Community Discussion Forum
Chat
Info and Media
Articles
Autism Talk TV
Books
Wiki
Contact Alex
Shop
Log in
|
Register
WP Members: > 70,000
New Today:
6
New Yesterday:
20
Wrong Planet Autism Forum Index
->
Autism Politics, Activism, and Media Representation
Post a reply
Username
Subject
Message body
Emoticons
View more Emoticons
[quote="Tuttle"]There are a whole lot of communication difficulties, and specifically verbal communication difficulties, that occur in people who can speak. The fact that I'm verbal and spoke on time (I'm assuming) doesn't mean I don't have verbal communication difficulties. How I read this set of criteria is saying that whether or not someone can speak is not relevant to whether they are autistic - some people will be verbal, others nonverbal and both can be autistic. What is relevant is communication difficulties, which occur in both the people who can speak and those who can't. Being completely nonverbal, or delayed in speech, is one type of communication difficulty, its not the only one.[/quote]
Options
HTML is
OFF
BBCode
is
ON
Smilies are
ON
Disable BBCode in this post
Disable Smilies in this post
All times are GMT - 5 Hours
Topic review
<table border="0" cellpadding="3" cellspacing="1" width="100%" class="forumline"> <tr> <th class="thCornerL" width="22%" height="26">Author</th> <th class="thCornerR">Message</th> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>aghogday</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Fri Jun 15, 2012 5:51 am<span class="gen"> </span> Post subject: Re: The diversity of Autism Spectrum Disorder</span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>TheSunAlsoRises wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">It's a long post, but if you will, please scan over it before answering yes or no to the poll question. The DSM5 definition of Autism Spectrum Disorder is provided at the end of the post for those that may not have seen it yet. <br /> <br />Here is an Interesting study linked below that suggests that male brain characteristics among females with Aspergers, are similar to male brain characteristics in males with Aspergers. <br /> <br />The study challenges the assumption of an extreme male brain, in males with Aspergers, because the brain characteristics associated with the male gender are similar to a control group of males without Aspergers. <br /> <br /> <br /><a href="http://sfari.org/news-and-opinion/in-brief/2012/cognition-and-behavior-asperger-brains-similar-across-sexes" target="_blank" rel="nofollow" class="postlink" >http://sfari.org/news-and-opinion/in-brief/2012/cognition-and-behavior-asperger-brains-similar-across-sexes</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">The difference in the volumes of total white matter and local gray matter between men and women is smaller in the group with Asperger syndrome than in controls. This suggests that the brains of women with the syndrome have more ‘male’ brain characteristics than those of controls, the researchers say. <br /> <br />The men with Asperger syndrome do not have more total white matter or more gray matter in the right parietal operculum compared with controls, however. The finding challenges the idea that men with Asperger syndrome have brains that are structurally more ‘male’ than those of controls. <br /> <br />Among controls, the men’s brains also have greater connectivity — as measured by the flow of water through the brain — than the women’s brains in a number of regions, including the corpus callosum, which connects the two hemispheres. This difference in connectivity between males and females is also smaller among the brains of individuals with Asperger syndrome.</td> </tr></table><span class="postbody"> <br /> <br />2D/4D digit ratio to test for the potential of exposure to prenatal testosterone wasn't mentioned in the study, but it might stand to reason that there is a pretty good likely-hood that females diagnosed with Aspergers, will have a low digit ratio. <br /> <br />If one is not familiar with 2D/4D digit ratio, one can figure it out by measuring their index finger on their right hand from the crease of the palm by millimeters with a ruler, and doing a similar measurement with the ring finger, and then dividing the ring finger measurement into the index finger measurement to determine how low the ratio is. Normal ratios for a female exceed .97. There is the potential that exposure to high levels of prenatal testosterone may influence brain development per characteristics that have been associated with male brains. <br /> <br />2D/4D digit ratio measured by Samuel Baron Cohen, in his research with autistic individuals, provided evidence of very low ratios among males with autism disorder. The ratio was not as low among males with Aspergers. His study was very limited per the number of females with Aspergers, but they had a lower 2D/4D ratio than would be expected as well. He used it as evidence for the "Extreme Male Brain" theory per systemizing/empathizing and the AQ test he developed. <br /> <br />While the association of systemizing hold fairly strong across the spectrum, in the AQ test, that is only one area of brain gender, associated with many other characteristics in the test provided by the BBC, linked below. <br /> <br />At least in the case of Aspergers, it might be more appropriate overall to call the theory, the "neutral gender brain" theory, per real world results of the BBC provided "Sex I.D. test taken by autistic individuals in online communities. Per self-reports many people diagnosed with Aspergers, male and female, score close to the middle of the brain gender spectrum. <br /> <br />Other research by Michelle Dawson indicates that verbal intelligence among individuals with Aspergers is higher than performance intelligence measured in standard measures of IQ testing, whereas those with Autism Disorder score higher in performance measures in comparison to their verbal measures of intelligence in standard IQ testing. That could impact some of the brain gender associations in the test provided by the BBC, linked below. <br /> <br />There is a strong correlation of symptoms of non-verbal learning disorder measured among those diagnosed with Aspergers syndrome, which could potentially explain some of the differences measured in IQ testing, done by Dawson. She didn't explore that area, though. <br /> <br />Of course none of it is a definitive cause of autism, just interesting associations, per the 2d/4d digit ratio, and this latest research on actual differences noted per male brain characteristics. <br /> <br />Here is the link to the interesting test that indicates associations per gender ID, not necessarily reflective of sexual orientation, provided by the BBC, if one hasn't come across it before. One of the questions on the test requires an individual to measure their 2d/4d digit ratio. <br /> <br /><a href="http://www.bbc.co.uk/science/humanbody/sex/add_user.shtml" target="_blank" rel="nofollow" class="postlink" >http://www.bbc.co.uk/science/humanbody/sex/add_user.shtml</a> <br /> <br />Physical and behavioral characteristics associated with masculinity and femininity, interestingly, do not always match the results of what might be expected from the test linked above that attempts to measure brain gender, nor what Cohen describes as strong systemizers with an extreme male brain, per traits measured in the AQ test. <br /> <br /><span style="font-weight: bold">And finally, per these interesting gender and hormonal associations, an individual diagnosed with autism, Andrew Lehmann, has provided a very interesting theory, of an Estrogen associated theory of evolution, autism, & social change that pursues a much greater area, than what Cohen pursued in his theory and research. <br /> <br />It is linked here, in free book form, on this site: <br /> <br /><a href="http://www.neoteny.org/" target="_blank" rel="nofollow" class="postlink" >http://www.neoteny.org/</a> <br /> <br />It has nothing to do with autism supremacy, but it provides a pretty an interesting theory as to why the broader autism phenotype remains a part of the population, regardless of reproductive success among those in the phenotype. <br /> <br />While there are similar behavioral characteristics measured in the definition of Autism Spectrum Disorders, across the spectrum, the recent research that has shown abnormal brain growth, almost limited to males whom develop regressive autism; the research per Aspergers and brain characteristics quoted above; the differences seen in intelligence testing by Dawson, per autism disorder opposed to aspergers; along with the work of Cohen, provides some evidence that these conditions, while similar per psychological behavioral assessment are likely diverse in potential causal factors, per biology and environment, including levels of prenatal hormones, seen associated with physical, cognitive, and behavioral characteristics in other mammals. </span> <br /> <br />These many factors, considered together, seem to suggest that the broader autism phenotype is likely a part of human nature that existed far into the past, and will likely continue to be a part of that nature, far into the future, regardless of changes in culture or medical technology. <br /> <br /> <br /> <br />DSM5 current revised definition of Autism Spectrum Disorder: <br /> <br /><a href="http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=94" target="_blank" rel="nofollow" class="postlink" >http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=94</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Autism Spectrum Disorder <br /> <br />Must meet criteria A, B, C, and D: <br /> <br /> <br /> <br />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: <br /> <br />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, <br /> <br />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. <br /> <br />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 <br /> <br />B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following: <br /> <br />1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases). <br /> <br />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). <br /> <br />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). <br /> <br />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). <br /> <br />C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities) <br /> <br />D. Symptoms together limit and impair everyday functioning.</td> </tr></table><span class="postbody"></td> </tr></table><span class="postbody"> <br /> <br /> <br />I found the information that you posted very informative. <br /> <br />I have seen 'natural' parallels in ASDs and groups of non-autistic individuals which may have some bearing on 'why' ASDs can be somewhat more difficult to detect amongst these groups( it's not all a result of lack of access). It does explain certain cultural components...paired with developmental stages. I'm curious to know the racial breakdown across the spectrum; pieces of the puzzle are held here BUT people are understandably reluctant to pursue it. <br /> <br /> <br /><span style="font-weight: bold">TheSunAlsoRises</span></td> </tr></table><span class="postbody"> <br /> <br />Unfortunately the only racial breakdown provided by the CDC is specific to a limited demographic among children at the age of 8, in classes for the developmentally disabled across the US. In that demographic the breakdown measured among identified race, is close to even. <br /> <br />I suspect the overall spectrum is strongly influenced by similar cultural factors, that historically have provided the potential for the general domestication of human beings, along the lines of the theory proposed by Lehmann, in the link above. The cultural factors that apply outside of the classes for the developmentally disabled are likely significantly different. <br /> <br />"Nerdiness", has become more accepted among males at about the same rate of Information technology advancements, across countries. I like the example of South Korea where martial arts was once the focus of machismo and now it is the "video gamer rockstar" that is the cultural icon. Physical prowess does not hold the same value across some cultures, as it once did. <br /> <br />Autism Speaks is providing a much more thorough statistical survey among the full population of the US. Just in time before the DSM5 goes into effect. It may provide some of that demographic information you are interested in, per the entire spectrum, that may be almost impossible to come by after the DSM5 is solidly the standard in the US. <br /> <br />Per the NAMI organization, there is still a strong cultural aversion among some African Americans against doctors, and anything associated with a psychological diagnosis, per some of the unfortunate experiences still not to far in the memory of some, per government organized medical research. And there are other subcultural factors at play as well, some not politically correct to discuss, but hard to ignore per observable subcultural realities. <br /> <br />The race issue is definitely a difficult one to pursue, but I suspect culture plays the largest part per my experience in military civilian employment. The military environment breaks down many stereotypes, that were common to my local community, in the deep south, inside and outside of the boarders of the US, into areas like the Caribbean, Saudia Arabia, and East Africa. <br /> <br />One quickly finds out that there are different cultures that strongly impact human behavior, but only one race per humankind, as far as characteristics of intelligence and general behavior. <br /> <br />One reason that I was glad that Obama was elected, is he has provided the US a microcosm of how little pigmentation counts in the grand scheme of life. A real-life lesson for some that are still caught up in cultural stereotypes, but a hard one as well, for some. The lesson and example though is one for all cultures in the US, regardless of pigmentation. There are no strict limitations for human beings per pigmentation, or geographical ancestry, when it comes to the highest levels of what is understood as human achievement. <br /> <br />And I suspect Obama has a few autistic-like traits, as well. