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attention-tunnel
Yellow-bellied Woodpecker
Joined: Jul 14, 2004
Posts: 57
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 Posted: Mon Nov 29, 2004 4:07 pm Post subject: Will Asperger survive? |
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Will Asperger survive as a clinical diagnosis?
The diagnosis apserger was newly introduced in DSM-IV, and it might well not even survive the DSM-V.
New research question the existence of boundaries the diagnostic criteria mark between 'early childhood autism', 'atypical autism', 'asperger' and 'autism'. Not to speak of 'sublinical autism', which is by definition not part of 'clinical autism' of any type, but which also questions the boundaries of the diagnostic criteria of 'autism' and 'not-autism'.
These research fundings point to the possibility of an 'autism spectrum diagnosis' replacing all of these different autism labels. And the question if not everyone is autistic too some degree might find more support. That would be in line with the monotropism theory of autism, which argues that the degree of undevided attention marks the human spectrum, of which one extrem is labeled 'autsitic'.
Will Asperger survive as a clinical diagnosis? |
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Tom
bass martian
Joined: Oct 20, 2004
Posts: 1240
Location: Where you least expect it
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| Posted: Mon Nov 29, 2004 4:57 pm Post subject: |
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| Well as Shakespeare said, "a rose by any other name smells just as sweet" |
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Glenn
Blue Jay
Joined: Nov 01, 2004
Posts: 96
Location: I am here, but its not where I belong.
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| Posted: Tue Nov 30, 2004 4:12 am Post subject: |
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Will Aperger's survive as a diagnosis?
Personally, I hope it does. The various types of autistic spectrum disorder present differently, have different characteristics, and maybe need different kinds of help.
My feeling is that you lump everything together under one "general" heading, it will not help anyone. Generalisations like this can lead to stereotyping. (I think this has been discussed under a different thread in this forum) And stereotypes, which encourage people to imagine they understand something without the need to really think for themselves, can lead to prejudice.
And we certainly don't need that! |
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attention-tunnel
Yellow-bellied Woodpecker
Joined: Jul 14, 2004
Posts: 57
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| Posted: Tue Nov 30, 2004 5:37 am Post subject: |
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Well, the problem in theory and with the diagnostic criteria is, that they work with subgroups of autism such as 'atypical autism', 'early childhood autism', 'asperger autism', 'kanner autism' while new research finds no significant boundaries between these categories.
I posted these findings recently in the two threads
"asperger = autism?!" and
"asperger = early childhood autism = atypical autism?!
a dignaosis like 'autism spectrum disorder' may well replace the former types of diagnosis, and some MDs indeed work like that already.
This does not answer the problem that the boundarie between 'normal', ''sublinical-autism' and 'autism' are statistical for the same reason: until present, there are clear significant differences. Yet there are vast differences in the functions of the individual person. So maybe a diagnosis type of 'autism spectrum' would followed by a detailed description of the indiviudal's situation. That may makes more sense than knowing wheather or not he has 'atypical autism' according to DSM-IV, but he has 'Asperger' according to Gillberg's criteria for Asperger. |
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nominalist
This WP Supporter climbed the pecking order ;-)
Joined: Jun 29, 2007
Age: 52
Posts: 1709
Location: The Kansas suburbs of Kansas City (originally from NYC)
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| Posted: Mon Aug 18, 2008 11:42 pm Post subject: |
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I can't imagine many people, especially aspie autistics, being too upset about some other term replacing "Asperger's," given what the word sounds like.
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Mark A. Foster, Ph.D. (full-time & tenured sociology professor)
The League to Fight Neurelitism: http://neurelitism.com
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Praetorius
Pileated woodpecker
Joined: Feb 21, 2007
Posts: 190
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| Posted: Mon Aug 18, 2008 11:49 pm Post subject: |
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| Lol. "Ass burgers" But yeah, a new name would be nice. |
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philosopherBoi
Phoenix
Joined: Aug 07, 2008
Age: 20
Posts: 1129
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| Posted: Tue Aug 19, 2008 12:04 am Post subject: |
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this sounds like a disaster, because people already diagnosed could have problems getting treatment. I mean people with asperger's have a hard enough time getting diagnosed and now they want to throw all information about it out the door great idea  |
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Callista
Phoenix
Joined: Feb 04, 2006
Age: 26
Posts: 2279
Location: Central USA
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| Posted: Tue Aug 19, 2008 12:10 am Post subject: |
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I'd prefer one big category, with subtypes. Check out the way they describe schizophrenia; that's what I'm talking about.
