Report of the DSM-V Neurodevelopmental Disorders Work Group

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Also, I feel it's important to mention that I can't really ignore the ASD; I can only maintain certain skills that don't come naturally, like eye contact and body language. On the inside I have no clue what I am doing because it's happening at an unconscious level. I am acting with the exception that I'm Not acting.

I won't comment on this.

Here is a pdf of a press release from the dsm-5 working group.
http://www.dsm5.org/Newsroom/Documents/ ... 202.05.pdf
And here is the text for those not wanting or having a pdf reader. I tryed to wordwrap but this was copyed from the pdf.


For Information Contact: EMBARGOED For Release Until:
Beth Casteel 703-907-8640 February 10, 2010, 12:01 AM EST
[email protected] Release No. 10-09
Jaime Valora 703-907-8562
[email protected]
EMBARGOED UNTIL FEBRUARY 10, 2010 12:01 AM EST
DSM-5 Proposed Revisions Include New Category of Autism Spectrum Disorders
Name Change for Mental Retardation Also Proposed
ARLINGTON, Va. (Feb. 10, 2010) – The American Psychiatric Association’s draft proposed diagnostic criteria for the fifth edition of Diagnostic and Statistical Manual of Mental Disorders(DSM) will include new categories for learning disorders and a single diagnostic category,“autism spectrum disorders” that will incorporate the current diagnoses of autistic disorder,Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder (not otherwise specified).The DSM is the standard classification of mental disorders used by mental health and other health professionals for diagnostic and research purposes. The APA today announced many of the proposed diagnostic criteria, which will be available for public comment until April 20. The proposed criteria will be reviewed and refined over the next two years. During this time, the APA will conduct three phases of field trials to test some of the proposed diagnostic criteria in real-world clinical settings.
The DSM-5 Neurodevelopmental Work Group members have also recommended that the diagnostic term “mental retardation” be changed to “intellectual disability,” bringing the DSM criteria into alignment with terminology used by other disciplines and the Department of Education. In addition, the Work Group is recommending that there be only one diagnosis for intellectual disabilities, with severity defined not only by IQ, but also by impairments in adaptive functioning. “In suggesting these revisions, the work group has considered the many advances in the field of autism and neurodevelopmental disorders, as well as the concerns of advocacy groups, family members and the medical groups who treat those living with autistic disorders,” said David Kupfer, M.D., chair of the DSM-5 Task Force. The proposed revisions to the neurodevelopmental disorders in DSM-5 also include a newoverarching category of learning disabilities, containing two subcategories: dyslexia (related to reading) and dyscalculia (related to mathematics). Edwin Cook, M.D., a member of the DSM-5 Neurodevelopmental Disorders Work Group, emphasized that the diagnostic criteria were relatedto a person’s age, intelligence and opportunity to acquire skills, and that individually administered, culturally appropriate and valid measures should be used to evaluate the learningdisabilities. “It’s important that we differentiate between the presence of a learning disability and the expected variations in individual abilities,” Dr. Cook said. The recommended DSM-5 draft criteria for autism spectrum disorders include a new assessment of symptom severity related to the individual’s degree of impairment. The draft criteria also specify deficits in two categories: 1) social interaction and communication (e.g., maintaining eye-to-eye gaze, ability to sustain a conversation and peer-relations) and 2) the presence of repetitive behaviors and fixated interests and behaviors. Additionally, in recognition of the Neurodevelopmental nature of the disorder, the criteria require that symptoms begin in early childhood. Clinicians must take into account an individual’s age, stage of development, Intellectual abilities and language level in making a diagnosis. “The Recommendation of a new category of autism spectrum disorders reflects recognition by the work group that the symptoms of these disorders represent a continuum from mild to severe, rather than being distinct disorders,” said Dr. Cook. In addition to specifying a range of severity of ASD, the criteria will include description of the individual’s overall development, course (e.g. regression), and language. “We expect that the proposed changes will improve the sensitivity and specificity of the criteria for autism spectrum disorders, so that clinicians may be able to more accurately diagnose these disorders.” Public Review of Comments to Draft Changes All proposed draft changes to DSM are being posted on the Web site www.DSM5.org for public review and comment until April 20. More information on the process for developing DSM-5 is also available on the Web site. Final publication of DSM-5 is planned for May 2013.

The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psych.org and www.healthyminds.org.

