DSM 5 and the elimination of AS , and serverity levels ...

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LoveNotHate
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16 Jan 2014, 5:22 am

See the following severity levels for the DSM 5 criteria for ASD (and elimination of AS) ...

Level 3
"Requiring very substantial support”


Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches

Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.


Level 2
"Requiring substantial support”


Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and how has markedly odd nonverbal communication.

Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action.


Level 1
"Requiring support”


Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to- and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.

Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.

source, http://www.autismspeaks.org/what-autism ... c-criteria

Does this mean only autistic people who "require support" can be diagnosed as ASD under the DSM 5?

Are many "prior U.S. diagnosed AS people, yet able to function without direct support- like me" now on the "NT spectrum" because of this change ?

Thanks.



Dillogic
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16 Jan 2014, 6:11 am

Notice:

"Without supports"

Meaning, without support you'd most likely never be independent and able to make friends, but with such you perhaps could.

Which seems about right (for level 1 anyway).



yournamehere
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16 Jan 2014, 8:27 am

o.k. now just for the sake of arguement. who, what, where, when, why, and how are these supports, are they special, i do not know, never had them. is there such a thing as a person who does not require some kind of support? who made everyone believe that being a social marvel, and carrying on a conversation just for the sake of conversation is soo important. NT's talk too much about non relivant things. especially narcissists. i have not figured out why not being very social is such a bad thing. i have read about it. might make sence to someone else. not me. I have stuff to do. is the DSM-5 going to try to tell me that I have a social issue because I don't want to talk to my sister about the neighbors dog? because i don't want to go fishing with fred, and all this is a problem? social overtures? really? I'm soo sorry that I do not interpret "hows it going" or "how are you" the way I'm supposed to according to "normal" people, and act accordingly by saying someting that relates to a question that doesn't make any sence, and than ask the undefinable question back to them and say "how are you"? is this even a problem. really?? what are we talking about here. lets get down to brass tax. on a non neurotypical point of view, I would have to say that there is a disability in the neurotypical mind. it is a disability that promotes control. a disability that promotes abuse towards an "autistic" mind. mostly due to non conforming agents of control. a disability that does not promote the neurotypical mind to see the reality of something being "proper" beyond the scope of their own imagination (wich sometimes doesn't go very far). im sorry if I said something wrong, and please, forgive me for being me.



yournamehere
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16 Jan 2014, 9:32 am

I would also like to add the idea that this disability in the neurotypical mind comes from oversocializing. that's right. new word, now there finally is such a thing, and there should be, because it is true. it is like a neurotypical disease. a plague. infecting every neurotypical mind in the world with projection transferrence and control. games. and a viscous circle. caused by socializing, fairy tales, lies, misinterpretations, and control. once again, sorry for being me.



AardvarkGoodSwimmer
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16 Jan 2014, 12:05 pm

My biggest objection to DSM is that it gives short shift to sensory issues. And short shift to stimming, or views it as entirely negative.



AardvarkGoodSwimmer
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16 Jan 2014, 12:15 pm

Quote:
"Requiring very substantial support”

. . . For example, a person with few words of intelligible speech who rarely initiates interaction . . .


Wow, so if someone uses sign language, or who is better at typing on a laptop, this is not considered an equally valid form of communication ? ? ?

This thing is way too pro-'normalist.' It is pro-'normalist' to a fault.

===================

So, what we need to do is to frankly advocate for neurodiversity. It's okay to be normal, it's okay to be the most normal person on the face of the earth. It's also okay to be on the Asperger's-Autism Spectrum. And it's okay to be different in a different way! :jester:

We should be about the business of building people up and helping them achieve various worthwhile goals and activities in life. This instead of putting people into boxes.



Ravenclawgurl
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16 Jan 2014, 12:46 pm

AardvarkGoodSwimmer wrote:
My biggest objection to DSM is that it gives short shift to sensory issues. And short shift to stimming, or views it as entirely negative.


exactly accrding to those severity level i would vary at differnt times deppending on how im doing sensory wise that day i also think 3 are to little numbers eat if someome is between 1 and 2 or between 2 or 3 will they lable it 2.5? and in the socializing part it can also depend on who im socializing with.



Aspiewordsmith
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16 Jan 2014, 1:13 pm

What confusion about whether Asperger syndrome and autism is just a fallacy because what most people call autism is really Kanner syndrome and they both are autism. The removal of the terms Asperger syndrome in favour of autism spectrum condition or disorder in allistic supremacist language. This will not mean that Asperger syndrome is non existent it is just that it will be thought of as another form of autism which it is at the moment. This has been people have been using the term autism when they really mean Kanner syndrome (after Leo Kanner) which is an autism spectrum condition which is more likey to accompany learning disability and or have some degree of traits that are unique to it and no other form of autism such as substantially delayed cognitive development and speech. Asperger syndrome on the other hand has no such speech and cognitive delays. The DSM was developed using an allistic supremacist language that sees sensory regulation as a symptom of the condition rather than the solution to sensory processing disorders.

I don't think that people that are reasonably independent will be pushed off the autistic spectrum and onto the neurotypical spectrum to ultimately be 'diagnosed with allism' :arrow:



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16 Jan 2014, 1:21 pm

Dillogic wrote:
Notice:

"Without supports"

Meaning, without support you'd most likely never be independent and able to make friends, but with such you perhaps could.

Which seems about right (for level 1 anyway).


This.

