Comments on: What’s in an autism diagnosis?: Changes in DSM-V ahead

By: Tonya Malench

Tonya Malench — Fri, 20 Nov 2009 19:40:22 +0000

Krista, you asked the very question I was preparing to post! Now, let’s pray that someone will answer your question and relieve this anxiety building in us.
-Tonya

By: Krista Fox

Krista Fox — Wed, 18 Nov 2009 19:45:56 +0000

I just learned about the upcoming revisions to the DSM last night at an Asperger’s Syndrome workshop I attended. I am confused as to what these revisions may entail. Are the changes to the DSM going to kick Asperger’s out of being an autism spectrum disorder entirely? Or will a child who would have normally been classified as Asperger’s now simply be considered ‘on the autism spectrum’?
Is it seriously being considered that Asperger’s has nothing to do with autism and people with Asperger’s symptoms will no longer have a diagnosis at all?

By: The Book of Human Troubles

The Book of Human Troubles — Sat, 20 Dec 2008 01:57:02 +0000

[...] York Times refers to the DSM, the Diagnostic and Statistical Manual of Mental Disorders, now in its fifth revision. Will Asperger Syndrome and “high-functioning autism” be merged? Will sensory [...]

By: Chuck

Chuck — Fri, 21 Nov 2008 00:16:05 +0000

“Marking a phase change is pretty standard stuff, esp. if there is definitional change. If the numbers in a category change, will it be because there are more cases or because there is a modification of category criteria?”

If they haven’t tracked that kind of information in the past, why would they start now?
The other logical question becomes how long will it take for DSM-V to be “globally” accepted by all practitioners? When is the starting point for the implementation of the count?

By: Regan

Regan — Thu, 20 Nov 2008 22:13:18 +0000

Not controlling for a variable in the past does not mean you don’t account for it at any time…one of the reasons that there are problems defining what autism “is”.

Marking a phase change is pretty standard stuff, esp. if there is definitional change. If the numbers in a category change, will it be because there are more cases or because there is a modification of category criteria?

However, given the way your “question” was phrased, I expect that we will simply disagree.

By: Chuck

Chuck — Thu, 20 Nov 2008 21:58:50 +0000

“Hope there is accounting in the counting statistics for this phase change.”

If there wasn’t any for the last change (DSM III to DSM IV). Why do you need one now? It still will not help with overall numbers.

By: Regan

Regan — Thu, 20 Nov 2008 19:33:55 +0000

Whatever it eventually says, I wonder how it will change the prevalence and incidence data? ‘Hope there is accounting in the counting statistics for this phase change.

By: siliconmom

siliconmom — Thu, 20 Nov 2008 16:46:09 +0000

When our kids were diagnosed (2 sons with Asperger’s 2 daughters with HFA) we were confused as to what the exact difference was. Hopefully the new DSM V will address that issue.

Eleanor – we’ve had the opposite problem. Our eldest son was an early talker and hyperlexic as well (and like your child, his comprehension has always been strong as well – I love the “too smart!” comment – if I only had a dollar for every time we’ve heard that over the years!).
Because he didn’t have “language delays” he didn’t qualify for HFA.

And yet this is now a young adult (over 18) who can’t really initiate or carry on a conversation that doesn’t revolve around video games. He struggles to articulate his thoughts on other topics. In other words, low expressive language. And because it’s a struggle for him, it impairs his desire and motivation to interact with others on a social level.

We often feel some guilt that our eldest was our learning process and while his younger sibs have benefited, we feel that he’s gotten the short end of the stick in many ways. He’s one of the reasons I’m a big advocate for early identification and intervention/treatment.

By: Eleanor

Eleanor — Thu, 20 Nov 2008 16:19:32 +0000

I’ve always thought the DSM assumption that an autism diagnosis pre-empted an ADHD diagnosis was dubious–and all of the psychiatrists I know ignore it, as well. Unfortunately, it is difficult to get insurance to pay for treatment for ADHD once it has decided a child has “untreatable” autism which can’t co-exist with ADHD. (Fortunately, my son’s psychiatrist has overcome this hurdle with our insurance.)

Is all HFA asperger’s syndrome? No. At least not as asperger’s is currently defined, as involving no language delays. My son, who is 8, is at this point in his life indistinguishable from an 8 year old with asperger’s. But he can’t qualify for that diagnosis–he had speech delays (plus hyperlexia; he was reading at age 2). So HFA, definitely, but asperger’s, no.

And one final point before I get off my soapbox: The only mention of hyperlexia in the DSM IV is in the autism section, and makes a passing mention of it merely describing it as reading without comprehension. While hyperlexia can certainly involve reading without comprehension, it by no means always involves that. That reference is unfortunate, because that one sentence in the DSM is many service providers’ only knowledge of hyperlexia. I can’t even cound the number of times that various professionals have tried to tell me, “Your son can’t have hyperlexia–he’s too smart!”

By: M

Thu, 20 Nov 2008 15:39:35 +0000

Let’s just hope Dennis Leary didn’t have any input.

Then it might be something like: “The DSM defines autism as a scam parents use in order to obtain services for their selfish children”.