NEW YORK - 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.
The definition is now being reassessed by an expert panel appointed by the American Psychiatric Association, which is completing work on the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard reference for mental disorders. It is the first major revision in 17 years.
The results of the new analysis, presented Thursday at a meeting of the Icelandic Medical Association, are preliminary, but they offer the most drastic estimate of how tightening the criteria for autism could affect the rate of diagnosis. People with the latter two disorders endure some of the same social struggles as those with autism but do not meet the definition for the full-blown version.
Certainly this child and his family need help. An occupational therapist consulting in the school setting would be able to help this child give words to his experience. She could support both the teachers' efforts to understand what environments are challenging and how to manage these challenges. She might even recommend a different school setting that is more compatible. A therapist working with parents and child together would similarly help them as a family to manage this child's unique biological vulnerabilities.
If the proposed changes to the diagnostic criteria for autism in DSM V, the newest version of Diagnostic and Statistical Manual of Mental Disorders, result in children like this not getting the help they need, as a recent article in the New York Times suggests, it will be a terrible loss for these families. It will result in increased costs to society when these unaddressed problems grow into bigger problems in later childhood and adulthood, as they inevitably will. This fear was expressed by Lori Shery, president of the Asperger Syndrome Education Network, when she was quoted in the article saying "If clinicians say, 'These kids don't fit the criteria for an autism spectrum diagnosis,' they are not going to get the supports and services they need, and they're going to experience failure."
A new study suggests that many of those on the higher-functioning end of the autism spectrum may no longer meet the criteria for a diagnosis if a new definition makes its way into the Diagnostic and Statistical Manual of Mental Disorders (DSM), the book considered to be the standard reference for mental disorders. The New York Times looked into both the study, which found that only 45 percent of those diagnosed with higher-functioning forms of autism might meet the new criteria, and the proposed changes to the definition.
The proposed changes to the diagnostic definition would be published in the fifth edition of the American Psychiatric Association's (APA) "Diagnostic and Statistical Manual of Mental Disorders (DSM-5)." "Given the potential implications of these findings for service eligibility, our findings offer important information for consideration by the task force finalizing DSM-5 diagnostic criteria," said Yale Child Study Center (CSC) director Fred Volkmar, M.D., who conducted the study with CSC colleagues Brian Reichow and James McPartland.
The new definition will be part of the psychiatric association's Diagnostic and Statistical Manual of Mental Disorders (DSM), the "bible" for psychiatric diagnoses. The manual is currently in its fourth edition, which was released in 1994, but the much-anticipated fifth edition should be final by the end of this year. Although the new definition of autism isn't final, it's "very likely," Dawson said. "They are extremely close, so any changes at this point will probably be relatively minor."
The potential change would consolidate all three disorders into one category known as "autism spectrum disorder," eliminating Asperger syndrome and pervasive development disorder, not otherwise specified. This might make it more difficult for many people to get health, educational, and social services. The narrower definition of these disorders is expected when the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is officially published in 2013. This will be the first major revision in 17 years.
The change would go in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The new industry standard will come out in May 2013 and will be its first major update since the mid 1990s. The definition change concerns those who help children with autism, such as the iCan House in Winston-Salem. Officials there worry they will end up helping fewer people who need it. "They're narrowing the scope. They're narrowing the diagnostic criteria so that fewer people, whether they be children or adults, qualify," said Kim Shufran, iCan House executive director.
Autism has been the subject of much discussion recently due to proposed changes in diagnostic criteria, as laid out in the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These proposed changes would collapse three current diagnoses - Autistic Disorder, Asperger Disorder, and a diagnosis called PDD-Not Otherwise Specified - into one diagnosis. This change has led to concerns about how individuals with these previous diagnoses, as well as individuals who have yet to receive a diagnosis, will be impacted.
For the first time in 17 years, a major revision to the nation's standard reference for mental disorders will redraw the diagnostic guidelines for developmental disorders like autism and Asperger syndrome, making diagnoses less frequent: "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."
In the new analysis, Dr. Volkmar and others used data from a large 1993 study that were used to develop the current criteria. They focused on 372 children and adults who were among the highest functioning and found that overall, only 45 percent of them would qualify for the proposed autism spectrum diagnosis by the definition now under review, The Times said. Some advocates told The Times they fear the effects of the new definition, should it become final later this year. "If clinicians say, 'These kids don't fit the criteria for an autism spectrum diagnosis,' they are not going to get the supports and services they need, and they're going to experience failure," Lori Shery, president of the Asperger Syndrome Education Network, told The Times. I asked whether the change, if it takes effect, means that all the students who receive special education services now based on a diagnosis of Asperger syndrome or PDD-NOS would suddenly lose those services. The study is authored by Dr. Fred R. Volkmar, who resigned from the panel of experts currently working on the autism defintion. Essentially, the American Psychiatric Association has appointed a panel to create a new edition of the DSM (which is long overdue; it's been 17 years since the current edition was created), and in re-defining autism, experts are trying to contend with the skyrocketing rate of diagnosis for autism and similar disorders like Asperger syndrome and "pervasive developmental disorder, not otherwise specified," abbreviated to P.D.D. -N.O.S by those in the know. They're doing this by combining all three categories of diagnosis under "autism spectrum disorder," and by narrowing the criteria that must be met for a diagnosis.
