Autism Spectrum disorders in the new upcoming DSM-V

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It's close enough, as before we could see viruses, we only had how they affect people; we still can't see Hepatitis C, but it's still defined and treated. Psychology is objectively defined as a science; look up the dictionary, and it'll tell you such.

Age1600,

Concerning ADHD, it's saying that it can be allowed as a comorbid diagnosis, rather than a part of ASDs; like OCD, Tourette's, etcetera.

Aspies don't have a childhood speech delay; HFAs do. You can't tell the difference after functional speech emerges, which usually happens by age five.

I agree on the allowing ADHD and autism to be diagnosed together. It really makes a lot of sense because there are a lot of differences between autism with ADHD symptoms, and autism without ADHD symptoms.

That's pretty much it. Some studies say that the group with the cognitive delay are a little worse off [based on outcome studies], whilst others say there's effectively no difference based on studies of children in severity (I've read them all).

Just Autistic Disorder with the same three areas; social, communication, and repetitive behaviours would be wise (nearly all people with Asperger's have communication problems as children, i.e., most can't initiate and sustain a conversation, and the stereotypical way that they repeat facts is no different than echolalia, it's just echolalia from a person with a higher level of intelligence).

NOS can be there for people who don't have deficits in all three areas.

I wonder, though, if people with speech delays are more likely to be visual thinkers?

Comparing me (Aspie) and a friend (autie) in the same general field (engineering)... he's a visual thinker, did wonderfully at learning Newtonian physics (the study of forces on objects) and had to think hard for statistics (logic, relationships between probabilities, a bit of math). I'm the exact opposite; I'm a natural at statistics, where a lot of the thinking is verbal rather than visual logic, and I'm barely scraping along with the physics. We are both visual thinkers when it comes to mathematics, though.

According to the DSM-IV, one arbitrary source of diagnostic information, this is the difference. There are other diagnostic criteria more common in countries outside the US that actually list speech delay as a symptom of AS. I can't stand it when people worship the DSM, a politically-influenced and ever-changing guide for a very subjective and poorly understood field of study, as the ultimate authority on mental health because, as should be very evident in that article, the symptom list might be very different in the next edition. In fact, the dubiousness of the speech delay distinction is mentioned in the article.

To be fair to the DSM, it does list a whole lot more in its expanded text, and for some reason, even professionals overlook the vital information found within (though it does say in short, the easiest way to determine the difference is a delay in the acquisition of speech, so the criteria are "right"). I like Gillberg's Asperger's Criteria for everyone with verbal Autism (whether they had a delay or not), personally.

I wonder if people will still call themselves "aspies"?

There's been several studies on the different cognitive styles of Autistic Disorder [without mental retardation] and Asperger's, and the overall finding is that there's no difference in verbal and performance ability between the two; there was an early study that was positive, but later ones showed that there isn't (I don't know the details other than the conclusions).

Though a speech delay in AS is possible, if it is a normal speech delay, one that is not clinically relevant.

It's okay if a child is 15 months when it says it's first word. Or at 18 months. Though that's late as compared to when most babies say their first words, which is at about 12-14 months.

Such 'normal' delays happen all the time and are perfectly possible and acceptable in people with AS.

It's when a child has not started to use single words by the age of 2 or, even when started speaking early, has not developed communicative phrases at age 3 it's a no-go for AS.





The DSM description is interesting! Echoed words can be utmost communicative as well as that communicative phrases can be present, but not spontaneous.

I don't think so. Because...

1. Lots of totally non-autistic people are visual thinkers.

2. Visual thinking is only one kind of non-word-oriented thought

3. Lots of non-speaking people have verbal thoughts, there are a lot of reasons for speech delay that have nothing at all to do with thinking being visual, verbal, etc.

4. Lots of people who have no speech problems at all (whether autistic or not) are visual thinkers.

The reason for the echoed words thing is probably that many of Kanner's patients had things like that go on. There's actually a number of ways that language can be atypical and thus still counted the same way as a speech delay for those purposes.