Let me get this straight- they're combining all these diagnoses into one ASD? Won't that mean much more generalized therapy and services, which won't be tailored to individual needs? Our special education system has enough problems with that.
Wrongplanet should sponsor some kind of protest about this. Anyone know how to get in touch with whoever maintains the site? I tried email, but never got a response. Maybe a message to his YouTube account. Also, we should email/write to APA.

Perhaps we need to wait and see how the new approach to add more finegrained details (clinical specifiers) to the diagnosis is to be implemented? By making the diagnosis less specific it might get more people to realise that the diagnosis is not the individual and that services need to be targeted to the particular needs.

actually I feel the effect will be quite the opposite. The problem with separating them is people get the idea that theres a specific set of issues for people with HFA and a specific set of issues for those with AS. But in reality someone diagnosed with AS could have just as many if not more difficulties than HFA and vise versa. They can also have certain issues people wouldnt think those with AS would have. It seems to me drawing a line in the spectrum makes no sense if you cant possibly define it consistently. For one its impossible to define where that line is because of the spectrum nature, for another its hard to say which side of that line a patient may fall under. What people are starting to realize, is its irrelevant whether someone is AS or HFA, what matters is recognizing the individual difficulties regardless of what they are and understanding they are autism related. In my opinion, people will be much better served by merging the diagnosis into one category. Less focus on categorization, more focus on assisting the people seeking help.

I agree with you Auntyjack on this one as that is what happened with my oldest son, originally dx'd with PDD-NOS at 29 months solely based on the ADOS which only shows one day of observation compared to what he's like at home, etc... he was having a good day that day so trusting the ADOS alone bothers me. Once they did a combination of ADOS and ADI-R around 41 months old, he showed clearly as having Autism. He didn't receive as thorough of services under the PDD-NOS label as he did when they switched it to Autism. I really hope that encompassing it all into one dx. will help people understand that no matter how high or low functioning, services should still be provided.

I do not know. Is any change in the dx. really going to help or hurt us as a group that much if the group itself has factions at war with each other? I tire of seeing comments on blogs and forums alluding to all Aspies/HFAs as being elitist jerks who want nothing to do with the lower functioning austistics and other comments made by the few Aspie/HFA elitist jerks that show a holier than thou attitude towards anyone who does not have their favorable diagnosis. In the end, it is not going to be some dictionary of diagnosis that determines what services we receive. That is going to be up to us, along with those who support us whole heartedly, to get the services needed by all members of the autistic community. That is hard to do when some on one side of the spectrum considers everyone on the other side of the spectrum as only worthy of their hate. How are neurotypicals going to even take us seriously and see that they do discriminate against us and form stereotypes about autism if there are members of the community who form stereotypes about others of the same community?

Until just a few minutes ago, I had no problem at all with DSM-V merging AS into Austism. Now I have a big problem with it, but it's not the merge itself that bothers me. It's the fact that the actual criterion are changing, and NOT in a good way for many of us.

In case you haven't seen the actual changes being proposed, here they are:

DSM-IV now reads:

Asperger’s Disorder

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

(1) marked impairment in the use of multiple nonverbal behaviors 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 achievements with other people (e.g., 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 behavior, 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 (e.g., 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 (e.g., 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 behavior (other than in social interaction), and curiosity about the environment in childhood.

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


DSM-V proposed changes:

Autism Spectrum Disorder

Must meet criteria 1, 2, and 3:

1. Clinically significant, persistent deficits in social communication and interactions, as manifest by all of the following:

a. Marked deficits in nonverbal and verbal communication used for social interaction:

b. Lack of social reciprocity;

c. Failure to develop and maintain peer relationships appropriate to developmental level

2. Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:

a. Stereotyped motor or verbal behaviors, or unusual sensory behaviors

b. Excessive adherence to routines and ritualized patterns of behavior

c. Restricted, fixated interests

3. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)[u]


So basically what they've done is they've taken a system that now allows for quite a lot of diversity among us, which we ALL know exists (a concept that Asperger and Uta Frith supported), by allowing two out of four symptoms so that if you don't qualify with one, you may with another, and another two out of three symptoms, with the same flexibility (if you don't qualify with one, you may with the other two, and three more "non-negotiables" and changed that to a system of seven symptoms, four of which you must have, and then three out of which you must have two or, "Sorry, you don't have Autistic Disorder."

What they've done is to dumb down the symptoms, making it easier for themselves to diagnose, MUCH easier to dismiss a dx, and quite possibly leave a HUGE number of people with this problem out in the cold!