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /> Perhaps hidden better under the stereotype, and in part, subcultural requirement, of the rare African American Nerd/Aspie. <br /> <br />He takes Erkel up to a place that could not have been imagined, not too many years ago. And not too many years before that, when idea of an Erkel could not be imagined by some, per cultural expectations and stereotypes in the US. <br /> <br />It reminds me too of the Revenge of the Nerds Movies, where the only African American Nerd, was portrayed as effeminate, as well as Nerd, and eventually provided his fraternity protection of the physical prowess associated with another African American Fraternity. <br /> <br />One of the most interesting transformations in my community though, which also shows the power of culture over pigmentation is what is the new generation of the "redneck sub-culture" in my area, that has moved into the hip-hop genre, from the country music genre. They can relate to many of the same cultural issues that inspire the music; regardless of pigmentation, white, red, or dark. <br /> <br />I had an African American female friend when I was young, that had that same little professor voice, that has no culture, race, or geography. I too, had no ability to pick up my own cultural dialect. I lived in the same area most of my life, as well as my friend, and continued to get the question throughout school of, where are you from. I'm sure she did as well. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /> <br /> <br />As far as human beings go, I did not have the same ability my classmates had to negatively discriminate against others whom were different; I suppose that might have been some type of neuro-developmental blessing, because I did not have the ability to negatively discriminate against myself either. I could not see the limitations in others or myself. As I look back, my friend seemed to share what seemed like an unusual characteristic as well. <br /> <br />If I had the vision to see the reality of my limitations, I would likely not have survived. <br /> <br />Perhaps that is part of Obama's success as well as many others that meet adversity; but I'm not sure that it is entirely a culturally based inclination, or one limited as specific to autistic like traits. <br /> <br />But, it is a powerful human phenomenon that I believe moves beyond any physical prowess, or commonly measured intellectual strength. Perhaps it is a deficit, that for some becomes advantage. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /></span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>TheSunAlsoRises</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Fri Jun 15, 2012 2:25 am<span class="gen"> </span> Post subject: Re: The diversity of Autism Spectrum Disorder</span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">It's a long post, but if you will, please scan over it before answering yes or no to the poll question. The DSM5 definition of Autism Spectrum Disorder is provided at the end of the post for those that may not have seen it yet. <br /> <br />Here is an Interesting study linked below that suggests that male brain characteristics among females with Aspergers, are similar to male brain characteristics in males with Aspergers. <br /> <br />The study challenges the assumption of an extreme male brain, in males with Aspergers, because the brain characteristics associated with the male gender are similar to a control group of males without Aspergers. <br /> <br /> <br /><a href="http://sfari.org/news-and-opinion/in-brief/2012/cognition-and-behavior-asperger-brains-similar-across-sexes" target="_blank" rel="nofollow" class="postlink" >http://sfari.org/news-and-opinion/in-brief/2012/cognition-and-behavior-asperger-brains-similar-across-sexes</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">The difference in the volumes of total white matter and local gray matter between men and women is smaller in the group with Asperger syndrome than in controls. This suggests that the brains of women with the syndrome have more ‘male’ brain characteristics than those of controls, the researchers say. <br /> <br />The men with Asperger syndrome do not have more total white matter or more gray matter in the right parietal operculum compared with controls, however. The finding challenges the idea that men with Asperger syndrome have brains that are structurally more ‘male’ than those of controls. <br /> <br />Among controls, the men’s brains also have greater connectivity — as measured by the flow of water through the brain — than the women’s brains in a number of regions, including the corpus callosum, which connects the two hemispheres. This difference in connectivity between males and females is also smaller among the brains of individuals with Asperger syndrome.</td> </tr></table><span class="postbody"> <br /> <br />2D/4D digit ratio to test for the potential of exposure to prenatal testosterone wasn't mentioned in the study, but it might stand to reason that there is a pretty good likely-hood that females diagnosed with Aspergers, will have a low digit ratio. <br /> <br />If one is not familiar with 2D/4D digit ratio, one can figure it out by measuring their index finger on their right hand from the crease of the palm by millimeters with a ruler, and doing a similar measurement with the ring finger, and then dividing the ring finger measurement into the index finger measurement to determine how low the ratio is. Normal ratios for a female exceed .97. There is the potential that exposure to high levels of prenatal testosterone may influence brain development per characteristics that have been associated with male brains. <br /> <br />2D/4D digit ratio measured by Samuel Baron Cohen, in his research with autistic individuals, provided evidence of very low ratios among males with autism disorder. The ratio was not as low among males with Aspergers. His study was very limited per the number of females with Aspergers, but they had a lower 2D/4D ratio than would be expected as well. He used it as evidence for the "Extreme Male Brain" theory per systemizing/empathizing and the AQ test he developed. <br /> <br />While the association of systemizing hold fairly strong across the spectrum, in the AQ test, that is only one area of brain gender, associated with many other characteristics in the test provided by the BBC, linked below. <br /> <br />At least in the case of Aspergers, it might be more appropriate overall to call the theory, the "neutral gender brain" theory, per real world results of the BBC provided "Sex I.D. test taken by autistic individuals in online communities. Per self-reports many people diagnosed with Aspergers, male and female, score close to the middle of the brain gender spectrum. <br /> <br />Other research by Michelle Dawson indicates that verbal intelligence among individuals with Aspergers is higher than performance intelligence measured in standard measures of IQ testing, whereas those with Autism Disorder score higher in performance measures in comparison to their verbal measures of intelligence in standard IQ testing. That could impact some of the brain gender associations in the test provided by the BBC, linked below. <br /> <br />There is a strong correlation of symptoms of non-verbal learning disorder measured among those diagnosed with Aspergers syndrome, which could potentially explain some of the differences measured in IQ testing, done by Dawson. She didn't explore that area, though. <br /> <br />Of course none of it is a definitive cause of autism, just interesting associations, per the 2d/4d digit ratio, and this latest research on actual differences noted per male brain characteristics. <br /> <br />Here is the link to the interesting test that indicates associations per gender ID, not necessarily reflective of sexual orientation, provided by the BBC, if one hasn't come across it before. One of the questions on the test requires an individual to measure their 2d/4d digit ratio. <br /> <br /><a href="http://www.bbc.co.uk/science/humanbody/sex/add_user.shtml" target="_blank" rel="nofollow" class="postlink" >http://www.bbc.co.uk/science/humanbody/sex/add_user.shtml</a> <br /> <br />Physical and behavioral characteristics associated with masculinity and femininity, interestingly, do not always match the results of what might be expected from the test linked above that attempts to measure brain gender, nor what Cohen describes as strong systemizers with an extreme male brain, per traits measured in the AQ test. <br /> <br /><span style="font-weight: bold">And finally, per these interesting gender and hormonal associations, an individual diagnosed with autism, Andrew Lehmann, has provided a very interesting theory, of an Estrogen associated theory of evolution, autism, & social change that pursues a much greater area, than what Cohen pursued in his theory and research. <br /> <br />It is linked here, in free book form, on this site: <br /> <br /><a href="http://www.neoteny.org/" target="_blank" rel="nofollow" class="postlink" >http://www.neoteny.org/</a> <br /> <br />It has nothing to do with autism supremacy, but it provides a pretty an interesting theory as to why the broader autism phenotype remains a part of the population, regardless of reproductive success among those in the phenotype. <br /> <br />While there are similar behavioral characteristics measured in the definition of Autism Spectrum Disorders, across the spectrum, the recent research that has shown abnormal brain growth, almost limited to males whom develop regressive autism; the research per Aspergers and brain characteristics quoted above; the differences seen in intelligence testing by Dawson, per autism disorder opposed to aspergers; along with the work of Cohen, provides some evidence that these conditions, while similar per psychological behavioral assessment are likely diverse in potential causal factors, per biology and environment, including levels of prenatal hormones, seen associated with physical, cognitive, and behavioral characteristics in other mammals. </span> <br /> <br />These many factors, considered together, seem to suggest that the broader autism phenotype is likely a part of human nature that existed far into the past, and will likely continue to be a part of that nature, far into the future, regardless of changes in culture or medical technology. <br /> <br /> <br /> <br />DSM5 current revised definition of Autism Spectrum Disorder: <br /> <br /><a href="http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=94" target="_blank" rel="nofollow" class="postlink" >http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=94</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Autism Spectrum Disorder <br /> <br />Must meet criteria A, B, C, and D: <br /> <br /> <br /> <br />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: <br /> <br />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, <br /> <br />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. <br /> <br />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 <br /> <br />B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following: <br /> <br />1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases). <br /> <br />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). <br /> <br />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). <br /> <br />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). <br /> <br />C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities) <br /> <br />D. Symptoms together limit and impair everyday functioning.