http://www.dsm5.org/ProposedRevisions/Pa...px?rid=97#

I have a friend who is a social worker in London, working with people with learning difficulties, who forwarded some info (these are her co-worker's words, not mine - i haven't had time to look at the DSM stuff yet, going out now)

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is currently being revised and version five (DSM-V) is set to be published in May 2013.  A preliminary draft revision of the DSM-V is now out for public review.  One of the proposed revisions is that Asperger Syndrome becomes subsumed into ‘Autistic Disorder’, i.e. there will no longer be distinct criteria to separate them.  Part of the rationale is that whilst the Asperger label has proved popular it is used “loosely and with little agreement”

It is further proposed that the new category of ‘Autistic Disorder’ will then have three severity levels which will range from Severity level 1 ‘requiring support’ to Severity level 3 ‘requiring substantial support’.

In summary, it appears that research highlights difficulties in applying the diagnosis of Asperger Syndrome in a clinically relevant and consistent way and the authors of the DSM-V are seeking to iron out any anomalies in diagnosis with the new proposed category of ‘Autistic Disorder’.  This may serve as a reminder to us that the criteria for a learning disability need to be applied to our client group, regardless of whether a person has a diagnosis of any kind of autistic spectrum disorder.

from http://www.dsm5.org/ProposedRevisions/Pa...x?rid=97#, 'rationale' tab

Q.3.  If Asperger disorder does not appear in DSM-V as a separate diagnostic category, how will  continuity and clarity be maintained for those with the diagnosis?

The aim of the draft criteria is that every person who has significant impairment in social-communication and RRBI should meet appropriate diagnostic criteria.  Language impairment/delay is not a necessary criterion for diagnosis of ASD, and thus anyone who shows the Asperger type pattern of good language and IQ but significantly impaired social-communication and repetitive/restricted behavior and interests, who might previously have been given the Asperger disorder diagnosis, should now meet criteria for ASD, and be described dimensionally. The workgroup aims to provide detailed symptom examples suitable for all ages and language levels, so that ASD will not be missed by clinicians in adults of average or superior IQ who are experiencing clinical levels of difficulty.

There may be some individuals with subclinical features of Asperger/ASD who seek out a diagnosis of ‘Asperger Disorder’ in order to understand themselves better (perhaps following an autism diagnosis in a relative), rather than because of clinical-level impairment in everyday life. While such a use of the term may be close to Hans Asperger’s reference to a personality type, it is outside the scope of DSM, which explicitly concerns clinically-significant and impairing disorders.  ‘Asperger-type’, like ‘Kanner-type’, may continue to be a useful shorthand for clinicians describing a constellation of features, or area of the multi-dimensional space defined by social/communication impairments, repetitive/restricted behaviour and interests, and IQ and language abilities.

Mmm... it seems like they are simplifying this substantially... I don't like that B (

What's missing here is 'severity' 0.1 'requiring little or no support' but then, people who fall under that catogory have never been acknowledged or catored for. Why would they start now?

Good. This would mean I could get rid of my diagnosis!

I'll stay out of this for two reasons:

(1) I don't have a diagnosis anyway, when I were a lad nobody who would currently be considered high-functioning or aspie was diagnosed.

(2) If I did have a diagnosis it would be autism (significant speech delay and other developmental delays as a child).

I do support the continuation of the aspergers diagnosis if that is what most aspies want.

here it is:

Autism Spectrum Disorder (draft, last updated 26 jan 2011)

Must meet criteria A, B, C, and D:

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,

2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people

B.    Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following:

1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).

2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C.    Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D.         Symptoms together limit and impair everyday functioning.

Since I don't have A, B, C AND D I just got booted off the spectrum.

This post was last modified: 03-19-2011 09:51 PM by Ana54.

I always wonder what is going to happen to me with my AS diagnoses? Would I not get the help anymore? Would I have to be rediagnosed? What if I get booted off the spectrum too?

So, now I'm 'Asperger-type' Autistic?

OK, so I guess many of us are now 'AD level 1'. Not as catchy as 'Aspie'.

Well, If they go with 'Asperger-Type' then we can still use 'Aspie'.
I think I read something about it being Asperger-Type, Kanner-Type etc.

At least I won't have to be diagnosed for the third time, then again I might have to be. :-/

well- it seems spot on in decribing my son.

He is A. that line.
half of the list on line 1.
a little less than half of the list on line 2 (used to be more than half of that..
all of line 3. (minus the lack of interest - that comes and goes depending on how badly he has recently been rebuffed)
B.Yes..  1,& 2 (varying levels)     but 3.. not any more - he grew out of the "highly fixated"... However, he has learned various coping skills to ameliorate the discomfort of broken routines.
C.Yup ( i love the way they do not fully manifest until capabiites are exceeded - that is so well put
D.Yes, put together they can impair at varying levels

My son meets every single one of the criteria: A-D and all the subgroups too.

I suppose I am impaired everyday by my ASD. Take my social skills and how I am in relationships and there it is, everyday I am impaired. It doesn't matter what I do different to not be impaired but it is still considered an impairment by society.

And just because someone isn't struggling every day because they don't work for one nor go to school and their families accept them for the way they are, there will be no impairments there but I don't think it should make them off the spectrum. And even if they did have a job and everyone there was accepting and the bosses liked their work so they never fired them, it shouldn't throw them off the spectrum. It's still considered an impairment.

And what happens when someone did meet that criteria when they were children but no longer do as adults? I suspect this is with me. Of course it be hard to tell in my early childhood if these symptoms were present because I wasn't an older child yet and things I did were more acceptable then because it's expected in toddlers and then they outgrow it. But I would say they were present in my early childhood since my IEP did read I had autistic behavior. Then they got less as I got older.

I would say I slip on and off this.