If you weren't concerned about it before, as I wasn't, you should be now! If this thing does pass, YOU may be told you don't qualify anymore! And if that happens, for a lot of you, THERE GOES YOUR SUPPORT SYSTEM!

I gotta tell ya. I'M PRETTY STEAMED NOW!! !

I don't really care WHAT it's called (Aspeger called it Autism!), but I sure do care a whole lot that they are deliberately narrowing the chances for a lot us who desperately NEED help, to get it!

Why do I suddenly have a sneaking suspicion that a bunch of big lobbyists for insurance companies just might be behind all this?

Asperger must be rolling in his grave muttering, "Man, they just don't GET IT!" No way on earth would I believe that Uta Frith agrees with this after reading her work. This idiocy ('scuse me I'm mad!) cuts out the core of what makes this disorder what it is for crying out loud!

They're trying to take something that's complicated, and very difficult to explain and understand, and make it simple and easy for NT's to grasp. Well it's NOT simple, and it's never going to be easy for NT's to grasp! All this does is provide an easy way to brush it under the rug so the rest of the world can go back to ignoring it like they always have. Hell, they don't need it dumbed down to ignore it. Too ------ many of them are already ignoring and dismissing it!

This crapola is just going to make it easier for them to keep doing it.

Last edited by MrXxx on 28 May 2010, 3:44 am, edited 8 times in total.

Don't be to sure about that. That's exactly the line of thinking I had too until I actually looked at the proposed merge. If they make the diagnostic changes they're proposing, a whole bunch of us will suddenly no longer qualify according to them.

Good points regarding everything else you said in that post though. I couldn't agree more.

Let's take a mathematical look at the differences between current criterion, and the proposed criterion. Maybe this will enlighten some of you:

DSM-IV:

Item A: Two out of four symptoms allows for 8 subtypes that can fit item A

Item B: One out four allows for 4 more subtypes that could fit item B

The rest are all "must fits" so they don't change anything, because it only multiplies the above subtypes by one.

This means the current criteria allows for a minimum of 24 subtypes, with more subtypes added for those who have more symptoms than are necessary.


DSM-V:

The only item in DSM-V that allows for any flexibility is item 2, which allows for 2 out of 3 symptoms, for a total of 6 subtypes.

This means if DSM-V is approved, we've dropped from 24 possible subtypes down to only 6.




Symptoms eliminated:

"(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)" - GONE

"(4) lack of social or emotional reciprocity" - HALF GONE [They're taking emotion out]

"(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus" - GONE (Uh - what? This one is a classic hallmark of AS!)

"2) apparently inflexible adherence to specific, nonfunctional routines or rituals" - GONE


"(4) persistent preoccupation with parts of objects" - GONE

"E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood." (This one actually makes some sense to me to eliminate since it clearly isn't true of many of us)

"C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning." - GONE (you've got to be kidding me!)

"D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years). " - GONE

"E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood." - GONE, BUT GOOD RIDDANCE IMHO! What on earth this was doing there to begin with is beyond me! What about AS kids and hygiene for crying out loud?

Feel free to pick apart the analysis. I was pretty tired when I did this, and may have overlooked some details.

No question I'm still in the process of trying to get a complete handle on this, and it does look as if, at least in some cases some of the lost symptoms could be construed to fall under something in the DSM-V, but the problem is, ii's going to be far easier for a lot of professionals already predisposed to dismiss Autistic behavior, to do so even more frequently if this goes through.

No question in my mind anymore. I AM definitely dead set against this change.

A lot of us are going to regret it if it passes.

Seriously, what about the new criteria do you feel is wrong for a diagnosis of AS?
Your numbers argument is meaningless as most of these subtypes are not subtypes at all because of the problems in DSM-IV criteria. Some criteria are really just examples of the same aspect. Basically its a mess. DSM-IV needs fixing. Not personally sure DSM-V is the answer but its better than IV IMO.

This is not a proper criteria, just an arbitrary example of a lack of social interaction which would contribute to diagnosing the Social dimension.


Could you give an example of emotional reciprocity that has no social dimension?


"2c. Restricted, fixated interests" ?


"2b. Excessive adherence to routines and ritualized patterns of behavior" ?


What is the significance of this? Is it not just another form of restricted, fixated interests?


"1. Clinically significant, persistent deficits in social communication and interactions..." ?




Obviously as this simply served to distinguish AS from AD - were lots of problem with this criteria.

