DSM-V Contradiction

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For years people have been saying AS is a difference, not a disability. Well now here it is, their dream has come true, they are taking it out of the DSM and now they are throwing a fit about it. but if it's such a difference, then they wouldn't need any support right or any services? After all it is not a disability. But wait a minute, those who are freaking out about this are probably the ones who have never claimed it wasn't a disability. It is one of my pet peeves when I hear it's not a disability. If it's not, then there be no accommodations for it would there? We wouldn't need help and the support we need if it wasn't a disability. Maybe they have finally gotten convinced it's not a disability so they are taking it out and making it all autism.


People are also thinking doctors are doing this for money. People are saying how schools are running out of money helping students with autism so they decided to eliminate the high functioning ones just to save money on helping kids so they would only help the ones who are far more disabled than the high functioning ones. Also the schools wouldn't have to help the high functioning students either and only help more of the severe ones. I also hate people saying how the high functioning kids are taking the help away from the kids who "really need it." Basically they are doing the "They are more disabled than your child" crap so they would rather throw the higher functioning ones under the bus thinking they don't need the help and they can make it in life without it.

That's right! & I never said it was not a disabillity. The ones who say that can function better than I can & live independently, some have spouses & raise children & have good jobs, etc. so for them, it is NOT a disability, just a "difference". For me, it is far more than a difference, it is a disability, an impairment. & yes, they ARE doing it to save money. They ARE looking to just help the "lower" ones & throwing the "higher" ones under the bus saying, "Well they can fend for themselves!" Well I may appear "higher" to clinicians, but it is not a fair assumption, because they do not see the hardships I have, so they are very insensitive to my difficulties. It really pisses me off to hear, "Well, you can type on the computer, therefore, you can travel in the city yourself and/or travel at night by yourself or live by yourself, etc.!" Totally different things, Morons who say that to me! I don't totally agree w/ this whole "Higher or lower functioning-schmunctioning" thing, anyway. I believe that there are people who need DIFFERENT types of help, but I am not "higher" than anyone. I do know that there are a lot of ppl who function better than me, w/o help, tho. You set the bar too high for me, I am bound to fail!

_________________
I always know the right thing to say,....AFTER the right time has already passed,....

This information, the figures which are causing all this fuss, did not come from the people who are revising the DSM criteria.

This one study, reported in one newspaper, was co-authored by someone who resigned from the group revising the DSM. It is one small study, based on old data, and it seems not even to have been published yet, but have been presented to a conference in Iceland.

The group who are reviewing and revising the DSM do not agree with his findings.

The rationale for the changes is available on the DSM website. It has become apparent over the years since the introduction of the current criteria that while the boundaries, if you like, of Autism Spectrum Disorder are working well and are understood and applied with consistency, there is confusion about the boundaries within the broader ASD diagnosis. Asperger's lies within the clear and consistent boundary of ASD.

These changes have been proposed based not on financial considerations which are the concern not of the review group, but of education, health, social care etc providers around the world, but instead on the actual experiences and considered opinions of those involved in assessment and diagnosis of ASDs.

Marcia-
The point of this entire thread is that I believe there are two apparent contradictions in the committee recommendations for revision 5 of the DSM as they relate to the new diagnostic criteria for ASD. At no point in my arguments have I presented information from the NY Times article which I believe fails to capture the weakness of criteria C and D. The fuss from my perspective is the short comings of the new diagnostic criteria.

As the DSM committee itself notices in his recommendation to eliminate Asperger's, there are considerable financial implications of a diagnosis. These financial considerations are not only confined to research funding but also to the patients themselves. In terms of the economic consideration of the individual, the new criteria should have little impact on those receiving direct governmental disability funding however the largest effect will be seen in academic settings. If reasonable accommodations are no longer available to those high functioning individuals who lose their diagnosis , the long term economic cost will be quite dramatic. Their test scores will drop and access to university education will be diminished. This may potentially deny the world of the individuals contribution and will most likely increase unemployment roles. (the unemployment rate is much lower for college educated individuals)

I'm very confused about all of this. I was diagnosed almost a decade ago, and I believe I fit most of the new DSM requirements, but I'm also very good at faking eye contact for a short period of time and am extremely good at parroting verbal intelligence on most subjects I know nothing about. I'm on SSI currently, and the extra money is really helpful for my family and me during this economic struggle. I also plan to use some of it to fund my education...