The Arc's response to the latest news regarding the American Psychiatric Association's work on revisions to the definition of autism. The Arc is the nation's largest and oldest human rights organization for the people with intellectual and developmental disabilities (I/DD), serving more than a million individuals and their families including people with autism, Asperger's syndrome, and pervasive developmental disorder, not otherwise specified (P.D.D. -N.O.S). "Over the last decade, we have made major strides in ensuring that people diagnosed with autism, Asperger's syndrome, and P.D.D. -N.O.S. have access to the services that advance their health, education, independent living skills, and work skills. These efforts have increased inclusion in educational settings, and in society, young adults with disabilities are gaining life skills that can lead to jobs and independence. The unintended consequences of a diagnostic definition change could potentially limit access to the services that children and adults with autism and P.D.D. -N.O.S. need, potentially putting at risk their education, and the health and economic stability of their own lives and the lives of their families," said Peter V. Berns, CEO of The Arc. Autism, as a psychiatric disorder, is defined by the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), published by the American Psychiatric Association (A.P.A.), which covers all mental health disorders for both children and adults. That definition matters -- an official diagnosis of autism is what opens up access to services and treatment to many affected individuals, both children and adults.
The American Psychiatric Association has appointed an expert panel to reassess the definition of autism, part of work being done to complete the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. It's the first time the standard reference has been updated in 17 years.
According to a Thursday report by Benedict Carey of the New York Times, a panel of experts appointed by the American Psychiatric Association (APA) is considering narrowing the definition of the disorder as part of revisions planned for the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Experts working on the manual strongly disagree with the study's findings, the New York Times reports. The Times reported that the American Psychiatric Association is finishing the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, which marks the first time the manual has been revised in 17 years.
The American Psychiatric Association is in the process of reassessing the definition of autism for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (M.S.M.).
SPRINGFIELD, Mo. -- Some autism therapists say they are concerned a new definition of the disorder could make it more difficult for families to get the therapies they need. The American Psychiatric Association just released the proposed definition in the latest edition of its Diagnostic and Statistical Manual of Mental Disorders.
The American Psychiatric Association ( APA ) is proposing a change in the definition of Autism Disorder in the 5th edition of Diagnostic and Statistical Manual of Mental Disorders ( DSM-5.) The American Psychiatric Association is re-evaluating the formal definition of the autism disorder published in the Diagnostic and Statistical Manual of Mental Disorders.
The American Psychiatric Association is considering narrowing the definition of autism as it updates the Diagnostic and Statistical Manual of Mental Disorders, the widely-used reference manual for mental disorders.
American Psychiatric Association mulling new definition for fifth edition of Diagnostic and Statistical Manual of Mental Disorders.
The new definition will be part of the Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), the "bible" for psychiatric diagnoses. The manual is currently in its fourth edition, which was released in 1994, but the much-anticipated fifth edition should be final by the end of this year.
The New York Times is reporting on potential upcoming changes to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., which an analysis suggests could sharply curb the number of autism diagnoses.
The proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, will unite the definitions of autism, Asperger and pervasive developmental disorder under one set of symptoms. According to some estimates, nearly half of those currently diagnosed would become intelligible for government assistance in the form of special education, housing assistance and disability pay, particularly individuals with high cognitive abilities.
The Times's Benedict Carey reports that as it prepares for a new edition of the D.S.M., the A.P.A. is revisiting the question of what it means to be officially diagnosed as "autistic." A proposed change in that definition would eliminate Asperger's syndrome and "pervasive developmental disorder not otherwise specified" from the diagnosis, and in the process remove up to a million people, statistically, from the numbers of those diagnosed with autism. One expert suggested that the narrower definition would "nip in the bud" -- without, of course, changing the daily lives of those disabled by their symptoms one bit.
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." Bonnie Rochman writes on the Time Healthland blog that the change might actually increase access to care for some children, particularly those in states where having Asperger syndrome or the broad diagnosis of a pervasive development disorder doesn't qualify them for services. The change would consolidate those diagnoses with autism.
"Many times to obtain services you have to have a diagnosis of an autism spectrum disorder," said Geraldine Dawson, Chief Science Officer of Autism Speaks. "This might allow you to get early intervention, or allow you to participate in a classroom that's specialized." Others, like Dr. Zachary Warren of Vanderbilt University, say while the list of symptoms used to diagnose autism will be cut down, it doesn't mean children who have the condition will be excluded. "The hope is that we have refined symptoms to a point that this represents the core of the disorder and that this could be applied across that continuum of people who have intellectual impairments as well as individuals that might have very very high IQs," said Dr. Warren. The changes are still under review and won't be finalized until later this year.
In this photo taken Thursday, Sept. 8, 2011, Aspiritech co-founder Moshe Weitzberg works with employees at the nonprofit enterprise that specializes in finding software bugs, as they test a new program in Highland Park, Ill. Aspiritech hires only people with autism disorders. PHOENIX -- The American Psychiatry Association is preparing to change the way they diagnose children with autism. Under current classifications, there are three separate types of Autism Spectrum Disorder: Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDDNOS), and Asperger's Syndrome. The new classification would put all three of those types in to the same category. "It adds to a lot of confusion within the diagnostic system."
A therapist of Dora Alonso Special School gives a ball to an autistic child, on February 11, 2008, in Havana. What happens if your professionally diagnosed disorder is no longer defined as a disorder by doctors? Thousands of people may find their mental disorder diagnoses moot based on a pending reassessment of autism, Asperger syndrome, and pervasive development disorder being conducted by the American Psychiatric Association.
Fifteen-year-old Tim Morano has Asperger syndrome, a disease experts consider to be a higher functioning form of autism. While he's intelligent, Tim struggles socially. If the American Psychiatric Association changes what it means to be autistic, Tim's parents worry he could be left behind and without his special education classes. "He won't be able to function. He can't function in a regular school setting," Tim's mom Leja Morano said. Tim also relies on several medications every day and therapy once a week all covered by insurance two other necessities his family is worried about losing.
Jan. 20 (Bloomberg) -- The American Psychiatric Association is moving a step closer to overhauling the criteria for diagnosing autism after two just-completed field studies found the new definition won't exclude patients who need treatment. Disease advocates have said they're concerned the change may improperly reduce the number of children diagnosed, limiting access to health services.
