Autism Spectrum disorders in the new upcoming DSM-V

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Ravenclawgurl
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07 Oct 2008, 10:56 pm

Here is a article describing the planning process on what they may do to chategorize Autism Spectrum disorders in the new DSM-V coming in 2012


http://www.psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/ConferenceSummaries/AutismConference.aspx



theres were 9 panels in the conference each adressing each of these issues (the article is what was discussed at the conference)


what are the core symptom domains in autism?


how are fixated interests and stereotypes related to each other, to autism, and to obsessions and compulsions?


how does the presentation of autism change across the lifespan?


how does developmental regression (and particularly Childhood Disintegrative Disorder) fit into the autism spectrum?



Asperger’s Disorder – is it Autism?



Is Autism a Life-Long Diagnosis?




How does comorbidity affects symptoms of Autism?



what role should neurobiology play in the DSM-V diagnostic criteria for autism?



International, Cultural, and Gender considerations in the diagnosis of Autistic Spectrum Disorders.




what are ur comments?



KateShroud
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07 Oct 2008, 11:56 pm

So what happens if they actually delete AS from the DSM? Does that mean we aren't entitled to services and understanding, or should I just say I have an autistic spectrum disorder?



LostInSpace
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08 Oct 2008, 12:07 am

KateShroud wrote:
So what happens if they actually delete AS from the DSM? Does that mean we aren't entitled to services and understanding, or should I just say I have an autistic spectrum disorder?


I only read it quickly, but it looks like Aspies will just be diagnosed under the umbrella of ASD (no longer called PDD) without a separate designation. They cited some evidence that there is no detectable difference between AS and HFA even by the school years (despite the early language difference), so why make a distinction?

It looks like there will be some changes for Rett syndrome and CDD as well. CDD will be removed as a separate diagnosis and just be included as an ASD with a later onset, and Rett syndrome will no longer be an ASD.

Also, ADHD will be allowed as a comorbid diagnosis with ASD. I didn't see any mention of NLD anywhere though.


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Ah_Q
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08 Oct 2008, 12:16 am

Don't worry, it's not going anywhere. I think the main thing they're considering is whether it should remain a separate diagnosis, as it is right now, or simply be combined into a subset of autism.

I'm of the opinion that it is not a separate diagnosis, autism is autism, just different manifestations.



LostInSpace
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08 Oct 2008, 12:32 am

Note: For people interested in NLD, I wasn't able to find anything online as thorough as what Ravenclawgurl has posted, but the general consensus based on what I read is that NLD will receive its own DSM diagnosis! Yay! Not that I would bother getting re-diagnosed anyway (so I guess I'll keep the extremely generic diagnosis of LD-NOS), but it is still nice that it will be receiving some recognition. I would only bother with re-diagnosis if I needed it for services (which I hopefully never will).


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Danielismyname
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08 Oct 2008, 12:40 am

Just "ASD" works for me.

Just like with the DSM-III, and how they removed "Childhood-onset Autism" in its revision (see: Asperger's), as they found it was the same thing in severity and outcome as "Infantile-onset Autism" (see: Autistic Disorder).

If you have Asperger's now, you'll still meet the criteria for ASD, it'll just have a different name.



CatsareAwesome
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08 Oct 2008, 1:47 am

What is the difference between HFA and AS? Doesn't HFA stand for "high-functioning autism," and isn't that what AS is?



Sora
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08 Oct 2008, 1:54 am

LostInSpace wrote:
Also, ADHD will be allowed as a comorbid diagnosis with ASD. I didn't see any mention of NLD anywhere though.


That's handy, because I expect the ICD-11 to adjust to that too. I really consider a diagnosis if I indeed go to university.



On a side note,

ASD works perfectly I think.

But I expect that there will be autistic people to get worked up about it, especially those who already have a problem with AS and HFA being associated.

Some would love it, some will hate it, in 10 years hopefully nobody cares any more.


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Danielismyname
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08 Oct 2008, 1:55 am

Early cognitive delays in expressive and/or receptive speech being the biggest differences. Some with HFA are more socially aloof than those with AS, but that isn't always the case. "HFA" as of now, is Autistic Disorder with a [verbal] IQ over 75.

Studies have shown that severity of symptoms aren't different in school age children, and that those with "HFA" are a little more severe in adulthood, but not by much. Hence, two of the three groups pondering changes to the next DSM-V said that they'd like Asperger's removed.

I agree with them.



LostInSpace
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08 Oct 2008, 2:12 am

Danielismyname wrote:
I agree with them.


