How severe is your autism by proposed DSM-V severity levels?

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Which DSM-V severity fits you best?
Level 3 ‘Requiring very substantial support’ 4%  4%  [ 5 ]
Level 2 ‘Requiring substantial support’ 27%  27%  [ 35 ]
Level 1 ‘Requiring support’ 40%  40%  [ 52 ]
I don't require support as defined in DSM-V, but will probably still be classified with ASD based on DSM-V 19%  19%  [ 25 ]
Looks like I'll lose the ASD diagnosis based on the DSM-V criteria. 11%  11%  [ 14 ]
Total votes : 131

zette
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29 Feb 2012, 4:07 pm

Here's the text of the proposed severity levels for autism under the new DSM-V definition. What level do you think you (or your child if you are an NT parent) would fit in? I don't know how they will classify people who are different levels for social communicaiton and restricted interests, but for purposes of this poll go with the more severe of the two.

Quote:
Level 3 ‘Requiring very substantial support’

Social Communication
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.

Restricted interests & repetitive behaviors
Preoccupations, fixated rituals and/or repetitive behaviors markedly interfere with functioning in all spheres. Marked distress when rituals or routines are interrupted; very difficult to redirect from fixated interest or returns to it quickly.

Level 2 ‘Requiring substantial support’

Social Communication
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 response to social overtures from others.

Restricted interests & repetitive behaviors
RRBs and/or preoccupations or fixated interests appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress or frustration is apparent when RRB’s are interrupted; difficult to redirect from fixated interest.

Level 1 ‘Requiring support’

Social Communication
Without supports in place, deficits in social communication cause noticeable impairments. Has difficulty initiating social interactions and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions.

Restricted interests & repetitive behaviors
Rituals and repetitive behaviors (RRB’s) cause significant interference with functioning in one or more contexts. Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.



Sora
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29 Feb 2012, 4:38 pm

Urgh, I don't understand the levels.

What if your autism makes you react in a way not covered by these sentences? Anyone have an idea about that?

I'm spontaneously thinking of stuff such as loss of skills, different levels of initiation of interaction and reaction to interaction depending on availability of abilities as well as such factors as the target group of said interaction as well as simply varying levels of autistic symptoms depending on environment and possibly other unknown factors.


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CyclopsSummers
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29 Feb 2012, 4:39 pm

The fourth option. I can go without support now, ever since coming of age, but autism has shaped my life and personality in such a way, that I'd still have the diagnosis after the DSM revision.

If I got the diagnosis at a child with these DSM V criteria, however, I'd be classed as Level 1, mild.


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Tuttle
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29 Feb 2012, 4:41 pm

I wish I knew how they take into account sensory things...

With the descriptions given, going by the more severe of the two, I'd be level 2. The level two social communication part is a good description of me (though people need to take into account that they never see me without support. If my boyfriend's not up to doing the needed support, I'll not go into public.)



Tuttle
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29 Feb 2012, 4:46 pm

Sora wrote:
Urgh, I don't understand the levels.

What if your autism makes you react in a way not covered by these sentences? Anyone have an idea about that?

I'm spontaneously thinking of stuff such as loss of skills, different levels of initiation of interaction and reaction to interaction depending on availability of abilities as well as such factors as the target group of said interaction as well as simply varying levels of autistic symptoms depending on environment and possibly other unknown factors.


I went with "assuming no sensory overload, or other types of overload, what are my abilities probably at" or "assuming minimal overload if avoiding overload is not an option, then we is it at."

Shutdowns and meltdowns of course would be more severe than the average time.



CyclopsSummers
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29 Feb 2012, 4:50 pm

Sora wrote:
Urgh, I don't understand the levels.

What if your autism makes you react in a way not covered by these sentences? Anyone have an idea about that?

I'm spontaneously thinking of stuff such as loss of skills, different levels of initiation of interaction and reaction to interaction depending on availability of abilities as well as such factors as the target group of said interaction as well as simply varying levels of autistic symptoms depending on environment and possibly other unknown factors.


I guess with this new DSM-V, they'll just play "add the symptoms", stack those aspects of one's autism to determine in what way someone's impaired in their functioning until they come to a level of 'severity'. What we have now with the DSM-IV is a very horizontal autistic spectrum, with severity being relevant for a whole scala of ASDs under the same umbrella. What we get in the DSM-V is a more vertical thing, not even truly a 'spectrum' as there's only one name, 'autistic disorder'. The main thing that's going to distinguish one autistic person from the other IS severity in this scenario.