"If you have a diagnosis of autism you get better services than if you don't," said Boutilier. She says the diagnosis itself can get people speech therapy and extra educational support. Which is why the proposed changes in the definition of Autism have many people worried they will no longer meet the criteria. Dr. Boutilier says even if the definition does change, getting those extra services shouldn't be a problem. "For the most part children and adults who receive services receive them because they need them not because they have a label, but based on their actual physical disabilities, their mental/emotional disabilities."
Proposed changes in the definition of autism would sharply reduce the rate at which the disorder is diagnosed and could make it more difficult for many people who would no longer meet the criteria to get services, according to a New York Times report.
Syracuse (WSYR-TV) -- Proposed changes to the definition of autism have some Central New York families on edge. If the changes were to be approved, the criteria for an autism diagnosis would tighten and some say it would leave patients without the educational and health services they need.
Eulingborough fears that if the proposed changes do go through in 2013, it could alter the way state agencies and insurance handle services. She also feels that by narrowing the definition of autism, some children won't get the help that her son received, and ultimately made the difference. "For a lot of parents who can't afford the services, and for children who really need it, it's hard," she said. The new definition would eliminate sub-threshold categories of autism such as asperger's or pervasive developmental disorder. "Those sort of separate categories are not very helpful in either treating children or in really diagnosing them," said Dr. Douglas Vanderbuilt of Children's Hospital Los Angeles. He thinks having one category of autism and evaluating a child based on his severity of symptoms makes more sense. He also said that when it comes to what insurance companies decide to cover or not cover is really a matter of interpretation.
The person would have to show three deficits in social interaction and communication and two repetitive behaviors, a stricter set of criteria." ]] “under a narrower category of autism. The person would have to show three deficits in social interaction and communication and two repetitive behaviors, a stricter set of criteria.” Currently, children have to show 6 out of 12 behavioral characteristics to meet the definition of autism spectrum disorder. This new definition of autism could exclude several children who currently have the diagnosis of Asperger's and PDD-NOS (Pervasive Developmental Disorder-Not Otherwise Specified.) This is relevant, because insurance companies, schools, state and local agencies use the DSM diagnosis to decide on treatment plans, compensation and services. Experts believe that this new definition will also decrease the diagnosis rate of autism.
Will pervasive developmental disorder not otherwise specified (PDD-NOS) and childhood disintegrative disorder. Those diagnoses will be "subsumed" into the single diagnosis of autism spectrum disorder or ASD. Volkmar told the NYT that this means fewer than half of the higher-functioning kids now diagnosed with autism would meet the new diagnosis. Some 75% of kids with Asperger's would be excluded, he says, as would some 85% of those with PDD-NOS. A member of the committee writing the new diagnostic criteria, Catherine Lord, PhD, director of New York's Institute for Brain Development, told the NYT she strongly disagrees with Volkmar's estimates of the impact of the new criteria for autism diagnosis.
Right now, children and adults diagnosed with autism fall into a number of different subcategories, including Asperger's syndrome. To clear up confusion, doctors want to give all of those categories one label. It would just be called Autism Spectrum Disorder, or A.S.D. "I work with many, many children and families and parents, and they don't really understand the names and what they mean. There are certainly people many people who do understand thoroughly, but I would say it is more common to be confused by all of these labels, and it's more helpful to parents and families to have one category," says Dr. Melissa Nishawala of the New York University Child Study Center.
Dr. Lawrence Kaplan is Director of Developmental and Behavioral Pediatrics at Baystate Children's Hospital. We spoke with him about the study," What D.S.M. Five does now is really clarify the distinction between autism, autism spectrum disorders and those other conditions and excludes specific named syndromes, and requires or asks the clinicians to focus more on severity and on following stricter criteria to make the diagnosis," says Dr. Kaplan. Those proposed changes are expected to sharply reduce the skyrocketing rate of of diagnosed cases of autism.
The proposed change would consolidate the autism spectrum, which now includes people with Asperger syndrome and pervasive developmental disorder, not otherwise specified (PDD-NOS). They and those now diagnosed with autism would all be under one label--autism spectrum disorder.
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.
With the proposed new definition, all three diagnoses would be consolidated under one category, autism spectrum disorder. This would eliminate Asperger syndrome and P.D.D. -N.O.S. from the M.S.M.
The new definition would create just one diagnostic category -- autism spectrum disorder -- that would replace the three subtypes that are used now. Those subtypes are Asperger syndrome, autism spectrum disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS).
What's in a name? If that name is autism or Asperger syndrome or P.D.D. -N.O.S. (pervasive developmental disorder, not otherwise specified), the answer is: a lot. Laurisa Stuart credits intensive therapy with the turnaround her 4-year-old son, Bryson, has made since being diagnosed with autism two years ago. He wasn't speaking at all then, but after countless hours of speech and occupational therapy, he's gearing up for kindergarten, where he'll be mainstreamed along with other children -- albeit with an aide. Potentially losing those services in the event that Bryson would no longer meet the criteria for autism is "a very scary prospect."
The new definition, the panel says, will provide clarity to diagnosing a disorder that badly needs it. While the panelists believe the impact of a new definition will be appropriate, Volkmar's study indicates it might have a much more widespread effect on those with Asperger's or P.D.D. -N.O.S., with a majority losing their diagnosis according to his analysis. If he's correct, about a quarter of those currently diagnosed with autism proper would also not meet the critera. For those who might lose their diagnosis -- or who may never be disagnosed at all -- the stakes are high: without a diagnosis, individuals will lose or be excluded from access to services like special education in schools and disability support.