Like I said, I am not convinced DSM-V is right but it is a hell of a lot better than IV.

I think more usefully would be to say which part that DSM-V requires would you consider to be something that could be removed and still be an example of an individual with AS?

First let me say I really WAS hoping someone would pick through my analysis. It's never a good idea, especially when you have restricted processing systems, to draw conclusions on your own. I haven't drawn any "final" conclusions yet, just so you know. Making it look like I have is one way I have to get a REAL dialogue going on the real issues. In this case almost everyone sees to think the issue is the label, when the real issue ought to be how they are defining AS or AD, regardless of what it's called.

It's too simplistic. Each item is far too broad and open to interpretation, which will lead to two separate and opposing positions. One, there will be those who choose to use broad interpretations of the new "simpler" criteria, and two, there will be those who interpret them narrowly. The former are most likely going to be professionals that are already "seeing" Autism where many others are not, and the latter, who already may have a problem with the condition "fitting" what they consider criterion to be too broad, will find it much easier to dismiss by applying much narrower interpretations.

One current real life example of narrow interpretation is a Psychologist who insisted my eldest son couldn't possibly have AS because he doesn't have any "specialized interests." That's just one of several examples I have experienced myself.



Obviously I disagree with your assessment of the numbers argument, else I wouldn't have used it. But I should, at this point, clarify that I do NOT mean for the numbers to be taken as literally as many may think I meant them to be. You are very correct that some of the criteria that have seemingly been removed can, and in my opinion SHOULD be considered to be part of, or "included" in some of the new criterion.

The problem is that now that they are no longer specified, as I said above, they will become much easier to dismiss.

I use mathematical analysis like that, not to present a definitive "here's what's happening," but as a tool, or a springboard from which to determine what to look at next. "There used to be 24 correct answers to this problem, now there are only 6," isn't meant to be taken literally. But when you see a list "this long" with several options for correct answers, shrink to a list "this long" with far less options for correct answers, it is sometime helpful to quantify the difference, then look at how many of the answers to the former, are encompassed in answers to the latter.

This would have been my next step, and that's exactly what we're doing here. Clearly we don't agree on some points here, but hey, we wouldn't be having this discussion if everyone agreed now would we?



Why is this not a "proper" criteria?" Though I do see that it could be looked at as an example, to me it's much more than that. It is an example, but it is an example of a specific aspect of AS that happens to be quite wide spread, and very marked when it does appear. Excluding it allows for this classic symptom to be arbitrarily accepted or dismissed. Keeping it there gives those of us who see professionals that will not take it into consideration the ability to point to it and say, "It's right there, and it describes your patient."

And it is part of a small group of criterion that may or may not apply, so it's not has if one "has" to display it, else one doesn't qualify. It's just one specific out of a few others that helps, and because it's there, SHOULD NOT be dismissed.

Now that it isn't there anymore, doctors can easily decide to pay no attention at all to it, and we have no means of telling them they shouldn't other than our own opinions.






It's not that difficult to be apathetic, yet still be very sociable. Not all Aspies lack social reciprocity. The criteria as it reads now allows for social reciprocity, without emotional reciprocity. The new criteria does not. Kids like my eldest son are great examples of this. He makes friends very quickly and loves to join groups. He's the one Aspie who will gravitate toward the center of a crowd (though not always, it depends on the situation), yet when it comes to emotional give and take with the same people he, for all intents and purposes, appears to be very social with, there is none.

This criteria, as it currently reads, means we have to dig deeper than surface appearances. When a child appears to make friends easily, and be socially adept, we need to start looking at whether that appearance is merely superficial or if the child is forging real emotional bonds.

The criteria as it will read means we don't have to look any further if the kid appears to be making friends.




This one should fit, but will it? I'm concerned with the shortened wording, again, because it takes away from the specificity of the original wording. I'm a little aloof on this point. Not sure if I'm okay with it or not. I'm definitely uncomfortable with it. I'm of the ilk "if it ain't broke, don't fix it." Makes me nervous whenever things are changed that were working perfectly fine before the change.




First of all, they took the word "apparently" out. That word is VERY important as many Autistic behaviors are too easily misinterpreted. It may not be that the Aspie is inflexible in his/her routines. It may only be that WE haven't yet figured out what motivates them to flexibility.




It's very different actually. A kid with fixated interests might play with and talk about nothing but cars. He might race toy cars on tracks, collect them, and talk about them to, or almost to the exclusion of all other topics.

