DSM5 ASD "Essentially Everyone Gets In"
16 Dec 2012, 8:04 pm
Loborojo wrote:
why do I expect that one will give me an explanation?
www.google.com
You're welcome.
_________________
"If we fail to anticipate the unforeseen or expect the unexpected in a universe of infinite possibilities, we may find ourselves at the mercy of anyone or anything that cannot be programmed, categorized or easily referenced."
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16 Dec 2012, 8:10 pm
Loborojo wrote:
why do I expect that one will give me an explanation?
This
Quote:
Why wasy assume that everyone understands these acronyms...what is DM...whatever
is formulated very unclearly.
From the context of this thread it is likely that you mean the DSM.
It is the "The Diagnostic and Statistical Manual of Mental Disorders".
It is not unlikely that autistic people find a special interest (SI) in autism and that is a reason why it is assumed that people understand these acronyms, at least among those who find a special interest in it or in parts of it like the changes in the DSM (from IV to V, May 2013).
There is a big change about to happen in diagnosis of autism and me being autistic I do need clarity as the world itself is quite unpredictable for me per se, so I also belong to those who really want to know how these changes in the coming DSMV will affect the diagnosis of autism.
_________________
English is not my native language, so I will very likely do mistakes in writing or understanding. My edits are due to corrections of mistakes, which I sometimes recognize just after submitting a text.
16 Dec 2012, 9:49 pm
Loborojo wrote:
Why wasy assume that everyone understands these acronyms...what is DM...whatever?
I apologize for that, I went back and edited my comment in what I hope will provide more detailed information for you. If you have any other questions I don't mind answering them if I can and providing references that I have accumulated over a period of time, to support my answers.
16 Dec 2012, 10:53 pm
Thanks a lot for explaining to me...I haven't been around for 4 years on here, and alos did not much look up autism on the net..so, don't assume that everyone knows those acronyms...it is the same with the trubo language in chat i grappled with...I still read some I don't understand. It is n ot my lingo.
_________________
Your Aspie score: 152 of 200
Your neurotypical (non-autistic) score: 48 of 200
You are very likely an Aspie
17 Dec 2012, 1:02 am
XFilesGeek wrote:
aghogday wrote:
But even with those potentials of misdiagnosis and the overlap of the criterion, those developmental delays in social interaction or abnormal functioning in social interaction, language development and imaginative allowed before the age of 3 for a diagnosis of Asperger's syndrome and autistic disorder, are not issues that adults going in for a diagnosis have any record of.
Quote:
(II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
(A) social interaction
(B) language as used in social communication
(C) symbolic or imaginative play
(A) social interaction
(B) language as used in social communication
(C) symbolic or imaginative play
https://sites.google.com/site/gavinboll ... for-autism
https://sites.google.com/site/gavinboll ... -aspergers
From the Asperger's Disorder DSM-IV-TR Diagnostic Features text:
Quote:
"Lack of social or emotional reciprocity may be present (e.g.,not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids)(Criterion A4). Although the social deficit in Asperger's Disorder is severe and is defined in the same way as in Autistic Disorder, the lack of social reciprocity is more typically manifest by an eccentric and one-sided social approach to others (e.g.,pursuing a conversational topic regardless of other' reactions) rather than social and emotional indifference."
From the Autistic Disorder DSM-IV-TR Diagnostic Features text:
Quote:
"Lack of social or emotional reciprocity may be present (e.g.,not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids)(Criterion A1d) Often an individual's awareness of others is markedly impaired. Individuals with this disorder may be oblivious to other children (including siblings), may have no concept of the needs of others, or may not notice another person's distress."
This is where I get confused.
My social problems sound more like what is described for "autism," and yet I'm DXed with Aspergers.
Do the sub-types of Aspergers described by Lorna Wing factor into this?
I went back and edited my previous comment, for what I hope might provide greater detail and clarity.
My understanding is that Lorna Wing was not satisfied with the DSMIV classification or the ICD10 (The international classification of Diseases version 10 more often used in 66 countries in the world than the DSMIV-TR) classification of Asperger's syndrome because it doesn't require enough of or what it described as similar symptoms for what she termed as Asperger's Syndrome, and Hans Asperger's described as "Autistic Psychopathy". My understanding is she is more in agreement with the Gillberg criteria which is commonly acknowledged to better represent what Hans Asperger's described.