</td> </tr></table><span class="postbody"></td> </tr></table><span class="postbody"> <br /> <br /> <br />I found the information that you posted very informative. <br /> <br />I have seen 'natural' parallels in ASDs and groups of non-autistic individuals which may have some bearing on 'why' ASDs can be somewhat more difficult to detect amongst these groups( it's not all a result of lack of access). It does explain certain cultural components...paired with developmental stages. I'm curious to know the racial breakdown across the spectrum; pieces of the puzzle are held here BUT people are understandably reluctant to pursue it. <br /> <br /> <br /><span style="font-weight: bold">TheSunAlsoRises</span></span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>aghogday</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Thu Jun 14, 2012 3:40 am<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Ellingtonia wrote:</b></span></td> </tr> <tr> <td class="quote">I think it's a mistake to criticize the new DSM in terms of how it will affect people applying for services. The DSM should be a reflection of our best current knowledge about mental disorders, and laws should be written to work around that. <br /> <br />Take ASD vs Social Communication Disorder: these experts have apparently decided that some people now diagnosed with PDD-NOS are not truly on the autistic spectrum, and should be moved to the new SCD diagnosis. They are still being recognised as having problems, just slightly different problems; perhaps they only have one or two of autism's 'triad of impairments'. <br /> <br />This may seem like semantics to some, but keep in mind that the DSM is used by researchers as well. For people trying to study the causes and neurological differences behind autism this separation would be crucial. <br /> <br /> <br />You say that people moved to SCD may lose access to services, and you may be right, but it seems backwards to change our definition of disorders to better fit the service system. Instead our treatments should be changed to reflect our growing knowledge about these disorders. There is still time before the DSM5 becomes official to make some small fixes to current laws and to look at what more significant changes might be warranted (if lawmakers can get their act together which, granted, is not a certainty). <br /> <br />Experts have decided that these people with SCD are not on the autistic spectrum, and so to change the criteria for ASD to fit them would be a 'white lie' to get them services. I think this is a mistake and it is the service system that needs changing. The current service system was written around the DSM IV, so it makes sense that there would need to be changes made when the DSM IV is replaced <br /> <br />You can argue that people moved to SCD in fact do have autism, and you may be right, but expert professionals seem to think otherwise. I firmly believe that having ASD makes your opinion on this subject valuable, but does not make you a substitute for an expert.</td> </tr></table><span class="postbody"> <br /> <br />The concern per the re-diagnosis and move of some to SCD and the loss of continuing support efforts provided by the government and the law, is a concern reported by the ASAN. It is a valid concern, per the laws as they exist, but I do think it is reasonable per PDD NOS that the triad of social/communication/RRB's are now going to be made mandatory requirements along with non-verbal communication impairments. <br /> <br />I agree the proper route will be to change laws as they exist, and would expect the government to provide reasonable efforts to do so, per the time frame that will be provided after the final revision is publicized. The government at this point has no direction for changes until that final revision is made. Where the real problem may lie for some is among private insurers, some of whom are currently required to provide coverage for expensive ABA therapy for those currently diagnosed with Autism Spectrum Disorders, including PDD-NOS. <br /> <br />I think the chances of the DSM5 organization making the changes that I linked in their quote in my post, close to zero, in that what they are asking for would mean that non-verbal communication impairments would not be a mandatory requirement, thereby moving Autism out of the territory as a disorder of communication, both non-verbal and verbal. <br /> <br />My argument is mostly a semantic one, per logic and consistency, as a non-expert in the actual subject matter. <br /> <br />It is not reasonable per the research that had already been done to the point of the DSMIV, that the criteria for non-verbal communication impairments were not a mandatory requirement of ASD's. It is not a mandatory requirement in either the DSMIV definitions of Aspergers or Autism Spectrum Disorder, that have identical 2 out 4 requirements for criteria elements associated with Social Interaction impairments, including that non-mandatory criteria of non-verbal communication impairments. <br /> <br />Nor are verbal delays in the development of language or the lack of the ability for spoken language a mandatory requirement, per that criteria in the communication impairments category of Autism Disorder. <br /> <br />And, hypo/hyper reactivity to sensory input was not a criteria in any of the disorders, nor motor development delays seen as part of the criteria in the Gilberg and ICD10 diagnostic manuals. <br /> <br />My point is that verbal delays in the development of language and/or the lack of the ability for spoken language are defining characteristics of subgroups of autism spectrum disorders, particularly regressive autism as much as hypo/hyper reactivity to sensory input is among some individuals currently diagnosed with ASD's. <br /> <br />However, neither of these two criteria are specific to ASD's as Disorders nor are either universal traits seen in ASD's. This is used as the rationale by the DSM5 work group, quoted in a couple of posts previous to this one, to exclude the long standing non-mandatory criteria of verbal delays/ lack of ability for spoken language in the communication impairments category for ASD, but at the same time they are adding an additional criteria per hypo/hyper reactivity to sensory input that is also not specific to ASD's or a Universal trait seen in ASD's. <br /> <br />I do think it is an excellent decision to add this new sensory related criteria, but the rationale to remove the older longstanding non-mandatory criteria, is not a logical one, based on what could be a similar logical rationale for refusing the addition of the new sensory associated criteria. <br /> <br />I do believe their nomenclature in severity levels 2 and 3, requiring both verbal and non-verbal impairments, remedy the situation where there should be no reasonable concern per those individuals with impairments that rise to the severity of not being able to speak at all, but the basic criteria ignores regressive autism per the lack of speech that is studied as an inherent part of autism for that sub-group as well as others, in the overall current diagnosis of autism disorder. <br /> <br />A large study done recently reflects abnormal brain growth specific to males with the condition of regressive autism that lose their ability for speech, vs all other groups of children with ASD's. <br /> <br />My opinion is that they should continue to include this long standing criteria in the basic criteria of the new Autism Spectrum Disorder, in acknowledgement that it is indeed an inherent part of some subgroups of autism, this potential change would present a problem per their current diagnostic structure that make all three criteria, per the social communication category mandatory. <br /> <br />Therefore, my comment and suggestion provided to the organization is to add another sub-category under the Social Communication category per a 1 of 2 requirement for the criteria of the verbal communication impairments and the criteria for the non-verbal communication impairments, and then provide another sub-category of Social communication for the 3 of 4 existing social interaction criteria that both Aspergers and Autism share under the DSMIV, excluding the existing non-verbal communication impairment moved to the first subcategory with the long standing verbal communication impairments. <br /> <br />Of those remaining 3 current social interaction criteria, placed in the new subcategory under social communication disorder in the DSM5, 2 out 3 would be required. <br /> <br />One of those criteria addresses developing and maintaining peer appropriate friendships and the other two address social reciprocity. They've combined the two criteria associated with social reciprocity in the current revision of the DSM5 in the Social Communication category into one, but it would be easy to reclaim them as two separate criteria. <br /> <br />As it stands, I think there is zero chance that the ASAN organization is going to get what they are requesting per the unlikely-hood that the DSM5 is going to keep non-verbal communication impairments as a non-mandatory requirement; but the additional issue, per ASAN's concerns is that there are a significant number of individuals diagnosed with Aspergers that do manage to adapt over time to develop and maintain peer appropriate friendships in adulthood. <br /> <br />As it stands now, a significant impairment is going to be required in this criteria as a mandatory requirement for re-diagnosis or a new diagnosis per the DSM5. <br /> <br />While some diagnosing professionals may overlook those acquired social abilities in developing and maintaining peer appropriate relationships, if they play by the diagnostic rules there are some that will not be diagnosed and there are some that will lose their diagnosis based on this one criteria, per developing and maintaining peer appropriate relationships, that is currently not a mandatory requirement in either an Aspergers or an Autism Disorder Diagnosis. <br /> <br />If that is the only criteria preventing them from retaining or gaining an Aspergers diagnosis they will likely be put into the SCD diagnostic category. Problem is though, that if they have all of the other required social communication impairments as well as the required RRB's, and potentially the new criteria per sensory issues, they are going to be put in the wrong diagnostic category, because they would otherwise exceed the requirements to meet a diagnosis of Aspergers per existing diagnostic criteria without that one mandatory requirement, as well as likely meeting or exceeding diagnostic requirements per the ICD10 and Gilberg criteria for Aspergers. <br /> <br />The ability to develop and maintain age appropriate friendships, is highly dependent on many factors out of the control of the individual with social communication impairments. It is more likely than if one finds a niche in life, where there are personalities that are more compatible the odds go up for adaptation, whereas if there is not that niche in life, and a potential demographic to develop and maintain friendships the odds go down per that potential adaptation. <br /> <br />It's not likely that many diagnosing professionals will play by that strict rule, in the real world, so the diagnostic criteria might as well reflect a more reasonable approach per the current revised mandatory requirement to meet that criteria. <br /> <br />Just as a potential example those folks at the headquarters of ASAN may maintain close friendships with each other per their niche, but some might neither develop or maintain relationships if they were removed from that relatively comfortable life niche. <br /> <br />Significant impairments in developing and maintaining friendships is another inherent problem of ASD's that the majority of individuals share as a criteria for the diagnosis, but it is not a universal trait per ASD's or a mandatory requirement in any diagnostic criteria that currently exist in the world for any Autism Spectrum Disorder. <br /> <br />I think the DSM5 may be sacrificing reason for brevity in their decision to make that a mandatory requirement as well as excluding the long-time standing non-mandatory communication criteria that addresses verbal delays and the lack of spoken language as an inherent part of autism spectrum disorders for subgroups of individuals diagnosed with the disorders. <br /> <br />What makes my argument one that is not very compelling for actual change is that these current revised changes are not likely going to negatively impact anyone currently diagnosed or future diagnosed with autism spectrum disorders per language delays or the lack of spoken language; the change would be based on retaining consistency per their nomenclature in severity levels one and two, and acknowledgement that the criteria remains an inherent symptom of subgroups of autism spectrum disorder. <br /> <br />In real life, per the mandatory requirement for significant impairments in developing and maintaining friendships, as stated before, there aren't likely going to be many diagnosing professionals that exclude someone from a diagnosis, because they don't meet that one criteria, regardless of what the diagnostic manual says to do. <br /> <br />It is not a practical real world mandatory requirement, per variable environmental social circumstances. But if one wants to provide a realistic diagnostic procedure I think it is worth the time and effort for the DSM5 organization in consideration of the change back to a non-mandatory requirement for that specific criteria, which would require the other change I suggested as well to keep non-verbal communication impairments a mandatory requirement per most every diagnosis. <br /> <br />It's highly unlikely that an autistic person without the ability to speak is not going to also have significant non-verbal communication difficulties, so in most every case those individuals should meet both verbal and non-verbal criteria in the new suggested sub-category. This is also, in part, reflective of the DSM5 revision requirements in severity levels 1 and 2, per the nomenclature of the requirements for verbal and non-verbal communication impairments.