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nominalist
This WP Supporter climbed the pecking order ;-)
Joined: Jun 29, 2007
Age: 52
Posts: 1709
Location: The Kansas suburbs of Kansas City (originally from NYC)
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| Posted: Tue Aug 19, 2008 12:21 am Post subject: |
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No one really knows what will happen, since the DSM-V task groups have not yet issued any formal reports. However, one APA committee recently recommended replacing autism, Asperger's, and PDD-NOS with "autism spectrum disorder" with only two subtypes. What is now called "Asperger's Disorder" in the DSM-IV-TR would seem to be encompassed by one of those subtypes.
_________________
Mark A. Foster, Ph.D. (full-time & tenured sociology professor)
The League to Fight Neurelitism: http://neurelitism.com
My personal self-advocacy website: http://markfoster.name
Portal to my 24 domains & 22 sites: http://markfoster.net |
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earthmonkey
Phoenix
Joined: Jun 06, 2005
Age: 19
Posts: 558
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| Posted: Tue Aug 19, 2008 12:49 am Post subject: |
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| Glenn wrote: | | The various types of autistic spectrum disorder present differently, have different characteristics, and maybe need different kinds of help. |
I would personally re-phrase this as:
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Various autistic individuals present differently, have different characteristics, and maybe need different kinds of help.
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For instance, someone with the Autistic diagnosis, who let's say had a significant speech delay, while could benefit from speech therapy when younger, by age 20 they may not need any sort of autism, disability-related assistance. They could also need substantial assistance. And of course they may need various kinds of accommodations and services, but not related to speech.
Whereas, a person with Asperger diagnosis, let's say no speech delay, tends to go on monologues about computers, etc. - someone who fits this description may need help with living independently. Or they may not.
Really, it's down to the individual's needs and wants, and those don't always go hand in hand with what's expected of people with their specific diagnosis.
| Glenn wrote: |
My feeling is that you lump everything together under one "general" heading, it will not help anyone. Generalisations like this can lead to stereotyping. |
I don't think this would be any different today. There's the stereotype of someone who is autistic, significantly disabled, "non-communicative" though this is usually used to mean "non-speaking", and there's another prominent stereotype of someone with Asperger's who is fixated on math/science/computers, speaks endlessly on one or two favorite subjects, mostly bright but a little socially awkward, with few to no difficulties other than social.
With the Asperger diagnosis, I have had professionals who assume that I have no difficulties other than minor social stuff. When they re-evaluated me and thought I fit more into classic autism dx, then they were suddenly "very concerned" about me living on my own, though I think I'll be successful as long as I learn some more skills.
But they didn't attempt to teach the things that I needed to learn, there was no option presented to us, though they knew full well that I'd be attending college in a different state in a few months. Neither diagnosis gave access to needed treatment, therapy, or education. Neither one cleared up any stereotypes; they simply got tweaked.
| Glenn wrote: |
(I think this has been discussed under a different thread in this forum) And stereotypes, which encourage people to imagine they understand something without the need to really think for themselves, can lead to prejudice.
And we certainly don't need that! |
I agree that we certainly don't need that! But it exists today, as it is. I really don't see how it would be made any worse by changing it to "autistic spectrum disorder" instead of the various categories; especially since many people by adulthood, are difficult to impossible to distinguish what diagnosis their childhood history best matched. Also, there are people whose traits and skills profiles are very mixed between them, and on the borderline.
I may have had a slight delay in the development of speech from single words to non-echolalic communicative speech, but just barely within what's considered clinically significant. Shortly thereafter I developed the communicative phrases, though I have speech difficulties that persist to this day at age 18. They are not to do with non-literal language, the kind of thing I went to speech therapy for. It has more to do with using echolalia and not speaking a fair amount of the time, though when I am speaking communicatively (which is still the majority of the time, just not a "vast majority"), I am told I speak quite well, if slowly and with time delays (I wrote more about my unusual speech in the "non-verbal" thread).
I won't go into excessive detail, but lots of the different traits that are meant to distinguish (such as appearing aloof versus appearing to want to socially interact, but being awkward and having difficulty), are either mixed (so I'll be one way some of the time, the other way at other times), and I have a big mix of traits. I'm far from the only one, who can be considered to be in a gray area here.
I just don't see how it would lead to even more stereotyping than there is now. Also, considering the wide range of characteristics, if there was just one autistic diagnosis, then that would mean that the professionals would possibly have to look more at the individual needs and strengths than what is stereotypically "Aspergers" or whatever. Then again, it could lead into increased use of functioning label use to stereotype, but then again that is also pretty prevalent, and often when used non-clinically, Asperger's is referred to as a synonym of HFA, even if diagnostically they're supposed to be different.
