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Autism Diagnoses: DSM V Should Separate Autistic Disorder from Aspergers and HFA

Posted May 12 2009 3:23pm 3 Comments
There are two major problems with the current DSM categorisation of Pervasive Developmental, or Autism Spectrum, Disorders. One is the lack of any relevant distinction between Aspergers Disorder and those with higher functioning PDD -NOS and autistic disorders.

The other DSM problem which generates much unnecessary conflict is the inclusion of these various disorders on a "spectrum".

This inclusion of substantially different disorders, with wildly different challenges, in one "spectrum" of disorders implies that the very serious challenges of persons with Autistic Disorder who lack a fundamental understanding of the world, who have very limited abstract thought and who have very little in the way of communication skills are somehow fundamentally similar to persons with good to excellent facilities in all these crucial areas of life.

The intellectual, understanding and communication deficits of the severely autistic should be recognized in a category separate from the high functioning persons who live in the media spotlight and purport to speak on their behalf, even while they deny their existence, and complain that honest description of their realities by loved ones constitutes stereotyping and partying.

Research is resulting in more and more people describing autism in the plural as autism disorders with different causes and different possible treatments. The life realities for those with severe Autistic Disorder are much different than those of Ari Ne'eman, Dora Raymaker, Alex Plank, Michelle Dawson, Amanda Baggs, Jim Sinclair and other high functioning "autistics" and " Aspergians" are very, very different and the DSM should reflect those differences.

As an added bonus if the DSM V modified its autism spectrum as suggested, ASAN and other HFA and Aspergers groups would not have to feel embarrassed by lower functioning, more severely affected persons with Autistic Disorder. My son Conor, who I love dearly, is one of those lower functioning, severely autistic persons that the Neurodiversity crowed is embarrassed by. I speak honestly about his challenges. I do so as the father that has loved and cared for him for 13 years and will do so as along as I am alive. I do not see his autism realities, his real life challenges and prospects reflected in the ideology and rhetoric of the "autism is a culture, a natural variation" crowd at ASAN.

It is time for the DSM to get realistic about the Autism "Spectrum".

It is time to merge High Functioning autism disorders with Aspergers Disorder and separate them from Autistic Disorder.

It is time for the DSM to recognize the importance of levels of ability to function in and understand the world and to reflect those levels in their classification of development disorders.

I say this on behalf of my son with Autistic Disorder and profound developmental delays. I say this as the person with the legal and moral right to speak on his behalf since he cannot.


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Comments (3)
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Hence why it is called a "SPECTRUM" disorder! No two people are alike even on the spectrum, there is actually no medical definition of "High functioning autism" as some like to imply, based on IQ, and verbal ability. When your child can tell you everything and anything about starwars, but doesn't have the language skills to even say I'm sick. Then a whole lot of good talking does. When your child can sound like a professor, but can't use his intellect in functional ways, such as brushing teeth, combing hair etc, then what does that say about his functioning level. People need to get a grip, and focus on taking care of their childs specific needs, rather then argue over their ability to function, or speak!One thing they all have in common, are deficits in three areas. To what degree of the impairment is different for each person. My son's intellect placed him between the 60-80 percentile, but his overall general adaptive composite score placed him below the 1st percentile. What would that tell you about his "functioning" level?
Oh right, and others would consider him high functioning, because of verbal ability and his intellectual score. He's 7, but developmentally hasn't made it past 3-4 yrs. I love peoples definition of "high functioning"!
I'm responding almost a year later, having just discovered this.  However, I look forward to reading your honest and educated views more thoroughly.  I just wanted to point out that it is my understanding that it's very difficulty to diagnose an infant/toddler as being on the spectrum, let alone HOW much on the spectrum; I wonder how/when you would want children diagnosed.  The sooner the better, yet the presentations change over time.  My son is 14; when I hear people argue what is and is not x, I think-wow, by their definition, my son was Autistic as an infant through preschooler.  He's now considered a highly gifted Aspie.  The fact that he's incredibly bright does not negate his atypical development or his current struggles.  How was he "autistic" before many are obviously autistic, and yet isn't severe now?  I don't know.  I just don't think it's so clearcut, which is perhaps unfortunate but still simply is.
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