Not autistic under DSM 5!

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errr isn't a) = c)??

I can't speak for North America, but in Australia it's largely merit based. I think where two applicants for a Grad program have an identical grade point average then other factors are taken into account i.e. referees reports and evidence of volunteer work.

No, it is not (at least according to the DSM) - if you don't have a speech delay, but have other communication problem (for example "marked impairment in initiat and sustain a conversation"), you are also in HFA territory.

Well, c) could still have significant language impairments (though the same person can by some be described as having good expressive language) that someone with a) does not have and possibly never had to begin with.

That's why I intend to get retested to see if I would receive an official diagnosis of classical autism ("HFA") as opposed to AS. I can talk, I can talk well too whenever my language isn't bad but my understanding of language is wonky and my use of language (grammar, use of single words, phrasing) is atypical compared to someone who had a more typical language/speech development.

I wish I could figure out why people think that an AS diagnosis excluding particular traits means that an autism diagnosis requires those traits. If only it were that simple.

I knew children with language delay, who were NOT autistic, but formed first words just at age 3 to 4.
Now I have found this article:
http://www.sciencedaily.com/releases/2012/01/120125195530.htm



Languge delay for example does exist without autism, but if high levels of testosterone can and have an influence on language development and there is a likelihood that these high levels contributes to develop an "autistic brainstructure", then it is somehow connected, but maybe just in little differences of the levels of prenatal testosterone, so language delay means another symptom (but of course it is better noticable), but language delay is not "autism" itself.

I don't know if I expressed in a good way what I mean...

A recent study, provided evidence that an increase in brain mass in young autistic males was associated with regressive autism in most cases, however no significant association was shown in autistic females, or in individuals with early onset autism.

http://www.ucdmc.ucdavis.edu/publish/news/injuryprevention/5983

In these children with regressive autism speech begins to develop at a normal age, and then is lost. Children with regressive autism are considered to have a speech delay, and most if not all cases are diagnosed as autism disorder.

There has been some suggestion that a larger than normal brain size is related to other forms of autism, including Aspergers, but this study provides evidence that it is for the most part specific to regressive autism.

Levels of prenatal testosterone, as well as prenatal estrogen, have been evidenced to affect brain development and language. Samuel Baron Cohen found a higher correlation among those with autism than aspergers in low 2d/4d digit ratio, a physical indicator that provides evidence of prenatal exposure to high levels of testosterone.

This finding, in general, seem to be in alignment with the criteria that individuals diagnosed with Aspergers do not have clinically significant delays in the development of language.

At this point, it seems obvious, from the research that has been done that there are many factors both inherent and environmental, inside and potentially outside of the womb that impact the development of autism; specifically in the way the brain develops.

Perhaps, some of the best evidence of this, is research on IQ tests in Autism Disorder vs. Aspergers Syndrome that show an inverse relationship between the two disorders as related to verbal and performance measures of IQ on standard measures of IQ; specifically the Weschler test of intelligence.

Verbal IQ, on average higher among those with Aspergers as compared to Performance IQ, and Performance IQ higher that Verbal IQ, among those with Autism Disorder including those considered HFA.

Fortunately, standard IQ tests will continue to provide this information, when Autism Spectrum Disorder becomes one disorder, where developmental delays are no longer part of the criteria.

There is no doubt that a child with no words is impacted much differently than a child that expresses verbosity; the support needs are much different.

This is probably the best evidence that there are differences in the brain among individuals with "high functioning autism" opposed to "aspergers syndrome".

At least one study provided an Aspergers specific finding that showed lower than average cerebellum size, as support for an explanation of the motor skills problems that are common among individuals with Aspergers.

That's interesting because much of the research on actual structural differences in the brain, done to date, have been focused on individuals with Autism Disorder, to the exclusion of Aspergers Syndrome.

Before Aspergers syndrome, many individuals in the school system where typed with non-verbal learning disorder, a learning disorder where verbal IQ is often measured much higher than performance IQ. In many of these cases lesions in the right hemisphere of the brain are thought to play a role.