The ICD10 description of Asperger's Syndrome is more similar to the DSMIV-TR description of Asperger's syndrome than the Gillberg Criteria for Asperger's syndrome.
In the abstract linked and quoted below from a study authored by both Gillberg and Lorna Wing, in the UK, in 2000, in a comparison of the ICD10 description of Autism Disorder, Atypical Autism, and Asperger's Syndrome as compared to the Gillberg Criteria for Asperger's syndrome, only 1 percent of those diagnosed with the ICD10 description of Autism disorder and Atypical Autism met the requirements for a diagnosis of Asperger's Syndrome in the ICD10. However 45% of the same individuals met the diagnosis of Asperger's Syndrome in the Gillberg Criteria.
The difference here, in this study than the one I linked earlier that might have supported Lord's statement in the New York Magazine that about over half of the people using Asperger's would not be diagnosable under the DSMIV-TR, because in that study over half of those diagnosed with asperger's syndrome met the requirements for autistic disorder, is that two hundred children and adults were directly assessed in the abstract quoted below, as opposed to the clinical records of children only in the study published in 2008, I linked in the previous post, using patient's records from the year 2000, in New South Wales, Australia.
http://aut.sagepub.com/content/4/1/11.abstract
Quote:
In this study, algorithms designed for the Diagnostic Interview for Social and Communication Disorders (DISCO) were used to compare the ICD-10 criteria for Asperger syndrome with those suggested by Gillberg. Two hundred children and adults were studied, all of whom met the ICD-10 criteria for childhood autism or atypical autism. Only three (1 percent) met criteria for ICD-10 Asperger syndrome. In contrast, 91 (45 percent) met criteria for Asperger syndrome defined by Gillberg, which more closely resemble Asperger’s own descriptions. Results showed that the discrepancy in diagnosis was due to the ICD-10 requirement for ‘normal’ development of cognitive skills, language, curiosity and self-help skills. When comparisons were based on Gillberg’s criteria only, results showed the participants diagnosed as having Asperger syndrome differed significantly from the rest on all but two of Gillberg’s criteria. However, all of these criteria could be found in some of those not diagnosed as having Asperger syndrome. The results emphasize the differences between the two diagnostic systems. They also question the value of defining a separate subgroup and suggest that a dimensional view of the autistic spectrum is more appropriate than a categorical approach.
And in this most recent study in the UK, published in 2012, linked and quoted below, provides a review of past and current research on the diagnosis of Asperger's syndrome in children (since there is little to no research that has been done on adults specific to diagnosis in the DSM-IV).
The results were in opposition to the study I linked in the previous post that suggested over half the individuals diagnosed with DSM-IV Asperger's would meet the more "severe" identified symptoms in the DSM-IV version of Autistic Disorder.
This study, quoted below, identifies the concerns of Gillberg and Wing, that the DSMIV criteria for Asperger's was not restrictive enough, missing clinical features described by Hans Asperger's in his paper "Autistic Psychopathy", suggesting there is a potential bias towards the diagnosis of the "high-functioning" end of the spectrum.
This a much different analysis than what the DSM5 committee used to justify the change, per that much earlier study, and the committee's claim that most people diagnosed under the Asperger's diagnosis would meet a diagnosis for Autistic Spectrum disorder, under DSMIV-TR standards. Neither of these studies quoted here in this post come close to supporting that hypothesis.
After reading descriptions of Asperger's and Wing's case studies, as well as Kanner's case studies, in view of the Gillberg criteria quoted below as opposed to the current Diagnostic criteria for both DSMIV-TR Autistic Disorder and Asperger's Disorder, it seems to me that the DSMIV, in 1994, failed in requiring enough mandatory criterion in the social interaction section for both disorders in the criteria set, and failed miserably in providing a warranted criterion category of communication for speech and language impairments in Asperger's syndrome. None of the impairments in speech and language so often mentioned as clinical features of Asperger's in various reference points specified in the Gillberg Criteria below are even currently mentioned as associated features in in the DSMIV-TR.
