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mikassyna
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06 Aug 2013, 2:49 pm

An article against social communication disorder as a diagnosis:

http://sfari.org/news-and-opinion/speci ... n-disorder

The webpage also has other articles disputing the DSM-5 categories under Related Content



nominalist
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06 Aug 2013, 3:34 pm

mikassyna wrote:
An article against social communication disorder as a diagnosis:


Social (pragmatic) communication disorder (SCD) was apparently a way of accommodating two separate categories: pragmatic language impairment and nonverbal learning disability. Whether SCD survives the next revision, no one knows.


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Musicgirl
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06 Aug 2013, 7:23 pm

nominalist wrote:
mikassyna wrote:
An article against social communication disorder as a diagnosis:


Social (pragmatic) communication disorder (SCD) was apparently a way of accommodating two separate categories: pragmatic language impairment and nonverbal learning disability. Whether SCD survives the next revision, no one knows.

I was diagnosed with AS. Will my new diagnosis more than likely be social communication disorder or ASD?



nominalist
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06 Aug 2013, 9:09 pm

Musicgirl wrote:
I was diagnosed with AS. Will my new diagnosis more than likely be social communication disorder or ASD?


I can't say, but I can quote from the DSM-5:

Quote:
Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.


To my understanding, social (pragmatic) communication disorder (SCD) is basically autism spectrum disorder (ASD) minus the routines and ritualized behaviors.

According to the DSM-5, these are the three severity levels of ASD (courtesy of tinypic.com):

Image


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06 Aug 2013, 9:56 pm

I too have read that people with a current AS or PPD-NOS diagnosis will be 'grandfathered in', but how things play out in the real world is often different than what's in the books. My concern is more for people who will be diagnosed with SCD in the future and lose access to school/work accommodations, medicaid, and other ADA protections as a result. The studies on the reduction in ASD diagnoses range from 10% on the low end to 55% on the high end. IMO sacrificing even 10% for the good of the public coffers is too much. If I were in a position of diagnosing people I couldn't live with diagnosing SCD over ASD because of sub-threshold RRBIs knowing that SCD would cut people off from getting supports that are far too few as it is.



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06 Aug 2013, 9:59 pm

Can we accommodate all the categories and just say "Nutz"?
UTH - Unified Theory of Humans?

hehe just kidding..


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06 Aug 2013, 10:02 pm

Rascal77s wrote:
I too have read that people with a current AS or PPD-NOS diagnosis will be 'grandfathered in', but how things play out in the real world is often different that what's in the books. My concern is more for people who will be diagnosed with SCD in the future and lose access to school/work accommodations, medicaid, and other ADA protections. The studies on the reduction in ASD diagnoses range from 10% on the low end to 55% on the high end. IMO sacrificing even 10% for the good of the public coffers is too much. If I were in a position of diagnosing people I couldn't live with diagnosing SCD over ASD because of sub-threshold RRBIs knowing that SCD would cut people off from getting supports that are far too few as it is.


Lets hope it doesn't play out that way, because that would be a terrible development, personally I'd like to see all HFA versions collected under a sub diagnosis of autism, with levels of severity within the diagnosis based on certain cognitive and analytical coping abilities ( not IQ ).



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06 Aug 2013, 10:42 pm

So the PLI/SCD kids are either SLI or mild ASD, they're saying...or, of course, NLD, and possibly other stuff. Maybe...but...what if a kid is basically BAP, and never quite meets the criteria for autism even in early to mid childhood, but still has social pragmatic issues like taking things literally and saying inappropriate things and not taking hints well?

I might have been that kid. But after reading about what Aspies go through on here and elsewhere and thanking my lucky stars that if I did have sensory issues I outgrew them, I also can't rule out that I was just a brat who was somehow acting out PLI/SCD symptoms because I thought that's what smart people were like based on, I don't know...exposure to nerd stereotypes? school? Hard to say. Or maybe I really did have the ADHD they labeled me with, but I just don't see it so much anymore, as most of my problems were behavioral and social.

In any case, in the best case scenario SCD might be able to help some kids who are hard to diagnose but have behavioral and social issues get on IEPs and get at least some recognition, even if it won't be as extensive as what's available for a proper ASD. But it sounds like they need to do some more research into these conditions.


