Autism Diagnosis Changing?

For those of you that know me, you know that I am all for research. I totally understand (especially in the field of psychology), that things are continually being looked at, re-evaluated, and studied. If it weren’t for other researcher’s in the field of psychology, we all might still be stuck with what Freud thought about everything. Oy Vey!

I recently heard that the DSM-V is going to revise the diagnosis of ASD disorders such as Autism, Aspberger’s, and PDD-NOS. I decided to check in to this by reading an exorbitant amount of stuff on the internet.  I am very mindful of the fact that all things on the internet should be taken with a grain of salt, however, I also try to look in to “trustworthy sources”. As such, I will definitely give credit where it is due.

First, I will give the current DSM-IV criteria for diagnosis of Autism, Aspberger’s and PDD-NOS.

AUTISM (Austismwatch.org)

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3)
(1) qualitative impairment in social interaction, as manifested by at least two of the following:

  • (a) 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
  • (b) failure to develop peer relationships appropriate to developmental level
  • (c) 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)
  • (d) lack of social or emotional reciprocity

(2) qualitative impairments in communication as manifested by at least one of the following

  • (a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
  • (b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
  • (c) stereotyped and repetitive use of language or idiosyncratic language
  • (d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

  • (a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • (b) apparently inflexible adherence to specific, nonfunctional routines or rituals
  • (c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
  • (d) persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play

C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.

Aspberger’s (autreat.com)

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

      (A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
      (B) failure to develop peer relationships appropriate to developmental level
      (C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
      (D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

      (A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
      (B) apparently inflexible adherence to specific, nonfunctional routines or rituals
      (C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
      (D) persistent preoccupation with parts of objects

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) 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)

(V) 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.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

PDD-NOS (firstsigns.org)

This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. For example, this category includes “atypical autism” –presentations that do not meet the criteria for autistic disorder because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

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I understand that all that information is a lot to take in, but if you have a child that falls into one of those categories, you kind of get the gist.

Now, from what I understand from this article, the DSM-V (coming out sometime in 2013), will drop Aspberger’s and PDD-NOS as their own separate diagnoses and lump them in to the Autism diagnosis.

According to Daniel DeNoon, “The researcher, Fred R. Volkmar, MD, director of the Child Study Center at the Yale School of Medicine, re-analyzed data from a 1993 autism study using a new definition of autism proposed for 2013.

As currently proposed — the new definition won’t be final until later this year — the diagnosis of Asperger’s disorder will go away. So will pervasive developmental disorder not otherwise specified (PDD-NOS) and childhood disintegrative disorder.

Instead, those diagnoses will be “subsumed” into the single diagnosis of autism spectrum disorder or ASD.

Volkmar told the NYT that this means fewer than half of the higher-functioning kids now diagnosed with autism would meet the new diagnosis. Some 75% of kids with Asperger’s would be excluded, he says, as would some 85% of those with PDD-NOS.”

I agree that Autism and other ASD disorders are sprouting up everywhere these days and in my opinion, it is because doctors and psychologists are more aware of what these disorders encompass. However, my HOPE is that those with Aspberger’s and PDD-NOS will not be left out when it comes to educational and medical assistance. Each of the children on the spectrum deserve the best treatment and coverage possible whether they be at the high or low end of said spectrum.

If you get a chance, take a look at the article.

Hope this helps explain things a bit.

~Kari

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7 Comments

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7 responses to “Autism Diagnosis Changing?

  1. This worries me a great deal. My Grandson has not been diagnosed with autism, we’ve been on a long waiting list to get to see doctors who will make the final diagnosis. I’m just a Nana, in love with a grandson that I can see plainly is not where he should be, in order to be considered ‘normal.’ He does not fall into what I read as ‘autisitic’ either. I NEED to get a medical diagnosis. I need to know that he will qualify for any and all help. Recently we were informed he has to start school in September or be dropped from further help. He just turned 4. He has never made a statement when called for or as needed. He can say things like, ‘thirsty, juice, milk, hungry…’ He doesn’t say things like I want a drink or I am so thirsty. He has no friends and until recently didn’t seem to want any. Lately I do see him trying to bond with children his age…who walk away because he is ‘different.’ We need help and the waiting has been killer. The thought we can finally get a dianosis just in time to be turned away again is rather scary. Here’s to knowing God NEVER gives us more than we can handle and that no matter what may come..OUR boy is one of our greatest blessings!

    • Although I would never wish a diagnosis on anyone, I would want the same for my child. I can’t imagine not knowing and not being able to get assistance. My prayer for you is that a diagnosis comes quickly and that your grandson will get all the help he needs.

      Please know that I am on your side and am here if you need me!

  2. I’ve seen a lot of people posting about this on Facebook. It’s concerning to a point. My main concern is if they decided to take away the label of autism, do they really think that will solve the problem? If we take the label away from my son, will he automatically start talking right, be “normal”? No, he won’t. And neither will anyone else. They are solving nothing by doing this. My limiting the ASD dx, they will be increasing the dx of ADHD and behavior disorders. Because just like before the kids with autism will be called bad kids and made to fall through the cracks of the education and societal world. I pray that someone wises up to this crap. I know kids who are high functioning and already fighting for services, with the proposed changes, they are screwed. Pretty sure my son will maintain his dx. But so many others won’t. It’s a terrible thing that is being done. Several petitions are on the web. Sign them!

    • I agree Katie. I think that a hard look needs to be taken at the whole situation. Thank goodness that not everyone agrees with that doctor. There is a whole committee that has to put this together and I pray that God will guide them.

  3. Dannell

    Very informational…thanks kari

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