Now many of these individuals are diagnosed with Aspergers syndrome, that also have accompanying problems with math, and non-verbal communication difficulties, also specific to non-verbal learning disorder. The repetitive restricted behavioral patterns, seen in Aspergers, are not defined in Non-verbal learning disorder.

There are many other conditions that overlap; pragamantic language impairments are common in Aspergers as well.

And of course, other genetic disorders as well, like 22Q11 deletion syndrome, Down's Syndrome, Fragile X syndrome, and cognitive related disabilities, that are co-morbid with Autism Disorder.

The bottom line I think, is that, the psychological profession has determined criteria that many conditions have in common to some degree or another, with the autism spectrum disorders as currently defined in the DSMIV.

The DSMV seeks to provide a narrower definition, and provide new diagnoses to better characterize the specific problems that are currently very broad in the criteria as defined in the DSMIV for autism spectrum disorders.

They have basically come to the conclusion, that some of what they have been measuring is not what they want to continue to define and measure as Autism Spectrum Disorders.

None of this changes the influence of prenatal testosterone & estrogen, brain overgrowth, abnormal number of neurons, cerebellum size, and all the other factors that are suggested to underly the limitations/disabilities in life, that are produced by all these and other factors.

What is important is that those with problems continue to be provided the supports they need in life; whatever they are diagnosed with has always been a moving target, based on the determinations of those within the psychiatric profession for what the diaganosis is called and how it is defined.

In effect, there is no specific inherent condition of Autism or Aspergers or PDD NOS, and there never has been. It is only a collection of criteria, dependent on analysis by psychiatrists/psychologists and other professionals. As is with most other personality disorders, mental disorders, etc.

It's why input is so important to the DSMV organization; this thing we call autism continues to morph into whatever the psychiatric profession determines it should morph into. If their supporting research and provided input is limited, the diagnosis will be limited as well.

It won't ever capture Autism perfectly, because there was never an inherent condition of autism, only a construct, based on research and opinion, to describe similiar problems humans were having.

People that identify with the diagnosis, are identifying with a construct that has been created by psychiatrists. It is soon to become something different, as has historically happened through the course of psychological research, and opinion. I'm not so sure that many people are aware of how much this has changed over the course of the last half a century. Same too, with many other conditions like ADHD.

The problems people have remain fairly consistent, but there is the real potential that new environmental factors, introduced into the environment by man in the last half a decade, have made a significant impact in people's symptoms, in almost every realm of medical and psychological diagnoses.

Per that factor, diagnostic criteria will likely continue to change, as these factors influence human beings in ways that are not currently well understood.

The experiment of modern culture on human beings, is an ongoing one, where the scientists are guinea pigs, as well as researchers.

Yes. I've heard of people with ADHD and without anything else at all having language delays.



I am not sure what you are saying in relation to what I posted. Autism does not strictly require a language delay for a diagnosis, but AS requires no apparent language delay at all (I say apparent because for some people "When you start speaking" is all that counts, and not how effectively you speak). For some reason, people seem to think that a language delay is an absolute requirement for an autism diagnosis even though it is not.

I am also extremely dubious about the whole "extreme male brain" theory.

I see, I guess this revolves around the DSM definition of what is "speech delay". So you have three categories of HFA then,
a) HFA no speech (non-verbal)
b) HFA with speech but no conversation (verbal but words expressed in echolalia)
c) HFA with speech with conversation but selectively mute

My daughter is currently transitioning from b) to c).