"There is a group of people who are currently meeting diagnostic criteria who may not meet according to the proposed DSM5 criteria," said James McPartland, Ph.D., of the Child Study Center at the Yale School of Medicine. Experts estimate half of autism patients who are high-functioning, meaning they have normal IQs, would no longer be considered autistic under the new definition. Autism advocates said these diagnoses have real-world implications and that cutting out this group of high-functioning children would be cutting access to the aid they need. Accuracy in diagnoses should be paramount (and are, to most) but autism is a booming industry. Cutting those back is going to be a negative development to people working in that industry and to parents who are concerned. Yale Child Study Center director Fred Volkmar, M.D., and colleagues Brian Reichow and James McPartland analyzed people (without intellectual disabilities) who were evaluated and determined to be autistic during the 1994 DSM-IV field trial and they estimated that about half those might not qualify for a diagnosis of autism under the proposed new definition. Obviously, looking at old diagnoses, rather than actual people, and matching those to new proposed criteria and claiming they might not qualify is not entirely rigorous but autism was less faddish in 1994 so they may have a point. If autism is being reconfigured by negotiation and lobbying rather than science, DMS-V will be basically useless for deciding what should be covered by insurance companies, which means their coverage will be arbitrary. It's impossible that those economic factors aren't being considered.
According to analysis of data from a 1994 study, "half of the people diagnosed with autism in that trial would no longer merit a diagnosis under the new proposed criteria." If patients lose their diagnosis, they may no longer be eligible for important services and therapies.
A study suggests that with the proposed new definition of autism, fewer people with the condition will be diagnosed and deprived from health, educational, and social services. This is concerning for families with one or more members who display characteristics of autism.
FRIDAY, Jan. 20 (HealthDay News) -- The number of people diagnosed with autism will likely decrease if a new definition of the disorder is adopted by mental health experts later this year. Doctors aren't sure what the implications of the changes will be, but they agree there will be an impact on the lives of people with autism and the professionals who treat them. Some experts contend that a clearer definition of autism is needed because the current definition is too hazy and may have contributed to an exaggerated number of people with the developmental disorder. "This is not an academic exercise," said Geraldine Dawson, the chief science officer for Autism Speaks, an advocacy organization, and a professor of psychiatry at the University of North Carolina at Chapel Hill. "These changes in the diagnostic criteria will have a real impact on people's lives and we have to be very careful as we begin to implement the new criteria that we monitor how this is affecting people's ability to obtain services."
"There was a group of people, about half, who didn't meet criteria according to the proposed definition," says James McPartland with the Yale Study Center. At this point no decision has been made on the exact changes to the definition, but the conversation is underway among autism experts.
"The proposed changes would put an end to the autism epidemic," Dr. Fred R. Volkmar, director of the Child Study Center at Yale University School of Medicine and an author of a new analysis that predicts a decrease in diagnoses should the definition be altered. In a 2005 report in Current Directions in Psychological Science, Gernsbacher and her co-authors, Michelle Dawson and H.H. Goldsmith, presented three reasons not to assume that the increases in autism diagnoses are due to an unknown autism epidemic in the United States. They demonstrate how the rise in autism diagnoses over the last couple of decades could result from broadened diagnostic criteria, uptake of autism as a special education category, and greater public awareness. Amid the public debate over the proposed changes to the DSM, Gernsbacher strongly believes that any individual who needs support, accommodations, or services for his or her disability should have access to those accommodations and supports. "I hope that the new DSM-5 criteria don't make that more difficult," she remarks. NYTimes reports that the proposed changes "would probably exclude people with a diagnosis who were higher functioning." The changes could affect thousands of children and adults who rely on the services they receive because of their diagnosis. It is crucial that these changes don't result in discrimination against people who are struggling with autism symptoms." NY1's Kafi Drexel filed the following report. With so many people impacted by autism, there is a big concern that tightening up the definition will cause them to lose their diagnosis and with that, access to services and medical coverage. The Psychiatric Association and doctors responsible with making changes say that's the exact opposite of what they are trying to do. Doctors currently examine a wide range of behaviors to reach a diagnosis. The Psychiatric Association proposes breaking those down and looking at a few common characteristics, like social and communication issues and repetitive behaviors. The idea is to rank those behaviors from mild to severe instead of saying "yes" or "no" to a specific disorder. Doctors working on this issue say giving everything on the spectrum the same label may actually help expand coverage and services for people who don't meet all the classic symptoms. The Psychiatric Association is expected to finish work on its recommendations by the end of this year. The American Psychiatric Association's proposal would narrow the diagnosis criteria, and require patients to show three deficits in social interaction and two repetitive behaviors. "The hope is that we have refined symptoms to a point that this represents the core of the disorder and that this could be applied across that continuum of people who have intellectual impairments as well as individuals that might have very high IQs," said Dr. Zachary Warren, clinical psychologist at Vanderbilt University.
The New York Times reported the American Psychiatric Association is proposing taking Asperger's syndrome off the list of disorders on the autism spectrum. A study presented Thursday at a meeting of the Icelandic Medical Association estimated that less than half (45 percent) of 372 children and adults diagnosed with autism in a 1993 paper would qualify under the new criteria, The New York Times reported. A previous study came to a similar conclusion, Dawson said, with both papers appearing to identify fewer people with autism. "In particular, they're identifying fewer individuals who are higher functioning, for example, Asperger," she said. A new definition of autism could dramatically reduce the number of people who qualify for the diagnosis, a preliminary study reported by The New York Times suggests. The New York Times reported that revamping the definition of autism, by making it more stringent and emphasizing "classical autistic," or more severe, symptoms, could exclude many people and sharply curtail the trend of rising diagnoses.
