75% Asperger's don't qualify for ASD?

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tomaszidek
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01 Feb 2018, 3:38 am

Asperger's syndrom is no longer listed in the DSM as you know. People are now diagnosed with ASD. Is the new criteria more restrictive? I have read an article (Google: You Do Not Have Asperger’s) which stated that 75% of Asperger's would not meet the criteria for ASD. The topic is pretty controversial because some experts say that the change is just formal.



Joe90
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01 Feb 2018, 4:04 am

I think Asperger's should still be a diagnostic label. I don't think I would qualify for a diagnosis of autism.

Maybe that's a good thing on my part, as I've never wanted anything to do with the autism spectrum.


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auntblabby
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01 Feb 2018, 4:06 am

as a child, one of my shrinks thought I was autistic. another thought I was schizoid. i'm somewhere in between. "schizotypal autism"? :chin:



tomaszidek
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01 Feb 2018, 4:08 am

Asperger is no longer a diagnosis in USA.



CloudClimber
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01 Feb 2018, 4:43 am

The criteria for asperger's hasn't changed, but those diagnosed with asperger's may have been diagnosed wrong and just have social disorder. Asperger's has the same criteria under ASD as it did as its own diagnosis.



Last edited by CloudClimber on 01 Feb 2018, 4:46 am, edited 1 time in total.

Amaltheia
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01 Feb 2018, 4:45 am

tomaszidek wrote:
Asperger's syndrom is no longer listed in the DSM as you know. People are now diagnosed with ASD. Is the new criteria more restrictive? I have read an article (Google: You Do Not Have Asperger’s) which stated that 75% of Asperger's would not meet the criteria for ASD. The topic is pretty controversial because some experts say that the change is just formal.

I'm not sure exactly what article you're referring to, but when I Googled You Do Not Have Asperger’s I got a Slate piece from May 22 2013 talking about the (then) recent release of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) which came out on May 18 2013. That edition did, indeed, combine several conditions from the preceding DSM-IV (Asperger Syndrome, Autistic Disorder, Pervasive Developmental Disorder - Not Otherwise Specified, and Disintegrative Disorder) into a new umbrella Autism Spectrum Disorder.

As far as I'm aware, most diagnosticians take a grandfather-clause approach to the older diagnoses —
if you were diagnosed with one of them, you're automatically counted as having ASD.

Beyond that, the DSM-5 criteria tend to be a bit broader than those in the preceding DSM-IV, so, if anything, it's proven to be a bit more inclusive.



Amaltheia
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01 Feb 2018, 4:54 am

tomaszidek wrote:
Asperger is no longer a diagnosis in USA.

True. The DSM-5 is only official in the United States, though a number of other countries, especially English-speaking ones, tend to also use it.

Most of the rest of the world uses the ICD-10 (International Statistical Classification of Diseases and Related Health Problems, Tenth Edition), which still lists Asperger Syndrome as a separate diagnosis. However, the upcoming ICD-11, currently available in draft form, follows the DSM-5 and folds various older diagnoses into a new general Autism Spectrum Disorder. The goal being to bring the two systems into closer alignment. When that's officially published, Aspergers will no longer be a diagnosis anywhere — though, as with the DSM-5, I suspect those that currently have a diagnosis of Aspergers will automatically be included in the new Autism Spectrum Disorder.



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01 Feb 2018, 5:12 am

As far as I’ve read the newer DSM-V is more inclusive and takes things like sensory issues into account.

My clinician is still using DSM IV - I’m certain I have aspergers, he diagnosed me with ASD because he reckons aspergers requires learning difficulties in early years, despite the wealth of information contradicting this fact - even on the National Autistic Society website they say Aspergers doesn’t necessarily mean having early age learning difficulties.

I would say that the newer DSM-V is more inclusive than the old one.
The NHS is supposed to be introducing ICD-11 this year so I would probably qualify for an Aspergers diagnosis when that happens - but it has been removed and lumped in with ASD.
Although I believe that a lot of practitioners will still mention Aspergers if it’s relevant as it’s easier to find information online (or in books) about it than just searching for ASD.


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firemonkey
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01 Feb 2018, 5:46 am

auntblabby wrote:
as a child, one of my shrinks thought I was autistic. another thought I was schizoid. i'm somewhere in between. "schizotypal autism"? :chin:


There was a 'schizotypal autism' page on Wikipedia until it got taken down as fake.