When you talk about requiring traits in an diagnosis of autism which are not apperant in AS, speech delay is the first being thing talked about. But I guess I want to say that - well, as you do not believe in the "extreme male brain" theory or not (I do not know what to believe in, because before I got diagnosed I did not know so much about autism and was just in my SI), I think there must be something - if it is hormones, steroids or whatever substancy - which impacts the brain of the prenatal child. And somehow I think, that the same substancy or whatever it is can cause different "traits" according to the exact moment in pregnancy when it is released [edit: I mean the actual level of it at a certain moment] and the state the embryo is in in its development at that specific moment (where are apparently differences between male and female embryos).
So I somehow think that it is maybe just a matter of density of the braintissue or the quantity of what is being released or ..., which is causing apparently "huge" differences, but in fact they seem to be "minor"(I am not talking about the impact on an individual itself suffering from it, only about an eventually location in the brain, quantity of released substancy, ...) differences watching the whole picture of Autism, but some traits are much more apparant than other traits and that people are somehow not able to connect it, as separately this traits can exist on themselves without any diagnosis of Autism or Aspergers.
So how can you make a trait an almost "main autistic" trait, when it does exist without autism as well and ignore other traits which are not less insignificant? (not "openly", but to the individual suffering from it, like sensory issues for example).
[edit: And sorry if I don' t explain very well, but there is often "something" in my mind, where I am not really able to find words for, because I think in pictures and colours mainly and try to "explain" it somehow. Words are not my biggest quality].

Last edited by Eloa on 14 Apr 2012, 7:26 pm, edited 2 times in total.

Thank you for your post.
Do you mean with new environmental factors for example environmental toxines which are leading to a higher rate of individuals being diagnosed with autism or any other clinical psychological condition?
According to enviromental toxines I learned recently that it effects also all sorts of degenerative diseases like cancer etc.
But I am not sure if it is that, what you are according to, but maybe an interesting topic for researchers to find out about the increasing number of people having an ASD.
In fact, about cancer and enviromental toxines I did not only read about it, I studied it (autodidactic) for quite a time.

It's more the fact that it costs a lot to get tested. By the time I can save the money up the changes will be in and instead of it being aspergers it will be mild autism.

I can live with ADD, Dysleixa and the anxiety issues. But but to have aspergers thrown all the way into autism and instead be place under mild autism. At that point I just don't really care to be tested nor would I ever want to be tested. I guess I kind of issue they would not see aspergers as part of the autism spectrum. I'm not one to see people with autism as bad people and would not want to be around them.

I just don't want to be said I'm like some one with really really bad autism by saying I have mild autism instead of aspergers.

Last edited by Cryforthemoon on 15 Apr 2012, 12:09 am, edited 1 time in total.

When I was going to school as a kid I typically did not have friends...I was usually the outcast who everyone picked on, consistently even though I switched schools a lot since my parents moved houses every year just about. Until highschool where i spent 10th-12th grade at the same school.

I just have to point out I don't really see Autism Speaks as a valid source of information, it seems they are contributing to all the fears people have about the changes to the DSM, trying to scare people into thinking 'OMG I'm going to lose my diagnoses and be considered neurotypical under these changes.' I still have seen nothing to really suggest that's what will happen....from what I've seen of this new criteria I think most people with AS would still fit.

Well the thing is mental disorders aren't all that clear cut, from my understanding the spectrum idea works just fine, as it acknowledges the same disorders can present differently at different levels of severity. trying to make rigid guidelines for disorders that are likely to leave people who do struggle with symptoms out on the basis of them not perfectly fitting into a specific little category. So I guess I don't understand the problem with it.

Some research even indicates sometimes different factors can create the same symptoms....so there might be more than one way the brain becomes autistic during fetal development or whatever, to leave people out on the basis of not having a specific physical brain feature that can be seen........hell in general everyone's brain is different so as of now we don't even have the technology to determine what exact things are abnormal in someones brain as there is no specific standard to go by due to the variations.

Autism's causes may be epigenetic, triggered by environmental factors (as in, what things are like in the womb).

What I was talking about was requiring certain traits to not be present in AS does not mean that they are required for a diagnosis of autism, and in addition, some of those traits are not typically absent in people diagnosed with AS.



You mean, why is speech delay so central in perceptions of autism when it appears outside of autism? That's a good question.



It's fine. I am not sure I understand what you are saying, but it's not necessarily because of how you write.