See, I still think this leads some kids (right now) to not be diagnosed with a specific ASD. I mean this purely based on what's happened with my youngest son. He didn't start saying multiple words until 2 1/2 (previous to 2, he only said maybe 5 words total), but now he's 3 and half and speaking in full sentences. He has some speech therapy, but not much. For the most part, he's gained a lot of his speech just by being around kids who are talking (his older brother didn't start talking til my youngest was 2 1/2). So right now the criteria is very vague when it comes to him. The person that diagnosed him said it was really too early to say and that she'll most likely diagnose him with PDD-NOS or AS when he gets around 6 yrs old, but for now, she just has him as ASD with SPD.

I'm wondering where this leaves those who don't have the classic autism spectrum "triad" but still struggle and could use help. What about the part of the spectrum at the opposite end of Kanner's autism, past Asperger's Syndrome, to the Not Otherwise Specified ones? I believe that some mental health professionals understand the needs of those who are affected, but not as severely, but from what I read those professionals don't seem to live in the US.

One of my favorite recent diagnostic quotes comes from Lorna Wing, the British psychiatrist who introduced the English-speaking world to the writings of Dr. Asperger. The quote comes from an interview on the UK site www.autismconnect.org:

Lorna Wing Quote:

"What we want to know is what makes this person tick in the way they are ticking? It's fascinating disentangling; its a piece of detective work, how this person has reached this point.

It seems to us from our experience that it is far more important than deciding whether or not someone fits the classic criteria. We have come across a lot of people who don't fit any of the classic criteria, but deep down they actually have poor development of their social understanding and their capacity for planning. These two things (they may not have anything else) in life are going to be hellishly difficult for them, and they're going to get into all kinds of silly situations and terrible trouble, even legal trouble as a result. This to us is what matters."

I come from one of those families who "have poor development of their social understanding and their capacity for planning." We also have members who could have/had a diagnosis of Asperger's. But because most of us have fairly normal communication, the overt difficulty is mostly hidden - until we become overwhelmed by trying to figure out how to relate to others, or make decisions, or deal with inevitable emotional stress. There is enough anxiety, depression, and suicide in my family, as a result of having a lack of social and emotional understanding, that I can attest the not-fitting-the-diagnostic-criteria end of the spectrum has it's share of human tragedy and need for understanding, too.

Maybe they will figure it out in DSM-VI, due out in 2032 .

Z

That's what PDD-NOS is for (or ASDNOS in the DSM-V).

If you "only" have the social deficits, you can still be hit with a PDD label. It's why PDD-NOS is the most prevalent diagnosis of PDD; it equals the Asperger's and Autism diagnoses combined in numbers.

There's Schizoid PD too for those who don't fit the classic difficulties in reciprocal social interaction that's in Autism (people seem to neglect this one).

about a week before I happened onto WP (&c),
i went to my gp for a referral on the basis of
possible schizoid pd (not totally excluding schizo-typical pd)

(i also remember Martine Delfos remarking on the difference between the response of an autistic child in a classroom and the response of the s(t)pd kid; where the latter shows primarily fear, the autistic child shows primarily amazement (which could secondarily turn to fear))

I really don't like the idea of getting rid of Aspergers as a diagnostic category. Before he was diagnosed with AS, my son's diagnosis was "PDD-NOS". The problem was that all of his teachers and therapists saw a 4 year old boy on the autism spectrum and thought "LANGUAGE DELAY".

So, enormous amounts of time was wasted while various teachers and therapists insisted on making him label pictures of farm animals. Needless to say, this was torturously boring for a 4 year old with average expressive and receptive language skills.

It was a constant battle to get teachers and therapists to stop underestimating him. This problem was exactly the reason I took him to be re-evaluated when he was 6.

I was confirmed AS after an MRI that showed a distinct difference between my brain from HFA. The research showed, in 1,000 "patients" that the difference is there, concerning the language delay and other brain functions. I really don't understand why DSM wants to cut of Asperger's if neurology proves other ways. Anyone to respond about that?

Could you point to the research? I'm really interested in this, as I'm not aware of any research that directly compares AS brains to HFA brains.

A lot of the practical research finds little difference between AS and HFA in terms of outcomes, impairments, and the like.