I have friends, but I still live at home and probably will do until I graduate from college. I'm able to work full-time, though. To actually be able to make friends and blend in enough to be able to get work, I needed a lot support in my teens. I'm trained by professionals in basic social skills that NTs get instinctively, for instance. I've also had the good fortune to get necessary help from a psychologist and a psychiatrist with a lot of experience on Asperger's syndrome.

Something that has helped me tremendously, is that one of my special interests (the technology behind various computer related products as opposed to the products themselves) has a college degree and plenty of available jobs.



Kurgan
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16 Jan 2014, 1:26 pm

AardvarkGoodSwimmer wrote:
My biggest objection to DSM is that it gives short shift to sensory issues. And short shift to stimming, or views it as entirely negative.


Someone with mild autism (or something that isn't autism at all, such as ADD or Tourette's) can stim a lot, and someone who's completely mute and unable to focus on anything beyond his special interests may not stim at all. Sensory issues can manifest iteself in many ways, so it's difficult to tell just how severe these issues are. It's a myth that stimming means a lot of complex whole body movements or anything like that; usually, it's limited to excessive leg bouncing, pacing, rocking and so on.



yournamehere
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16 Jan 2014, 1:41 pm

having no friends, because I am not well liked by "normal" people is not a deficiency on my part. trying to be social, and having people pick on me for it, tell me im babbling, and than tell me I'm weird is not either. having me try to listen, and understand NT thinking, and aspects of the world, and assuming there is something wrong with me because i can't is a one sided view. i'm telling you, these people are sick.



Willard
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16 Jan 2014, 1:42 pm

Quote:
Level 1
"Requiring support”


Without supports in place, deficits in social communication cause noticeable impairments.


While they are insufferably vague about just what they mean by "support," I think this is the key phrase.: "deficits cause noticeable impairments."

I'm guessing "support" can mean anything from financial assistance from family to get by, to living in an Assisted Living group home. Or it could just mean moral support.:shrug:

Even though I managed to maintain a specific career for 30 years and live on my own, without the support provided by Unemployment Insurance and the occasional bailout from my parents, I couldn't have made it alone, I got fired too often, directly due to my social impairments. To the rest of the world, I was just a loser who couldn't keep a job - the same people who now think I'm not impaired enough to be classified as Disabled. :roll:



ASPartOfMe
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16 Jan 2014, 1:47 pm

Other criteria
C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

The OP asked about people previously diagnosed with Aspergers
"Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder."

Here is another source The Autism Society of North Carolina.
http://autismsocietyofnc.wordpress.com/ ... -disorder/

They report that as far as loss of services "early data are promising"

As noted sensory issues are mentioned under Restricted, Repetitive Behaviors
"Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment "



My opinion
It is language based a neuromajority/Ableist viewpoint. Any condition must be considered a "disorder" in order to be included in the manual.

I would rate myself Level 1 for social communication and social interaction and Level 2 for Restricted, Repetitive Behaviors


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DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


Last edited by ASPartOfMe on 16 Jan 2014, 2:19 pm, edited 3 times in total.

ASPartOfMe
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16 Jan 2014, 2:12 pm

Off Topic but related

Three levels idea is very old idea in psychology. In the late 19th century and early 20th century there were three basic levels of diagnosis for "illnesses or 'deficiencies' of the mind." It was tied to the popular eugenics movement of that (and hopefully not this) era.

The levels are presented Lowest to Highest
Idiocy
Imbecility
Feeble-mindedness

https://en.wikipedia.org/wiki/Feeble-minded


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DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


Ashariel
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16 Jan 2014, 2:54 pm

It's vague what they mean by 'supports'.

In my own case, the 'supports' would include:
• A plan for how to function with my specific weaknesses
• Help with job placement, since I don't interview well
• A job tailored to my abilities, not requiring skills I'm hopelessly bad at
• Boss and co-workers understanding that I have special needs
• Being allowed to dress comfortably, wear earplugs, and not have to socialize on the job
• Public transportation to and from my job
• Some kind of miracle cure for insomnia, so I'm actually semi-functional on a consistent basis
• Counseling to deal with the constant stresses and confusion of working with other people

I have no idea what 'level' of support that would translate to, but that's what I'd need in order to be able to function independently, and have a job (which I've never managed to do in the past.)



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16 Jan 2014, 4:53 pm

I have been reading about this stuff, and it is giving me some anxieties. something is not right about this. there is a problem with the world, and the way people think. we are not supposed to question it. it may be why this dsm-5 is written this way. there is a fool the fool mentality with this I think. it doesn't have to make sence, it just has to work (good luck). to be perfectly honest, I really don't want to tell the outside world that I took a test, and it shows I have a disability anyways. actually, with the exception of quite a few major bumps, and hurdles I had to overcome when I was younger, and the meltdown I had from my last job, and especially the job before that wich made me seek this place out, and the support i did not get from all the "normal" friends and family, because they do not understand. i have been doing pritty well. i just wish people could understand me, maybe not be soo social, stop telling me i need to smile more, stop making fun of the way i am, and call it constructive criticism. basically just shutup, let me do a job and say "it's o.k., it's just him... and hey, mr. sociopathic, narcissistic, mentally abusive, toxic, overlysocial, pranking trickster, gamer, lying guy!! ! leave him alone!! ! that means you too mr. manager, boss, owner guy!! !" once again, im sorry for being me. and thank you for your support. im going to do what I do best now... fix a car or two.