Either way, I don't see it opening the door for a whole bunch of new stereotypes, and I don't see it as depriving people of needed access to services. Maybe there's something else I'm missing, but I don't see "Because according to the DSM they are defined as different things" as a good reason that the current way is better - after all, "autism" itself was primarily referring to a subset of schizophenic symptoms, and there have been other diagnoses (both within DSM and without) that have been modified or dropped, as more information was gained about simmilarity and dissimilarity between different conditions (as with catatonia, schizophrenia, and movement disorders).
_________________
"Public transportation is for jerks and lesbians." --Homer Simpson
"why is it bad for me to discuss why I need the lights off above my desk but it is ok for you to tell me you had a camera shoved up your a#$?" --an aspie coming out |
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Danielismyname
I wish I were a classical nihilist
Joined: Apr 03, 2007
Posts: 6255
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| Posted: Tue Aug 19, 2008 5:09 am Post subject: |
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Whilst I disagree with many of his ideas, Attwood recently did a trial, where he compared those diagnosed with Autistic Disorder (100 or so with the DSM-IV-TR) and Asperger's Disorder (50 or so with Gillberg's Criteria); he found no difference in the two groups in symptom severity with age matched children.
A funny thing: back in the DSM-III, there was this diagnosis called Childhood-onset Autism, which isn't really any different to Asperger's now in the DSM-IV-TR. They found that this "Childhood-onset" form of Autism was no different in outcome and severity than the Infantile-onset Autism. So in the -R of the DSM-III, they just made it Autism, or PDD-NOS.
The same thing is happening now, really.
I'd like, personally:
"Autism, full-disorder" (which is defined by severity and/or the amount of symptoms); which can turn into "Autism, residual disorder" if there's marked improvements during development that persists into adulthood
"Autism, part-disorder" (which is defined by less severe and/or less symptoms);
"Autism, atypical" (a mix and match of the above);
Everyone with an ASD would be able to fit this. And everyone would be able to say they have Autism too, which seems to be a big thing, for some reason or another. |
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Ishmael
Phoenix
Joined: Jul 08, 2008
Posts: 1265
Location: Australia
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| Posted: Tue Aug 19, 2008 5:27 am Post subject: |
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Check out what I wrote about this a few days ago.
Lovin' Autism:
You might find it interesting.
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Oh, well, fancy that! Isn't that neat, eh? |
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2ukenkerl
Phoenix
Joined: Jul 20, 2007
Posts: 5238
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| Posted: Tue Aug 19, 2008 7:00 am Post subject: |
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Frankly, when I first heard about AS, I thought "WOW! That sounds like I WAS, and a bit like I am, but I may have fallen a bit away from it.". Believe me, that wasn't saying that I was better. I was WORSE! I have seen at least 2 others here express the same idea. I felt I was on the LOW end. Well, after being here a bit, I find I am like in the center. I didn't get better, the bar was lowered.
So what is my point? I think the psychiatrists should have diagnosed things better. If people paid more attention to the last parts of the AS definition, and tried to diagnose EVERYONE, AS and HFA would be more clearly defined. Kids would probably be less adversly affected by expectations that are far lower than what they can do, or that much higher than they can meet.
It is like the time that I saw a proposed list of changes for DIBOL from ANSI. They were obviously written by idiots, and suggested that the original behaviour of statements be eradicated, some others would be eradicated, and some new statements be taken as the normal and/or only behaviour. It would be like taking the proverbial rose, changing the petal arrangement, the smell, the thorns, etc... and still calling it a rose. Those changes weren't done to DIBOL, and it lasted for many years past that point, by the way. It apparently exists even to today! http://en.wikipedia.org/wiki/DIBOL
BTW yesterday, a fire alarm went off. I was apparently the ONLY person plugging my ears. That is, perhaps, the most obvious symptom I had. Granted, there are others, but they are hidden, etc... I would hate being grouped with Kanner's simply because of such things. I felt like an idiot just because of plugging my ears, but the sound DID create pain. |
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Ivanov_Kuznetsov
Blue Jay
Joined: Aug 02, 2008
Posts: 87
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| Posted: Tue Aug 19, 2008 7:04 am Post subject: |
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| Praetorius wrote: | | Lol. "Ass burgers" But yeah, a new name would be nice. |
Everyone I'd tried explaining the syndrome to at work always looks at me rather perplexed and googles "ass burgers"  |
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serenity
Phoenix
Joined: Feb 26, 2007
Age: 30
Posts: 780
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| Posted: Tue Aug 19, 2008 9:07 am Post subject: |
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I agree with Earthmonkey.
I'd especially would like to see at least the PDD-NOS label chucked out. It is so ambiguous, and leads to confusion. Some people don't even consider it a form of autism. Try getting services that one desperately needs with that label. My son has been diagnosed with it, and people brush him, and his daily struggles off to the side all the time. Invalidating how hard he works at the skills he has, while lavishing attention (and unwanted pity) on his profoundly autistic brother. |
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