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01 Feb 2018, 5:47 am

It's never easy when a new edition of the DSM is released.

People still think, and have argued with me despite me being a psych major and someone who worked in behavioral health for years, that ADD is completely separate from ADHD. While it may be different, diagnostically it hasn't been for years.

It seems to me it may be the same with the transition from the DSM-IV to the DSM-V. People have this now outdated preconceived idea of what something is without doing their research on what is current diagnostically. I can't even begin to count the eye rolls I got when I went into my oldest son's IEP evaluation last year. He had a previous dx of PDD and moderate/severe ADHD - mindblowingly no one ever bothered to check off the criteria for Asperger's during that time frame. When we did the eval I tried to explain that he currently met the criteria for high functioning autism and his teachers could not contain their facial expressions. I wanted to speak my mind, but I knew they had this idea in their head and they were not educated on the current facts and how the DSM had changed.

After the testing was completed his school psychologist grabbed me by the shoulder and very passionately said he was very delayed for his age and needed all the help he could get. Which was ironic because she was initially the main one who was adamantly opposed when I brought up IEP eval testing. At the time he only had a 504.



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01 Feb 2018, 6:42 am

Yeah, its likely I am part of the 75% but won't know for sure until I can get reevaluated. Its very possible what I have is a combination of ADHD and severe social anxiety, paired with an isolated childhood (leading to a lack in social skills).

I do have BPD, though. So many people think if you have ASD, you can't have BPD. Which is insane...even if I don't have ASD, there's so much false info out there about mental health in general that sometimes I wonder if psychologists aren't just guessing. Or if people like being stupid. Or both.



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01 Feb 2018, 1:07 pm

Discussing DSM manuals only in this post

First of all, any DSM IV diagnosis of Aspergers is supposed to stay but be renamed.
Autism Spectrum Disorder (ASD) diagnostic criteria - CDC

Quote:
Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.


Prior to the DSM 5 coming into effect in 2013 there were these fears of massive underdiagnosis. At most the DSM 5 might have stopped the rapid increase in Autism diagnosis.
Prevalence of autism in U.S. remains steady, new data suggest
Quote:
The prevalence of autism in the United States remained relatively stable from 2014 to 2016, according to a new analysis. The results were published 2 January in the Journal of the American Medical Association1.

The researchers report the frequency of autism in the U.S. as 2.24 percent in 2014, 2.41 percent in 2015 and 2.76 percent in 2016, respectively. The new data come from the National Health Interview Survey — a yearly interview in which trained census workers ask tens of thousands of parents about the health of their children. These questions include whether a healthcare professional has ever told them that their child has autism.


Clinicians can still either not follow the DSM or strictly or loosely interpret the manual. If a psychologist thinks that "high functioning" autism not "real autism", a bunch a spoiled brats he or she can find justification for finding that the client is not autistic. The opposite is also true.


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01 Feb 2018, 1:20 pm

There are some entities in the US which use the ICD-10, rather than the DSM-V.

Under the ICD-10, Asperger's is still an official diagnosis.



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01 Feb 2018, 1:32 pm

The new diagnostic label of ASD does require an individual who would've previously fulfilled Asperger's criteria to fulfill one more additional criterion than s/he used to. So, yes, it is more strict. I don't honestly know about the 75% percent claim though.

In addition, many centers around the country are moving away from informal diagnostic procedures and using the ADOS-G, which, I suspect, many currently diagnosed with Asperger's would no fulfill. The ADOS-G is notoriously strict. I know I would not pass. As a researcher, while I'm all for consistency in diagnosis, I think the ADOS fails to identify a broad enough array of the spectrum. Especially in adults and especially in women.


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02 Feb 2018, 8:02 pm

This may, or, may not be relevant, but, in mid-childhood, I was diagnosed with Autism. Several years, ago, I was diagnosed with Asperger Syndrome. Close to a year, ago, I had an identity crisis, after realizing I process emotions far differently than most of my Aspie counterparts I have come in contact with, and I requested reassessment and received an ASD Level 1 dx. But, indeed, AS was long gone from the DSM at that point. My ASD therapist adamantly stands by my AS dx.



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02 Feb 2018, 8:36 pm

I like the casual term ‘spectrum.’ :D as in, it’s so much more interesting to be ‘spectrum’ than plain vanilla (even though it definitely causes problems!)

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and maybe DSM-5 is an improvement, but clinicians seem to give short shift to sensory issues