The manual that all doctors use to diagnose behavioral disorders is changing the definition of autism. With new, stricter guidelines, it could be harder for people who no longer meet the criteria to get the aid they need. The number of children diagnosed with autism has skyrocketed over the last decade, with roughly one in 110 children said to have the condition. That could change soon. The manual that doctors use to guide them through an autism diagnosis, called the DSM, is changing the definition of autism by narrowing the criteria. One in every 110 children are currently diagnosed with autism, but that number could be going down due to a proposed definition change. As per the reported information, the proposed change in the definition would be applicable by 2013. This change is said to exclude 25% of the newly diagnosed autistic children. This has raised concerns among the public who have affirmed that if changes get applicable then their children who have been suffering mild form of autism would not be able to get the desired treatment. It is also said that no confirm decision would be taken till the time all parents get assured that the move would be beneficial for their children suffering from autism. If the proposed changes are being made to the American Psychiatric Association's definition, then about 25% newly diagnosed with milder form of autism would get excluded from the list. LOS ANGELES (KABC) -- The American Psychiatric Association is currently looking at whether it should adopt a changing definition of autism into its manual of mental disorders. The definition is being reviewed by a panel appointed by the American Psychiatric Association. The association is putting together the latest edition of its Diagnostic and Statistical Manual of Mental Disorders. The definition is being re-assessed by the American Psychiatric Association for the Diagnostic and Statistical Manual of Mental Disorders. It's one of the first major revisions in 17 years.
"We don't think that's likely to happen, based on our assessment." The psychiatric association, based in Arlington, Virginia, is scheduled in May 2013 to publish its fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the definitive resource used by doctors to diagnose, study and treat illnesses.
An expert panel that was appointed by the American Psychiatric Association has had the task of revising the Diagnositc and Statistical Manual of Mental Disorders(D.S.M.).
Some experts, including Dr. Allen Frances, who co-authored the last edition of the D.S.M., have long suggested that the broadened definitions of autism, attention-deficit hyperactivity disorder, and bipolar disorder included in that edition were mistakes with "terrible consequences." Gary Greenberg, writing for Wired in 2010, suggested that Dr. Frances "thinks his manual inadvertently facilitated these epidemics -- and, in the bargain, fostered an increasing tendency to chalk up life's difficulties to mental illness and then treat them with psychiatric drugs." You've probably heard of Science 2.0® but never heard of me - "Oh, you're that guy" is the comment I get most frequently at a talk or conference. Changes to the diagnostic definition of autism will be published in the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" - DSM V - but exactly what those changes will be is a key point of discussion. The group is wrapping up work on the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, which The New York Times reports is the manual's first major revision in 17 years. The D.S.M., Diagnostic and Statistical Manual of Mental Disorders is undergoing the most dramatic revision in 17 years.
Federal special education law--the Individuals with Disabilities Education Act--doesn't rely solely on the Diagnostic and Statistical Manual of Mental Disorders, Ms. Trainor said. "That diagnosis may have some bearing, but it's not the sole determining factor," she said.
The D.S.M. is the standard used to diagnose mental disorders. By new definitions, most of those now diagnosed with high functioning Aspergers will lose their diagnosis. Experts believe that this will stem the rising tide of numbers of those diagnosed with ASD, numbers which now are reaching "epidemic proportions." An infographic also published in the times shows how the new definition could affect current diagnoses of autism, Asperger Syndrome and pervasive developmental disorder, narrowing the number of cases of each that would fit into the newly agreed-upon definition. A patient would have to exhibit three deficits in social interaction and communication and two repetitive behaviors - a much tighter control than current guidelines. According to Volkmar, about a quarter of patients diagnosed with autism in 1993 would not be under the new definition, three-quarters of Asperger syndrome patients would no longer qualify, and up to 85 percent of those diagnosed with P.D.D. -N.O.S. would not.
"Previously, the criteria were equivalent to trying to cleave meatloaf at the joints," is how the DSM-V rationale for the new catch-all diagnosis goes. Those most affected by the new diagnosis will be some of the highest-functioning people with the least severe forms of autism: Asperger's syndrome and PDD-NOS. It's not clear exactly how many patients who currently have one of the autism diagnoses would no longer be diagnosed as having autism if the preliminary draft of the DSM-V becomes final. "Our fear is that we are going to take a big step backward," Lori Shery, president of the Asperger Syndrome Education Network (ASPEN), told Carey. "If clinicians say, "These kids don't fit the criteria for an autism spectrum diagnosis,' they are not going to get the supports and services they need, and they're going to experience failure." The new criteria is very specific. The proposed revisions to the Autism diagnosis is being interpreted by professionals that if a child doesn't fit the detailed, limited criteria for an Autism Spectrum diagnosis, they will then be at risk of not receiving the critical supports and services from the public school.
"Autism is diagnosed by an observation of behavioral characteristics, and right now you have to have six of the 12," said Tanya Baynham, the program director for the Kansas City Autism Training Center. Some of the characteristics that are observed during a diagnosis are a person's concentration, social skills and their ability to adapt with routine. Those are just a few of the areas teachers at the autism training center work daily with Eli Carter on. At age 4, Carter is considered higher functioning on the autism spectrum, and how his learning may be affected by proposed changes to the disorder's diagnosis isn't yet known. "If all of the changes were in effect now, today, they would absolutely (negatively affect things). "We would nip it in the bud -- think of it that way." Some parents -- especially those who have children with Asperger's -- are nervous about losing their diagnosis. "Parents are worried that autism spectrum disorder is very different from Asperger’s and they're concerned what that autism label will mean for their child," says Eric Peacock, who recently launched MyAutismTeam, a social network for parents whose children have autism. Often it's associated with quirkiness more than anything else." "There is a broad spectrum so there are people that have some features of autism, not full blown. They may have autistic features that are caused by another disorder," said child neurologist, Dr. Susan Boutilier. She works with autistic children on a daily basis. When it comes to diagnosing them she says there's mixed reaction from parents. "Some parents really want their kids to get the diagnosis of autism so they can receive services, other parents are scared to death of having their child labeled, don't want the diagnosis."