I also agree, although I am intrigued by the suggestion some have made that AS should be part of an NLD spectrum. Although I realize it wouldn't be this simple in practice, it would be interesting for spectrum-ish people to be differentiated by neuropsych profile. People with language impairment could receive the ASD diagnosis, and people with visual-spatial impairment but good language skills could receive the NLD diagnosis. Both would need social skills training of course, but after that each group would be differentiated by their major areas of weakness, which would be useful for planning intervention and designing IEPs. Each group might be more homogeneous than the ASD population is now, as the ASD group and the NLD group would each exhibit their own broad areas of impairment (language skills versus nonverbal perceptual skills). But of course, it's not that simple in practice, as there are things NLD-profile Aspies share with autistics but not NLDers (stimming for example).

One of the arguments for a difference between HFA and AS actually was that some studies found stronger performance IQs in HFAers, and stronger verbal IQs in Aspies. Such a simple neuropsychological dichotomy has not been found consistently by other studies however. It is possible that some people diagnosed AS maybe would fit an NLD label better, though. After all, NLD is a new (not even official) diagnosis, so that NLD kids with more severe social impairments might have been labeled AS. If 80% of Aspies meet the (not standardized of course) criteria for NLD, maybe researchers should look more closely at the difference between them and the 20% that don't fit an NLD profile.


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Danielismyname
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08 Oct 2008, 2:52 am

I think diagnostic confusion has led to people placing Asperger's and NLD together as the same thing; many people have seen "Asperger's" as a mild disorder that is used to define a group of computer/library geeks (note the two different learning stereotypes here), whereas the original intent was for a severe disorder of social reciprocation and repetitive behaviours, but with less of a cognitive delay compared to Kanner's. As it says, most people with an ASD also have a NLD to some extent, and people can have NLD by itself, just as they can have a VLD by itself. Now, NLD does have social deficits, but they're not to a level of how Asperger's was originally defined, much like VLD in relation to Autism.

Autism and Learning Disorders (NLD for example), but with a cognitive criterion for each to point out strengths and weaknesses would be the simplest and most objective view.



Greentea
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08 Oct 2008, 2:53 am

LostInSpace wrote:
Note: For people interested in NLD, I wasn't able to find anything online as thorough as what Ravenclawgurl has posted, but the general consensus based on what I read is that NLD will receive its own DSM diagnosis! Yay! Not that I would bother getting re-diagnosed anyway (so I guess I'll keep the extremely generic diagnosis of LD-NOS), but it is still nice that it will be receiving some recognition. I would only bother with re-diagnosis if I needed it for services (which I hopefully never will).


That's great news, thanks for the info!


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Woodpeace
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08 Oct 2008, 5:22 am

I regard it as significant that Dr. John Constantino said that "autism represents the severe end of a continuum of inherited social deficiencies and it is arbitrary where to draw the line between affected and normal states."

After the panel discussions, one group recommended revising "the criterion for peer relationships given that it is too broad (most psychiatric disorders affect peer relationships)".



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08 Oct 2008, 6:04 am

As I see it we are as difference and diverse on the autism spectrum as those of you who are not on the autism spectrum, I except being part of the Autism Spectrum, but feel the "Disorder" part should be dropped! and maybe replaced with “Difference”. The way I see it apart from being on the autism spectrum I have many co morbid / associated conditions, in fact a whole list, not sure anyone has it right, including me. Often our labels can get over complicated... and near impossible to know which bit is which, with many overlaps, but any label does not change who we are. I have my own simplified version - The center as I see it, is us - the Autism heart, differently minded part... which to an extent feel many people just do not quite get or understand. So often the most important thing the center, gets neglected, so it’s no wonder we are often a little off balance.
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Surrounding the center are a web with many chaotic paths, often disjointed and ineffective, as these neuro associated conditions, co morbid mental disorders (or misunderstood difference), environmental factors are all blamed and continue to circle around the most important part of us. I feel its time other started with the center - the Autism Heart, forget the labels. Because if our hearts were balanced and allowed, as I see it. A lot of these existing links in the web, may start to fade... I feel many of the labels are often caused by others misinterpretation, dealing with small aspects of the whole person, often neglecting or not understanding our centers from when we are born.


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Danielismyname
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08 Oct 2008, 7:22 am

Woodpeace wrote:
After the panel discussions, one group recommended revising "the criterion for peer relationships given that it is too broad (most psychiatric disorders affect peer relationships)".


It'll probably add Autism specific causes for why there'd be a lack of peer relationships, rather than just saying that this disorder can mean that there might not be any.

asplanet,

When you can show me or anyone else that individuals who "only" have Autism aren't disordered compared to their peers, you then have an argument for "difference".



anna-banana
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08 Oct 2008, 7:46 am

I would really welcome a diagnosis of an ASD without that horrid Asperger-Assburger-aspie therminology...


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