christianity for the stigma than the DSM. Also, I might add that the stigma is still around, especially in the more... "conservative" fringes of the US. I won't even go into other, non-western, parts of the world and their attitudes towards gays, women, etc. Put simply: billions of people do not agree with you or me about homosexuality. They still see it as a sin.

I suppose from my words you can infer I'm something of a Fedora-tipping atheist.

As far as ASD is concerned, it's a disorder so I have no problem with its inclusion in the DSM. I have no truck with the "it's not a disorder, it's a difference" school of thought. I'm not a gifted snowflake; instead I have a sh1tty social and communication impairment which has affected my life since birth.

As far as homosexuality is concerned, I have no problem with two people of the same sex living together, raising a kid together, or whatever. I don't consider it to be a disorder or mental illness.

But what about other expressions of sexuality which does not or cannot have legal consent between adults, such as paedophillia, exhibitionism, bronies, etc.? I've already seen a few dodgy liberal sorts passionately defend paedophiles on medical grounds. Next they'll be saying bronies are normal. Where does the madness end? Should paedophillia be removed from the DSM as well?

I regard paedophilia as intrinsically evil (a moral view) and criminal (that's the law) with sanctions (imprisonment) that are necessary. My view then would not regard it as a mental disease. No harm in this scenario would be done by removing it from the DSM, because sanctions would still operate. I would take it out, yes.

However. If you take the view (which I don't) that it is a compulsion that the offender has no choice over, you would have to defend it's inclusion in the DSM; the "poor souls can't help it". I don't have that view - the offenders I have had the misfortune to have met in the course of work etc have shown a sense of entitlement to use others which was so similar to other kinds of narcissistic people and were not only able to exercise choice in their actions but also a level of cunning that was the model of chosen and manipulative evil.

If you take the view that offenders should be chemically punished, castrated, forced to undergo "treatment" - which is largely useless in reforming them anyway - then you would argue to keep it in the DSM so that there was "justification" for this kind of treatment, which is intrinsically punitive.

I would rather lock them up with their own kind for 50 years and then if released keep them under 24 hour surveillance. I have seen close up the terrible damage they do.

It is a professional vanity that they can be reformed with treatment - in 99% of cases.

Yes, my suggested new ASD would work. It would equal less discrimination for people with High Functioning Autism or Aspergers. As a matter of fact I forgot that in my suggested ASD the requirements to have either Classic Autism or High Functioning Autism would be that both must have a speech delay, impaired social skills, Repetitive and Steryotipical Behaviors all before the age of 5. High Functioning Autism must have some empathy a socioemotional age equivalent to maximun 75% of their chronological age but at least 50% of their chronological age equivalent (ie 20 yo HFA has socioemotional age equivalent to NT 13 yo). An individual with Classic Autism must have their socioemotional/mental capacity(from low IQ) less than 50% equivalent of their chronological age (ie Classic Autistic 20 yo has socioemotional age and mental capacity of an NT 5 yo [25% of chronological age]). My 3 suggested ASDs are 1)High Functioning Autism (IQ 85 and above) 2)PDD-NOS and 3)Classic Autism (IQ less than 85). My suggestions to add to Aspergers, which would be considered seperate from my suggested ASD, are the following: higher socioemotional age of at least 80% of their chronological age or higher (ie 20yo Aspie has socioemotional age equivalent to NT 16 yo), must be using language in a sophisticated way like Mr. Spock from Star trek, and ABSOLUTLEY No delays in speech, self care indepedance, curiosity about childhood/teenhood environment. In other words, potential Aspies must grow up like an NT in every area except for social skills. For High Functioning Autistic Individuals, all of this is optional. In my suggested criteria for PDD-NOS are the following: 1)Must have autistic characteristcs (at least minumin 2 in each area or all in one area [either HFA or Classic Autism criteria] to be considered autsitic in the first place), 2) a)Meets an incomplete criteria for Classic Autism or High Functioning Autism and/or b)The symptons began after 5 years of age, and 3) Must not complete the criteria for Aspergers Syndrome. This would finally create a wall between Aspergers Syndrome and High Functioning Autism for good. It would finally make a spark diffrence between HFA and Classic Autism seen by people once and for all.

Hans Asperger treated people with speech and motor coordination difficulties and Average IQ so I don't think we should throw those people out of the syndrome named after him. Functioning abilities are as much about the environment as the condition itself. I do not see why 3 categories are sacrosanct, maybe 30 categories is fine. I don't see why early development should be a make or break criteria for diagnosing a 50 year old either. The people you wanted in the Asperger category to me are NT's with social difficulties ie a stereotype. As with most stereotypes there is a grain of truth. And many of these types of people resent being labeled with a disorder so you call them Asperger personality. Label the people that are more like the people he treated Aspergers- Autism. Right now there is a growing consensus that there are Autisms, not Autism. Maybe there are such things as "Extreme Male Brain Autism", "Intense World Autism", "Schizoid Autism", "ADHD Autism" and various combinations of these.

Even though I disagreed with some key points you did the right thing by trying to get us out of the rut of defining things solely on 1940s observations of two people.

I like the idea of Asperger's Autism (AA), as well as any other defined segment of the spectrum while recognizing the existence of a spectrum. The two aren't mutually exclusive.

Yep...the "Intense World Theory" might apply to some autistic people, but not to others.