DSM V changes.. How do you feel?

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But we now have these different diagnostic categories. Am I not correct in thinking that DSM-V wants to remove all the various categories?

I'll be honest: I'm by no means an expert on psychiatrics. The only shrinks I've ever seen was the father of another kid and a woman who helped on the autism buddy program at our university (I wanted to volunteer for that. Not a happy story), so I'm not sure how they deal with various other spectrums. And while even then, it may not matter for therapy, I do think it matters for governmental things. Governments want clear diagnoses and clear lines. It would be hugely unpopular to say "we'll only give free public transit tickets to severe autistics" or some such. There is a theme park in the Netherlands where, if you have a disability, you can skip queues and the like. Autism, apparently, is one of the disabilities with which you can do that. However, I simply don't see the need to give that kind of support to Aspies. I don't like standing in queues, but I don't overload because of them. (I'm simplifying matters here by generalising "me" into "all Aspies", but you get my point: severity in autism should affect the kind of help you can get)

I am not sure I understood this correctly, but if I did:

What about the fact that many people diagnosed with autism are about as severe as many diagnosed with AS? DO the people in the former category need more assistance while the latter need none at all?

In my perfect ideal world, the categorisation would be based on the amount of help needed. I thought that the current system had that going on pretty well. Apparently, it does not (or psychiatrists are just bad at using the criteria).

The diagnoses are not and have never been based on the amount of help needed. Most people diagnosed with PDD-NOS and AS fit the criteria for autism, and shouldn't be diagnosed with either PDD-NOS or AS, at least per the DSM-IV guidelines.

At most, the way the AS criteria are written tends to filter out those who need more assistance, but in practice a lot of people who are more severe than many people think AS can be are diagnosed with AS (I can think of several on this forum).

This is one of the reasons that everything's being placed under one diagnosis along with severity identification: Because there is very little conformity in regards to who gets diagnosed with what relative to their difficulties and needs.

I thought both HFA and AS were good filters for the amount of help needed. The first thing, though, seems to me as a psychiatric flaw, not a flaw in the methodology itself.

The problem is, when you use a severity criterion, I'm afraid we'll still have the same problem. Different psychiatrists see different people as being in different severities.

The AS diagnosis also makes a bit of sense because of the differentiation between "active but odd" and "aloof and passive" social behaviour. Aspies, in general, seem to want social interaction more, whereas Auties generally don't. Or am I engaging in more awful generalisation?

HFA is not a diagnosis. And it is perhaps a psychiatric flaw, but the criteria for AS as written are virtually impossible to meet.



The severity criteria are problematic as they exist (being based almost entirely on how much assistance one needs), but this isn't the same problem as exists now. It is entirely possible for professionals see people as more or less mild than they really are, and I don't really see a way around it.



Yes, this is a generalization. Also, if anything, research and discussion about autism needs to move away from putting socialization at the center and making it the most important thing all the time.

Not if the people doing the treatment use their brain, and treat people as individuals, as persons, not as a diagnostic label.

Since when does the population at large have common sense enough to do this? I put this "doubly" for those supposed to be doing the treatment.

I forsee GREAT pain for AS if/when lumped with LFA...especially in the grade school years. Peers can be cruel with the bullying and to say that all roses are flowers but not all flowers are roses is enough to confuse the unenlightened.

I'm all for keeping things separate AND having more research done...as a woman who wasn't even diagnosed until I was 41, I believe it would be a great disservice to lump it all together.

I am not sure why people think that the proposed changes will mean the same treatment for everybody. That does not make sense to me. People will get treatment based on their needs. If you need social skill help, you can get it. If you need fine motor help, you can get it.

People who break their leg, don't always get the same treatment. Depends on how bad the break is and where in the leg it is.

Today, people with HFA and with LFA already have the same diagnostic label ("299.00 Autistic Disorder"/"F84.0 Childhood autism") but receive different treatments.

And people with different sorts of Asperger's get different sorts of treatment, too.

The categories do more damage than good. People are expected to be able to do certain things or not do certain things because of their labels. They expect Aspies to be active-but-odd and socially anxious; what do they do when they get someone who just ignores other people and doesn't care what they think? They expect auties not to be particularly good at taking care of themselves; but what if they're on their own at 18 and their Aspie friend is living at home at 35?

You simply can't predict what a person can do based on their diagnosis. You can't get any more meaning out of "Asperger's" or "classic autism" than you can get out of "autism spectrum disorder". The only thing you get are stereotypes and incorrect predictions.

I thought I said this already, but apparently not:

I agree with nearly everything Callista has been saying on this thread. I feel like me adding anything would be superfluous.

It would appear all my concerns and arguments have been soundly squashed. About the only thing that's left is that AS has a "good reputation" because of the "little professors" comment in Asperger's original research. It would be a bit of a shame to lose the good side-effects of that comment (though I also understand it could be a burden to those diagnosed with AS who are not "little professors").

We aren't talking about the population at large. We are talking people with autism spectrum disorders, and the people they or their parents CHOOSE to go to for treatment. Don't choose to use someone who's not competent at their job. It's that simple.

And, as been said already before (though put differently), there's nothing to keep separate. Right now, it's different labels for the same thing. Okay, not quite totally, as the severest case don't ever get the Asperger's label. But who gets what label isn't a matter of the diagnostic criteria, nor of anything else systematic. If we are going to have different labels, they need to reflect actual difference. Keeping the current labels gets in the way of that. Keeping the current labels does NOT help the cause of more research into the differences within the spectrum.

Some people have their minds made up already. And regardless of information that is new to them, they can not manage to reconsider.

When the "new" information only contains things you've studied already and concepts you've already considered, it's not exactly going to change your current opinion...