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Ai_Ling
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06 Aug 2013, 11:03 pm

I do agree that SCD has weak evidence for its "existance". To me, its sorta comparible to a PDDNOS diagnosis. To give people with weak social communication skills some sorta diagnosis when they cant fit anything else. Sorta a filler diagnosis. They do still need accomidations however. Although, the woman does have a point, what if someone has only 1 catagory in the restrictive and repetative behavior catagory, then what? For me, it would be highly up to the discretion of the psych if I was diagnosed according to the DSM-5. I've always been very very mild in catagory B of the autism diagnosis. Like barely there. But socially, I very much have my difficulties. I know the psych that diagnosed me with aspergers did it more based on instinct then following a psych checklist.



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06 Aug 2013, 11:08 pm

I am just guessing, but "BAP" (broad autism phenotype) may be a combination of ASD and SCD.

The Broad Autism Phenotype Questionnaire

Broader Autism Phenotype: Evidence From a Family History Study of Multiple-Incidence Autism Families


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06 Aug 2013, 11:12 pm

Personally, I just can't see someone having all of the social deficits of autism [from birth] without the repetitive behaviors/sensory stuff to some extent.

By the very nature of early social impairments, one will focus their behavior internally, leading on to at least having stronger interests than normal people, as normal people also focus on social aspects of life -- the person with ASD level impairments doesn't (at least early on. Later on it can be there, but the deficits will make it super hard and the repetitive behaviors from the early social isolation will still be there to some extent).

Semantic and/or Pragmatic disorders always included various symptoms from the repetitive behaviors of autism in the past, usually with the qualifier, "not as bad".



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06 Aug 2013, 11:24 pm

Rascal77s wrote:
I too have read that people with a current AS or PPD-NOS diagnosis will be 'grandfathered in', but how things play out in the real world is often different than what's in the books. My concern is more for people who will be diagnosed with SCD in the future and lose access to school/work accommodations, medicaid, and other ADA protections as a result. The studies on the reduction in ASD diagnoses range from 10% on the low end to 55% on the high end. IMO sacrificing even 10% for the good of the public coffers is too much. If I were in a position of diagnosing people I couldn't live with diagnosing SCD over ASD because of sub-threshold RRBIs knowing that SCD would cut people off from getting supports that are far too few as it is.

What do you mean by "grandfathered in?" That is a concern about not getting support. Good point.



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06 Aug 2013, 11:32 pm

Here is a page of links I put together (my term, the similarly dissimilar) recently:

The Similarly Dissimilar to Autism Spectrum Disorder (ASD)


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nominalist
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07 Aug 2013, 1:00 am

Musicgirl wrote:
What do you mean by "grandfathered in?" That is a concern about not getting support. Good point.


In this case, "grandfathered in" means that if you were already diagnosed with Asperger's disorder, autistic disorder, or PDD-NOS, you now meet the ASD criteria. In other words, you don't have to jump through any more hoops. Only the name was changed.

Kind of like, say, in pharmacy, physical therapy, and audiology: Now, people in those fields need to get a doctoral degree. However, if you were in one of those fields before the doctorates began, you are "grandfathered in." You are excused from the doctoral requirement.


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Musicgirl
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07 Aug 2013, 1:22 am

nominalist wrote:
Musicgirl wrote:
What do you mean by "grandfathered in?" That is a concern about not getting support. Good point.


In this case, "grandfathered in" means that if you were already diagnosed with Asperger's disorder, autistic disorder, or PDD-NOS, you now meet the ASD criteria. In other words, you don't have to jump through any more hoops. Only the name was changed.

Kind of like, say, in pharmacy, physical therapy, and audiology: Now, people in those fields need to get a doctoral degree. However, if you were in one of those fields before the doctorates began, you are "grandfathered in." You are excused from the doctoral requirement.

Thank you. So I will probably still be considered Autistic? I hope so. I do think anyone who has AS, PDD-NOS, and autistic disorder should be "grandfathered in." Being diagnosed with SCD would now take getting used to and I have grown to love being "Autistic" because of this website. Also, like mentioned earlier in this thread, I do hope people get the support they need.



nominalist
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07 Aug 2013, 9:20 am

Musicgirl wrote:
Thank you. So I will probably still be considered Autistic? I hope so. I do think anyone who has AS, PDD-NOS, and autistic disorder should be "grandfathered in." Being diagnosed with SCD would now take getting used to and I have grown to love being "Autistic" because of this website. Also, like mentioned earlier in this thread, I do hope people get the support they need.


I think so. IMO, it couldn't hurt for the patients or clients of therapists to be aware of the DSM-5, so that they could point out what it says to their therapists.


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