I kid with preoccupation with parts of objects might turn the cars upside down and spin their wheels instead of actually playing with them as most kids would do, and never be interested in doing anything else with them, performing similar acts with other toys. It's very, VERY different.




Again, the wording is over simplified, and doesn't encourage those predisposed to dismiss symptoms to think outside their own boxes of understanding. The current wording DOES encourage them to consider things they might not otherwise consider.





I totally agree with you on this point. "Clinically significant" leaves a lot of room for interpretation. I have another son, who we suspected had AS when he was one year old. He was evaluated and it was quickly dismissed, in part because his speech was somewhat delayed.

He received a dx from the school Psychologist seven years later. The doctor who dx'd him knew nothing of our concerns. I have a problem with this one as it is, but don't agree that simply dropping it is the answer.




Have to say I totally disagree with you on this. I think they are proceeding in the wrong direction, simplifying things instead of becoming more detailed. AS is not simple. It is very, very complicated and even somewhat ambiguous (at least in appearance. There are things about it that are extremely difficult to understand, and creating an apparently simpler means of dxing does nothing but make the doctors jobs easier. It does nothing for expanding the understanding of the condition.




Sorry I'm really not understanding this question at all. All of my complaints so far have been about what the DSM-V removes from current criteria, not what it adds.

It doesn't ADD anything. It takes away. Why would I want anything taken out of it? I would like it to be even more detailed than DSM-IV.

Yeah, it would be more complicated to arrive at accurate diagnoses. It should be! AS is not something that can be determined simply. It's far too complex. The criterion became the way they are because too many people weren't getting it. Simplifying it does nothing but stroke the need for simplistic answers to a extremely complex problem. the vast majority who do not want to take the time that's necessary to take to fully understand such a complex problem might be very happy with it. And that's really too bad, because instead of leading to better understanding, this seems to me to be far more likely to lead to it being ignored more than ever before.

Hans Asperger's work was about EXPANDING contemporary understanding of Autism. DSM-V seems to me to be all about narrowing it. Totally dismissive of the spirit of his work IMHO.

First let me say I really WAS hoping someone would pick through my analysis. It's never a good idea, especially when you have restricted processing systems, to draw conclusions on your own. I haven't drawn any "final" conclusions yet, just so you know. Making it look like I have is one way I have to get a REAL dialogue going on the real issues. In this case almost everyone sees to think the issue is the label, when the real issue ought to be how they are defining AS or AD, regardless of what it's called.

It's too simplistic. Each item is far too broad and open to interpretation, which will lead to two separate and opposing positions. One, there will be those who choose to use broad interpretations of the new "simpler" criteria, and two, there will be those who interpret them narrowly. The former are most likely going to be professionals that are already "seeing" Autism where many others are not, and the latter, who already may have a problem with the condition "fitting" what they consider criterion to be too broad, will find it much easier to dismiss by applying much narrower interpretations.

One current real life example of narrow interpretation is a Psychologist who insisted my eldest son couldn't possibly have AS because he doesn't have any "specialized interests." That's just one of several examples I have experienced myself.



Obviously I disagree with your assessment of the numbers argument, else I wouldn't have used it. But I should, at this point, clarify that I do NOT mean for the numbers to be taken as literally as many may think I meant them to be. You are very correct that some of the criteria that have seemingly been removed can, and in my opinion SHOULD be considered to be part of, or "included" in some of the new criterion.

The problem is that now that they are no longer specified, as I said above, they will become much easier to dismiss.

I use mathematical analysis like that, not to present a definitive "here's what's happening," but as a tool, or a springboard from which to determine what to look at next. "There used to be 24 correct answers to this problem, now there are only 6," isn't meant to be taken literally. But when you see a list "this long" with several options for correct answers, shrink to a list "this long" with far less options for correct answers, it is sometime helpful to quantify the difference, then look at how many of the answers to the former, are encompassed in answers to the latter.

This would have been my next step, and that's exactly what we're doing here. Clearly we don't agree on some points here, but hey, we wouldn't be having this discussion if everyone agreed now would we?



Why is this not a "proper" criteria?" Though I do see that it could be looked at as an example, to me it's much more than that. It is an example, but it is an example of a specific aspect of AS that happens to be quite wide spread, and very marked when it does appear. Excluding it allows for this classic symptom to be arbitrarily accepted or dismissed. Keeping it there gives those of us who see professionals that will not take it into consideration the ability to point to it and say, "It's right there, and it describes your patient."