They have repaired some of that concern of Wing and Gillberg with the new more restrictive requirements for the combined social-communication section in the last published revision of the DSM5 criteria set for ASD, but there is hardly any emphasis on communication per speech and language impairments in the new criteria set, except under the new RRB Restrictive Repetitive Behavior criteria section describing idiosyncratic phrases and echoalia in a new criterion described as Stereotypical and repetitive speech. And in addition, describing a lack of initiating social interaction in the new Deficits in Social-Emotional Reciprocity criterion under the new Social-Communication criteria section as opposed to the phrase initiating conversation that was used in the current DSMIV-TR Autistic Disorder communication criteria section.
The DSM5 improves on all other diagnostic standards in adding in a new criterion of hypo/hyper sensitivity to input from the environment that was described in detail by Han's Aspergers in his case studies. They don't mention motor clumsiness in the criteria set, but it is mentioned in the current associated features section, and will likely continue to be mentioned there.
The mandatory requirement for that criterion identified in the Gillberg Criteria, if similarly used in the DSM5 would likely exclude a significant portion of individuals currently diagnosed, if re-diagnosed, and potentially exclude a substantial portion of those might be diagnosed in the future.
Motor Clumsiness is a pretty stiff mandatory requirement in the Gillberg Criteria, that many do meet, but others would potentially not meet considering reports by some of outstanding team sports achievements. Neuroplasticity is not just considered a cognitive adaptation specific to mental functions to challenges in the environment. It has also been identified with motor functions, so the potential to adapt in that area from childhood from a developmental deficit perspective in childhood seems to be a reasonable potential.
http://aut.sagepub.com/content/16/5/465.abstract
Abstract
Quote:
This paper presents a review of past and current research on the diagnosis of Asperger syndrome (AS) in children. It is suggested that the widely used criteria for diagnosing AS in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV are insufficient and invalid for a reliable diagnosis of AS. In addition, when these diagnostic criteria are applied, there is the potential bias of receiving a diagnosis towards the high-functioning end of the autism spectrum. Through a critical review of 69 research studies carried out between 1981 and 2010, this paper shows that six possible criteria for diagnosing AS (specifically, the age at which signs and symptoms related to autism become apparent, language and social communication abilities, intellectual abilities, motor or movement skills, repetitive patterns of behaviour and the nature of social interaction) overlap with the criteria for diagnosing autism. However, there is a possibility that some finer differences exist in the nature of social interaction, motor skills and speech patterns between groups with a diagnosis of AS and autism. These findings are proposed to be of relevance for designing intervention studies aimed at the treatment of specific symptoms in people with an autism spectrum disorder.
http://www.bbbautism.com/asp_gillberg.htm
Quote:
GILLBERG'S CRITERIA FOR ASPERGER'S DISORDER
1.Severe impairment in reciprocal social interaction (at least two of the following)
(a) inability to interact with peers
(b) lack of desire to interact with peers
(c) lack of appreciation of social cues
(d) socially and emotionally inappropriate behavior
2.All-absorbing narrow interest (at least one of the following)
(a) exclusion of other activities
(b) repetitive adherence
(c) more rote than meaning
3.Imposition of routines and interests (at least one of the following)
(a) on self, in aspects of life
(b) on others
4.Speech and language problems (at least three of the following)
(a) delayed development
(b) superficially perfect expressive language
(c) formal, pedantic language
(d) odd prosody, peculiar voice characteristics
(e) impairment of comprehension including misinterpretations of literal/implied meanings
5.Non-verbal communication problems (at least one of the following)
(a) limited use of gestures
(b) clumsy/gauche body language
(c) limited facial expression
(d) inappropriate expression
(e) peculiar, stiff gaze
6.Motor clumsiness: poor performance on neurodevelopmental examination
(All six criteria must be met for confirmation of diagnosis.)
