New Autism Definition would Exclude many

[DS3]

I thought those with children or know of people with autism should read this. They're changing the criteria and many may not qualify for the diagnosis now...

http://www.nytimes.com/2012/01/20/h...n-would-exclude-many-study-suggests.html?_r=1'

 

[buddy]

We were talking about the DSM change of Pervasive Developmental Disorder (PDD) to Autism Spectrum Disorders (ASD) more like the school does it on a thread maybe a couple of months ago???

I think we added links to the dsm web pages there too if anyone wants to search.

For years the schools have done it that way and kids with Aspergers are included in Autism Spectrum Disorders (ASD) in the schools so I do wonder if it will be more of the same, some people will interpret restricted patterns of behavior one way and others another way... etc. I have looked at it and I can see most of the Aspies I know still being included. That said, I am not sure it is a good idea to not use the Asperger's diagnosis. I think it does describe a lot of people much more clearly. But there are those boarder line folks... people say are they high functioning Autism Spectrum Disorders (ASD) or Aspies and some use the delayed lang at an early age, others say but they are so high functioning except for that early lang delay so they say Asperger's anyway and on and on..... there is not a really good answer.

If it is like i is around here though, if an autism specialist who is any good is doing the assessment in the school is involved, they get the Autism Spectrum Disorders (ASD) school label. I hope that happens in the medical community too.

Funny thing, MR Special Education admin's wife works at a local family/child development center that Q went to when young. They havce an intensive treatment program daily half days for K and under and Q went there two years. His wife is a psychologist there and she was interviewed in our news today. I really believe this is why he does get it some of the time. He understands more than the others do and has even reduced principal punishments for us. Made them at least doable at times.

 

[TeDo]

I don't like the sounds of these changes so far. Technically, difficult child 1 carries the Asperger's diagnosis but with all his sensory stuff, thinking errors apparent in school work, and EXTREME anxiety with transitions and changes I really do think he's more Autism Spectrum Disorders (ASD) than just Asperger's. He NEEDS the services offered under the Autism Spectrum Disorders (ASD) diagnosis in life and in school. This has me scared a little.

I wonder how this would affect eligibility for SSI?

 

[buddy]

I am not saying I think there should be no aspergers, but why I have not been very concerned because this is how we have done it in the schools the whole time. So I guess I view it similarly....it is not that they are eliminating the symptoms of Aspergers, they are broadening symptoms to include the higher functioning levels and then ranging to the lower functioning rather than the more has it or doesn't view. Not perfect, but it wasn't the other way either...some kids didn't fit in there at all. I worry more about Pervasive Developmental Disorder (PDD)-not otherwise specified kids. I have to read more carefully to see if they have Autism Spectrum Disorders (ASD)-not otherwise specified??? Here is what the web site for dsm has listed:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning.

 

[DS3]

I don't know much about Autism Spectrum Disorders (ASD) so I found the article interesting and thought that others would too. I honestly don't know much, but I know that there is a scale, and Aspergers is at the top of the functioning level. So yeah... wish I could add more, but brain doesn't seem to be functioning anymore tonight...

 

[HaoZi]

One of the (current) defining differences between Aspies and high-functioning Autism Spectrum Disorders (ASD) is that Aspie's in particular don't have the early language delay; many are way ahead of their peers in language skills of some stripe, whether vocabulary, speech in general, written language, etc. Ours tend to show up as social expectations are put on us that we can't process, can't handle, etc. Then the Obsessive Compulsive Disorder (OCD)/anxiety stuff overrides us as we try to cope. I'll take a scientific talk about megalodon over small talk any day of the week. Gesturing is to some degree natural to me because I was raised by New York Italian, and they can't talk without using their hands, lol.

 

[buddy]

the new criteria does not even mention language delay so Asperger's kids would not be excluded from the diagnosis of Autism Spectrum Disorders (ASD)

If the fear is that they wont get services I just think this seems like a broad enough definition to include them. What it doesn't do is help be more specific about what KINDS of support kids who have aspergers need. But that is the same dilema that kids iwth high functioning autism have had vs. kids who have more struggles like non verbal etc.

I don't know, I guess I am not worried about anyone being excluded....If they really had aspergers this criteria seems so broad their symptoms would be in this. but I do think there is value in finding a way to help define different levels of autism on the spectrum and generally Aspergers has been thought of as a level with very different needs than children who are non verbal etc. I imagine that the term Aspergers is still going to be used for that purpose. (kind of like how ADD is used even though it is really adhd-inattentive type)

 

[runawaybunny]

Autism redefined: Yale researchers study impact of proposed diagnostic criteria

Getting an autism diagnosis could be more difficult in 2013 when a revised diagnostic definition goes into effect. The proposed changes may affect the proportion of individuals who qualify for a diagnosis of autism spectrum disorder, according to preliminary data presented by Yale School of Medicine researchers at a meeting of the Icelandic Medical Association.

