| Does the DSM5 Definition of Autism Spectrum Disorder Describe One Disorder? |
| Yes. |
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50% |
[ 5 ] |
| No. |
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50% |
[ 5 ] |
| If other comment, please provide response. Please scan over post before answering yes or no. |
|
0% |
[ 0 ] |
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| Total Votes : 10 |
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aghogday
KATiE MiA
Joined: Nov 26, 2010
Posts: 4746
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 Posted: Tue Jun 12, 2012 6:11 am Post subject: The diversity of Autism Spectrum Disorder |
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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.
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.
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.
http://sfari.org/news-and-opinion/in-brief/2012/cognition-and-behavior-asperger-brains-similar-across-sexes
| 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.
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.
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. |
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.
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.
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.
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.
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.
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.
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.
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.
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.
http://www.bbc.co.uk/science/humanbody/sex/add_user.shtml
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.
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.
It is linked here, in free book form, on this site:
http://www.neoteny.org/
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.
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.
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.
DSM5 current revised definition of Autism Spectrum Disorder:
http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=94
| Quote: | Autism Spectrum Disorder
Must meet criteria A, B, C, and D:
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).
C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)
D. Symptoms together limit and impair everyday functioning. |
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outofplace
Geometrophile
Joined: Jun 11, 2012
Age: 39
Posts: 1771
Location: In A State of Quantum Flux
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| Posted: Tue Jun 12, 2012 6:39 am Post subject: |
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My problem with the DSM V criteria is that it manages to be both vague and specific at the same time. What are appropriate levels of relationships for a given development level? Isn't that determined by the kind of people the child was around and how understanding they were? Also, the reliance on childhood symptoms of relational issues may lead to someone not getting a proper diagnosis as an adult. It relies too much on both the memory of the subject and the memories of the subject's parents. What if the parent(s) were also on the spectrum and have no idea what a normal childhood is? What if the parents weren't especially interested in their child and thus do not have the proper memories of their child's early life?
_________________
Uncertain of diagnosis, either ADHD or Aspergers.
Aspie quiz: 143/200 AS, 81/200 NT; AQ 43; "eyes" 17/39, EQ/SQ 21/51 BAPQ: Autistic/BAP- You scored 92 aloof, 111 rigid and 103 pragmatic
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Ellingtonia
Pileated woodpecker
Joined: Oct 10, 2011
Age: 21
Posts: 186
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| Posted: Tue Jun 12, 2012 8:10 am Post subject: |
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| outofplace wrote: | | My problem with the DSM V criteria is that it manages to be both vague and specific at the same time. What are appropriate levels of relationships for a given development level? Isn't that determined by the kind of people the child was around and how understanding they were? Also, the reliance on childhood symptoms of relational issues may lead to someone not getting a proper diagnosis as an adult. It relies too much on both the memory of the subject and the memories of the subject's parents. What if the parent(s) were also on the spectrum and have no idea what a normal childhood is? What if the parents weren't especially interested in their child and thus do not have the proper memories of their child's early life? |
Which parts rely too heavily on childhood symptoms? The only mention I can see is part C., which doesn't require any detail at all. |
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Blownmind
Phoenix
Joined: Feb 19, 2012
Age: 33
Posts: 823
Location: Norway
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| Posted: Tue Jun 12, 2012 1:01 pm Post subject: Re: The diversity of Autism Spectrum Disorder |
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| aghogday wrote: | Does the DSM5 Definition of Autism Spectrum Disorder Describe One Disorder?
TL;DR |
Yes, it is one in DSM-5, but it describes ASD level 1, 2 and 3.
However, it does describe many disorders from DSM-IV; "New name for category, autism spectrum disorder, which includes autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified." (source, click the "Rationale" tab )
_________________
AQ: 42/50 || SQ: 32/80 || IQ(RPM): 138 || IRI-empathytest(PT/EC/FS/PD): 10(-7)/16(-3)/19(+3)/19(+10) || Alexithymia: 148/185 || Aspie-quiz: AS 133/200, NT 56/200 |
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LennytheWicked
Phoenix
Joined: Oct 23, 2011
Posts: 516
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| Posted: Tue Jun 12, 2012 1:32 pm Post subject: |
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All things considering, it will still identify a lot of people.
My little brother is nonverbal, stims all the time [he runs up and down the stairs in our house], and has meltdowns from time to time.
I'm verbal, stim in private, and have a high IQ. I still have meltdowns from time to time but they're usually wordier than my brother's.
There's a pretty wide gap there, in my opinion. Under DSM-V we both qualify for an autism spectrum disorder, so I'm going to go with yes, it's still a diverse spectrum. |
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aghogday
KATiE MiA
Joined: Nov 26, 2010
Posts: 4746
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| Posted: Wed Jun 13, 2012 12:14 am Post subject: |
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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.
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.
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.
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.
http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf
| 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. 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. |
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.
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.
The only significant criteria that is added is hypo/hyper-reactivity to sensory input.
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.
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.
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.
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.
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 they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak, 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:
| 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 |
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.
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.
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.
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.
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.
The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie. Ironically per that new criteria, autism speaks.  |
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vermontsavant
My father 1934 to 2010
Joined: Dec 08, 2010
Age: 37
Posts: 1779
Location: Bellows Falls,Vermont USA
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| Posted: Wed Jun 13, 2012 4:26 am Post subject: |
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most of this information suports my long time personal beliefs about autism
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Abstract concepts are for those who dont know there facts.Liaison for the political forum.Please contact if you have any questions or problems |
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vermontsavant
My father 1934 to 2010
Joined: Dec 08, 2010
Age: 37
Posts: 1779
Location: Bellows Falls,Vermont USA
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| Posted: Wed Jun 13, 2012 4:50 am Post subject: |
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| aghogday wrote: | 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.