1.Severe impairment in reciprocal social interaction (at least two of the following)
(a) inability to interact with peers
(b) lack of desire to interact with peers
(c) lack of appreciation of social cues
(d) socially and emotionally inappropriate behavior
2.All-absorbing narrow interest (at least one of the following)
(a) exclusion of other activities
(b) repetitive adherence
(c) more rote than meaning
3.Imposition of routines and interests (at least one of the following)
(a) on self, in aspects of life
(b) on others
4.Speech and language problems (at least three of the following)
(a) delayed development
(b) superficially perfect expressive language
(c) formal, pedantic language
(d) odd prosody, peculiar voice characteristics
(e) impairment of comprehension including misinterpretations of literal/implied meanings
5.Non-verbal communication problems (at least one of the following)
(a) limited use of gestures
(b) clumsy/gauche body language
(c) limited facial expression
(d) inappropriate expression
(e) peculiar, stiff gaze
6.Motor clumsiness: poor performance on neurodevelopmental examination
(All six criteria must be met for confirmation of diagnosis.)
17 Dec 2012, 1:12 am
answeraspergers wrote:
This criteria basically means I would never have been diagnosed as AS.
So basically 8 years ago I was told I have something that they dont know what it is and now it no longer exists. lol Clowns.
So basically 8 years ago I was told I have something that they dont know what it is and now it no longer exists. lol Clowns.
Regardless of the history of the difficulties in defining and describing Autism Spectrum Disorders, if you currently have a diagnosis unless there is a clinical reason to re-assess it, there seems to be a good potential that the diagnosis will stay intact, and be coded with insurance, hospitals, and clinics, under the new ASD code. While this topic article presents bits and pieces of what was quoted by Catherine Lord, I think more details will follow in the public media soon, if they haven't already and I'm just not aware of it. I think some of the new people looking for a diagnosis in the US, some point after May 13th, when the new criteria is published, might have a larger warranted concern ahead, particularly adults.
17 Dec 2012, 1:33 am
Loborojo wrote:
Thanks a lot for explaining to me...I haven't been around for 4 years on here, and alos did not much look up autism on the net..so, don't assume that everyone knows those acronyms...it is the same with the trubo language in chat i grappled with...I still read some I don't understand. It is n ot my lingo.
No problem, I see you are from Peru and am not sure whether or not this DSM standard is used widely in your country or the ICD10 standard.
If the ICD10 is used, here is a link that describes all the criteria sets for Autism Spectrum Disorders; the criteria used is very similar to the DSMIV-TR criteria sets for Autism Spectrum disorders.
http://www.pervasivedevelopmentaldisord ... icd-10.htm
17 Dec 2012, 2:28 am
XFilesGeek wrote:
Do the sub-types of Aspergers described by Lorna Wing factor into this?
The social and emotional indifference the DSM-IV-TR describes comes under the most common subtype, "aloof". They're one and the same. These people usually have LFA, though some with HFA can manifest this aloof behavior even into adulthood. This is generally seen as, "ignores people", even if functional speech exists for demands and asking for things.
Whilst is proclaims that most with AS tend to present with the usual "active but odd" behavior (that's the one-sided, verbose and lecturing approach to social situations), people with AS can be socially withdrawn, and/or only prefer to talk to a select few people (they may just be "active and odd" to them, or perhaps "passive", which means they tend to reply rather than initiate).
The main point overall with all of these social descriptors is just pointing out the various ways a lack of social speech manifests along disorders that share various symptoms, even if they manifest differently. Enter, ASD. There's some clear cut groups where people display the same symptoms (prototypical AS and Kanner's for example), but there's an equal number that don't (which come under PDD-NOS).
18 Dec 2012, 4:39 am
The paper below by the author of the Gillberg criteria, is not recent; but it is interesting as a substantial part of his narrative seem to reflect the DSM5 changes and support the idea that "High functioning Autism" is essentially the same as "Asperger's Syndrome", but he seems to suggest that the DSMIV definition of Asperger's syndrome was too restrictive in some ways and not restrictive enough in other ways.
He describes a language delay in Asperger's that matches the description of Hyperlexia, and delays in expressive language development, which is much different than the language delays and developmental issues in language described in some others with Autistic Disorder. I can see where a significant number of individuals with hyperlexia might have been diagnosed with Autistic disorder or even more likely PDD NOS who should have been diagnosed with Asperger's syndrome in early childhood, but I guess that will be a moot point soon, at least in the US.