And it is part of a small group of criterion that may or may not apply, so it's not has if one "has" to display it, else one doesn't qualify. It's just one specific out of a few others that helps, and because it's there, SHOULD NOT be dismissed.

Now that it isn't there anymore, doctors can easily decide to pay no attention at all to it, and we have no means of telling them they shouldn't other than our own opinions.






It's not that difficult to be apathetic, yet still be very sociable. Not all Aspies lack social reciprocity. The criteria as it reads now allows for social reciprocity, without emotional reciprocity. The new criteria does not. Kids like my eldest son are great examples of this. He makes friends very quickly and loves to join groups. He's the one Aspie who will gravitate toward the center of a crowd (though not always, it depends on the situation), yet when it comes to emotional give and take with the same people he, for all intents and purposes, appears to be very social with, there is none.

This criteria, as it currently reads, means we have to dig deeper than surface appearances. When a child appears to make friends easily, and be socially adept, we need to start looking at whether that appearance is merely superficial or if the child is forging real emotional bonds.

The criteria as it will read means we don't have to look any further if the kid appears to be making friends.




This one should fit, but will it? I'm concerned with the shortened wording, again, because it takes away from the specificity of the original wording. I'm a little aloof on this point. Not sure if I'm okay with it or not. I'm definitely uncomfortable with it. I'm of the ilk "if it ain't broke, don't fix it." Makes me nervous whenever things are changed that were working perfectly fine before the change.




First of all, they took the word "apparently" out. That word is VERY important as many Autistic behaviors are too easily misinterpreted. It may not be that the Aspie is inflexible in his/her routines. It may only be that WE haven't yet figured out what motivates them to flexibility.




It's very different actually. A kid with fixated interests might play with and talk about nothing but cars. He might race toy cars on tracks, collect them, and talk about them to, or almost to the exclusion of all other topics.

I kid with preoccupation with parts of objects might turn the cars upside down and spin their wheels instead of actually playing with them as most kids would do, and never be interested in doing anything else with them, performing similar acts with other toys. It's very, VERY different.




Again, the wording is over simplified, and doesn't encourage those predisposed to dismiss symptoms to think outside their own boxes of understanding. The current wording DOES encourage them to consider things they might not otherwise consider.





I totally agree with you on this point. "Clinically significant" leaves a lot of room for interpretation. I have another son, who we suspected had AS when he was one year old. He was evaluated and it was quickly dismissed, in part because his speech was somewhat delayed.

He received a dx from the school Psychologist seven years later. The doctor who dx'd him knew nothing of our concerns. I have a problem with this one as it is, but don't agree that simply dropping it is the answer.




Have to say I totally disagree with you on this. I think they are proceeding in the wrong direction, simplifying things instead of becoming more detailed. AS is not simple. It is very, very complicated and even somewhat ambiguous (at least in appearance. There are things about it that are extremely difficult to understand, and creating an apparently simpler means of dxing does nothing but make the doctors jobs easier. It does nothing for expanding the understanding of the condition.




Sorry I'm really not understanding this question at all. All of my complaints so far have been about what the DSM-V removes from current criteria, not what it adds.

It doesn't ADD anything. It takes away. Why would I want anything taken out of it? I would like it to be even more detailed than DSM-IV.

Yeah, it would be more complicated to arrive at accurate diagnoses. It should be! AS is not something that can be determined simply. It's far too complex. The criterion became the way they are because too many people weren't getting it. Simplifying it does nothing but stroke the need for simplistic answers to a extremely complex problem. the vast majority who do not want to take the time that's necessary to take to fully understand such a complex problem might be very happy with it. And that's really too bad, because instead of leading to better understanding, this seems to me to be far more likely to lead to it being ignored more than ever before.

Hans Asperger's work was about EXPANDING contemporary understanding of Autism. DSM-V seems to me to be all about narrowing it. Totally dismissive of the spirit of his work IMHO.

The E. in the DSM IV seems to apply to me very well.
A secondary point is the emotiveness around the usage of Autism and Aspergers in the general populace.
Say (disclose) you have AUTISM and people look at you in a funny (not haha) way and start treating you like an idiot (sorry only term I could think of). Where as ASPERGERS does not elicit an immediate sympathy response and once explained to a person generally is not seen solely as a negative and you can retain the ability to talk to that person without them attempting to dumb everything down.

Why doesn't the DSM include some mention of sensory processing issues?