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>Ellingtonia</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 10:30 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody">I think it's a mistake to criticize the new DSM in terms of how it will affect people applying for services. The DSM should be a reflection of our best current knowledge about mental disorders, and laws should be written to work around that. <br /> <br />Take ASD vs Social Communication Disorder: these experts have apparently decided that some people now diagnosed with PDD-NOS are not truly on the autistic spectrum, and should be moved to the new SCD diagnosis. They are still being recognised as having problems, just slightly different problems; perhaps they only have one or two of autism's 'triad of impairments'. <br /> <br />This may seem like semantics to some, but keep in mind that the DSM is used by researchers as well. For people trying to study the causes and neurological differences behind autism this separation would be crucial. <br /> <br /> <br />You say that people moved to SCD may lose access to services, and you may be right, but it seems backwards to change our definition of disorders to better fit the service system. Instead our treatments should be changed to reflect our growing knowledge about these disorders. There is still time before the DSM5 becomes official to make some small fixes to current laws and to look at what more significant changes might be warranted (if lawmakers can get their act together which, granted, is not a certainty). <br /> <br />Experts have decided that these people with SCD are not on the autistic spectrum, and so to change the criteria for ASD to fit them would be a 'white lie' to get them services. I think this is a mistake and it is the service system that needs changing. The current service system was written around the DSM IV, so it makes sense that there would need to be changes made when the DSM IV is replaced <br /> <br />You can argue that people moved to SCD in fact do have autism, and you may be right, but expert professionals seem to think otherwise. I firmly believe that having ASD makes your opinion on this subject valuable, but does not make you a substitute for an expert.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>aghogday</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 8:31 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Dillogic wrote:</b></span></td> </tr> <tr> <td class="quote">unable to speak equating to autism has always been a misnomer as far as I can tell <br /> <br />Most individuals with Autistic Disorder were found to develop adequate speech by the time of adulthood (it was over 70%). <br /> <br />I think the lack of "social speech" and people not following up on stories of nonverbal children are a big part to blame for this perception that autism = no speech. <br /> <br />Most people would think I couldn't talk for the simple fact that I don't talk to them (I have no social speech, but I have mechanically functional speech regarding seeing a doctor for example).</td> </tr></table><span class="postbody">\ <br /> <br />I agree, but it's been a misconception, not based on facts. Not unlike many other incorrect perceptions such as the commonly repeated mantra that autism speaks is attempting to speak for autistics whom speak can speak for themselves, when the comment as provided and described on the website of Autism Speaks, was designed as a moral booster to give families that felt disenfranchised a voice, whom had children with regressive autism that lost the ability to speak. <br /> <br />Non-verbal (lack of ability for verbal communication) symptoms have never been a mandatory requirement for DSM diagnosis. It's still an issue for some estimates at 25 to 30% of individuals diagnosed with autism disorder, with higher statistics reported, per the CDC at 40%, so there is close to a 1 out of 4 to 3 chance that this is going to be a major disability for an individual diagnosed with Autism Disorder, per a current diagnosis. <br /> <br />I'm of the opinion that the DSM5 organization discarded the non-mandatory non-verbal criteria, in their basic criteria for Autism Spectrum Disorder, that describes a core symptom for a significant portion of individuals with autism spectrum disorders, for brevity, rather than consistency, per severity levels 2 and 3, that address verbal communication and non-verbal communication impairments as requirements to meet those severity levels. Leaving the door open for those that do not speak at all, to be described as such in those severity levels per clinical records, specific to the severity levels.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>Dillogic</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 7:51 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody">unable to speak equating to autism has always been a misnomer as far as I can tell <br /> <br />Most individuals with Autistic Disorder were found to develop adequate speech by the time of adulthood (it was over 70%). <br /> <br />I think the lack of "social speech" and people not following up on stories of nonverbal children are a big part to blame for this perception that autism = no speech. <br /> <br />Most people would think I couldn't talk for the simple fact that I don't talk to them (I have no social speech, but I have mechanically functional speech regarding seeing a doctor for example).</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>aghogday</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 7:42 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Tuttle wrote:</b></span></td> </tr> <tr> <td class="quote">There are a whole lot of communication difficulties, and specifically verbal communication difficulties, that occur in people who can speak. The fact that I'm verbal and spoke on time (I'm assuming) doesn't mean I don't have verbal communication difficulties. <br /> <br />How I read this set of criteria is saying that whether or not someone can speak is not relevant to whether they are autistic - some people will be verbal, others nonverbal and both can be autistic. What is relevant is communication difficulties, which occur in both the people who can speak and those who can't. Being completely nonverbal, or delayed in speech, is one type of communication difficulty, its not the only one.</td> </tr></table><span class="postbody"> <br /> <br />The reference I was making toward verbal communication was developmental verbal delays or the lack of ability to speak, not other difficulties in verbal communication, addressed in the basic criteria such as the ability to coordinate verbal and nonverbal communication, in the non-verbal communication criteria. <br /> <br />Non-Verbal communication impairments are a mandatory requirement in the revised DSM5 basic criteria for Autism Spectrum Disorder, but Verbal communication impairments, per developmental delays or the lack of ability to speak, while not included in Autism Spectrum Disorder in the basic DSM5 criteria, are addressed in general terms per levels 2 and 3 of severity, <br /> <br />Currently, verbal delays are part of the way that autism is screened among children, as well as in children with the loss of verbal language in regressive autism, so it is very relevant at this point per an autism spectrum diagnosis. It's highly unlikely that those two elements are going to be taken out of the screening process for Autism Spectrum Disorder, so while it is has never been a mandatory criteria requirement for an autism spectrum disorder, never the less, it is a core symptom of some subgroups of autism spectrum disorders that aren't going away, if the DSM5 stays with their decision to exclude that existing criteria as part of the basic criteria of autism spectrum disorder. <br /> <br />Since verbal and non-verbal communication impairments are addressed as separate required impairments in severity levels 2 and 3, there is an acknowledgement of the issues as they currently exist among those in subgroups diagnosed with autism spectrum disorder whom lack the ability to speak, but not a specification of them as verbal communication impairments severe enough in those subgroups where a child cannot speak at all. <br /> <br />Motor skills developmental delays and verbal delays/lack of spoken language are part of what has been defined as autism disorders and will continue to be part of what is defined as autism spectrum disorders in both the ICD10 and Gilberg criteria for autism spectrum disorders. <br /> <br />These developmental delays are currently very much a part of what defines subgroups of individuals with autism spectrum disorders along with hypo/hyper-reactive sensory input issues that are all, in part, biologically determined per a pervasive developmental disorder, instead of externally observable behavioral impairments, potentially influenced by the interaction with the social/cultural environment at levels required to meet the current guidelines of the criteria in the DSM5 criteria for a diagnosis of Autism Spectrum Disorder. <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">1. 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) <br /></td> </tr></table><span class="postbody"> <br /> <br /><a href="http://www.autreat.com/dsm4-autism.html" target="_blank" rel="nofollow" class="postlink" >http://www.autreat.com/dsm4-autism.html</a> <br /> <br />This is the major criteria discarded from the criteria for DSMIV Autism Disorder that has been part of the criteria for the disorder since 1980, in the DSMIII. <br /> <br />Per the DSM5, revised definition, it appears it will in the future be considered a co-morbid symptom, per the basic criteria, rather than an inherent part of autism commonly observed in subgroups of individuals with the disorder, as currently included in the basic criteria of Autism Disorder. <br /> <br />The severity levels remedy this issue, in part, however the DSM5 basic criteria for Autism Spectrum Disorder does not match severity levels 2 and 3 per the nomenclature that is used that addresses verbal and communication impairments as separate identified characteristics that are a requirement in severity levels 2 and 3. <br /> <br />Non-verbal communication impairments are identified as impairments of Social Interaction in both Autism Disorder and Aspergers in the DSM IV. Communication impairments are a separate category in Autism Disorder. <br /> <br />A solution to maintain consistency could be to keep the four criteria associated with Social Interaction, currently common to a DSM IV diagnosis of Autism Disorder and Asperger's Syndrome, and require 2 out of 3 of those criteria, excluding the non-verbal communication impairment criteria. <br /> <br />An additional subcategory under the general category of Social-Communication could be created for the criteria of non-verbal communication impairments currently listed under the DSM5 Social-Communication category and add the verbal communication impairment criteria quoted above, per verbal delays and the lack of spoken language. 1 out 2 of these criteria under the general category of Social-Communication, per this 2-element sub-category of Social-Communication, could be required. <br /> <br />It's highly unlikely that an individual with autism without the ability to speak is going to have skills in non-verbal communication that are not clinically impaired, so in virtually every case a non-verbal individual with autism would meet both criteria. And for those with verbal abilities per spoken language, they would still have to meet the criteria of non-verbal communication impairments. <br /> <br />The 2 out 3 requirements for the remaining social interaction criteria as they currently exist, in the DSMIV, common to both Aspergers and Autism Disorder, added as the second sub-category under the general category of Social-Communication would allow leeway in part for the concerns of the ASAN organization, at least per the concern, for those that have adapted well enough to develop and maintain friendships, in young adulthood. <br /> <br />I've been thinking about a reasonable way to put that into words, for some time now, and I am now sufficiently motivated to make a comment to the DSM5 organization that might satisfy my inclination toward rigid logic, and part of the concern of ASAN, before time runs out. I have no credentials, so it is not likely going to make a difference, but I think I'll give it a shot. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /> <br /> <br />I don't see it as anything but a win-win scenario, per the concern of ASAN. The DSM5 is never going to consider 2 out 3 of the Social-Communication criteria as they currently exist, because that could result in a person diagnosed with Autism Spectrum Disorder without non-verbal communication impairments. <br /> <br />The only real significant issue I see is the potential of some individuals who have adapted to developing and maintaining friendships among those in their appropriate aged peer group, in retaining or gaining a diagnosis. <br /> <br />There are definitely some individuals currently diagnosed with Aspergers that have adapted well enough to develop and maintain friendships, if they have found a suitable peer group, that might no longer meet that mandatory requirement in the DSM5, that currently is not a mandatory requirement in the DSMIV for either Autism Disorder or Aspergers Syndrome.