The proposed changes to the diagnostic definition would be published in the fifth edition of the American Psychiatric Association's (APA) 'Diagnostic and Statistical Manual of Mental Disorders (DSM-5).'

'Given the potential implications of these findings for service eligibility, our findings offer important information for consideration by the task force finalizing DSM-5 diagnostic criteria,' said Yale Child Study Center (CSC) director Fred Volkmar, M.D., who conducted the study with CSC colleagues Brian Reichow and James McPartland.

Volkmar and his team found that in a group of individuals without intellectual disabilities who were evaluated during the 1994 DSM-IV field trial, it was estimated that approximately half might not qualify for a diagnosis of autism under the proposed new definition.

Volkmar stressed that these preliminary findings relate only to the most cognitively able and may have less impact on diagnosis of more cognitively disabled people. 'Use of such labels, particularly in the United States, can have important implications for service,' he said. 'Major changes in diagnosis also pose issues for comparing results across research studies.'

---

Story Source:
The above story is reprinted from materials provided by Yale University.

Journal Reference:
Volkmar first presented the preliminary research results in September at Yale and in October at the Institute On Autism American Academy of Child Adolescent Psychiatry Meeting In Toronto. Volkmar and colleagues will publish full study results in the April print edition of the Journal of the American Academy of Child and Adolescent Psychiatry. The study may be available online as early as late February or early March 2012.

Disclaimer:
This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ConductDisorders or its staff.

 

[BusynMember]

I was told long ago that this was going to happen so I'm not surprised. I was also told, by the same neuropsychologist, that Aspergers would just be included in Autism Spectrum Disorders (ASD). IF so, it should be easier to get services. In many cases, Aspies are denied services now. Guess we'll have to see what happens.

 

[buddy]

Some friends and I went through this (very unscientifically) to check to see if our kids would qualify...Q was a slam dunk, always is... Three of the kids with aspergers, easily would still qualify, the problem we had was with two kids who have Pervasive Developmental Disorder (PDD)-not otherwise specified.... They both have some services now and get supports under Autism Spectrum Disorders (ASD) in the school system, but our school system has a higher percentage of Autism Spectrum Disorders (ASD) kids than many school districts. So many in general...who have Pervasive Developmental Disorder (PDD)-not otherwise specified, even now have a hard time getting services for many but in this new classification I wonder if there will be any similar way to say they are Autism Spectrum Disorders (ASD)-almost. I have not seen an Autism Spectrum Disorders (ASD)-not otherwise specified type of category to make up for this. I wonder if people will use Pragmatic Communication Disorder more now? We did that in the school for one little girl who had diabetes, some learning issues and lots of social communication issues but not any behavioral problem or mood problem. I fear many of them will be switched to just anxiety disorder or something..(not that this may not be part of it for them anyway, but how to get them the social support?? The direct teaching and training some of them may need.... and since so many get Occupational Therapist (OT) accommodations and services as a related service that is common for Autism Spectrum Disorders (ASD), will people be forced to fight even harder for that... likely just that more will not get it.)

Well, we all felt ok about the new criteria for Asperger's (of course with only looking at those three kids, I have thought of others though too and I can see them qualifying). Should try it yourself and see what you think. It is very broad descriptions of symptoms...from has a problem with a symptom to can't do it at all in many cases.

I sure hope especially, that kids who are now getting services dont lose them.

 

[BusynMember]

My son was diagnosed with Pervasive Developmental Disorder (PDD)-not otherwise specified. Under the new definition Pervasive Developmental Disorder (PDD)-not otherwise specified and Aspergers all get the same diagnosis...Autistic Spectrum Disorder. My son's diagnosis was changed to this and he is now eighteen...he is getting a lot of services transitioning to an adulthood where he will be needing special work and life accommodations. I'm very pleased. The diagnoses of Aspergers and Pervasive Developmental Disorder (PDD)-not otherwise specified will become a thing of the past. Aspergers and Pervasive Developmental Disorder (PDD)-not otherwise specified ARE on the autism spectrum.

Bipolar II was changed to Mood Spectrum Disorder (I have this) and nothing has changed except the diagnosis. I would wait and see...I think it will actually turn out to be beneficial for most kids

 

[TeDo]

I can't even get services for difficult child 1 with the Asperger's diagnosis he has technically been given so far. I'm waiting for psychiatrist to decide if he's more on the spectrum than that. Our county case manager is coming on Tuesday with plans to close his case because "there are no other services he needs".....ummm.....according to who? They have respite (THEIR only "option" is a week-end in a behavioral residential treatment) and community social skills which is 1:1 with a person who INSISTED difficult child 1 was just being defiant when it turned out to be caused by medications so difficult child 1(with my approval) fired him. I can't get any other services because his symptoms aren't "bad enough". Never mind that we have regular weekly Occupational Therapist (OT) & speech appts along with the fact that I can't work because difficult child 1 needs constant supervision AND I had to pull him out of public school because they WOULDN'T believe the behavior was not intentional defiance & opposition.

I wonder what's going to happen out here in nowheresville with services when the new definitions take affect.