Diagnostic Criteria

ColdBlooded · Posted: Thu Jul 30, 2009 8:12 am Post subject:

Ok, i made a similar thread awhile back, but this is still bugging me.. Maybe i'm just focusing too much on the exact wording... i do kind of obsess on wording sometimes.... but, even if that's true, then that means that something must be wrong with the way the DSM is wording things. But, yeah... Has anyone else noticed that in the criteria in the most recent DSM, it seems like pretty much most people with Asperger's Syndrome are also going to match the criteria for Autistic Disorder? In fact, it clearly DOES NOT require any kind of speech delay.. And it looks like, to me, the vast majority of people who are diagnosed with AS actually do also fit the criteria that the DSM lays out for Autistic Disorder. I don't even have an official AS diagnosis yet, so there obviously wasn't anything that sent off red flags to too many people when i was little(and compared to a lot of folks here, i'm probably a pretty mild case), but it even looks like i could basically fit into the DSM's Autistic Disorder criteria. Barely, but still. For any of you diagnosed with AS, look over each of these criteria and tell me how well you fit. Because, with the DSM criteria for AS, you, supposedly, shouldn't be given an AS diagnosis if you match the Autistic Disorder criteria.

Autism criteria:

"A. A total of six (or more) items from (1),(2), and (3), with at least two from (1), and one each from (2) and (3):
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g.,by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity

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

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

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

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

Results? Is this a flaw in the DSM, or is it just illustrating how grey the area between HFA and AS is? Or both?

1 and 3 are both in the AS criteria... But, i'm sure that a bunch of aspies can find at least one thing in 2 that fits. Speech delay is only one of the possibilities. Impairment in the ability to initiate or sustain conversations can easily apply to lots(maybe most) of aspies, though. Then, the other little thing that's different from the AS criteria... B. Aspies have the language part down... But.... how many aspies can really say that they didn't have "abnormal functioning" in social interaction before they were 3? I think that, considering aspies generally have problems with "social interaction," that the onset was probably before age 3 in most of them. And i'm sure lots(of not most) of aspies have at least 6 out of sections 1-3. Tell me, am i on to something here? Because something about this does not compute.