I wonder how many people have been placed in the PDD NOS category because of this issue of hyperlexia. My diagnosing professional took me out of the Asperger's label and put me into the PDD NOS diagnosis label in my adult diagnosis, when he became aware of my language delay in childhood. Not likely that would have happened if I had been diagnosed under Gillberg criteria. I thought Gilberg's description below of the child that didn't speak because he didn't feel the need to interesting, but that doesn't match the description of some others that experience language delays.
I think he makes some good points, but one of his comments about females diagnosed with Asperger's Sydrome seem a little harsh as it almost seems like he is suggesting that a kind of "oppositional defiance" is a characteristic more specific to females diagnosed with Asperger's. I suppose someone might want to weigh in on that observation of his.
http://www.tonyattwood.com.au/pdfs/shared_deficits.pdf
Quote:
Asperger’s Syndrome and High Functioning Autism: Shared Deficits or Different Disorders?
Gillberg, C, M.D., Ph.D., The Journal of Developmental and Learning Disorders;5:79-94.
The terms are more likely synonyms than labels for different disorders. I should perhaps add that it was not Asperger who first described the syndrome that now bears his name. A Russian neurologist, Eva Ssucharewa, published a paper in the mid 1920’s in which she described “schizoid personality disorder”in children. Reading Sula Wolff’s translation of that paper it becomes clear that Ssucharewa described the core deficits and major hallmarks of autism long before Asperger or Kanner (Ssucharewa 1926, Wolff 1995).
The ICD-10 (WHO 1992) and DSM-IV (APA 1994) criteria for the syndrome are virtually identical to each other. They are problematic in that they specifically exclude cases with signs of early language, developmental or social delays. Virtually nobody with an autism spectrum disorder fits these criteria. Asperger’s own cases do not meet criteria for DSM-IV Asperger’s disorder.
In clinical practice, the DSM-IV criteria for Asperger’s disorder are not helpful. I have yet met a patient with the clinical presentation that Asperger described who was completely normal in his development early on. Another problem is that the actual symptom threshold for qualifying for a diagnosis is very low; only two social and one behavioural symptom are required to reach diagnostic status. The ICD-10 has the additional problem that there is no specification that symptoms have to be handicapping in daily life. There are no universally agreed criteria for high-functioning autism.
There is always marked social impairment in Asperger’s Syndrome, usually showing an extreme egocentricity. There is mostly a much decreased ability to interact with peers, often coupled with a lack of desire to interact with peers, a lack of appreciation of social cues, and socially and emotionally inappropriate behaviours.
Several years may pass before family, peers, relatives and teachers understand that something is seriously amiss, and it may only be with hindsight that they realise that there was never a period of normal development. The narrow interest pattern, was something that Asperger himself put a lot of emphasis on. He felt that this interest should lead to the exclusion of other activities, or be very repetitive, or be more relying on memory than underlying meaning. Even though the narrow interest pattern is highly characteristic of the most typical cases of males with Asperger’s Syndrome, there are those, and particularly those females, who otherwise fit the criteria for the disorder, who do not demonstrate this feature. Some girls (and a very few boys) with the other core features of the condition have a strong tendency to avoid demands and to always say “no”. It is as though their main interest in life is to say no, negative things, and to go around “being bored”. They themselves cannot seem to find anything to interest them.
It is common for a child with Asperger’s Syndrome to have “delayed”expressive language development; they do not speak at an early age, even though you had the feeling that they would have been able to if they wanted to/felt the need to. I certainly see a number of kids who say nothing for two-three years and then suddenly start speaking because they “have something to say”. Some of them actually say: “Why should I speak before I have something important to say?” There are also children who, are able to read before they start speaking. They have superficially expressive perfect language and they are very often formal and pedantic in their style and they have, most of them, this very odd prosody.
Gillberg, C, M.D., Ph.D., The Journal of Developmental and Learning Disorders;5:79-94.
