DSM5 ASD "Essentially Everyone Gets In"

Post Reply New Topic

Only if you can easy pick up the details, which are immensely better at than NTs.

I have high functioning autism but am diagnosed with Asperger's. I have the self-help skills delays. I also had language skills problems.

I could be diagnosed with either.

Could you elaborate on each of these claims? Because I haven't read any research that properly substantiates any of them. The closest would be neurological differences observed in AS brains vs. NT brains as compared to autistic brains vs. NT brains by collating multiple studies.

Most research is directed towards autism "proper". All you can do is look at the existing research unless you are fortunate enough to be in the field - in which case I have some ideas.

If you look at the extreme examples, dont you think that people with AS present differently to Autism proper excluding the complexity of HFA?

Its 3:30 am here and I've been out, so sorry this is short and I'm resorting to a link:

AS vs ASD

DSM5 is to redress the explosion of AS cases. I dont think changing the criteria adequately explains things but it does seem to exclude me. My mind clearly makes connections others dont and it is a different experience to be me than an NT person but I dont fit the criteria anymore.

I trust science and I want to see more brain scan based diagnosis than this vague subjective diagnostic bible.

I do not think you can get valid data by excluding the data that conflicts with your conclusion. The complexity of HFA is precisely why it is difficult to justify that AS really is entirely distinct from autism.




Brain scan based diagnosis is coming, but we're not there yet. Calling the DSM a "vague subjective diagnostic bible" is not accurate at all, however. It is not vague, and the diagnostic criteria it lists is based on existing research. At this time, the only possible replacement is the ICD. The parts of that available in the public domain are even less detailed than the DSM, however.

Also, do not mistake the publicly available symptom lists for the entirety of what the DSM offers. The actual book includes several pages of description of each possible diagnosis that go well beyond the criteria. It's worth looking at to refine one's criticisms.

There are those with severe autism that with therapy can become HFA. Then there are those born HFA. I think the former show different characteristics than AS.

Sorry you don't fit the criteria but you won't lose your dx.

Im not excluding data that conflicts with my view. But I need to establish a frame to even begin to explain it. I didnt succeed there.

I personally have the frame AS and Autism proper - based on neuroscience. I think the complexity of HFA/AS makes approaching research as one unhelpful - most of it is directed at autism proper not AS (from what i have seen).

DSM is profoundly vague and based on assumptions that are outdated. The plasticity of the brain for one. DSM is the backwards way to understand the condition and i prefer a brain/biology diagnostic than the vague drivel in what I have read of DSM.

I accept your last point and I may get an actual copy - but it is no longer a credible approach to me. I was told for 8 years I have something that does not exist. I dont have much respect for the general understanding of the subject and brain scan based diagnosis renders DSM outdated soon. Thankfully.

Most of the cognitive neuroscience research in recent years is based on subjects with HFA or AS, because it is easiest to do research with these people who can understand what they are supposed to do in the eggsperiments and meet the requirements of the instruments, MRI, EEG, eye-tracking, etc.

That may be the case over recent years but MOST research was done before the last few years. I'm glad there is more research most people think diagnosis is hard, painful and takes too long.

From BBC:

A simple brain trace can identify autism in children as young as two years old, scientists believe.
A US team at Boston Children’s Hospital say EEG traces, which record electrical brain activity using scalp electrodes, could offer a diagnostic test for this complex condition.
EEG clearly distinguished children with autism from other peers in a trial involving nearly 1,000 children.
Experts say more work is needed to confirm the BMC Medicine study results.
Early detectionThere are more than 500,000 people with autism in the UK.
Autism is a spectrum disorder, which means that it is not a single condition and will affect individuals in different ways.
Commonly, people with autism have trouble with social interaction and can appear locked in their own worlds.
It can be a difficult condition to diagnose and can go undetected for years.
Continue reading the main story
“Start Quote
EEG might offer a way to check for the same condition in younger siblings”
Dr Frank DuffyLead investigator
BBC Health: Autism in depth
The latest study found 33 specific EEG patterns that appeared to be linked to autism.
These patterns consistently spotted autism in children across a range of age groups, spanning from two to 12 years old.
Hallmark brain activityThe researchers repeated their analysis 10 times, splitting up their study group (children with a medical diagnosis of autism and children with no signs of autism) in different ways.
Around 90% of the time, the EEG patterns could correctly detect the children diagnosed with autism.
The team now plan to repeat their study in children with Asperger’s syndrome – one particular subset of autism. Typically, people with Asperger’s have higher-than-average intelligence and struggle less than people with other types of autism with their speech.
Dr Frank Duffy who is leading the investigation said the work could help determine if Asperger’s should be thought of as an entirely separate condition.
And it could point the way to determining if younger siblings of children with autism are likely to develop the same condition themselves.
“It is a great cause of anxiety when an older sibling develops autism.
“EEG might offer a way to check for the same condition in younger siblings in advance of them having symptoms.”
EEG could also be used to track what effect different autism treatments are having on the condition, he said.
Caroline Hattersley of The National Autistic Society said: “We welcome any research that may help us to understand autism better and improve diagnosis times for those with the condition.
“In a recent survey we commissioned, 50% of people with autism and their families said it was difficult to get a diagnosis and 55% said the process took too long.
“While further testing of EEG scans is still required, any tools that help identify autism at a younger age could potentially improve a person’s quality of life by allowing the right support to be put in place earlier.”