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>Dillogic</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 7:26 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody">The proposed DSM-V criteria fit me, so I'm not going to complain about it. Seems to jive with Kanner's and Asperger's/Wing's papers in many ways (as did the DSM-IV-TR). <br /> <br />I don't care what it's called though. Autism, ASDs, and/or whatnot, are just names. Any name they give it will work as far as services go, as services where I live aren't based on specific labels [for the most part], rather more objective tests for how you're disabled.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>vermontsavant</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 5:29 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>vermontsavant wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>vermontsavant wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">The ASAN organization has done what appears to be a good analysis of the circumstances surrounding the changes in the DSM5 definition, in research, in part funded by the US Department of Health and Human Services. <br /> <br /> <br />They bring up some good points, in the full article linked below, per individuals that may be potentially re-diagnosed with Social Communication Disorder SCD, because they do not meet all mandatory requirements of the DSM5 definition, per example of those that fit under PDD-NOS currently not diagnosed with the RRB criteria, and those potentially losing their current diagnosis, because they do not meet the mandatory requirement of 3 out of 3 criteria, per Social/Communication impairments, that were not previously required in either Autism Disorder or Aspergers in the DSMIV. <br /> <br />One of the main concerns they express is that these individuals may no longer qualify for the government support in education and services that they currently receive, as well as the potential that there may be those misdiagnosed under SCD, that may not receive those services in the future. <br /> <br />The potential solutions offered to the DSM5 organization, by the ASAN analysis, is to reduce the required criteria from 3 to 2, and to include SCD under a different label adding it as an additional disorder linked to Autism Spectrum Disorder per sub-type, or (NOS) Not otherwise specified label. <br /> <br /> <br /><a href="http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf" target="_blank" rel="nofollow" class="postlink" >http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">THIRD, we urge the Work Group to consider the implications on service provision and legal rights of shifting individuals who at one point were or would have been diagnosed on the autism spectrum into the non-ASD Social Communication Disorder (SCD) diagnosis. As we have outlined above, the SCD diagnosis would provide none of the access to publicly funded service provision or legal rights under IDEA, the Americans with Disabilities Act or the SSI/SSDI income support programs and associated public health insurance. Despite this, SCD is likely to be a frequent misdiagnosis for ASD — a misdiagnosis whose implications would be stark and significant. SCD’s criteria also contains an explicit requirement that ASD be ruled out, making it likely that school districts would disallow the use of the autism educational category under IDEA to serve students with diagnoses of SCD. These issues can be addressed, however, by linking the SCD diagnosis to the broader autism spectrum, even as it retains a distinct diagnostic category. <span style="font-weight: bold">We urge the Work Group to consider re-naming Social Communication Disorder as ASD-Social Communication subtype (ASD-SC), ASD-Not Otherwise Specified (ASD-NOS) or another term which explicitly communicates to service provision and legal infrastructures the connection between the SCD diagnosis and the autism spectrum</span>.</td> </tr></table><span class="postbody"> <br /> <br /> <br />Per the current revised DSM5 definition of Autism Spectrum Disorder, it is interesting that they require non-verbal communication impairments as a mandatory requirement, that was not mandatory in either autism disorder or Aspergers Syndrome, under the DSMIV, and do not mention language delays or language loss per verbal communication impairments, that have been seen as one of the most severely disabling impairments in autism disorder since 1980, when Autism Disorder was first included as a disorder under the DSMIII. <br /> <br />And also, Autism Spectrum Disorder has been narrowed to require RRB's as a mandatory part of the disorder, whereas before technically they weren't a mandatory criteria in a diagnosis of PDD NOS. <br /> <br />The only significant criteria that is added is hypo/hyper-reactivity to sensory input. <br /> <br />It stands to reason that most people with autism disorder with severe verbal impairments, will almost by default be impaired in non-verbal communication as well; while they likely would not lose a diagnosis, because the criteria associated with impairments in verbal communication have been removed, it seems that the DSM5 is ignoring a major impairment seen in autism now, for what appears to be a trade-off to require that all three social-communication impairments now listed will be mandatory. Basically to ensure, it seems, that non-verbal communication impairments are a mandatory requirement, which per research, specific to non-verbal communication impairments seems like a valid decision. <br /> <br />The problem that the ASAN identifies is that some can learn skills related to non-verbal communication as an adaptation, per the 3 criteria of social/communication impairments, that may mask the disorder, per the requirements that will be mandatory in the future. <br /> <br />While this adaptation could be overlooked, per the non-mandatory criteria of non-verbal communication impairments, in the DSMIV definition of Aspergers, technically it will not be overlooked in the mandatory requirement in the DSM5. <br /> <br />Part of the reason I provided the research above, is to show the state of research per potential biologically determining factors and how diverse those factors may be per Autism Spectrum Disorders, as currently defined. There do appear to be language development issues, that may eventually be explained by biological and/or environmental causation, and even potentially prevented. <br /> <br />I suggest that what the DSM5 is defining as Autism Spectrum Disorder retains many of the core elements of autism spectrum disorders seen in the 4 disorders currently described, consolidated to create one autism spectrum disorder, but at the same time <span style="font-weight: bold">they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak</span>, in the sense that verbal language impairments per the lack of inherent ability to speak, are no longer addressed in the basic criteria. The rational for this, per the DSM5 link provided in the first post is: <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Delays in language are not unique nor universal in ASD and are more accurately considered as a factor that influences the clinical symptoms of ASD, rather than defining the ASD diagnosis </td> </tr></table><span class="postbody"> <br /> <br />Interestingly, behaviors associated with and the condition of hyper-reactivity or hypo-reactivity to sensory input are added as a criteria, per RRB's, which is also not unique to ASD or universal in ASD. It's commonly seen in ADHD. <br /> <br />I'm not sure how hyper or hypo-reactivity to sensory input defines autism either, for those diagnosed that don't have an issue with it. Their logic in dropping the delay in language development does not appear to be consistent with the addition of hypo/hyper reactivity to sensory input. <br /> <br />The addition of hypo/hyper reactivity to sensory input, in itself, appears to be a good decision, because it's not likely a criteria that can easily be developed through social stress, alone. <br /> <br />A developmental delay in language or the loss of language in regressive autism, likely, at least in part, has biological causation as well as hypo/hyper reactivity to sensory input. <br /> <br />Other than those two factors, almost any behavioral impairment measured in the revised DSM5 criteria can be a result of environmental/psychological social stresses, not unlike what is seen in children isolated in childhood from human contact. <br /> <br /><span style="font-weight: bold">The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie.</span> Ironically per that new criteria, autism speaks. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /></td> </tr></table><span class="postbody">you dont think hyper/hypo sensitivity describes the core essence of autism. <br />hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident</td> </tr></table><span class="postbody"> <br /> <br />Self evident, yes, definitely for myself as an individual. It has played a defining role for me since I can remember as a small child, with hyper-reactivity to tactile sensory input and other sensory input along with a delay in speaking and difficulty expressing myself verbally most of my life, but some people diagnosed with autism spectrum disorders report neither of those issues, so it is not a defining issue for them. <br /> <br />Neither have been a mandatory requirement for an Autism Spectrum Diagnosis in the past, nor will they be in the DSM5. It appears that the psychological profession has come to a determination that non-verbal communication impairments are an issue that everyone with autism spectrum disorder must share for a diagnosis. <br /> <br />I can't disagree with that. Otherwise, since they are leaving out the verbal developmental delays in the basic criteria, I'm not sure how they could call it a social/communication/RRB disorder. <br /> <br />Even though the disorder is not considered a hypo/hyper reactivity to sensory input disorder, per a mandatory required criteria in the DSM5, that specific issue was certainly a defining issue for me along with verbal and non-verbal social-communication/RRB impairments.</td> </tr></table><span class="postbody">The hyper/hypo sensory input issues are the core root of deficits in non verbal communication. <br /> <br />neurotypicals dont feel things as intensly as autistics but everything they feel,they feel it all. they wont be hypnotized by sensory stimuli causing endorphins in the brain to anestitize there feelings which makes them more in touch with peoples feelings</td> </tr></table><span class="postbody"> <br /> <br />The hyper/hypo sensory input issues may be at the core root of deficits in some people with non-verbal communication difficulties, but not all people diagnosed with an ASD, with non-verbal communication difficulties experience these sensory input issues so it is not a core issue for them. Some people diagnosed with autism spectrum disorders report they are very much in touch with other people's feelings and other people report that they are rarely in touch with other people's feelings so that differs as well per individual. <br /> <br />That was another point of my references that describe the biological differences among those on the spectrum, per the differences in brain structure in females with Aspergers, abnormal brain growth seen specific to male children with regressive autism, and differences in verbal vs performance IQ among individuals diagnosed with Aspergers as opposed to Autism Disorder. There are characteristics associated with subgroups of diagnosed individuals with autism that very from other subgroups of individuals with autism. While the Disorder may become one disorder, those varying characteristics will continue, regardless of an attempt to make the behavioral assessment consolidated and consistent. <br /> <br />To this point there could actually be some individuals diagnosed with Asperger's Syndrome with neither verbal communication delays or non-verbal communication difficulties, because verbal delays and non-verbal communication difficulties are not currently a mandatory diagnosis in that disorder, per the DSMIV.