The terms are more likely synonyms than labels for different disorders. I should perhaps add that it was not Asperger who first described the syndrome that now bears his name. A Russian neurologist, Eva Ssucharewa, published a paper in the mid 1920’s in which she described “schizoid personality disorder”in children. Reading Sula Wolff’s translation of that paper it becomes clear that Ssucharewa described the core deficits and major hallmarks of autism long before Asperger or Kanner (Ssucharewa 1926, Wolff 1995).
The ICD-10 (WHO 1992) and DSM-IV (APA 1994) criteria for the syndrome are virtually identical to each other. They are problematic in that they specifically exclude cases with signs of early language, developmental or social delays. Virtually nobody with an autism spectrum disorder fits these criteria. Asperger’s own cases do not meet criteria for DSM-IV Asperger’s disorder.
In clinical practice, the DSM-IV criteria for Asperger’s disorder are not helpful. I have yet met a patient with the clinical presentation that Asperger described who was completely normal in his development early on. Another problem is that the actual symptom threshold for qualifying for a diagnosis is very low; only two social and one behavioural symptom are required to reach diagnostic status. The ICD-10 has the additional problem that there is no specification that symptoms have to be handicapping in daily life. There are no universally agreed criteria for high-functioning autism.
There is always marked social impairment in Asperger’s Syndrome, usually showing an extreme egocentricity. There is mostly a much decreased ability to interact with peers, often coupled with a lack of desire to interact with peers, a lack of appreciation of social cues, and socially and emotionally inappropriate behaviours.
Several years may pass before family, peers, relatives and teachers understand that something is seriously amiss, and it may only be with hindsight that they realise that there was never a period of normal development. The narrow interest pattern, was something that Asperger himself put a lot of emphasis on. He felt that this interest should lead to the exclusion of other activities, or be very repetitive, or be more relying on memory than underlying meaning. Even though the narrow interest pattern is highly characteristic of the most typical cases of males with Asperger’s Syndrome, there are those, and particularly those females, who otherwise fit the criteria for the disorder, who do not demonstrate this feature. Some girls (and a very few boys) with the other core features of the condition have a strong tendency to avoid demands and to always say “no”. It is as though their main interest in life is to say no, negative things, and to go around “being bored”. They themselves cannot seem to find anything to interest them.
It is common for a child with Asperger’s Syndrome to have “delayed”expressive language development; they do not speak at an early age, even though you had the feeling that they would have been able to if they wanted to/felt the need to. I certainly see a number of kids who say nothing for two-three years and then suddenly start speaking because they “have something to say”. Some of them actually say: “Why should I speak before I have something important to say?” There are also children who, are able to read before they start speaking. They have superficially expressive perfect language and they are very often formal and pedantic in their style and they have, most of them, this very odd prosody.
18 Dec 2012, 4:46 am
aghogday wrote:
I certainly see a number of kids who say nothing for two-three years and then suddenly start speaking because they “have something to say”.
My mother saw me like that.
I found this the other day, which is an article by Wing, Gillberg and Gould on the DSM-5; haven't really read it, but it's their critique of such, so I'm sure it's relevant:
ASDs in DSM-5
(I like how it talks of people with an ASD lacking empathy but containing sympathy, whereas it's the opposite for those with psychopathy. Just a tidbit I like. O, and I like how it points to the original set lacking sensory symptoms; which was changed later on.)
18 Dec 2012, 6:39 pm
Dillogic wrote:
aghogday wrote:
I certainly see a number of kids who say nothing for two-three years and then suddenly start speaking because they “have something to say”.
My mother saw me like that.
I found this the other day, which is an article by Wing, Gillberg and Gould on the DSM-5; haven't really read it, but it's their critique of such, so I'm sure it's relevant:
ASDs in DSM-5
(I like how it talks of people with an ASD lacking empathy but containing sympathy, whereas it's the opposite for those with psychopathy. Just a tidbit I like. O, and I like how it points to the original set lacking sensory symptoms; which was changed later on.)
Thanks for that link. I think people, at times, use the words empathy and sympathy interchangeably. Some people equate sympathy only with feeling sorry for someone rather than the recognition of another person's distress, concern for that distress, and reaction to that distress. Some people are very good at determining the emotions of others through the ability of cognitive empathy, may or may not be able to or want to share their feelings, but have no concern (sympathy) for the other person's distress.