At a time when school budgets for special education are stretched, the new diagnosis could herald more pitched battles. Tens of thousands of people receive state-backed services to help offset the disorders' disabling effects, which include sometimes severe learning and social problems, and the diagnosis is in many ways central to their lives. Close networks of parents have bonded over common experiences with children; and the children, too, may grow to find a sense of their own identity in their struggle with the disorder.
I had a similar discussion with a child psychiatrist who is advocating for the diagnosis of "preschool depression." Certainly young children can struggle with disturbances of mood, and, as is the case with the above child, these families need help, and early intervention is essential to prevent more significant and deeply entrenched difficulties. As is the case with the diagnosis of autism, the diagnosis of depression in a young child reduces the complexity of his experience to a disorder, and clearly locates the problem within the child. In a previous post I wrote about a new book,Childism, that calls attention to a kind of prejudice against children that exists in our culture. Many parents of children with the diagnosis of autism object to my perspective, describing relief that the things they were struggling with had a name. What if teachers, friends, grandparents, and clinicians were respectful of their struggles and provided help without having to burden their child with a "disorder?" I suspect that these same parents would prefer the latter scenario.
Tobias said insurance companies in Missouri are required to help pay for treatment for children under age 21 who have been diagnosed with autism. She is concerned many patients in the autism spectrum will not meet the new definition's standards and will not be able to get the care they need. "You don't want your child to stay at a two-year-old level, if you can get them the proper early intervention. Eric was diagnosed on the autism spectrum at age 10 with "pervasive developmental disorder, not otherwise specified" - also known as PDD-NOS. "He wants to have friends desperately. He doesn't always know how to interact appropriately," she said. Eric qualifies for state-funded services that help him become more independent and help him thrive socially and behaviorally in the community, at a potential job, in school or at home. LaCross says that if he were to lose the critical service, she would not be able to work outside the home. "Having a kid with a disability, we have a lot of unknowns already in life," she said. "Then, when something like this happens, it just makes you nervous." "We found no evidence that maternal smoking during pregnancy increases the risk of autism spectrum disorders," study leader Brian Lee, an epidemiologist at the School of Public Health at Drexel University in Philadelphia, said in a university news release. "Past studies that showed an association were most likely influenced by social and demographic factors such as income and occupation that have associations with both the likelihood of smoking and with the rate of autism spectrum disorders," he added. Lee said the findings help reassure mothers who smoked during pregnancy that their behavior likely didn't cause their child's autism and "crosses off another suspect on the list of possible environmental risk factors for ASD (autism spectrum disorders).
If changed the new definition would make it much harder for people to meet the criteria for health, education and social services. Tightening the criteria for autism may hurt more than help those who are autistic. Current defined behavior characteristics of autism include failure to develop relationships, inflexible adherence to a routine, or delays in communication or imaginative play. This new proposed definition narrows the criteria for autism and deprives some people with milder conditions from services. This new definition represents an attempt to reduce misdiagnoses of autism. Under the current criteria for autism, a person must exhibit six or more of the 12 behaviors, compared to the new proposed definition, a person must exhibit three deficits in social interaction and communication, and at least two repetitive behaviors. Under the current criteria a person can qualify for the diagnosis by exhibiting six or more of 12 behaviors; under the proposed definition, the person would have to exhibit three deficits in social interaction and communication and at least two repetitive behaviors -- a much narrower menu.
According to a preliminary analysis, proposed changes to the definition of autism would likely exclude higher functioning individuals, making it more difficult to obtain health, educational, and social services. The article points to a study suggesting that proposed changes to the way autism is diagnosed will threaten "health, educational, and social services" many autistic children now receive.
Proposed changes to the definition of autism might make it a lot harder for a person to be diagnosed with the disorder. The proposed change would consolidate all three diagnoses under a single category called autism spectrum disorder. Under the proposed new guidelines, children with Asperger's would no longer be considered part of the autism spectrum. Advocates say these diagnoses have real-world implications, and that cutting out this group of high functioning children would be cutting access to the aid they need.
Autism which is also known as Asperger syndrome is a neurological disease which creates difficulties for a person while speaking. One of the mothers who has five-year-old autistic child shared that her son has been receiving play therapy, occupational therapy and behavioral therapy. All these therapies have helped him a lot and they could even feel the difference as earlier he used to be totally unresponsive, but now he reacts to things. It is quite natural for parents to have concerns about their children. They might have a tough time to convince the authorities concerned that they should suspend the proposed move. Kupfer said that in the last few years, children with autism have increased by four times. This has led to shrinkage of resources and resultant of which, newly diagnosed children are not able to get treatments. If the definition comes into practice, then autism treatments would be defined and children would be getting only those treatments which are meant for them. Such is not the case till now, as doctors provide majority of all the treatments to autistic children thinking that one or the other treatment would work for a child. This is the reason that parents have now got scared that their children might get very less therapies or it could also happen that the definition would exclude their child from being classified as an autistic. The changes would likely slow the rapidly increasing rate of autism diagnoses by narrowing the definition. Majiney Eulingbourgh is one such parent. Her son, Dameon, was diagnosed with autism at the age of 2. "Most kids pay attention to the cartoons, the loud noises he didn't. He was fascinated with things that turned: wheels, ceiling fans," she said. Because of that early intervention, Eulingborough said her now 10-year-old boy can read, write and interact like any child his age.
Sally Ozonoff, a University of California, Davis, psychiatry professor who authored a study published in August that found that autism runs in families to a much greater degree than previously thought, thinks parents are worrying unnecessarily. She wasn't involved in refining the definition, but she wrote in an email that: "…I can state that the intentions of that group, and of most professionals in the field, would not be to exclude anyone from services or to tighten criteria to reduce the number of diagnoses. A new definition of autism could dramatically reduce the number of people diagnosed with the disorder, and deny government funding and educational services. A new definition of autism could dramatically reduce the number of people diagnosed with the disorder, and could cut funding for educational programs and government support.