</td> </tr></table><span class="postbody">i guess i am a dedicated believer of the higher level of reactivity intense world theory as the core root of all types of autism spectrum disorders</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>aghogday</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 4:49 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>vermontsavant wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>vermontsavant wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">The ASAN organization has done what appears to be a good analysis of the circumstances surrounding the changes in the DSM5 definition, in research, in part funded by the US Department of Health and Human Services. <br /> <br /> <br />They bring up some good points, in the full article linked below, per individuals that may be potentially re-diagnosed with Social Communication Disorder SCD, because they do not meet all mandatory requirements of the DSM5 definition, per example of those that fit under PDD-NOS currently not diagnosed with the RRB criteria, and those potentially losing their current diagnosis, because they do not meet the mandatory requirement of 3 out of 3 criteria, per Social/Communication impairments, that were not previously required in either Autism Disorder or Aspergers in the DSMIV. <br /> <br />One of the main concerns they express is that these individuals may no longer qualify for the government support in education and services that they currently receive, as well as the potential that there may be those misdiagnosed under SCD, that may not receive those services in the future. <br /> <br />The potential solutions offered to the DSM5 organization, by the ASAN analysis, is to reduce the required criteria from 3 to 2, and to include SCD under a different label adding it as an additional disorder linked to Autism Spectrum Disorder per sub-type, or (NOS) Not otherwise specified label. <br /> <br /> <br /><a href="http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf" target="_blank" rel="nofollow" class="postlink" >http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">THIRD, we urge the Work Group to consider the implications on service provision and legal rights of shifting individuals who at one point were or would have been diagnosed on the autism spectrum into the non-ASD Social Communication Disorder (SCD) diagnosis. As we have outlined above, the SCD diagnosis would provide none of the access to publicly funded service provision or legal rights under IDEA, the Americans with Disabilities Act or the SSI/SSDI income support programs and associated public health insurance. Despite this, SCD is likely to be a frequent misdiagnosis for ASD — a misdiagnosis whose implications would be stark and significant. SCD’s criteria also contains an explicit requirement that ASD be ruled out, making it likely that school districts would disallow the use of the autism educational category under IDEA to serve students with diagnoses of SCD. These issues can be addressed, however, by linking the SCD diagnosis to the broader autism spectrum, even as it retains a distinct diagnostic category. <span style="font-weight: bold">We urge the Work Group to consider re-naming Social Communication Disorder as ASD-Social Communication subtype (ASD-SC), ASD-Not Otherwise Specified (ASD-NOS) or another term which explicitly communicates to service provision and legal infrastructures the connection between the SCD diagnosis and the autism spectrum</span>.</td> </tr></table><span class="postbody"> <br /> <br /> <br />Per the current revised DSM5 definition of Autism Spectrum Disorder, it is interesting that they require non-verbal communication impairments as a mandatory requirement, that was not mandatory in either autism disorder or Aspergers Syndrome, under the DSMIV, and do not mention language delays or language loss per verbal communication impairments, that have been seen as one of the most severely disabling impairments in autism disorder since 1980, when Autism Disorder was first included as a disorder under the DSMIII. <br /> <br />And also, Autism Spectrum Disorder has been narrowed to require RRB's as a mandatory part of the disorder, whereas before technically they weren't a mandatory criteria in a diagnosis of PDD NOS. <br /> <br />The only significant criteria that is added is hypo/hyper-reactivity to sensory input. <br /> <br />It stands to reason that most people with autism disorder with severe verbal impairments, will almost by default be impaired in non-verbal communication as well; while they likely would not lose a diagnosis, because the criteria associated with impairments in verbal communication have been removed, it seems that the DSM5 is ignoring a major impairment seen in autism now, for what appears to be a trade-off to require that all three social-communication impairments now listed will be mandatory. Basically to ensure, it seems, that non-verbal communication impairments are a mandatory requirement, which per research, specific to non-verbal communication impairments seems like a valid decision. <br /> <br />The problem that the ASAN identifies is that some can learn skills related to non-verbal communication as an adaptation, per the 3 criteria of social/communication impairments, that may mask the disorder, per the requirements that will be mandatory in the future. <br /> <br />While this adaptation could be overlooked, per the non-mandatory criteria of non-verbal communication impairments, in the DSMIV definition of Aspergers, technically it will not be overlooked in the mandatory requirement in the DSM5. <br /> <br />Part of the reason I provided the research above, is to show the state of research per potential biologically determining factors and how diverse those factors may be per Autism Spectrum Disorders, as currently defined. There do appear to be language development issues, that may eventually be explained by biological and/or environmental causation, and even potentially prevented. <br /> <br />I suggest that what the DSM5 is defining as Autism Spectrum Disorder retains many of the core elements of autism spectrum disorders seen in the 4 disorders currently described, consolidated to create one autism spectrum disorder, but at the same time <span style="font-weight: bold">they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak</span>, in the sense that verbal language impairments per the lack of inherent ability to speak, are no longer addressed in the basic criteria. The rational for this, per the DSM5 link provided in the first post is: <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Delays in language are not unique nor universal in ASD and are more accurately considered as a factor that influences the clinical symptoms of ASD, rather than defining the ASD diagnosis </td> </tr></table><span class="postbody"> <br /> <br />Interestingly, behaviors associated with and the condition of hyper-reactivity or hypo-reactivity to sensory input are added as a criteria, per RRB's, which is also not unique to ASD or universal in ASD. It's commonly seen in ADHD. <br /> <br />I'm not sure how hyper or hypo-reactivity to sensory input defines autism either, for those diagnosed that don't have an issue with it. Their logic in dropping the delay in language development does not appear to be consistent with the addition of hypo/hyper reactivity to sensory input. <br /> <br />The addition of hypo/hyper reactivity to sensory input, in itself, appears to be a good decision, because it's not likely a criteria that can easily be developed through social stress, alone. <br /> <br />A developmental delay in language or the loss of language in regressive autism, likely, at least in part, has biological causation as well as hypo/hyper reactivity to sensory input. <br /> <br />Other than those two factors, almost any behavioral impairment measured in the revised DSM5 criteria can be a result of environmental/psychological social stresses, not unlike what is seen in children isolated in childhood from human contact. <br /> <br /><span style="font-weight: bold">The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie.</span> Ironically per that new criteria, autism speaks. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /></td> </tr></table><span class="postbody">you dont think hyper/hypo sensitivity describes the core essence of autism. <br />hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident</td> </tr></table><span class="postbody"> <br /> <br />Self evident, yes, definitely for myself as an individual. It has played a defining role for me since I can remember as a small child, with hyper-reactivity to tactile sensory input and other sensory input along with a delay in speaking and difficulty expressing myself verbally most of my life, but some people diagnosed with autism spectrum disorders report neither of those issues, so it is not a defining issue for them. <br /> <br />Neither have been a mandatory requirement for an Autism Spectrum Diagnosis in the past, nor will they be in the DSM5. It appears that the psychological profession has come to a determination that non-verbal communication impairments are an issue that everyone with autism spectrum disorder must share for a diagnosis. <br /> <br />I can't disagree with that. Otherwise, since they are leaving out the verbal developmental delays in the basic criteria, I'm not sure how they could call it a social/communication/RRB disorder. <br /> <br />Even though the disorder is not considered a hypo/hyper reactivity to sensory input disorder, per a mandatory required criteria in the DSM5, that specific issue was certainly a defining issue for me along with verbal and non-verbal social-communication/RRB impairments.</td> </tr></table><span class="postbody">The hyper/hypo sensory input issues are the core root of deficits in non verbal communication. <br /> <br />neurotypicals dont feel things as intensly as autistics but everything they feel,they feel it all. they wont be hypnotized by sensory stimuli causing endorphins in the brain to anestitize there feelings which makes them more in touch with peoples feelings</td> </tr></table><span class="postbody"> <br /> <br />The hyper/hypo sensory input issues may be at the core root of deficits in some people with non-verbal communication difficulties, but not all people diagnosed with an ASD, with non-verbal communication difficulties experience these sensory input issues so it is not a core issue for them. Some people diagnosed with autism spectrum disorders report they are very much in touch with other people's feelings and other people report that they are rarely in touch with other people's feelings so that differs as well per individual. <br /> <br />That was another point of my references that describe the biological differences among those on the spectrum, per the differences in brain structure in females with Aspergers, abnormal brain growth seen specific to male children with regressive autism, and differences in verbal vs performance IQ among individuals diagnosed with Aspergers as opposed to Autism Disorder. There are characteristics associated with subgroups of diagnosed individuals with autism that very from other subgroups of individuals with autism. While the Disorder may become one disorder, those varying characteristics will continue, regardless of an attempt to make the behavioral assessment consolidated and consistent. <br /> <br />To this point there could actually be some individuals diagnosed with Asperger's Syndrome with neither verbal communication delays or non-verbal communication difficulties, because verbal delays and non-verbal communication difficulties are not currently a mandatory diagnosis in that disorder, per the DSMIV.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>Tuttle</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 2:56 pm<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody">There are a whole lot of communication difficulties, and specifically verbal communication difficulties, that occur in people who can speak. The fact that I'm verbal and spoke on time (I'm assuming) doesn't mean I don't have verbal communication difficulties. <br /> <br />How I read this set of criteria is saying that whether or not someone can speak is not relevant to whether they are autistic - some people will be verbal, others nonverbal and both can be autistic. What is relevant is communication difficulties, which occur in both the people who can speak and those who can't. Being completely nonverbal, or delayed in speech, is one type of communication difficulty, its not the only one.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>vermontsavant</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 7:21 am<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>vermontsavant wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">The ASAN organization has done what appears to be a good analysis of the circumstances surrounding the changes in the DSM5 definition, in research, in part funded by the US Department of Health and Human Services. <br /> <br /> <br />They bring up some good points, in the full article linked below, per individuals that may be potentially re-diagnosed with Social Communication Disorder SCD, because they do not meet all mandatory requirements of the DSM5 definition, per example of those that fit under PDD-NOS currently not diagnosed with the RRB criteria, and those potentially losing their current diagnosis, because they do not meet the mandatory requirement of 3 out of 3 criteria, per Social/Communication impairments, that were not previously required in either Autism Disorder or Aspergers in the DSMIV. <br /> <br />One of the main concerns they express is that these individuals may no longer qualify for the government support in education and services that they currently receive, as well as the potential that there may be those misdiagnosed under SCD, that may not receive those services in the future. <br /> <br />The potential solutions offered to the DSM5 organization, by the ASAN analysis, is to reduce the required criteria from 3 to 2, and to include SCD under a different label adding it as an additional disorder linked to Autism Spectrum Disorder per sub-type, or (NOS) Not otherwise specified label. <br /> <br /> <br /><a href="http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf" target="_blank" rel="nofollow" class="postlink" >http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">THIRD, we urge the Work Group to consider the implications on service provision and legal rights of shifting individuals who at one point were or would have been diagnosed on the autism spectrum into the non-ASD Social Communication Disorder (SCD) diagnosis. As we have outlined above, the SCD diagnosis would provide none of the access to publicly funded service provision or legal rights under IDEA, the Americans with Disabilities Act or the SSI/SSDI income support programs and associated public health insurance. Despite this, SCD is likely to be a frequent misdiagnosis for ASD — a misdiagnosis whose implications would be stark and significant. SCD’s criteria also contains an explicit requirement that ASD be ruled out, making it likely that school districts would disallow the use of the autism educational category under IDEA to serve students with diagnoses of SCD. These issues can be addressed, however, by linking the SCD diagnosis to the broader autism spectrum, even as it retains a distinct diagnostic category. <span style="font-weight: bold">We urge the Work Group to consider re-naming Social Communication Disorder as ASD-Social Communication subtype (ASD-SC), ASD-Not Otherwise Specified (ASD-NOS) or another term which explicitly communicates to service provision and legal infrastructures the connection between the SCD diagnosis and the autism spectrum</span>.