What the proposed revision of the DSM-5 actually says--link

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see

http://www.dsm5.org/proposedrevision/pa ... spx?rid=94

Not just the proposed new version, but rationale.

One of the biggest problems I see for some of us out there is they have to be ABC&D. And C is not something many of us have been showing to a doctor. How do they identify C, if it's not brought to the attention during that time? Many times this isn't even seen by parents, whether as a problem or whether they see it at all.

B words the problems at a more extreme level. This makes it hard for those that need the diagnosis as this seems to put some people with mild autistic traits out of the diagnosis. But D is what matters most. I think if they were to reword B and say that C is optional (since it may not have necessarily been brought to a doctor's attention), then it would fit those that have problems getting a job and incorporating themselves into the community. A diagnosis is necessary to take the steps to help people on the spectrum, but it looks like it's worded in a way that excludes those that still may need the help.

C and D were there in the DSM-IV-TR, and you needed to have them.

D was not there in DSM-IV. The language was dramatically changed from "significant impairment" and "qualitative impairment". for Asperger's and ASD respectively to "limit and impair" However the standard goes further and adds the term limit. For the new diagnose to be applied there would not only have to be impairment but there would also have to be a limit on the persons every day functioning.

For a rather detailed discussion of problems with both C and D look at the following thread
DSM-V Contradiction

"Clinically significant impairments" can easily contain "limit and impair everyday functioning", especially when you apply the fact that ASDs are lifelong disorders; a clinically significant impairment will always be there if the disorder is always there.

Hence, if you have an ASD, you'll be possibly impaired every second of the day compared to your peers without such. You might not feel it, but when you apply something that makes the symptoms manifest, enter impairment daily.

C doesn't mean that you have to be DIAGNOSED as a child, or that you even have formal medical documentation of having had those symptoms as a child. It just means that, at the very least, you (or somebody know knew you as a child) have to be able to convince the doctor that the symptoms began as a child, and didn't spontaneously appear during adulthood.

Worst-case, I suspect that most of us could just show the mean things our classmates wrote about us(*) in our middle school yearbooks to the doctor, and he'd sigh & say, "yeah, you WERE a pretty hardcore aspie back then, weren't you? Wow."

Insofar as section D goes, I noticed it says:
"Symptoms together limit and impair everyday functioning"
and not
"Symptoms together significantly limit and impair everyday functioning."
or
"ALL Symptoms limit and impair everyday functioning."

To me, this means that all you'll officially HAVE to demonstrate is at least one credible example of each required criterion, and for them to collectively impair your life to a degree that you find bothersome, even if no individual symptom is itself overwhelmingly debilitating.

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(*) Real examples: "You wouldn't be so annoying if you didn't talk about computers all the time", and "Do you own more than 3 shirts?"

Many of the big institutions require you to bring a parent along to the interview now (they always have). The small, singular clinicians usually don't require such. If you were to say you were always like this or that, they'd believe such if you were clearly showing the symptoms of an ASD as they're written.

They'd need to know if you were like that as a child as the differential diagnoses are there. If it came on as a late teenager or adult, Schizoid PD would be a possibility, for example. (There's really not many disorders that are like ASDs though.)

In regard to C, The same DSM committee in its recommendation for the removal of Asperger's from the DSM puts forth the argument that
" Early language details are hard to establish in retrospect, especially for older children and adults; average age of first diagnosis is late (7 years according to Mandell et al. 2005; 11yrs, Howlin & Asgharian, 1999)."

This was in response to the DSM-IV Asperger requirement that
D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).

The new requirement for C states, "C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)" If establishing the usage of language is prohibitively difficult then how can the nuanced social behaviors be retroactively determined?

In regard to D, the author deliberately choices to include the new word limit in addition to the word impair. This implies that impair and limit have discrete meanings both of which are now required. The definitions of the terms are as follows

Impair- to make or cause to become worse; diminish in ability, value, excellence, etc.;
Limit - to fix or assign definitely or specifically; the utmost extent.

Therefore the symptom must specifically define the utmost extent and diminish every day functioning. A "significant impairment" is no longer sufficient for the establishment of a diagnosis based upon the revised criteria.

By definition, an ASD will limit you for your entire life compared to your peers. It'll also impair you too. I don't see how it's much of...anything that's not already there with it being a disorder. You'll be "limited" in comparison to your peers regarding social relations, for example, and it's always going to be that way due to the deficits outlined in the criteria. So on and so forth.

Having it since childhood is there for differential diagnoses; you'd just have to say to the clinician that I've always been, felt, and thought this way. It's always been like this though with an ASD diagnosis. It's there to differentiate between Schizoid PD or a combination of other mental disorders (depression + OCD + social anxiety disorder can appear like an ASD at first glance), which have different treatments.

on october 1st, 2013, the USA is obliged to have adopted the ICD-10… over 20 years after the rest of the world… and two years before that same world adopts the ICD-11…

asperger syndrome is NOT eliminated from the ICD-10… nor the ICD-11

what relevance has the DSM-V anyway???

i simply do not understand.

If on a standardized test an individual is able to obtain a score that is in the top 5% however the test must be taken in a room without fluorescent lighting, are they limited?

I would argue that they are impaired and not limited. Unfortunately if they are not 'limited' the new DSM-V Standard would prevent the reasonable accommodation of taking the exam under different lighting conditions.

The connotations of the words impair and limit are very different. An impairment can be overcome through work and diligence, a limit can not. For instance the speed of light represents a limit where as gravity is an impairment (for those trying to fly). The inclusion of the word limit implies that there are daily activities that can not be performed. I honestly hope this is not the belief of the clinical community

aspi-rant
for a very good discussion of the differences between the ICD and DSM look at

http://www.apa.org/monitor/2009/10/icd-dsm.aspx
http://www.apa.org/monitor/2009/10/icd-dsm.aspx

and
http://www.apapracticecentral.org/reimb ... -9-cm.aspx http://www.apapracticecentral.org/reimbursement/billing/icd-9-cm.aspx

Which is from American Psychological Association, which is not to be confused with the American Psychiatric Association which produces the DSM.

In terms of insurance coverage you are completely right

does all this mean that if you have been dx'ed you will have to get a new one