Compassion for others goes one step further in the passion to alleviate another person's suffering. That can be as simple as taking up for someone who is being verbally bullied.
So a person does not have to necessarily share the feelings of another person to sympathize or have compassion for them. But they do have to recognize their distress.
http://en.wikipedia.org/wiki/Sympathy
Quote:
Empathy refers to the understanding and sharing of a specific emotional state with another person. Sympathy does not require the sharing of the same emotional state. Instead, sympathy is a concern for the well-being of another. Although sympathy may begin with empathizing with the same emotion another person is feeling, sympathy can be extended to other emotional states.
http://en.wikipedia.org/wiki/Compassion
Quote:
More virtuous than simple empathy, compassion commonly gives rise to an active desire to alleviate another's suffering. It is often, though not inevitably, the key component in what manifests in the social context as altruism. In ethical terms, the various expressions down the ages of the so-called Golden Rule embody by implication the principle of compassion: Do to others what you would have them do to you.[1]
Quotes from Gillberg and Wing's paper, from the link you provided below
Quote:
The absence or impairment of the social instinct must be differentiated from the abnormalities of social behaviour found in anti-social psychopathy. As pointed out by one of us (Gillberg, 1992) the anti-social psychopath usually has a full understanding of what goes on in his/ her own and other people’s minds. However, he/she uses this knowledge to manipulate other people to achieve his/her own ends. He/she has empathy but no sympathy.
A person with an autism spectrum condition lacks empathy but may have sympathy in situations where they can perceive another’s distress. When they do understand, they respond. Some of those of higher ability are very sad to read of the hardships of children in, for example, Africa, but are unable to understand the signs of emotional upset in their parents or siblings – which may be in response to the behaviour of the person with an autism spectrum condition. However, Rogers, Viding, Blair, Frith, and Happe´ (2006) found a small number of boys with ASD, also had psychopathic tendencies. The authors considered that this was a ‘double hit’ – the psychopathic behaviour was an additional problem, and was not due to the autism spectrum disorder. Boys and girls with pathological demand avoidance (Newson, Le Marechal, & David, 2003) may also have such a ‘double hit’.
A person with an autism spectrum condition lacks empathy but may have sympathy in situations where they can perceive another’s distress. When they do understand, they respond. Some of those of higher ability are very sad to read of the hardships of children in, for example, Africa, but are unable to understand the signs of emotional upset in their parents or siblings – which may be in response to the behaviour of the person with an autism spectrum condition. However, Rogers, Viding, Blair, Frith, and Happe´ (2006) found a small number of boys with ASD, also had psychopathic tendencies. The authors considered that this was a ‘double hit’ – the psychopathic behaviour was an additional problem, and was not due to the autism spectrum disorder. Boys and girls with pathological demand avoidance (Newson, Le Marechal, & David, 2003) may also have such a ‘double hit’.
And Perhaps the DSM took an action like what was suggested below, and Catherine Lord may have been referring to something like this in the final revision, associated with diagnostic history, and essentially everyone getting in.
Quote:
6. Removal of subgroups
This is an important and controversial aspect of the draft DSM-V (Ghaziuddin, 2010).
We, in our many years of clinical diagnostic work, have observed how extremely difficult, even impossible, it is to define boundaries of different sub-groups among children and adults with autism spectrum conditions (that is those who have an absence or impairment of the social instinct). While there is a very great difference in the clinical picture of one child with classic Kanner syndrome and learning disability compared with another with very high ability in their area of special interest who fits the criteria for Asperger’s syndrome, there are large numbers of individuals who have a mixture of features of both conditions. Furthermore, changes occur over the years and a child who was appropriately diagnosed with Kanner’s autism can grow into an adolescent who fits Asperger’s descriptions. Other sub-groups have been suggested in addition to those in the DSM-IV (and ICD-10). The same problem of defining the boundaries exists for all of these. Likewise there is difficulty in defining the boundaries between autism and the enormous range of ‘‘typical’’ development especially in individuals who have very high skills in specific areas.
