Act Now!!

Posted by: Sarah Trost in Aspies, Being Mommy, health, Today in the News Add comments

As many of you may know, they have been working on updating the DSM-IV, and had talked of putting Asperger Syndrome and PDD under the ASD umbrella diagnosis. Well, that had a good possibility of helping more aspies and those diagnosed with PDD, although perhaps confusing the lay people who really don’t know much about ASDs.

They are definitely doing such, but I’m now afraid that the change is actually going to hurt those with AS and PDD and perhaps even those who have classic ASD tremendously. The reason is because the diagnostic criteria is possibly being narrowed so much that the number of those diagnosed in the future will be much fewer and those currently diagnosed may loose their diagnosis. Fewer diagnosed means fewer will receive help that they may desperately need in school, with health and psychiatric care, and other services provided through private and state programs.

In the DSM-IV the diagnostic criteria for AS currently says

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.

The new proposed revision/criteria for DSM-V will say

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: (and what determines that something IS a ‘marked deficit?” People can be very flexible and learn, even those on the autism spectrum.)

b. Lack of social reciprocity; (so, if you can take turns in a game or conversation, you aren’t autistic?)

c. Failure to develop and maintain peer relationships appropriate to developmental level (does that mean that if you have a friend you aren’t autistic?)

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)

Condensing the criteria may make things simpler, but it certainly excludes many who are on the spectrum. This is horrible! Something should be done! And something can be done, they are asking for comments on the proposals. I know of no other time when health care professionals have actually asked for the public to give such input, so I’m hoping that people will do so in the droves.

If you have the time and inclination, please do say that while including AS and PDD under ASDs, limiting the diagnostic criteria so severely will seriously harm those on the spectrum who may be undiagnosed and possibly even those who have already been diagnosed and limit the amount of help they will receive. You will need to register but it was simple and then you can comment here

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