DSM-V: Proposed Severity Scale for Autism Spectrum Disorder

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http://www.dsm5.org/ProposedRevisions/P ... px?rid=94#

So, I see they have updated this section of the new criteria. I have to say, it's a step in the right direction.

I don't have the second criteria in the social commutation section, or at least, I don't think I have it. I don't have trouble with facial expressions except I can't seem to figure what boredom looks like. Other than that, I am fine.

"A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

"1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of
interests, emotions, and affect and response to total lack of initiation of social interaction, . . . "

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I'd rather just say I have patchy social skills.

The very formality of the language. To me, it gets in the way. It's kind of this pseudo-professionalism, and this push to be oh-so precise, maybe more precise than the facts on the ground warrant.


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I have patchy social skills, good social skills in some areas. And I think the very patchiness of my social skills can put people off. They think, 'gee, if you can do this, how can you not . . . ' I am open to developing a solid B game, where I don't need to be high energy all the time.

(Note: I am sometimes more comfortable about talking about something that happened several months or even several years ago. Talking about something right now sometimes makes me too vulnerable.)

One of the biggest problems for me with social skills and that my social skills are better when talking to adult than peers.

I would like to see the more in-depth material they're using for things like clinical trials to test the criteria. The DSM offers a summary while expanded information provides a more thorough grounding.

The severity scale talks about level of impairment with and without "supports" in place.
What are the supports they are referencing?

I think it is a major improvement but the severity requirements are overly vague. I was hoping for something more concrete. Also 3 levels seems like not much for your severely autistic intellectually disabled all the way to an above average IQ mild AS person. I like the improvements to the actual ASD criteria. Previously I'm not sure I would qualify but with these changes I fit 3/3 for A and and 3/4 for B. I think this new update isn't as skewed towards one end of the spectrum or another, but at the same time I like the tightening of criteria, it helps to cut down on the false positives (which I think are abundant in AS, ADHD, and some other diaggnoses).

Granted I prefer having seperate disorders instead of the spectrum, but I am pretty pleased. I think the ASDs could do with less floppy criteria that everyone and their mother could be seen as having. I also like that they gave examples which is something earlier versions were missing.

I think people should consider you are diagnosed ideally as, or as if you were a young child. For example my psychologist when questioning my mom told her to remeember me as a 3-4 year old child (in addition to other diagnostic tests), not what skills I've gained later in life. Only the more severe cases would remain stagnant (for example an 18 year old I worked with acts identical to the way she did at 3 when shs was offically diagnosed despite intensive therapies).

I don't see any update to the severity criteria. AFAIK they've said roughly the same thing for a long time, and I don't think it's useful what they say. (FWIW I'd score somewhere in between 2 and 3 on most of them I think.)

A severity scale is a good idea, but the criteria formulation bothers me. To be honest, it bothered me in DSM-IV too.
True, disease criteria must be concise, but these sound like barebones to me. And this is autism spectrum disorder where no patient is exactly like the other.

In the first section it says you need at least three of the following: (insert here) But it only gives 3 categories for the first section. Would you need 1 in each or could you have 2-3 in one and none in 1 or the others?

The version I see states the following:

You're not looking at the severity scale then. You have to click on the "severity scale" link or something like that across the top of the page. A lot of you are looking at the diagnostic criteria, which aren't what the OP was talking about at all.

The severity scales remain vague and seemingly focused on how much assistance an autistic person needs to not appear autistic. This is why I would love to see the material they're using for the clinical trials, which virtually has to be more detailed and useful.