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.
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.
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.
http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf
| 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. 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. |
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.
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.
The only significant criteria that is added is hypo/hyper-reactivity to sensory input.
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.
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.
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.
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.
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 they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak, 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:
| 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 |
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.
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.
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.
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.
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.
The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie. Ironically per that new criteria, autism speaks. |
you dont think hyper/hypo sensitivity describes the core essence of autism.
hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident
_________________
Abstract concepts are for those who dont know there facts.Liaison for the political forum.Please contact if you have any questions or problems |
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aghogday
KATiE MiA
Joined: Nov 26, 2010
Posts: 4746
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| Posted: Wed Jun 13, 2012 7:04 am Post subject: |
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| vermontsavant wrote: | | aghogday wrote: | 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.
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.
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.
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.
http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf
| 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. 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. |
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.
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.
The only significant criteria that is added is hypo/hyper-reactivity to sensory input.
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.
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.
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.
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.
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 they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak, 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:
| 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 |
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.
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.
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.
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.
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.
The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie. Ironically per that new criteria, autism speaks. |
you dont think hyper/hypo sensitivity describes the core essence of autism.
hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident |
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.
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.
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.
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. |
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vermontsavant
My father 1934 to 2010
Joined: Dec 08, 2010
Age: 37
Posts: 1779
Location: Bellows Falls,Vermont USA
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| Posted: Wed Jun 13, 2012 7:21 am Post subject: |
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| aghogday wrote: | | vermontsavant wrote: | | aghogday wrote: | 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.
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.
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.
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.
http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf
| 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. 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. |
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.
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.
The only significant criteria that is added is hypo/hyper-reactivity to sensory input.
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.
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.
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.
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.
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 they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak, 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:
| 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 |
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.
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.
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.
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.
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.
The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie. Ironically per that new criteria, autism speaks. |
you dont think hyper/hypo sensitivity describes the core essence of autism.
hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident |
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.
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.
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.
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. |
The hyper/hypo sensory input issues are the core root of deficits in non verbal communication.
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
_________________
Abstract concepts are for those who dont know there facts.Liaison for the political forum.Please contact if you have any questions or problems |
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Tuttle
Not a bird, a turtle.
Joined: Mar 27, 2006
Age: 24
Posts: 2592
Location: Massachusetts
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| Posted: Wed Jun 13, 2012 2:56 pm Post subject: |
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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. |
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aghogday
KATiE MiA
Joined: Nov 26, 2010
Posts: 4746
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| Posted: Wed Jun 13, 2012 4:49 pm Post subject: |
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| vermontsavant wrote: | | aghogday wrote: | | vermontsavant wrote: | | aghogday wrote: | 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.
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.
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.
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.
http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf
| 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. 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. |
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.
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.
The only significant criteria that is added is hypo/hyper-reactivity to sensory input.
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.
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.
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.
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.
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 they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak, 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:
| 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 |
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.
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.
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.
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.
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.
The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie. Ironically per that new criteria, autism speaks. |
you dont think hyper/hypo sensitivity describes the core essence of autism.
hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident |
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.
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.
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.
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. |
The hyper/hypo sensory input issues are the core root of deficits in non verbal communication.
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 |
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.
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.
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. |
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vermontsavant
My father 1934 to 2010
Joined: Dec 08, 2010
Age: 37
Posts: 1779
Location: Bellows Falls,Vermont USA
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| Posted: Wed Jun 13, 2012 5:29 pm Post subject: |
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| aghogday wrote: | | vermontsavant wrote: | | aghogday wrote: | | vermontsavant wrote: | | aghogday wrote: | 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.
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.
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.
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.
http://autisticadvocacy.org/wp-content/uploads/2012/06/DSM-5_Policy_Brief_ASAN_final.pdf
| 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. 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. |
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.
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.
The only significant criteria that is added is hypo/hyper-reactivity to sensory input.
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.
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.
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.
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.
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 they are describing a new disorder; basically a hybrid of Aspergers and Autism Disorder, that has gained the ability to speak, 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:
| 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 |
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.
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.
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.
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.
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.
The DSM5 has determined that developmental delays or the inherent lack of ability to speak, is not an inherent part of the autism pie. Ironically per that new criteria, autism speaks. |
you dont think hyper/hypo sensitivity describes the core essence of autism.
hyper/hypo sensitive reactions to sensory stimuli is the esence of autism.is that not self evident |
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.
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.
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.
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. |
The hyper/hypo sensory input issues are the core root of deficits in non verbal communication.
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 |
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.
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.
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. |
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
_________________
Abstract concepts are for those who dont know there facts.Liaison for the political forum.Please contact if you have any questions or problems |
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Dillogic
you know how it goes
Joined: Nov 25, 2011
Posts: 3325
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| Posted: Wed Jun 13, 2012 7:26 pm Post subject: |
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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).
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. |
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aghogday
KATiE MiA
Joined: Nov 26, 2010
Posts: 4746
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| Posted: Wed Jun 13, 2012 7:42 pm Post subject: |
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| Tuttle wrote: | 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. |
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.
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,
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.
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.
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.
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.
| 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)
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http://www.autreat.com/dsm4-autism.html
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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. |
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