Holy Smokes I'm no Longer Going to be Autistic!

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Yeah I definitely still qualify. I wonder how they are taking in to account speech delays in autism. I know the current criteria says that Asperger's children do not generally exhibit a speech delay... There is a huge difference in LFA children and Aspie kids. I would hope they would be a little bit more specific. It seems unfair to put a whole diverse group under one label.

While I'm definitely not cured, doesn't "D" mean if it stopped effecting functioning at all you would be cured?

If that's what "cure" means then I want to be cured, I just want to be cured by life experience NOT a pill.

And I'm sure then that I will be "cured" in time, by time.

I'm going to be autistic under the new criteria, due to the fact that my original Dx was HFA in 1980. That doesn't bother me because there are worse things to be than autistic. It's better to be autistic than it is to be a criminal.

Unless you're a corporate criminal. They get golden parachutes and, if they do get caught, they get upscale treatment in the penitentiary system. I heard they get a buffet breakfast everyday, which is better than what I get at home.

From my personal experience, research studies consistently use stricter criteria, not in the literal sense but in the sense of how the diagnosticians tend to view "autism". I've been associated with such studies and have seen the differences between what is considered "Asperger's" by many diagnosticians and the individuals I've known irl with AS. The former is considerably more severe.

In the new criteria, there's more emphasis placed on deficits in nonverbal communication. It's now a requisite for those with AS. Prior, nonverbal deficits were a possible criterion, but only that: not required. And while some maybe subsequently say to me, "Well, anyone without bigtime problems in nonverbal communicative behaviors (i.e., excluding those with less marked impairments) isn't truly autistic then," well I'd say that I disagree and both science and clinical treatment are truly missing the mark. Autism isn't an on/off condition, either you have it or you don't. There's a gradient, and there's plenty of people in that grayer area who have plenty enough autistic traits to be suffering and who could benefit from the same kinds of intervention. Why then call this a "broader phenotype"? Prior to the induction of AS into the ICD and later into the DSM, many could've made the same argument about high-functioning cases of autism and individuals with Asperger's. So why should this be different? --Unless now, on WP, we're dealing with autistic elitism and thus wanting to restrict the criteria to be more selective, which often happens with the continual NT vs. us attitude.

Is nonverbal communication a strong suit in autism? No. However, I don't think it has to be quite so severe either. But the new criteria truly stress the deficits, such that it sounds more like a blatant disability:

Old: "(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction."

New: "Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures."

Am I the only one here who sees that the implication in the phrasing of the latter, not to mention the requirement of this criterion to fulfill the diagnosis raises the bar for Asperger's??? In the old criteria, for someone who had deficits in this but were not as severe, they could still get the diagnosis and get appropriate treatment and intervention. However, now, this may be less likely to happen. This is a potential problem.

Not only does this frustrate me because I've known plenty of individuals who have found help and solace through a diagnosis who, were they to seek diagnosis after DSM-5 release, probably wouldn't get it, but as a scientist this just also makes my job all the more frustrating. There've been plenty enough years of restricting criteria and only including the moderate cases in research studies, but the aspects of the brain, the neuroanatomy, the biochemistry, these all fall on a continuum and that continuum must be studied as a whole, not piecemeal, otherwise we never get to truly see the larger picture of what we're looking at. Broader phenotypes are just as important to understanding autism as autism is.

There is no line that separates autism and not-autism. There just isn't. And it's foolish to pretend like there is one and waste our times searching for it. Instead, we need to seek the commonalities, study the differences, but realize that the latter are not a unique occurrence but are reflective of general human trends. They're just more extreme.

It's like a color gradient. That's how this works. So, somebody, please, tell me what is autism, where it ends, and where nonautistic begins. You can't do it.



Now, I fully realize that a diagnosis is a practical thing and if you have no cut-off then you loose its usefulness. I don't debate that. But where my gripe is is that the new criteria seem to be raising the bar too high and there will be people who will be missed by these changes who could've benefited from the diagnosis. That's my complaint. And for those who think it doesn't change things, true, there will be diagnosticians out there who already have their opinions set in place and any changes in criteria really aren't going to affect them all that much. But new diagnosticians, this is going to affect how they view autism. They may be prone to a narrower view. And I really don't see that as being beneficial.

Those of us on the extremely mild end will no longer be considered to have a disability, I guess we'll be lumped back into ADD again.

Since this is still relevant and the media is kicking this up again, thought I'd bump by sharing more info:

http://www.thetakeaway.org/people/john-gilmore/

And my own response to these issues:

http://wp.me/29AJk

You nailed it. I enjoyed your article. This part made me chuckle:

"Concepts of autism are currently confined by a human history. We’re working with outdated definitions, with poor understanding that’s solely based on outward behaviors and not an understanding of how the autistic person’s mind works, and we’re battling an ethical debate of whether Jimmy High-Functioning should be given as much pity and help as Joey Very-Severe. The autism of one person doesn’t alter that of another, even though the human brain loves to make comparisons."

BTW, I agree with the idea that what we think of "autism" is caused primarily by hyper-connectivity in local parts of the brain and under-connectivity between those local parts. It definitely seems to explain my issues and why manifestations of AS can be so varied.

As for the DSM-V, I actually fit the criteria better, but not the "severity" levels.

I am wondering. Although it says you cannot have impairment due to a developmental thing if one could still has aspergers or still be on the spectrum. I was born too early and do have a learning disability. While the learning disability is WAY less pronounced the aspergers characteristics are still very much alive and kicking. I did fairly well in college. My social skills and repetitiveness were the issues for me and along with my poor ability to adapt to changes in my personal life. I feel like a mystery. . . . . .

Do they test intelligence when diagnosing aspergers? I feel like I may be able to do fairly well on that. My GED and college records show that while I may not be the brightest crayon in the box I am definitely no dummy either.

Thanks! If you ever want materials to read on the subject, just ask. Our research group has done quite a bit with it on the neuroanatomy side of things, and there are also others who've focused on the functional imaging as well that seems to support the theory.



There's a fair portion of autistics who were premature, so I don't think that will be an exclusion criteria. Also, LDs could be linked to that, and could also simply be part of the autism, which is very common too.



It depends on the diagnostician. Some may prefer to use IQ testing as well, because they're an especially good tool for spotting learning disabilities, but a high IQ is not currently considered part of the criteria. More people I would say look on it as a secondary trait, not a core trait.

Another reason why I think the criteria system is bollocks.

The social domain doesn't seem all that strict now, especially with the bits added since the very first posting of such (examples of each criterion).

It's always been the best and easiest way to diagnose someone, as the deficits and presentation of the social domain are an outlier of human social behavior.