Will I need to go in for a reevaluation in 2013?
Will it effect obtaining extra help I need with studying in school if I do not meet these qualifications?
I'm very concerned, and extremely uncertain of if I'm reading this right... so...

The proposed plan of action is to remove Asperger's Syndrome from the DSM and replace it with Autism Spectrum Disorder, but the diagnosis for it is more rigid than for Asperger's? Will it change current diagnosis, or only those diagnosed in the future?

I'm just not really understanding what I'm reading, despite having read it four times...

Verdandi-
It is my belief that based upon criteria C and D discussed in depth on page 1 of this thread will preclude many individuals from a diagnosis.

In summary for criteria C, symptoms have to be present in early childhood. Aspeger's is frequently diagnosed frequently much later in life and as a result proving the presence of the behaviors is retroactively difficult.

For criteria D, the revised diagnostic criteria introduces the word "limit" to the existing criteria of impair as it relates to daily activities. It is my contention that if an individual is able to overcome the impairment regardless of the amount of work involved, to obtain a 'normal' level of a daily activities a diagnosis would not be possible because the symptoms are not limiting.

But to your point, based upon the new definition, all of those receiving government subsidies will still meet the diagnostic criteria. My concern is that high functioning individuals that need reasonable accommodations (more time on a standardized test, different lighting conditions etc) will be denied because their symptoms are not limiting.

If the condition isn't limiting, they wouldn't need extra time on a test or different lighting because they wouldn't be limited.

If they do need those things, they are - by definition - limited.

I had to establish a history going back to childhood for my AS diagnosis already, and that wasn't a problem. It's not always necessary to conclusively prove behaviors, but a matter of reporting them, as with everything else. It helps to have a parent or school records or whatever, yes, but I am curious if anything in the materials has indicated this will be a difficult criteria to meet.

This topic comes up quite frequently, and the arguments for and against have pretty much all been covered over and over.

I choose to view it this way:

Will some (or even many) people currently considered to be "Autistic" not be diagnosed with Autism in the future using the new criteria? The answer is yes. Some will not be diagnosed that might be using the current criteria.

But, some are already not being diagnosed, even with the current criteria.

It all boils down to the opinions of the diagnosing doctors. Even today some doctors are more strict than others in their interpretations and evaluations. The changes being made are mainly to the labeling, not so much the criteria (if you compare what's going to be in the ASD criteria to ALL current labels associated with Autism).

Next year, when the new DSM takes effect, the SAME doctors who are diagnosing AS, PDD-NOS, HFA, Autism, et. al. will still be diagnosing Autism. Those who are currently strict in their interpretations still will be, and those who are more liberal in their interpretations still will be.

Ergo, nothing much will change.

Verandi-

C- There is a very long discussion on this thread regarding the differences between the word limit and impair. The authors have chosen to add the word limit which implies that the term must have a different meaning than impair. In terms of the additional time example, the symptoms would only "limit" their functioning if scores were detrimentally impacted. The ability to complete the task on time would be an impairment.

D-
The committee in its recommendation to remove Asperger's from the DSM cited (http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=97#)

" Early language details are hard to establish in retrospect, especially for older children and adults; average age of first diagnosis is late (7 years according to Mandell et al. 2005; 11yrs, Howlin & Asgharian, 1999)."

I am not a clinician but those members of the same committee are citing the creation of a history as a prohibitively difficulty in the establishment of a diagnosis.

if you already have a diagnosis will it still be honored or will you have to get a new one.

I have been thinking about the "limit and impair" issue.

I have less than perfect eyesight. It's not really bad, but I do now have to wear varifocals to drive and when I am doing public speaking, so I can see both my notes and the people I'm speaking to.

So, my vision is impaired.

Without my glasses, I would be limited in what I can do, eg, driving a car and public speaking which is an essential part of my job.

My son's social communication is impaired and that limits his social interaction.

Marcia
You are correct that your need for glasses constitutes an impairment. However legal blindness would constitute a limit.