Fair enough. You reminded me of someone else who does argue that way and it got away from me. My fault.

However, why exclude the autistic people with presentations similar to those diagnosed with AS in order to establish that they are different?



The DSM is not about understanding anything. It's a book intended to assist with diagnosis, but actual diagnostic protocols can be significantly more involved.

I think many of us would prefer a brain/biology diagnostic but those haven't been available prior to this point and the diagnostics that are potentially available are still being tested before being properly implemented. I suspect by 2020 we'll see a lot more of this, and the DSM-6 will almost certainly incorporate that information.



I think the problem is that because it is referenced so often it it is taken to be far more authoritative than it really is. Right now, for most psychiatric diagnoses, it's really the only viable approach currently, in that we have nothing but symptoms to start with (but symptoms alone will never get you a diagnosis from a competent clinician).

People can present with severe autism as children and grow up to present as HFA and be indistinguishable from someone with AS. Other people who present the same way as children don't follow that course of development. If studied in childhood, these people would be in the same group in an eeg study, for eggsample. If studied as adults, one would be in the HFA/AS cognitive research group, and the other would not be studied in cognitive research at all. If genetic study, you might find the same mutation in a protein in both people, and they might share that mutation with someone with AS or one of their BAP family members.

Doesn't it just make sense that the brain scan of somebody with severe autism would show more differences in structure than in AS?

I fail the first test of autism: a larger circumference. I have more of a smaller one which studies have found to be quite common in ADHD which I also have.

There's a lot of research but nothing is concrete enough to prove brain scans can detect autism. I think in higher functioning individuals it would be even harder to find differences. I'll happily volunteer myself as a subject of study though.

I believe that is Shank3 gene.

@verdandi - DSM is used by many people to understand though. It is most peoples first point of call on the subject.

I was diagnosed with a Q and A and you can't discount the variability of environment.

I g2g to bed..........most of what i think is in my book. Not to say that its inherently right because of that but I did have a look at this subject (AS) and that was the result. I believe there are enough differences to warrant the distinction but classification wasnt my focus.

night

Last edited by answeraspergers on 22 Dec 2012, 12:56 am, edited 1 time in total.

First point of call doesn't mean that's how it's understood. It was my first point of reference to look into AS, but since then I have read articles, research papers, and books on the topic of autism. And if people mistake it for the beginning and the end of diagnosis that's not the fault of the book but that people are not looking closely enough.

Yes, and I believe scans have borne this out - that people who develop speech later or not at all show differences to those who develop speech early or on time.



The article answerasperger's quoted talks about the basics being established. It's still a few years away, though.

My husband told me he heard in a science show about this is it will take at least 15 years before this criteria takes full place because that is when psychiatrists will understand it better. Sure it will still be released in 2013 but it be at least 15 years before it takes full place. I didn't understand this too well so this may not make sense what I am saying.

I guess it's like when the aspie criteria was released, it was not fully understood by professionals so misdiagnoses happened and then they revised it in 2000 to make it more clear. The other one was too vague. Now professionals understand AS better.

When studies try to differentiate between HFA and AS, they will often conclude that there is no clear differentiator once verbal development has been taken into account. And verbal development is what segregated the groups in the first place in the study.