Asperger's Syndrome being redefined

Dr. Diane Twachtman-Cullen, editor-in-chief of Autism Spectrum Quarterly, began working with children with autism 25 years ago, "back when autism was a rare disorder," said Twachtman-Cullen in a telephone interview.

[Coldblooded]

I like the proposed changes to the DSM. Having a separate category for AS really makes no sense at all. Whether someone gets diagnosed with AS or autistic disorder a lot of the time comes down to just whether or not they had a speech delay as a child(therefore, two people could have basically the same symptoms and level of severity, and get different diagnoses based on a speech delay..), even though the autistic disorder criteria don't really require a speech delay. And a lot of the time the diagnosis just depends on the person who diagnoses you. Many people can go to one professional and get one diagnosis, and another professional will think they better fit into the other one. A lot of people, maybe even most, with AS fit into the actual autistic disorder criteria but get diagnosed with AS because they are high functioning. Then there's the whole thing with all the PDD-NOS people who are obviously autistic but don't fit any of the current criteria. It's just a mess right now. The new criteria should clean it up a lot, and it seems to better reflect the reality of autism. Also, last time I checked, it was going to use severity levels.. So it should still differentiate between people who are more disabled and less disabled(even better than currently, actually.. Because some people diagnosed with autistic disorder/classic autism have about the same level severity as someone diagnosed with asperger's.. Yet they have the same diagnosis as someone who is so severe that they may never speak, with no severity rating or anything to officially differentiate between them).

[Friend]

Aspergers are much different than regressive autism even though they share some of same symptomes. Angelman and Fragile X are completely distinct diseases but share again the same symptomes.

[Coldblooded]

I don't believe that either of those are in the DSM in the first place.. Fragile x isn't considered a type of autism, but, rather, many people with fragile x are also diagnosed as autistic(autistic disorder, pddnos, or whatever). In the case of "regressive autism," if by that you are talking about childhood disintegrative disorder, that isn't going to be affected as far as I know. I'm pretty sure that this criteria change they are talking about only applies to asperger's syndrome, autistic disorder, and pddnos. CDD and Rett's are pretty distinct disorders. The other three PDDs are like trying to differentiate between little variations on the same thing, with a lot of grey area.

[Coldblooded]

Ok, correction, I just looked over the proposed changed again and it actually does include CDD, but not Rett's.

[Coldblooded]

I guess it makes sense, because CDD has the same symptoms, it just starts out differently.
Here's the website if anyone want to read the proposed changes and the rationale behind them: http://www.dsm5.org/ProposedRevisions/Pages/p... #

[friend]

The current DSM, another difference between autism and asperger's other than speech delay is delay in cognitive. I know quite a few diagnosed with asperger's who did have speech and cognitive delays, but because they didn't have many sensory issues or melt downs, they considered them HF = asperger's.

I think many who have the diagnosis of PDD-NOS may not have ASD at all. I think doctors didn't spend enough time in the office, seen children which only had some of the autism criteria, which in fact could have a totally different cause. PDD-NOS is so broad, any one could fit into it.

What's important with Angelman, Fragile X, Landau-Kleffner syndrome and quite a few more mimic autism and often are not diagnosed any thing but autism which of course would be a mis-diagnosis. Many doctors never do MRI's, EEG's or chromosome testing prior to just diagnosing autism. Autism is a DSM psych diagnosis and few psych's give referrals to a neuro who would rule out Angelman, Fragile X, Landau-Kleffner syndrome. My child of course had all those tests, so I do know what he doesn't have.

The DSM changes will help some more defining, and many will be bumped right off the spectrum, but any DSM will always be problematic as long as there is no medical blood test to confirm the diagnosis. With the new changes, I know my son still fits the criteria but one will still notice the new version of the DSM does not include gut issues, seizures or immune disorders.

[Coldblooded]

friend wrote:

The current DSM, another difference between autism and asperger's other than speech delay is delay in cognitive. I know quite a few diagnosed with asperger's who did have speech and cognitive delays, but because they didn't have many sensory issues or melt downs, they considered them HF = asperger's.

I think many who have the diagnosis of PDD-NOS may not have ASD at all. I think doctors didn't spend enough time in the office, seen children which only had some of the autism criteria, which in fact could have a totally different cause. PDD-NOS is so broad, any one could fit into it.

What's important with Angelman, Fragile X, Landau-Kleffner syndrome and quite a few more mimic autism and often are not diagnosed any thing but autism which of course would be a mis-diagnosis. Many doctors never do MRI's, EEG's or chromosome testing prior to just diagnosing autism. Autism is a DSM psych diagnosis and few psych's give referrals to a neuro who would rule out Angelman, Fragile X, Landau-Kleffner syndrome. My child of course had all those tests, so I do know what he doesn't have.

The DSM changes will help some more defining, and many will be bumped right off the spectrum, but any DSM will always be problematic as long as there is no medical blood test to confirm the diagnosis. With the new changes, I know my son still fits the criteria but one will still notice the new version of the DSM does not include gut issues, seizures or immune disorders.

Yeah, but the autistic disorder criteria don't require a cognitive delay either... Actually i don't think it's even listed as part of the criteria.. Its just allowed for. Lots of high functioning people with autistic disorder have no cognitive delays. Asperger's criteria says no cognitive delays though.