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Sweetleaf
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29 Feb 2012, 4:51 pm

Well if my goal was to become neurotypical I would be level two, but its not. So the most support I want is leave me the hell alone if you want to pressure me to live life to your expectations, rush me to hurry up(I can't I process things slowly and its time people just deal with that). So I don't know.

But based on all that i would still fit the level 1 catagory because in its hard in general for me to initiate social interaction and in some situations impossible...and its not anxiety its like a mental block that prevents me from walking up to someone and talking to them unless I know them kind of well or am at a store and supposed to ask questions to find out things. And I demonstrate clear examples of atypical or unsuccessful responses to social overtures of others.

But that seems different from what the proposed changes I have seen look.


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Kyra71
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29 Feb 2012, 4:58 pm

I have no idea how to answer that.

All I know is that I've lived my whole life (until now) without diagnosis and support, and I have never been able to function successfully in school, or a job, or socially, at all - specifically due to challenges associated with autism. So the fact that I can't seem to function without support would indicate that I need some kind of support in order to succeed at these things. But how much support? I dunno :/



OJani
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29 Feb 2012, 5:03 pm

Personally I think these severity (functionality) levels are too subjective, need elaboration and examples.

I can only guess how relationships (or lack thereof) count, regardless of severity. My guess would be: they don't count at all, especially romantic types. :(

Anyway, I'm somewhere between these two, depending on many factors (voted for Level 1):

- Level 1 ‘Requiring support’
- I don't require support as defined in DSM-V, but will probably still be classified with ASD based on DSM-V


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Apple_in_my_Eye
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29 Feb 2012, 5:05 pm

Wierd scale. Is it meant for children?

There's nothing about executive functioning, sensory issues, shutdowns, or other things that would impact daily living more than just social issues and routine (well need for routine can be severe for some, admittedly).

Also "needs assistance" with social stuff and routine only? So, you get help with social communication, but not for navigating the supermarket to buy food because it overloads you too much? WTF? Is the scale meant for children? Otherwise, it makes no sense to me. Adults have to worry about survival issues.



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29 Feb 2012, 5:06 pm

CyclopsSummers wrote:
Sora wrote:
Urgh, I don't understand the levels.

What if your autism makes you react in a way not covered by these sentences? Anyone have an idea about that?

I'm spontaneously thinking of stuff such as loss of skills, different levels of initiation of interaction and reaction to interaction depending on availability of abilities as well as such factors as the target group of said interaction as well as simply varying levels of autistic symptoms depending on environment and possibly other unknown factors.


I guess with this new DSM-V, they'll just play "add the symptoms", stack those aspects of one's autism to determine in what way someone's impaired in their functioning until they come to a level of 'severity'. What we have now with the DSM-IV is a very horizontal autistic spectrum, with severity being relevant for a whole scala of ASDs under the same umbrella. What we get in the DSM-V is a more vertical thing, not even truly a 'spectrum' as there's only one name, 'autistic disorder'. The main thing that's going to distinguish one autistic person from the other IS severity in this scenario.


I actually think this new approach is far more mindful of the spectrum. Having different cut off points for different diagnoses seemed very arbitary. Nintendofans bafflement with her diagnosis shows this, pretty low functioning and severe symptons, but the ability to communicate gave her an AS diagnosis. Under the new system she would most likely be ASD S3, nice and clean.

Jason



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29 Feb 2012, 5:43 pm

I chose "lose" in the poll, but I'm thinking that level 1 descibes me. I'm not sure why that is listed as requiring support though. It's not as if you even average social skills to get through life (it's not a great life, but the ability to make friends, get a relationship, or interact with others socially outside forced interactions isn't required.)



Jtuk
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29 Feb 2012, 5:51 pm

noname_ever wrote:
I chose "lose" in the poll, but I'm thinking that level 1 descibes me. I'm not sure why that is listed as requiring support though. It's not as if you even average social skills to get through life (it's not a great life, but the ability to make friends, get a relationship, or interact with others socially outside forced interactions isn't required.)


This forum could be deemed "support", as could basic assistance from a counsellor or your doctor. It may just mean a social worker calling you once a month or so to check you are managing. Or some help from a family member with shopping or paperwork.. I interpret level 1 as pretty minimal support.

Jason



Marcia
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29 Feb 2012, 6:23 pm

I voted for Level 1 for my son, although in less familiar, more stressful situations/environments he is easily a 2.



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29 Feb 2012, 6:26 pm

Level 2 for me overall.



eigerpere
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29 Feb 2012, 6:42 pm

All three apply in social communication and RRB.