Not autistic under DSM 5!

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I don't know why that would be a source of fear; "mild autism" already requires the exact same support and therapy as "Asperger's", and can't be told apart clinically. They're essentially the same thing. How come saving money would get you diagnosed with one or the other?

Those who have gotten their diagnosis with the old system won't loose their diagnosis

Here's a reality check for your academic mentors.

If you are diagnosed with Aspergers or PDD-NOS in Australia then you are unlikely to receive federal government support in school.
If you are diagnosed with Autism then you will get more funding for education support - the more severe your symptoms the more funding you get.

At the moment that is the only value the "label" has.

I am by now quite familiar with the apartheid many higher functioning Aspergers like to create to distance themselves from less functioning individuals diagnosed with Autism. It's not very noble.

I mean really does it matter what you call yourself or what you perceive others think of you?

Nonetheless it's a free world...

Actually, my reluctance to say AS is autism has nothing to do with "distancing" myself from the label. I am against the notion, because I do not see ample scientific evidence that AS and HFA are the same thing. There are too many unanswered questions, neuroscientifically speaking, and as a neuroscientist, yes, it matters very much to me. I am not ashamed to call myself "autistic." On the contrary, I do not want to use the label until I am sure AS is severe enough to be considered autism, because it isn't fair to those who struggle much more than I.

aspergers already is considered autism.

Odds are that some people who do not struggle as much as you are labeled with autism, and many who struggle more than you are labeled with AS. Further, this isn't really a logical approach to any "AS/ASD dichotomy" as many disorders have a wide range of severities (apparent or actual). One person with cerebral palsy might have difficulty walking and need braces and/or crutches. Another person might be incapable of movement and speech.

Anyway, there's plenty of research that identifies and highlights the broad spectrum of similarities between autism and Asperger's, as well as research showing that which label you get depends a lot on where you get your diagnosis. There's no lack of evidence.

The autism research is shoddy and muddled with inconclusive and conflicting findings. Throwing people with HFA and AS in one "autism group" is poor. It continually angers me that, while AS can look more like NVLD than HFA, the research isn't properly looking at this question. There are several key studies that have found clear neurological differences between HFA and AS, and these studies' findings are largely ignored. Even if AS is neurobiologically a form of autism and not NVLD, it shouldn't be removed as a diagnosis before there is better research on subgroups. This is a problem all over neuropsych research. It's often preferred to lump diagnostic groups with potentially phenotypic differences together to increase sample size and power rather than to tease out all of the variability in the diagnostic groups. At the moment, I have both AS and NVLD. Should it be one diagnosis or two separate ones? If I do have autism and NVLD both, how does my brain differ from those with high-functioning autism who do NOT have NVLD? The list goes on and on of the questions that are not being asked and the confounds that are present in the current popular research.

As for the severity of autism being so varied, I am quickly growing tired of the "spectrum" approach to neuropsych disorders. It was a great concept at the start, but now, EVERYTHING is being put on a spectrum. The population is a spectrum of traits to begin with, and I feel that the heavier reliance on spectrum ideology is leading to increased and faulty diagnosis of neuropsych disorders. One of my biggest beefs about the DSM-V is how they are remodeling everything to be under a spectrum rather than trying to find better, neater categorical criteria. Pretty soon, if the spectrum idea keeps growing, virtually everyone will qualify for an Axis-I NOS disorder. It's becoming a paticular problem in bipolar research (my passion), but I'll save that rant for another day...

The genetic basis of Autism and Aspergers that manifests in sibling progeny in a spectrum of colinear symptoms is undeniable.

I know of a parent (and this is typical of families with more than one autistic child) who has 3 children where one is "low functioning" and non-verbal and one is HFA and spoke from 5 yrs of age and one is almost neurotypical except they have disgraphia, poor motor skills and intense shyness and is unable to make friends.

It is simply unscientific to categorise the third child in a "different disorder" when quite clearly all three children have inherited the same genes from their parents.

The spectrum model simply reflects the epigenetic basis of autistic traits...DSMV better classifies the level of symptoms that debilitate the child or prevent speech etc as a scale. I'm not 100% comfortable with it's accuracy but we can be sure that somebody who calls themselves an Asperger has not inherited a different set of genes from a person with HFA.

Secondly Baron-Cohen and Attwood's research has indicated that individuals with HFA and AS show insignificant developmental differences after the age of 13.

I have reviewed the literature that positions itself in favor of maintaining the seperate position of Aspergers. The research is not very convincing, particularly when I look at my own child. For example, one major study claims that HFA kids have a different gait when they walk compared to those with AS. I acknowledge they demonstrate statistical significance. Unfortunately when I observe my daughter walking she clearly does not fit the proposed model, infact I cant determine how her walking or motor skills are any different from an NT let alone somebody with Aspergers?

It's hard enough in this world to live with labels, it's worse when those able to partially transcend the label (i.e. act more NT) make this an excuse to create a new label.

Those interested in the spectrum model may want to read about Australian born child prodigy Terence Tao.