It was observing these clinical facts that made us suggest that the concept of a spectrum of autism fitted the facts better than any of the suggested sub-groups (Gillberg, 1990; Wing, 1998; Wing & Gould, 1979). In fact, the evidence now indicatesthat we are dealing with several different ‘‘autism spectra’’, and the most appropriate term for the whole group of disorders discussed here might be ‘‘the autisms’’ (Coleman & Gillberg, in press).
Our view on this has not changed, but we do recognise the problems that arise if the sub-group labels are no longer used. Many people with the diagnosis of Asperger’s syndrome object very strongly to the possible loss of their label, which they much prefer to that of autism spectrum disorder or just ‘‘autism’’. They also worry that their current diagnosis of Asperger syndrome will make them ineligible for medical or social services if DSM-V comes into use in the future.
The sensible solution would be to retain in the DSM-V a list of sub-group names that have been used, any of which will place the recipient within the autism spectrum. No specific diagnostic criteria need be attached, though it would be helpful to have a brief description attached to Asperger’s disorder, and childhood disintegrative disorder.
For example: Asperger’s disorder refers to individuals who have impairment of social interaction, social communication and social imagination but who have an average or high IQ, a wide vocabulary and good grammar but who use speech in non-social ways, e.g. to talk only about their special interests. In some individuals, the picture in the early years was like that of autistic disorder, but changes occurred with increasing age. The diagnosis of Asperger’s syndrome must be made on the current picture and not on the past, because it is the current picture that determines the individual’s needs.
This is an important and controversial aspect of the draft DSM-V (Ghaziuddin, 2010).
We, in our many years of clinical diagnostic work, have observed how extremely difficult, even impossible, it is to define boundaries of different sub-groups among children and adults with autism spectrum conditions (that is those who have an absence or impairment of the social instinct). While there is a very great difference in the clinical picture of one child with classic Kanner syndrome and learning disability compared with another with very high ability in their area of special interest who fits the criteria for Asperger’s syndrome, there are large numbers of individuals who have a mixture of features of both conditions. Furthermore, changes occur over the years and a child who was appropriately diagnosed with Kanner’s autism can grow into an adolescent who fits Asperger’s descriptions. Other sub-groups have been suggested in addition to those in the DSM-IV (and ICD-10). The same problem of defining the boundaries exists for all of these. Likewise there is difficulty in defining the boundaries between autism and the enormous range of ‘‘typical’’ development especially in individuals who have very high skills in specific areas.
It was observing these clinical facts that made us suggest that the concept of a spectrum of autism fitted the facts better than any of the suggested sub-groups (Gillberg, 1990; Wing, 1998; Wing & Gould, 1979). In fact, the evidence now indicatesthat we are dealing with several different ‘‘autism spectra’’, and the most appropriate term for the whole group of disorders discussed here might be ‘‘the autisms’’ (Coleman & Gillberg, in press).
Our view on this has not changed, but we do recognise the problems that arise if the sub-group labels are no longer used. Many people with the diagnosis of Asperger’s syndrome object very strongly to the possible loss of their label, which they much prefer to that of autism spectrum disorder or just ‘‘autism’’. They also worry that their current diagnosis of Asperger syndrome will make them ineligible for medical or social services if DSM-V comes into use in the future.
The sensible solution would be to retain in the DSM-V a list of sub-group names that have been used, any of which will place the recipient within the autism spectrum. No specific diagnostic criteria need be attached, though it would be helpful to have a brief description attached to Asperger’s disorder, and childhood disintegrative disorder.
For example: Asperger’s disorder refers to individuals who have impairment of social interaction, social communication and social imagination but who have an average or high IQ, a wide vocabulary and good grammar but who use speech in non-social ways, e.g. to talk only about their special interests. In some individuals, the picture in the early years was like that of autistic disorder, but changes occurred with increasing age. The diagnosis of Asperger’s syndrome must be made on the current picture and not on the past, because it is the current picture that determines the individual’s needs.
HDLMatchette
Deinonychus
Joined: 15 Dec 2012
Age: 29
Gender: Male
Posts: 338
Location: Fuquay-Varina, North Carolina
