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ASPartOfMe
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18 Jun 2018, 11:07 am

http://www.who.int/classifications/icd/revision/timeline/en/

Today the final version of the manual was released for preperation for implementation by member states

May 2019
ICD-11 will be presented at the Seventy-second World Health Assembly for endorsement by Member States.

January 2022
Following endorsement, Member States will begin reporting health data using ICD-11.


https://icd.who.int/dev11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f437815624

Quote:
Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities.

Inclusions
Autistic disorder
Pervasive developmental delay

Exclusions
Developmental language disorder (6A01.2)
Schizophrenia or other primary psychotic disorders


Autism spectrum disorder without disorder of intellectual development and without impairment of functional language

Autism spectrum disorder with disorder of intellectual development and without impairment of functional language

Autism spectrum disorder without disorder of intellectual development and with impaired functional language

Autism spectrum disorder with disorder of intellectual development and with impaired functional language

Autism spectrum disorder with disorder of intellectual development and with impaired functional language


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Professionally Identified and joined WP August 26, 2013
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


B19
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18 Jun 2018, 6:44 pm

I tend to think that these classifications would be more useful if routinely accompanied by briefing notes citing good meta-analysis data on the misdiagnosis of other conditions (like FXS, adhd and so on) as AS; missed diagnosis of AS; and the misdiagnosis of AS mistaken by unwitting clinicians as mental illness; and gender bias as a misdiagnostic factor.

We know from experience here, and from many studies and reports elsewhere, that classifications alone are not enough at this stage to guide clinicians to achieve valid and reliable diagnoses in a safe way for most people on the spectrum.



ASPartOfMe
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19 Jun 2018, 11:15 am

B19 wrote:
I tend to think that these classifications would be more useful if routinely accompanied by briefing notes citing good meta-analysis data on the misdiagnosis of other conditions (like FXS, adhd and so on) as AS; missed diagnosis of AS; and the misdiagnosis of AS mistaken by unwitting clinicians as mental illness; and gender bias as a misdiagnostic factor.

We know from experience here, and from many studies and reports elsewhere, that classifications alone are not enough at this stage to guide clinicians to achieve valid and reliable diagnoses in a safe way for most people on the spectrum.


There are sometimes more detailed criteria and guidelines in the actual manual that professionals see then is in the public internet version.


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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


ASPartOfMe
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11 Sep 2018, 12:51 am

Proposed revisions to global diagnostic manual for autism raise concerns

Quote:
The proposed new version of the global manual for diagnosing medical conditions gets many things right about autism — but some items diverge from the manual’s American counterpart and are provoking concerns from scientists.

Specifically, the manual lists eight subcategories of autism and ignores some key traits of the condition, these scientists say.

“It seems unnecessarily elaborate and not very user friendly,” says Tony Charman, chair of clinical child psychology at King’s College London.

The World Health Organization (WHO) released this latest version of the International Classification of Diseases, or ICD-11, on 18 June. The draft is open to comments before its formal adoption, which is expected to occur at the annual World Health Assembly in Geneva, Switzerland, in May 2019.

Overall, its treatment of autism is similar to that of the American DSM-5, the current edition of the Diagnostic and Statistical Manual of Mental Disorders, published in 2013. For example: Both manuals fold autism, Asperger syndrome and pervasive developmental disorder-not otherwise specified into a single umbrella category called ‘autism spectrum disorder.’ Both highlight impairments in two broad realms — social communication, and restricted interests and repetitive behaviors — as characteristic of the condition.

These similarities have drawn wide praise from researchers.

“The definition of autism in ICD-11 and the one in the DSM-5 are not identical, but they’re very, very close,” says Michael B. First, professor of clinical psychiatry at Columbia University and a member of the committee that drafted the mental and neurodevelopmental disorders chapter of the ICD. “So it’s not likely that there’ll be significant differences in who gets labeled.”

However, the ICD-11 diverges from the DSM-5 in significant ways.

Among the most popular features of the DSM-5 is its prominent treatment of sensory abnormalities — such as over- or undersensitivity to sound and touch — among people with autism. The definition of autism in the ICD-11, by contrast, makes no mention of sensory abnormalities.

“Sensory issues may well be near universal in autism,” says Simon Baron-Cohen, director of the Autism Research Centre at Cambridge University in the United Kingdom. “If true, we should count it as a core symptom of the umbrella category.

Researchers also take issue with the subcategories of autism detailed in the ICD-11.

The subcategories specify whether an autistic individual also has intellectual disability and the individual’s degree of language impairment.

Clinicians may use the subcategory codes for administrative purposes when required by hospitals or health care systems, Charman says. “But in terms of everyday usage, I don’t think this substructure holds much appeal.”

It’s also difficult to gauge how well the system will work based on the codes alone, says David Skuse, professor of behavioral and brain sciences at University College London.

“What has been published is very much a sketch of the key features of [autism],” he says. “However, it is really important to know how these guidelines will work in practice.”

The final version of this document is expected to be released before the ICD-11 is adopted in May.

Between now and then, health ministries of the World Health Assembly’s nearly 200 member states can review the ICD-11 and weigh in with any concerns.

Even after formal approval, countries are unlikely to begin using the ICD-11 until January 2022 at the earliest. That’s because it takes time for governments, insurers, and health care providers to retool their databases, and for clinicians to be trained to use the new codes.

In some countries, implementation could take much longer. The current version of the manual, ICD-10, was released in 1990. But the United States didn’t switch to that version until 2015.


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Professionally Identified and joined WP August 26, 2013
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