Outside experts said while the list of symptoms used to diagnose autism will be cut, it doesn't mean children who have the condition will be excluded. "The hope is that we have refined symptoms to a point that this represents the core of the disorder and that this could be applied across that continuum of people who have intellectual impairments as well as individuals that might have very, very high IQs," said Zachary Warren, Ph.D., a clinical psychologist at Vanderbilt University. The changes are still under review and won't be finalized until later this year. The Arc advocates for and serves people with I/DD, including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 700 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis. According to the Centers for Disease Control and Prevention (CDC), one in 110 children have a diagnosed autism spectrum disorder, and 1.5 million children and adults are diagnosed with autism spectrum disorder. The severity of these people's autism vary from severe to mild forms. Not only would narrowing the definition of autism hurt many children and adults on the spectrum, it would also hurt the psychological community. Psychologists, Psychiatrists, Occupational Therapists, Speech Therapists etc etc are paid to help these people, and if a large portion were to lose their insurance for services, who does that benefit? I don't think it makes any sense. Right now, nobody but an elite few in the world of psychology even know what the new definition is. Rightly so- I do truly understand why parents of children with autism would be fearful of losing the services that are their lifeline. I think these few quotes that were released have people panicked about something we really no nothing about.
Volkmar and his team found that in a group of individuals without intellectual disabilities who were evaluated during the 1994 DSM-IV field trial, it was estimated that approximately half might not qualify for a diagnosis of autism under the proposed new definition. Volkmar stressed that these preliminary findings relate only to the most cognitively able and may have less impact on diagnosis of more cognitively disabled people. "Use of such labels, particularly in the United States, can have important implications for service," he said. "I became more self aware and I could direct what my objectives were and just function in school," Duncan tells us. "I don't think I could succeed to the degree I do now without these services." Upstate New York Families for Effective Autism Treatment released a statement on the proposed definitional change to autism, indicating that its members are concerned that the new defintiion will limit the services available to some families. "This is an emotional issue for families, but we're trying to be objective about the new definition," Julie Wright says. He's a success story." What constitutes an autism diagnosis depends on who is asked because every answer will vary. A change to narrow its definition has been proposed by the American Psychological Association. More than a million children and adults in this country are estimated to have autism, and now the American Psychiatric Association is revamping just how an autism diagnosis is reached, leaving some families and advocates concerned that they could lose the support they need. Jan. 20 (Bloomberg) -- The American Psychiatric Association is moving a step closer to overhauling the criteria for diagnosing autism after two just-completed field studies found the new definition won't exclude. The revised definition of autism is being drafted by a panel of experts appointed by the American Psychiatric Association. Experts at the American Psychiatric Association are revising the definition of autism, making it more difficult to qualify for the condition.
It has been revealed that the American Psychiatric Association has been approached to revise the autism definition.
Experts working for the Psychiatric Association on the manual's new definition - a group from which Dr. Volkmar resigned early on - strongly disagree about the proposed changes' impact. A proposed change in the definition of autism could change many lives, and not for the better. James C. McPartland answers readers' questions about the impact of proposed changes in the diagnostic criteria for autism. The proposed changes would combine all forms of autism, including asperger's, under one umbrella.
The change, which is part of a revised mental health manual still under review, would mostly affect people who today would be diagnosed with Asperger's syndromeor high-functioning autism. Most experts expect that the new manual will narrow the criteria for autism; the question is how sharply… The psychiatrists' association is wrestling with one of the most agonizing questions in mental health -- where to draw the line between unusual and abnormal -- and its decisions are sure to be wrenching for some families." The latter two disorders would then be individually stricken from the manual. U.S. health experts are reportedly considering changing the definition of autism which would likely reduce the rate at which the disorder is diagnosed, while also possibly reducing some individuals' access to the treatment and social assistance they currently receive. As diagnosis rates have skyrocketed, some experts favor the narrowing of the autism definition. "It's going to have a huge impact financially in the state on the schooling system, who gets special education classes, who doesn't," said Upstate's Dr. Niamh Doyle. Either way, Dr. Doyle says the focus needs to be on those who are diagnosing the disorder. Doctors say the likelihood of being excluded under the new definition of autism depends on your original diagnosis. It's estimated that about ¾ of those with Asberger Syndrome and 85% of those with Pervasive Development Disorder (P-D-D) would be left out under the new definition.
"Many times to obtain services you have to have a diagnosis of an autism spectrum disorder. This might allow you to get early intervention or allow you to participate in a classroom that's specialized," said Geraldine Dawson, the chief science officer of Autism Speaks. Allison Wilmot, iCan House program director, said the autism term helps come to terms with the disorder. "To take away that answer from some people I think it's going to be very challenging," Wilmot said. "There's going to be a harder time finding those services if there's no directional label to give you, to say, 'This is the right path to go down.'" Shufran said those with Asperger's are very close to having a healthy, happy, normal and productive life. Those with Asperger's are also considered among the highly functional groups with autism, as well as the ones most likely to help society.
The Times says upcoming revisions to the D.S.M., the first major revision to the mental disorder desk reference book in 17 years, could make access to health, educational and social services more difficult to qualify for as it narrows the definition of the disorder. If the definition is changed, it could dramatically reduce the number of diagnoses, which have skyrocketed in recent years. That could mean many children with developmental problems could be denied health, education and social services.
