What's missing from the DSM?

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The DSM (as well as outside popular understanding of the disorder) seems to be lacking in a couple of areas, which IMO hinders its ability as a tool to set learning accommodations for school age Aspies. Unfortunately, I suspect that it is all too often the principal tool for setting these accomodations.

Here's the DSM:

A. Qualitative impairment in social interaction,
as manifested by at least two of the following:

1) marked impairment in the use of multiple nonverbal behaviours such
as eye-to-eye gaze, facial expression, body postures, and gestures
to regulate social interaction;

2) failure to develop peer relationships appropriate to developmental
level;

3) a lack of spontaneous seeking to share enjoyment, interests or
achievments with other people (eg: by a lack of showing, bringing,
or pointing out objects of interest to other people);

4) lack of social or emotional reciprocity.

B. Restricted repetitive and stereotyped patterns of behaviour, interests,
and activities, as manifested by at least one of the following:

1) encompassing preoccupation with one or more stereotyped and
restricted patterns of interest that is abnormal either in intensity
or focus;

2) apparently inflexible adherence to specific, nonfunctional routines
or rituals;

3) stereotyped and repetitive motor mannerisms (eg: hand or finger
flapping or twisting, or complex whole-body movements);

4) persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social,
occupational, or other important areas of functioning.

D. There is no clinically significant general delay in language
(eg: single words used by age 2 years, communicative phrases used by
age 3 years).

E. There is no clinically significant delay in cognitive development or in
the development of age-appropriate self-help skills, adaptive behaviour
(other than social interaction), and curiosity about the environment in
childhood.

F. Criteria are not met for another specific Pervasive Developmental
Disorder, or Schizophrenia.

Now...

Four things that I think need to be considered, all of which Tony Attwood has observed.

1. A sizable number of Aspies (myself included) seem to have trouble with short term memory but excellent long term memory, which even predates speech.

2. Aspies are sometimes hyper-mathematical, with deficiencies in language. Aspies are sometimes hyper-verbal, with deficiencies in mathematics. Most appear to be one or the other.

3. Areas of interest are not necessarily chronic or pervasive. I was a bit surprised that my college's disabillities counselor -- who had attended an autism conference a week before -- asked me what my area (singular) of interest was. I have had multiple areas of interest. And while I never totally abandon any of them, I do adopt new ones -- as I believe is fairly typical. If you put me in a setting where I am asked to study and write an overview of Ancient Rome, I may spend the better part of two days studying Roman naming conventions and adopt that as a temporary area of interest... Or perhaps even develop a new permanent area of interest.

4. Adult aspies may mask symptoms. I was fortunate enough to see a counselor who was able to recognize this. But I can and will occasionally fake eye contact or expressions thanks to years of practicing in a mirror and training to act on stage; I never bothered to tell anyone that I have spent many hours recording and modulating my voice to imitate the laughter and intonations of other people and developed techniques like eyebrow arching and forced laughs. It's not TOTALLY effective... But *I* had to realize that I had to drop the routine.

Good points,I think.

They do to into account that adults learn some NT "natural social skills"....One of the reasons that many depend on having a parent or sibling who can tell them what you were like as a child,when the AS traits are more pronounced and unadulterated.
The problem with the above,is when you are an adult with the following problems....

Your parents are no longer alive(or have poor memories)
Your parents dont want to admit that there was anything wrong with you(or that they may have raised you wrong)
Your parents memories are biased to see you as being "lazy,stupid,stubborn"
Your parents are psychotic OR have AS themselves,so see nothing "unussual" about your behavior
Probably more.......All these can influence their answers.

I would love to see a test that is less subjective and "fuzzy",there are to many things that can be inturprited by the individual testing....that is not "science".

I would also like to see something about emotional oversensitivity and under-sensitivity......

I think sometimes we can be hyper responsive to feelings and this can cause us to shut them down.(similar to eye contact being painful because it is hyper personal)This seems to contradict theory of mind but I think it is two different things....It has been mentioned that many with AS....are very protective of "underdogs" and "animals",but it is not part of the DX.So perhaps we "over relate" due to our own experiences of being picked on?From all the posting I see on WP,I notice a lot of people trying to help each other,they are less likely to be mean to others they see as vulnerable.

In general,I would like to see a change in the wording of AS traits to show some of the positives of AS,rather then making it sound like NT is the standard to achieve and AS is an aberration because it is different.

Sensory issues should be on there.

Good points by Tony Attwood. All four of these describe me. My long-term memory is far better than my short-term memory. My skills in English and languages far outstrip my mathematical ability. All of the interests, and all of the facts I have accumluated about them, are in my memory as stored knowledge. Some of my interests, such as cats, have been constant throughout my life. Finally, when seen in my areas of strength, I appear normal.

I'd like to see NLD as a diagnosis in the DSM. Because there's no entry for NLD, my offficial diagnosis is "Learning Disorder- NOS". Maybe in the next one...