Severity Scale

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

This was on a website for the proposed DSM V.. I just noticed it has a severity scale tab (you'll have to click it) and thought some would find it interesting

Thanks for that update.

So, I guess it may be possible that anyone who might likely be towards the higher functioning end of Asperger's - like someone who has a job, can prepare meals, and drives may no longer qualify under this proposed version because of this ? -

"Symptoms together limit and impair everyday functioning."

I wonder who decides what "impairment" really is.

Just wondering.

After watching a video of Carly, I am ashamed that I've been so depressed for so long, but it's difficult to see beyond one's depression once in it, you know what I mean?

As always, the criteria and the severity scale are both geared towards children. For diagnosing autism in children, they are adequate and appropriate as written. For diagnosing autism in adults, they are adequate and appropriate only as long as the clinician does not expect the adult to behave eggsacly like the child whom the adult used to be did, but instead, compares the adult to NT peers in terms of social, occupational, educational functioning and supports required.

The American psychiatric Association has been deciding what classes as an 'impairment' since 1952.

I suppose it depends on what you think is an impairment?

I still struggle to cook, can't drive, won't learn because of extreme sensory issues and needing to be on medication if I chose to drive (but am too scared about the days it doesn't work or give me strange symptoms or wears off), and don't have any job. Too many sensory issues to work.

Well, I personally am one of those 'higher functioning' Aspies. I have a steady job, which I keep at the cost of daily overwhelming anxiety, I can cook my own meals but often am too absorbed in my interests to remember to cook or too drained from the daily grind to want to eat, and I can drive a car because I was finally forced to get my license at the age of 23 by my parents, but I have to be careful of being 'blinded' by too much sensory input and doing things like turning into the wrong lane. I would certainly not say that my ability to complete certain tasks means that I am not affected by my Asperger's in other ways. Like you, I would also be interested in seeing what 'impaired daily function' ends up being defined as, though it will probably end being decided on a case-by-case basis.

Last edited by MrMagpie on 26 Jan 2012, 1:44 am, edited 2 times in total.

That was in the old criteria too. Limiting and impairing everyday functioning isn't new.

I thought I saw it somewhere before. Was going to bring it up but wasn't sure.


Sometimes I feel too tired/unstructured/panicky to make myself a meal at the end of a day. I might take a supplement (omega 3 works very fast in me) or something that will wake me up. That is definitely a support. Usually, I just see what food other people are making or help myself to leftovers.
Being overly absorbed in interests is still in the criteria. I have trouble expending too much energy into them I have little left for other things, especially cooking and socialising. I live in a house with three others who like to bring over their friends. I have barely any energy to even attempt to look like I want to talk to them.
I'm too damn scared of driving and working. If I walk down the street I usually get sensory overload. I have to wear sunglasses so I don't get a migraine. My medication helps but it's unreliable. When I get into a big social crowd I'll still get overload but might come out of it momentarily to talk to someone then go back into it.

That makes sense to me.

I've actually never lived on my own. My husband does most of the cooking (bless him) or I'd probably just make a piece of toast or ramen noodles.

I think "it depends on what someone thinks is an impairment" is the best way to put it.

That short list sounds about like me except that I can do certain jobs (but don't have one atm because there's none that I could do right now).

Out of the people who either have a child with AS or work with children with AS there are a lot who say upon meeting me that I must have extremely mild hf AS. I guess that's a case of a highly subjective interpretation of severity based on the misconception of that an autistic adult isn't an autistic child.

I hear that! When I first got addicted to the internet and was working on trying to learn HTML and java script, I only gave myself 3 hours of sleep per night and I never wanted to stop for dinner. I was also working at the time.

My husband would make dinner, and selfish person that I can be, I would usually get to the table of cold food after he was yelling at me for a while to get off the computer....I'd eat as fast as possible and get back online until the wee hours...sleep, internet, work, internet....I didn't know I had a problem.

Oddly, I felt so alive in my brain at that time - all of the little lights were on. But my marriage went through a rough patch during that time because of my behavior. I didn't know anything about AS back then.

That seems very interesting. Thank you for sharing that.

Actually this new version seems to be clearer for me. I think I fit level 1 ASD more precisely than autism disorder

When I only get three hours of sleep it has a lot to do with the jazz band downstairs. Seriously, no joke. I'm really cranky, unfocused, unmotivated and forgetful the next day. At night I can control how long I spent on the computer, but during the late afternoon before dinner time, that's a whole other thing. Presently, it is the late afternoon.

As previously mentioned, the criteria that requires you to be impaired and disabled isn't new, it's just somewhat ignored by people who self diagnose, and by autistics who simaltaniously say they are not disabled by fear losing their diagnosis with this new criteria.

I look foward to the tidied up profile, it'll help with studies on autism that were previously segregated.

This appears to me a part of a greater whole. I could see PDD-NOS and Aspergers categories placed along side this proposed (Autism ) scale. I can see the DSM committee excluding the B and C plans out of brevity and slight disagreements on the definitions that could distinguish Aspergers and PDD-NOS from AUTISM. This is an AUTISM severity scale which did not take into consideration some of the unique markers of the other ASD disorders.

As an AUTISM scale, the committee did a spectacular job. As an Autism Spectrum Disorder scale, it could use:

[youtube]http://www.youtube.com/watch?v=RZ-uV72pQKI&feature=related[/youtube]


TheSunAlsoRises

Having read descriptions of all three levels I still don't get how they apply to the everyday life of autistics, seriously. Highly subjective matter, and it always has been one, imho.

It tells nothing about the milestones (or benchmarks) of social functioning to which autistics could be compared and measured. Some regard having a job, a driver's license and living independently as signs of HF, though I think it's a misconception, puts too much emphasis on the material world. How much help one needs is also not a clear factor, it's hard to determine. Maybe they get help and function quite well (job, independence, own family), maybe they don't even know they are in need for help.

I think we should consider Maslow's hierarchy of needs, a theory in psychology:



The higher someone stands in the pyramid, the higher functioning one is. To what level the society is responsible to help people with impairments to get to? If someone has better abilities ASD aside (i.e. better education, better upbringing, fortunate past, better profession by chance, maybe higher IQ is also an independent factor), one is no longer considered as being in need for help, thus one isn't autistic per the diagnostic criteria?

Or, what should we do if someone is high in the pyramid in one respect, but have skipped (missed out) a level? Often autistics are deprived of having an own family, a spouse, children. It goes down to the very basis of being autistic, in a sense. Should the society stand up and help these autistics just as it helps those who have "more basic" problems with living?

I'm leaned toward it should, but it won't. I feel very disappointed about it.