I agree that a lot with pddnos probably dont really need an diagnosis.. But some people with pddnos have severe autism. Someone could have a few symptoms very severely, but not have enough of them to qualify for autistic disorder, and they also had a cognitive or speech delay which would keep them from qualifying for asperger's. so then they are definitely autistic but left in pddnos limbo because of the way the criteria are written.

[friend]

As far as I know, the DSM eliminated speech delay altogether, which was an odd thing to give the slash to. The revised DSM, the first part is mainly social. B is only covers repetitive speech and echolalia, but a non verbal child wont often display either. It also includes sensory input, when sensory integration disorder was a disorder to itself, and many with autism don't have sensory issues. To top it off, the potentil revises, the person has to fit all criteria. And then as always, youre left to the interpretation of the evaluator, as you suggested 2 hours ago. Any DSM leaves a great margin for error. One will not, I seen nothing in there about regressive anything. According to the new version, there is no such thing or it's at least not recognized.

[Coldblooded]

They don't have to fit all of the repetitive criteria, only two out of four.. And it includes other examples, like repetitive motor mannerisms.

But, yeah, that's how it is probably always going to be, to some extent, with diagnosing mental disorders.. because all they have to go on is a person's behavior. I still think this new one makes a lot more sense.

And it says under the "rationale" section that it is supposed to include childhood Disintegrative disorder(in which a child develops normally and then regresses).

[friend]

The fourth edition is "A total of six (or more) items from (A),(B), and (C), with at least two from (A), and one each from (B) and (C)".

On the link you gave for the fifth edition, it states "Must meet criteria A, B, C, and D". That to me means you have to meet all that criteria.

What I get out of the fifth version, is the link you gave is the criteria for autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. They're all subsumed into an existing disorder: Autistic Disorder (Autism Spectrum Disorder).

Childhood disintegrative disorder already was part of the fourth DSM's Pervasive Developmental Disorders; I have yet to meet any one who had that diagnosis. I think most get autism or PDD-NOS dx's. Not even the noise about vaccines considers it the regressive autism. Or they'd call it regressive CDD.

[friend]

Coldblooded, you hear any noise? I thought I did.

[Coldblooded]

Sounds like a small yapping dog off in the distance..

[friend]

Anti vaxxers fictional Autism-Vaccine link are now termed noise, but it's a great description for any who attempt to make this topic about vaccines. Deal with it.

[friend]

Coldblooded~ can you tell me where you see they don't have to fit all of the repetitive criteria, only two out of four? Where do you see that?

[Coldblooded]

It's what criteria b says. "B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:"
At least two of the following means that you only have to meet two of the four listed under it. You do have to meet all of criteria a, b, c, and d... But criteria b only requires you to meet two of it's own criteria.

[friend]

Thanks for letting me know where you seen that. They way they wrote it at the top is deceiving. Looking at needing 2 of the 4 under B, I'm not so sure this new version is going to change too much in diagnosis giving.
I think the rates are just going to be all over the place.

[Kelly Joanne Cannon]

I have Aspergers Syndrome, the spectrum of Autism. Unfortunately, some people in this world either think it means someone is just crazy, ungodly, or mean-hearted, don't even know what it is, don't understand it, or are afraid of it. That's a-okay because what the people who have it have to understand is that it's perfectly normal and okay for others not to understand because they may not have it or any disability at all themselves. But it also doesn't mean someone's crazy or a sicko at all and dealt with properly and positively, can definitely become far more positive daily in life. Also, making fun of people or with it or condescendingly talking down to them is just as prejudiced as doing that to a disabled kid with seizures, a down syndrome child or down syndrome person, or an autistic child or autistic person daily.

[Kelly Joanne Cannon]

People with Aspergers Syndrome, the spectrum of Autism, adults or children can, not can't, can learn to take full responsibility for their own actions. We must also, no matter what, and no matter how hard it may be or seem, sometimes, to forgive our enemies as God and Jesus always forgive us daily, and always wish them full, complete, great happiness, great joy, and great health, wonderful happiness blessings too, throughout life daily, again, no matter what. Do I, for example, still like being spied on or harrassed anywhere, any place at any time? No way, no how. However, regarding spying and harrassment, sometimes when we retaliate on our own towards people, instead of letting God and Jesus handle it for us, sometimes, we're doing the exact same thing in retrospect to them. That's definitely not right either. Two wrongs don't make a right.

[Kelly Joanne Cannon]

Am I for sale? No! No way, no how, and not ever will I be that. Nor will I ever put myself up for sale by behaving dangerously definitely because I'm not dangerous at all. I would never ever abuse anyone in a written way, verbal way, or physical way ever. God and Jesus don't like that at all from people, and know I wouldn't do that daily either. It's totally and completely wrong and a wrong sin is all. Thus, we must always all give all of ourselves and lives to God and Jesus daily not just halfway but all, as I'm doing daily. I'll also now, always, and forever give large amounts of money to animals, charities, less fortunate people and children, and my church whenever possible. I'll also now, always, and forever daily only be truly only very kind, very loving, and very sweet towards all animals, other people, and children.

[Kelly Joanne Cannon]

Because the main strong point here from me is that people or children with Aspergers Syndrome, the spectrum of Autism can most certainly and most definitely be strong as I am daily and not weak.