Will DSM V prevent some adults being diagnosed with Autism?

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I'm seeing a number of debates that seem to touch on aspects of this elsewhere on WP most recently here:-
http://www.wrongplanet.net/postt201474.html

However, I'm very confused and don't have time to read through all the possible posts on this on WP just now

So can someone explain - or point me at some good threads / links that will explain the following:-

[Apologies there are quite a lot of questions below]

My understanding is DSM V will get rid of Aspergers and PDD-NOS as seperate definitions, and instead there is a revised definition of autism, where it will not be required that there is a delay in verbal development...is this right?


Is the new DSM V definition of autism fixed yet - or is it still being debated?



The new proposed DSM V definition, if I read it right, seems to require that you have specific difficulties with socialisation, understanding / reading others etc...if you've learnt as you've got older how to handle these through lots of practice, allbeit it might be a bit of a struggle at times, - does this mean you can't be diagnosed with autism as an adult because you've now worked out how to cope?



Does it matter when you go for diagnosis i.e. if you get diagnosed when DSM IV is still in place, could it be possible you get diagnosed as having some kind of autism spectrum disorder (e.g. meet criteria for Aspergers or PDD-NOS under DSM IV), but come 2013 when DSM V comes in you won't be diagnosed as having an autism spectrum disorder even if you have exactly the same symptoms which got you a diagnosis under DSM IV?



Does it matter where you live, for example is DSM V used mainly the US so if you live in the UK or Europe is DSM V going to be used for diagnosis or will they use something else?



Given all the above, would it be better to seek to try and get diagnosed under DSM IV than DSM V or does it not really matter?



Given all the above, What happens to people who were diagnosed under DSM IV will they be required to be diagnosed again under DSM V? Is where they live likely to make a difference to this?

[edited once for typo]

The DSM is important in regards to insurance. If someone has autism they'll be automatically denied regular health insurance. They would be eligible for their state's guaranteed health insurance plan, but the cost is extremely high. For adults over 50, it's something like $1024/month. Can you imagine? If you didn't have any other predisposing conditions you can get regular insurance and just omit the bits about Asperger's. A diagnosis, then, would be done for one's edification, as it were.

Under the new definition, Asperger's folks would probably be classified as Type I. Severe autism is Type III. The title of autism itself would probably cause some people to "leave" the spectrum if the term Asperger's doesn't exist anymore. There's less of a stigma being diagnosed with Asperger's as opposed to autism. Asperger's seems to be synonymous with higher intelligence and higher function. Autism is seen as being related to mental retardation, Down's Syndrome, and so on.

Depends on location. About 20 of the US states explicitly have laws about autism and health insurance. These vary from you can't deny someone health insurance because of autism to you need to cover treatment for autism for any child with autism to treatment for autism spectrum disorders being covered for any person with a diagnosis (and diagnosis being covered too).

What's complicated is that each state has its own laws, and there are federal laws. Some health insurance is covered by the state's laws, others by the federal laws. Federal laws say nothing about ASDs, state laws sometimes do.

Personally, my health insurance (which I get through my parents still) covers my OT because its treatment for an ASD without limit, while for most OT and PT there is a limit of number of times you can see someone in a year.

Thank you for that info.

I'm very much still learning to appreciate how complex and difficult the US health insurance system seems to be. I didn't appreciate how many different exclusions there could be, and how much they could vary by state.

To narrow down my many questions above to just one simpler one - has the DSM V definition for autism been finalised yet or is it still being debated?

It's still being finalized, but the last public comment period has ended - that ended June 15th. They're making final decisions in December.

I don't really see much to appreciate, about the current U.S health insurance system that basically says....if you already have a disorder you don't qualify, If you can't afford it you don't qualify and a lot of times then don't have access to treatment essentially insurance companies are just profiting off of peoples misery. I mean it helps to learn how it works so you can get treatment you need and such, I can't really help you there as I have no idea.....but I would not worry about appreciating it, the reality is it sucks how complex and difficult it is.

Anyways as far as I know the DSM V definition has not been changed yet, but its likely it will....however chances are you would then qualify for a diagnoses of being on the autism spectrum. Unless you have no impairments I don't see how you wouldn't fit the criteria for being on the autism spectrum.

Sorry by appreciate, I meant get a better understanding of, not that the healthcare insurance system in the US was a good thing, sorry for any confusion.

I'm sure it works fine for some people, but it seems pretty uneven at best in how it treats people, and at times very unfair. However I suspect thats a debate for PPR at some point not here..

Your clarifications on DSM V are really helpful.

Thanks, everyone.

Yes it works pretty well for people with a decent amount of income and money who don't have per-existing health conditions. But yeah I'll save any more of this for the PPR section if it happens to come up as I don't want to derail your thread for it.

If you look at the history of the DSM, it has it roots in [no surprise here] The U.S. Department of Defense. I forget the Order or MIL-STD number offhand, but it was devised by an Air Force Psychiatrist as a [no surprise here again] standard way of classifying soldiers coming back from the front lines with different mental issues.

The DSM is the only "medical" manual where the diagnoses are decided on by committee, with huge influences by Big Pharma. It is 98% b*******. The 2% that actually makes sense, such as PDD, that can actually be observed clinically, is being diluted primarily because of Big Insurance and the current political climate, that believes in every man for themselves, no matter if you have a disability or not. One only needs to go to GRASP.org and read how they were treated by the task force on PDD when they asked questions as a somewhat neuteral party.

Frankly, why doesn't the U.S. just abandon the DSM, and use The World Health Organization's ICD-10? Because the American Psychiatric Association would end up losing $100 million dollars. Big Pharma would lose even more. Again, money talks, and b******* walks.

Maybe with the elimination of aspergers, that ridiculous stigma towards autism would end...Autism is a spectrum some people have it more severely than others. Downs Syndrome and Mental Retardation can probably be co-morbids but they are not related to autism necessarily, anymore than depression and anxiety are.

Co-morbid does not = related or same disorder.

From John Elder Robison's facebook page (link):

Does this include PDD-NOS?

Requoted from my post:



I bolded the bit about Asperger's because there has been so much complaining about losing AS as a label.

Last edited by Verdandi on 23 Jul 2012, 6:26 pm, edited 1 time in total.

Thanks Verdandi, that's really useful link.

My understanding is that in most of Europe the main diagnostic is ICD10 and this is not due for update until sometime after DSMV comes into being.

In the UK it seems that both the DSM and ICD 10 are influential but I don't know which on eis most used. It is possible it might even vary between mental health professionals since there is no requirement to have an 'official diagnosis' for insurance to get mental health help here. For getting diagnosis as an adult it appear the route involves convinving your GP for referral.

My personal experience suggests that the path to adult diagnosis may be easier if you are already getting help from mental health services.

Sorry I missed that, I tend to read to fast and miss content. Have they fine-tuned it recently or is this her interpretation of how the new criteria will be interpreted?

I shared everything I know, which I found on John Elder Robison's facebook page.