Tao now holds the James and Carol Collins chair in mathematics at the University of California, Los Angeles and graduated with a mathematics degree at the age of 14.
http://en.wikipedia.org/wiki/Terence_Tao

I recall there were murmurs that Tao may have been an Asperger due to his obsession with mathematics and his socialisation problems as a child.

What many people don't realise is that Terence Tao's brother, Trevor Tao, was already diagnosed as severely autistic as a child. Today Trevor is also a mathematical genius, holding a double degree in maths and music and will soon be featured in a book on autistic savants.

The amazing similarity between Terence and Trevor's obsession with mathematics and music makes for a dramatic demonstration of the genetics of autism, hyperlexia and genius.

I don't particularly care if I retain my diagnosis or not.

Call me when they develop a way to detect objective bio-markers that clearly demonstrate whether one is "autistic" or not.

Beyond that, "Aspergers" is just the closest label they currently have to describe my particular brand of weirdness.

I don't think it's very controversial to suggest there are neurological differences based on when one develops speech - someone who develops early or on time is likely to have a brain that reflects that as compared to someone who develops speech much later, if at all. This doesn't necessarily point to separate conditions and could point to variations within existing conditions. And again, this kind of variation is not controversial in other disorders - like cerebral palsy - and hasn't been for a long time.

A lot of the research on autism is shoddy, definitely. A lot of it is also dehumanizing toward autistic people. But it strikes me as strange to declare the entire field as shoddy, and then use that explanation to pick and choose the research that supports a desired conclusion. How is it that research that supports what you want to believe is more acceptable than research that doesn't? If autism research is shoddy in general, how do you determine that the research that supports your point of view is more reliable?



But the idea of an autistic spectrum is far from recent. Lorna Wing started the push to recognize AS in the late 70s, after all. And Kanner's first patients seemed to primarily be what people now would call "HFA" and "LFA" was a later addition to the spectrum. It's only now when people diagnosed with AS will instead be diagnosed with ASD that the idea of a spectrum becomes a problem?

I don't mind the spectrum approach. What I mind is the idea that it has to be a one-dimensional spectrum. There are more dimensions along which you could measure abilities and autistic traits than is practical to include in a diagnosis. Personally, I would rather have a single large "autism spectrum disorder" category, and retain the GAF scale for general assessment of how much help someone needs.

What we know about autism is that autism itself is relatively unchanging--if you have it now, you'll always have it unless you drop into the "subclinical traits" category (and that's just an artifact of the way we diagnose things, as only being diagnosable if there's disability involved). However, the skills of an autistic individual demonstrably change over the life-span, usually increasing as you learn, and occasionally decreasing during regression or when stress levels get high. What I would prefer, in terms of diagnosis, is to have the "autism" category be equally unchanging, but to allow the person to move around within it, in terms of GAF, as they become more or less independent and capable of doing what we expect of NTs.

If we put the spectrum into one group, but at the same time make rigid categories of mild, moderate, and severe, then we'll have the exact same problems we now have with Asperger's versus classic autism: People are either denied opportunity because they're believed not to have some ability; or they're denied accommodations because it's believed they must have some ability, purely based on their diagnostic category. We can't fall into that trap again; it's caused a lot of pain and placed a lot of barriers that didn't need to be there.

Within autism, there could be a spectrum of speech abilities and development. Same for non-verbal communication. Same for motor skills. Same for sensory issues. Same for social cognition. Same for stereotypies. Same for executive function. The autism spectrum could be split into subgroups based on differences in any of these categories, and speech was the one that was chosen to separate AD vs. AS, maybe because speech delay is most easily observed in early childhood. Within the speech development spectrum, there could be some children with precocious use of sentences for communication and some children who make no word noises at all. Within the speech development of one child, there could be precocious making of word noises, e.g. non-communicative echolalia at six months, with delay in use of speech and gesture for communication, e.g. no such things at six years. Within the motor development spectrum, there could be children with superior motor skills or normal motor skills or poor motor skills. Within the motor development of one child, there could be significant impairments in both fine and gross motor skills, e.g. unable to hold things and unstable gait, with good skills in specific areas, e.g. normal motor skills for block-building, superior motor skills for drawing and biking. There are many ways to split into subgroups and many ways for one person to move amongst subgroups, so it makes more sense to me to have one ASD diagnosis for all autistic people, then assessments of different traits for individuals.

If we never do the research that supports my point, how will we ever determine if it gives reliable conclusions or not? I'm not saying that any of my hypotheses will turn out to be correct, but if we never look at these issues, how will we learn? Researchers just look at the same old questions in the same old way, to ensure they receive funding. It is rare that you find innovative studies daring to look at different ideas.


It is only as of late that the spectrum concept has exploded into practically all neuropsych disorders. I think parts of spectrum ideology are very beneficial, but it is going overboard, as I explained above. I am more angered with the bipolar spectrum than the autism spectrum, because I think it is causing much more overdiagnosis.

The spectrum "concept" is one of the the only things right with the DSM, current clinical practice, etc. If anything, it's underused.