</td> </tr></table><span class="postbody"> <br /> <br /> <br />Per the current revised DSM5 definition of Autism Spectrum Disorder, it is interesting that they require non-verbal communication impairments as a mandatory requirement, that was not mandatory in either autism disorder or Aspergers Syndrome, under the DSMIV, and do not mention language delays or language loss per verbal communication impairments, that have been seen as one of the most severely disabling impairments in autism disorder since 1980, when Autism Disorder was first included as a disorder under the DSMIII. <br /> <br />And also, Autism Spectrum Disorder has been narrowed to require RRB's as a mandatory part of the disorder, whereas before technically they weren't a mandatory criteria in a diagnosis of PDD NOS. <br /> <br />The only significant criteria that is added is hypo/hyper-reactivity to sensory input. <br /> <br />It stands to reason that most people with autism disorder with severe verbal impairments, will almost by default be impaired in non-verbal communication as well; while they likely would not lose a diagnosis, because the criteria associated with impairments in verbal communication have been removed, it seems that the DSM5 is ignoring a major impairment seen in autism now, for what appears to be a trade-off to require that all three social-communication impairments now listed will be mandatory. Basically to ensure, it seems, that non-verbal communication impairments are a mandatory requirement, which per research, specific to non-verbal communication impairments seems like a valid decision. <br /> <br />The problem that the ASAN identifies is that some can learn skills related to non-verbal communication as an adaptation, per the 3 criteria of social/communication impairments, that may mask the disorder, per the requirements that will be mandatory in the future. <br /> <br />While this adaptation could be overlooked, per the non-mandatory criteria of non-verbal communication impairments, in the DSMIV definition of Aspergers, technically it will not be overlooked in the mandatory requirement in the DSM5. <br /> <br />Part of the reason I provided the research above, is to show the state of research per potential biologically determining factors and how diverse those factors may be per Autism Spectrum Disorders, as currently defined. There do appear to be language development issues, that may eventually be explained by biological and/or environmental causation, and even potentially prevented. <br /> <br />I suggest that what the DSM5 is defining as Autism Spectrum Disorder retains many of the core elements of autism spectrum disorders seen in the 4 disorders currently described, consolidated to create one autism spectrum disorder, but at the same time <span style="font-weight: bold">they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak</span>, in the sense that verbal language impairments per the lack of inherent ability to speak, are no longer addressed in the basic criteria. The rational for this, per the DSM5 link provided in the first post is: <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Delays in language are not unique nor universal in ASD and are more accurately considered as a factor that influences the clinical symptoms of ASD, rather than defining the ASD diagnosis </td> </tr></table><span class="postbody"> <br /> <br />Interestingly, behaviors associated with and the condition of hyper-reactivity or hypo-reactivity to sensory input are added as a criteria, per RRB's, which is also not unique to ASD or universal in ASD. It's commonly seen in ADHD. <br /> <br />I'm not sure how hyper or hypo-reactivity to sensory input defines autism either, for those diagnosed that don't have an issue with it. Their logic in dropping the delay in language development does not appear to be consistent with the addition of hypo/hyper reactivity to sensory input. <br /> <br />The addition of hypo/hyper reactivity to sensory input, in itself, appears to be a good decision, because it's not likely a criteria that can easily be developed through social stress, alone. <br /> <br />A developmental delay in language or the loss of language in regressive autism, likely, at least in part, has biological causation as well as hypo/hyper reactivity to sensory input. <br /> <br />Other than those two factors, almost any behavioral impairment measured in the revised DSM5 criteria can be a result of environmental/psychological social stresses, not unlike what is seen in children isolated in childhood from human contact. <br /> <br /><span style="font-weight: bold">The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie.</span> Ironically per that new criteria, autism speaks. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /></td> </tr></table><span class="postbody">you dont think hyper/hypo sensitivity describes the core essence of autism. <br />hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident</td> </tr></table><span class="postbody"> <br /> <br />Self evident, yes, definitely for myself as an individual. It has played a defining role for me since I can remember as a small child, with hyper-reactivity to tactile sensory input and other sensory input along with a delay in speaking and difficulty expressing myself verbally most of my life, but some people diagnosed with autism spectrum disorders report neither of those issues, so it is not a defining issue for them. <br /> <br />Neither have been a mandatory requirement for an Autism Spectrum Diagnosis in the past, nor will they be in the DSM5. It appears that the psychological profession has come to a determination that non-verbal communication impairments are an issue that everyone with autism spectrum disorder must share for a diagnosis. <br /> <br />I can't disagree with that. Otherwise, since they are leaving out the verbal developmental delays in the basic criteria, I'm not sure how they could call it a social/communication/RRB disorder. <br /> <br />Even though the disorder is not considered a hypo/hyper reactivity to sensory input disorder, per a mandatory required criteria in the DSM5, that specific issue was certainly a defining issue for me along with verbal and non-verbal social-communication/RRB impairments.</td> </tr></table><span class="postbody">The hyper/hypo sensory input issues are the core root of deficits in non verbal communication. <br /> <br />neurotypicals dont feel things as intensly as autistics but everything they feel,they feel it all. they wont be hypnotized by sensory stimuli causing endorphins in the brain to anestitize there feelings which makes them more in touch with peoples feelings</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>aghogday</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 7:04 am<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>vermontsavant wrote:</b></span></td> </tr> <tr> <td class="quote"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">The ASAN organization has done what appears to be a good analysis of the circumstances surrounding the changes in the DSM5 definition, in research, in part funded by the US Department of Health and Human Services. <br /> <br /> <br />They bring up some good points, in the full article linked below, per individuals that may be potentially re-diagnosed with Social Communication Disorder SCD, because they do not meet all mandatory requirements of the DSM5 definition, per example of those that fit under PDD-NOS currently not diagnosed with the RRB criteria, and those potentially losing their current diagnosis, because they do not meet the mandatory requirement of 3 out of 3 criteria, per Social/Communication impairments, that were not previously required in either Autism Disorder or Aspergers in the DSMIV. <br /> <br />One of the main concerns they express is that these individuals may no longer qualify for the government support in education and services that they currently receive, as well as the potential that there may be those misdiagnosed under SCD, that may not receive those services in the future. <br /> <br />The potential solutions offered to the DSM5 organization, by the ASAN analysis, is to reduce the required criteria from 3 to 2, and to include SCD under a different label adding it as an additional disorder linked to Autism Spectrum Disorder per sub-type, or (NOS) Not otherwise specified label. <br /> <br /> <br /><a href="http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf" target="_blank" rel="nofollow" class="postlink" >http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">THIRD, we urge the Work Group to consider the implications on service provision and legal rights of shifting individuals who at one point were or would have been diagnosed on the autism spectrum into the non-ASD Social Communication Disorder (SCD) diagnosis. As we have outlined above, the SCD diagnosis would provide none of the access to publicly funded service provision or legal rights under IDEA, the Americans with Disabilities Act or the SSI/SSDI income support programs and associated public health insurance. Despite this, SCD is likely to be a frequent misdiagnosis for ASD — a misdiagnosis whose implications would be stark and significant. SCD’s criteria also contains an explicit requirement that ASD be ruled out, making it likely that school districts would disallow the use of the autism educational category under IDEA to serve students with diagnoses of SCD. These issues can be addressed, however, by linking the SCD diagnosis to the broader autism spectrum, even as it retains a distinct diagnostic category. <span style="font-weight: bold">We urge the Work Group to consider re-naming Social Communication Disorder as ASD-Social Communication subtype (ASD-SC), ASD-Not Otherwise Specified (ASD-NOS) or another term which explicitly communicates to service provision and legal infrastructures the connection between the SCD diagnosis and the autism spectrum</span>.</td> </tr></table><span class="postbody"> <br /> <br /> <br />Per the current revised DSM5 definition of Autism Spectrum Disorder, it is interesting that they require non-verbal communication impairments as a mandatory requirement, that was not mandatory in either autism disorder or Aspergers Syndrome, under the DSMIV, and do not mention language delays or language loss per verbal communication impairments, that have been seen as one of the most severely disabling impairments in autism disorder since 1980, when Autism Disorder was first included as a disorder under the DSMIII. <br /> <br />And also, Autism Spectrum Disorder has been narrowed to require RRB's as a mandatory part of the disorder, whereas before technically they weren't a mandatory criteria in a diagnosis of PDD NOS. <br /> <br />The only significant criteria that is added is hypo/hyper-reactivity to sensory input. <br /> <br />It stands to reason that most people with autism disorder with severe verbal impairments, will almost by default be impaired in non-verbal communication as well; while they likely would not lose a diagnosis, because the criteria associated with impairments in verbal communication have been removed, it seems that the DSM5 is ignoring a major impairment seen in autism now, for what appears to be a trade-off to require that all three social-communication impairments now listed will be mandatory. Basically to ensure, it seems, that non-verbal communication impairments are a mandatory requirement, which per research, specific to non-verbal communication impairments seems like a valid decision. <br /> <br />The problem that the ASAN identifies is that some can learn skills related to non-verbal communication as an adaptation, per the 3 criteria of social/communication impairments, that may mask the disorder, per the requirements that will be mandatory in the future. <br /> <br />While this adaptation could be overlooked, per the non-mandatory criteria of non-verbal communication impairments, in the DSMIV definition of Aspergers, technically it will not be overlooked in the mandatory requirement in the DSM5. <br /> <br />Part of the reason I provided the research above, is to show the state of research per potential biologically determining factors and how diverse those factors may be per Autism Spectrum Disorders, as currently defined. There do appear to be language development issues, that may eventually be explained by biological and/or environmental causation, and even potentially prevented. <br /> <br />I suggest that what the DSM5 is defining as Autism Spectrum Disorder retains many of the core elements of autism spectrum disorders seen in the 4 disorders currently described, consolidated to create one autism spectrum disorder, but at the same time <span style="font-weight: bold">they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak</span>, in the sense that verbal language impairments per the lack of inherent ability to speak, are no longer addressed in the basic criteria. The rational for this, per the DSM5 link provided in the first post is: <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Delays in language are not unique nor universal in ASD and are more accurately considered as a factor that influences the clinical symptoms of ASD, rather than defining the ASD diagnosis </td> </tr></table><span class="postbody"> <br /> <br />Interestingly, behaviors associated with and the condition of hyper-reactivity or hypo-reactivity to sensory input are added as a criteria, per RRB's, which is also not unique to ASD or universal in ASD. It's commonly seen in ADHD. <br /> <br />I'm not sure how hyper or hypo-reactivity to sensory input defines autism either, for those diagnosed that don't have an issue with it. Their logic in dropping the delay in language development does not appear to be consistent with the addition of hypo/hyper reactivity to sensory input. <br /> <br />The addition of hypo/hyper reactivity to sensory input, in itself, appears to be a good decision, because it's not likely a criteria that can easily be developed through social stress, alone. <br /> <br />A developmental delay in language or the loss of language in regressive autism, likely, at least in part, has biological causation as well as hypo/hyper reactivity to sensory input. <br /> <br />Other than those two factors, almost any behavioral impairment measured in the revised DSM5 criteria can be a result of environmental/psychological social stresses, not unlike what is seen in children isolated in childhood from human contact. <br /> <br /><span style="font-weight: bold">The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie.</span> Ironically per that new criteria, autism speaks. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /></td> </tr></table><span class="postbody">you dont think hyper/hypo sensitivity describes the core essence of autism. <br />hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident</td> </tr></table><span class="postbody"> <br /> <br />Self evident, yes, definitely for myself as an individual. It has played a defining role for me since I can remember as a small child, with hyper-reactivity to tactile sensory input and other sensory input along with a delay in speaking and difficulty expressing myself verbally most of my life, but some people diagnosed with autism spectrum disorders report neither of those issues, so it is not a defining issue for them. <br /> <br />Neither have been a mandatory requirement for an Autism Spectrum Diagnosis in the past, nor will they be in the DSM5. It appears that the psychological profession has come to a determination that non-verbal communication impairments are an issue that everyone with autism spectrum disorder must share for a diagnosis. <br /> <br />I can't disagree with that. Otherwise, since they are leaving out the verbal developmental delays in the basic criteria, I'm not sure how they could call it a social/communication/RRB disorder. <br /> <br />Even though the disorder is not considered a hypo/hyper reactivity to sensory input disorder, per a mandatory required criteria in the DSM5, that specific issue was certainly a defining issue for me along with verbal and non-verbal social-communication/RRB impairments.</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row2"><span class="name"><a name=""></a><b>vermontsavant</b></span></td> <td class="row2" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 4:50 am<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody"></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>aghogday wrote:</b></span></td> </tr> <tr> <td class="quote">The ASAN organization has done what appears to be a good analysis of the circumstances surrounding the changes in the DSM5 definition, in research, in part funded by the US Department of Health and Human Services. <br /> <br /> <br />They bring up some good points, in the full article linked below, per individuals that may be potentially re-diagnosed with Social Communication Disorder SCD, because they do not meet all mandatory requirements of the DSM5 definition, per example of those that fit under PDD-NOS currently not diagnosed with the RRB criteria, and those potentially losing their current diagnosis, because they do not meet the mandatory requirement of 3 out of 3 criteria, per Social/Communication impairments, that were not previously required in either Autism Disorder or Aspergers in the DSMIV. <br /> <br />One of the main concerns they express is that these individuals may no longer qualify for the government support in education and services that they currently receive, as well as the potential that there may be those misdiagnosed under SCD, that may not receive those services in the future. <br /> <br />The potential solutions offered to the DSM5 organization, by the ASAN analysis, is to reduce the required criteria from 3 to 2, and to include SCD under a different label adding it as an additional disorder linked to Autism Spectrum Disorder per sub-type, or (NOS) Not otherwise specified label. <br /> <br /> <br /><a href="http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf" target="_blank" rel="nofollow" class="postlink" >http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf</a> <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">THIRD, we urge the Work Group to consider the implications on service provision and legal rights of shifting individuals who at one point were or would have been diagnosed on the autism spectrum into the non-ASD Social Communication Disorder (SCD) diagnosis. As we have outlined above, the SCD diagnosis would provide none of the access to publicly funded service provision or legal rights under IDEA, the Americans with Disabilities Act or the SSI/SSDI income support programs and associated public health insurance. Despite this, SCD is likely to be a frequent misdiagnosis for ASD — a misdiagnosis whose implications would be stark and significant. SCD’s criteria also contains an explicit requirement that ASD be ruled out, making it likely that school districts would disallow the use of the autism educational category under IDEA to serve students with diagnoses of SCD. These issues can be addressed, however, by linking the SCD diagnosis to the broader autism spectrum, even as it retains a distinct diagnostic category. <span style="font-weight: bold">We urge the Work Group to consider re-naming Social Communication Disorder as ASD-Social Communication subtype (ASD-SC), ASD-Not Otherwise Specified (ASD-NOS) or another term which explicitly communicates to service provision and legal infrastructures the connection between the SCD diagnosis and the autism spectrum</span>.</td> </tr></table><span class="postbody"> <br /> <br /> <br />Per the current revised DSM5 definition of Autism Spectrum Disorder, it is interesting that they require non-verbal communication impairments as a mandatory requirement, that was not mandatory in either autism disorder or Aspergers Syndrome, under the DSMIV, and do not mention language delays or language loss per verbal communication impairments, that have been seen as one of the most severely disabling impairments in autism disorder since 1980, when Autism Disorder was first included as a disorder under the DSMIII. <br /> <br />And also, Autism Spectrum Disorder has been narrowed to require RRB's as a mandatory part of the disorder, whereas before technically they weren't a mandatory criteria in a diagnosis of PDD NOS. <br /> <br />The only significant criteria that is added is hypo/hyper-reactivity to sensory input. <br /> <br />It stands to reason that most people with autism disorder with severe verbal impairments, will almost by default be impaired in non-verbal communication as well; while they likely would not lose a diagnosis, because the criteria associated with impairments in verbal communication have been removed, it seems that the DSM5 is ignoring a major impairment seen in autism now, for what appears to be a trade-off to require that all three social-communication impairments now listed will be mandatory. Basically to ensure, it seems, that non-verbal communication impairments are a mandatory requirement, which per research, specific to non-verbal communication impairments seems like a valid decision. <br /> <br />The problem that the ASAN identifies is that some can learn skills related to non-verbal communication as an adaptation, per the 3 criteria of social/communication impairments, that may mask the disorder, per the requirements that will be mandatory in the future. <br /> <br />While this adaptation could be overlooked, per the non-mandatory criteria of non-verbal communication impairments, in the DSMIV definition of Aspergers, technically it will not be overlooked in the mandatory requirement in the DSM5. <br /> <br />Part of the reason I provided the research above, is to show the state of research per potential biologically determining factors and how diverse those factors may be per Autism Spectrum Disorders, as currently defined. There do appear to be language development issues, that may eventually be explained by biological and/or environmental causation, and even potentially prevented. <br /> <br />I suggest that what the DSM5 is defining as Autism Spectrum Disorder retains many of the core elements of autism spectrum disorders seen in the 4 disorders currently described, consolidated to create one autism spectrum disorder, but at the same time <span style="font-weight: bold">they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak</span>, in the sense that verbal language impairments per the lack of inherent ability to speak, are no longer addressed in the basic criteria. The rational for this, per the DSM5 link provided in the first post is: <br /> <br /></span><table width="90%" cellspacing="1" cellpadding="3" border="0" align="center"><tr> <td><span class="genmed"><b>Quote:</b></span></td> </tr> <tr> <td class="quote">Delays in language are not unique nor universal in ASD and are more accurately considered as a factor that influences the clinical symptoms of ASD, rather than defining the ASD diagnosis </td> </tr></table><span class="postbody"> <br /> <br />Interestingly, behaviors associated with and the condition of hyper-reactivity or hypo-reactivity to sensory input are added as a criteria, per RRB's, which is also not unique to ASD or universal in ASD. It's commonly seen in ADHD. <br /> <br />I'm not sure how hyper or hypo-reactivity to sensory input defines autism either, for those diagnosed that don't have an issue with it. Their logic in dropping the delay in language development does not appear to be consistent with the addition of hypo/hyper reactivity to sensory input. <br /> <br />The addition of hypo/hyper reactivity to sensory input, in itself, appears to be a good decision, because it's not likely a criteria that can easily be developed through social stress, alone. <br /> <br />A developmental delay in language or the loss of language in regressive autism, likely, at least in part, has biological causation as well as hypo/hyper reactivity to sensory input. <br /> <br />Other than those two factors, almost any behavioral impairment measured in the revised DSM5 criteria can be a result of environmental/psychological social stresses, not unlike what is seen in children isolated in childhood from human contact. <br /> <br /><span style="font-weight: bold">The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie.</span> Ironically per that new criteria, autism speaks. <img src="modules/Forums/images/smiles/icon_smile.gif" alt="Smile" border="0" /></td> </tr></table><span class="postbody">you dont think hyper/hypo sensitivity describes the core essence of autism. <br />hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> <tr> <td width="22%" align="left" valign="top" class="row1"><span class="name"><a name=""></a><b>vermontsavant</b></span></td> <td class="row1" height="28" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="100%"><img src="http://cdn.wrongplanet.net/modules/Forums/templates/subSilver/images/icon_minipost.gif" width="12" height="9" alt="Post" title="Post" border="0" /><span class="postdetails">Posted: Wed Jun 13, 2012 4:26 am<span class="gen"> </span> Post subject: </span></td> </tr> <tr> <td colspan="2"><hr /></td> </tr> <tr> <td colspan="2"><span class="postbody">most of this information suports my long time personal beliefs about autism</span></td> </tr> </table></td> </tr> <tr> <td colspan="2" height="1" class="spaceRow"><img src="modules/Forums/templates/subSilver/images/spacer.gif" alt="" width="1" height="1" /></td> </tr> </table>
Forums ©
Read more Articles on Wrong Planet
Wrong Planet is a Registered Trademark.
Copyright 2004-2013,
Wrong Planet, LLC and Alex Plank
. Alex does
public speaking for Autism.
Advertise on Wrong Planet
Terms of Service - You must read this as a user of Wrong Planet
|
Privacy Policy
Subscribe:
Wrong Planet News
Wrong Planet Forums
