Proposed changes in the definition of autism would sharply reduce the skyrocketing rate at which the disorder is diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services, a new analysis suggests. ...Here is the new DSM-5 definition:
The results of the new analysis are preliminary, but they offer the most drastic estimate of how tightening the criteria for autism could affect the rate of diagnosis. For years, many experts have privately contended that the vagueness of the current criteria for autism and related disorders like Asperger syndrome was contributing to the increase in the rate of diagnoses — which has ballooned to one child in 100, according to some estimates. ...
The proposed changes would probably exclude people with a diagnosis who were higher functioning. “I’m very concerned about the change in diagnosis, because I wonder if my daughter would even qualify,” said Mary Meyer of Ramsey, N.J. A diagnosis of Asperger syndrome was crucial to helping her daughter, who is 37, gain access to services that have helped tremendously. “She’s on disability, which is partly based on the Asperger’s; and I’m hoping to get her into supportive housing, which also depends on her diagnosis.”
The new analysis, presented Thursday at a meeting of the Icelandic Medical Association, opens a debate about just how many people the proposed diagnosis would affect.
The changes would narrow the diagnosis so much that it could effectively end the autism surge, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine and an author of the new analysis of the proposal. “We would nip it in the bud.” ...
At least a million children and adults have a diagnosis of autism or a related disorder, like Asperger syndrome or “pervasive developmental disorder, not otherwise specified,” also known as P.D.D.-N.O.S. People with Asperger’s or P.D.D.-N.O.S. endure some of the same social struggles as those with autism but do not meet the definition for the full-blown version. The proposed change would consolidate all three diagnoses under one category, autism spectrum disorder, eliminating Asperger syndrome and P.D.D.-N.O.S. from the manual. Under the current criteria, a person can qualify for the diagnosis by exhibiting 6 or more of 12 behaviors; under the proposed definition, the person would have to exhibit 3 deficits in social interaction and communication and at least 2 repetitive behaviors, a much narrower menu.
Autism Spectrum DisorderCondition C makes autism impossible to diagnose in adults, without evidence of it as a young child. Condition D means that it cannot be diagnosed for just an eccentric personality; it must cause some sort of daily disability. In particular, TV characters such those on The Big Bang Theory and Bones would not qualify.
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: ...
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following: ...
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.
Condition A sounds like what can be called "not a people person". But it does not just mean anti-social habits. The person has to have some inabilities in social interactions.
Condition B seems just like harmless personality characterists to me. They include stereotypced use of objects, intense interests, and fascinations with spinning objects. Studies consistenty show that boys like to play with objects more, while girls play with dolls more. There is nothing pathological about having stereotyped male interests. In the DSM-5, it is only a symptom if conditions A, B, and D are also met.
Even if any of these things were true about me, they should have no bearing on the family court unless there is some demonstrated harm to the child. No one even alleges any such harm. It is not the law or the public policy in California to take kids away from parents who have some anti-social personality characteristics or intense interests or fascination with spinning objects.
The effeminate psychologists might say that it is better to be a people person than not. I don't agree with that. It is not my personal experience. There are no scholarly papers demonstrating that. There is no law giving preferential treatment based on that. The people person might make a better nurse but a worse engineer. And it is certainly no business of the family court.