The findings behind the NYT report are based on the highest-functioning 372 children and adults in that study. Volkmar told the NYT that an analysis of 1,000 cases will be published later this year. It's not entirely clear whether children receiving special educational or social services would lose them if their diagnosis changes. Eligibility for many of these programs is indeed based on a psychiatric diagnosis. In public school districts across the United States, including Rhode Island, numerous children receive school support services based on the diagnosis of Autism. This change could allow school districts to reduce or eliminate those support services. The Times talked to Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine and an author of a new analysis designed to weigh the potential effect of the proposal. He said the changes would narrow the diagnosis so much that it could effectively end the autism surge. "We would nip it in the bud," he told The Times. James McPartland, an assistant professor at Yale's Child Study Center and co-author of an analysis of the change that found that the new definition would exclude many higher functioning individuals, is taking questions on the New York Times Consults blog today.
A story in today's New York Times sounds an alarm for parents of children with autism particularly kids at the high-functioning end of the autism spectrum. Rochester, N.Y. - A new definition of autism has families concerned that their children could be pushed off the spectrum, limiting their access to vital services. Job support training is one of many services that would likely be denied to people with autism. Autism advocates say these diagnoses have real-world implications and changing the definition cuts access to the aid they need. "So at the end of the day the individual is going to be the same, but removing or changing the label is going to remove the services that allow people to retain jobs, stay in their community and have an adequate living situation," Tracey Sheriff, CEO of the Autism Society of North Carolina, said. Tracey Sheriff, chief executive officer of the Autism Society of Carolina, said Friday that thousands of people could potentially lose state-funded health, education and social services. "We want people to live within their communities, in their homes, near their families, just like a life you and I have," he said. Removing that support, Sheriff said, could force many of those in need into state facilities. "I'm learning the coding language used to make apps on the iPhone and iPad," Griffin said. Griffin uses his computer skills to manage the online bookstore at the Autism Society of North Carolina, working without pay. "Most important for him, I want him to be safe and happy," Griffin's mom, Linda, said. "His goal is to not live with us, and that would be my goal too. I would like for him to be an independent person." Griffin has applied for computer programming jobs, and although he has the technical skills to do the job, his mom says autism prevents him from having the social skills to succeed in the job interview process. Thanks to government funded services linked to his autism diagnosis, Griffin is eligible for job support training. The government funded service provides Griffin with a mentor who will help him deal with the social dynamics of a workplace.
"If you have a diagnosis of autism you get better services than if you don't," said child neurologist, Dr. Susan Boutilier. For now the Burtons say they will keep focusing on the services their daughters do get. It's help they hope to get for years to come.
Autism numbers: A new definition of autism could dramatically reduce the number of people who qualify for the diagnosis, a preliminary study suggests. A proposed new definition of autism could exclude many people now classified as having the disorder. Raleigh, N.C. -- Changing the definition of autism could have unintended consequences for people in North Carolina and across the nation living with the disorder.
That said, the current definition is so awful that a quarter of my coworkers probably qualify "autism spectrum". These are high-ranking, top-paid engineers and programmers who developed solid careers. They are more interested in things than people, socially awkward, and given to strange passions, but that used to be called eccentric. The proposed definition is different from the current definition in a couple ways. Under current guidelines, a patient is diagnosed with autism if he or she exhibits at least six of twelve outlilned behaviors. The new criteria would require patients to show three deficits in social interaction and communication, and at least two repetitive behaviors. Experts say people with high-functioning forms of the condition will no longer be diagnosed with autism -- which could affect their ability to qualify for government aid. Some experts say there has been a bona fide increase in the number of cases, while others contend that the lack of clear-cut diagnostic guidelines is to blame. Autism is a complex neurodevelopment disorder with typical symptoms that include difficulty communicating with others, the inability to form social relationships, and repetitive movements such as rocking and twirling, or even self-abusive behavior such as biting or head-banging, according to the U.S. National Institute of Neurological Disorders and Stroke. Autism now includes a range of complex disorders characterized by social impairment, communication difficulties, and restricted, repetitive patterns of behavior, according to the National Institutes of Health in Bethesda, Maryland.
The new criteria would require patients to show three deficits in social interaction and communication and at least two repetitive behaviors. "Parents have to jump through loops to get resources and funding for their children, so the more criteria they have to meet the harder it is going to be to have a diagnosis," said Stephanie Tobias, a lead teacher at the Rivendale Center for Autism in Springfield. Dr. David J. Kupfer, who is Chairman of the task force making the revisions, said that the definition can be changed. It is not final yet and parents need not worry, as they would ensure that children suffering from autism are being given complete diagnostic check up. Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, said the new definition is "trying to lend some greater precision" to the diagnosis of autism. Today the prognosis for a child diagnosed with ASD is better than ever, because early interventions have become so much better. To change the definition of the diagnosis to leave out who knows how many thousands of children is a great disservice to those children, their families, and in the long run to the communities who will still end up supporting them somehow if no early intervention is given. Funding isn't the only thing at stake for a family with ASD. The prospect of putting a child with ASD into public school has become one of increased trepidation. IEPs, Restraint and Seclusion, a lower standard of education, all these can be a maze of nightmares for parents to navigate. Take away the diagnosis and you have a child who needs extra help yet is now labeled only as a child with "behavior issues" and relegated to daily punishments to "correct" him. Many parents with special needs children choose to homeschool them instead of leaving their fates to the public school system. Parents often begin to regard behaviors as "symptoms" of the "disorder." For a very young child whose development is unfolding, his "true self" might be lost in the face of such a frightening label. It is my hope that we can move from an emphasis on diagnosis and labeling to an emphasis on prevention. We need to ask not "what is the disorder?" but rather, "what is the experience of this particular child and family?" and "what can we do to move things in a better direction?" From a young child's perspective, the diagnosis with a psychiatric disorder reduces the complexity of his experience to a label that by its very nature indicates that there is something "wrong with him." " As I state in my book Keeping Your Child in Mind," is a dangerous example of the tail wagging the dog." From the young child's perspective, there is a significant downside to receiving such a label. Parents who receive a label of a major psychiatric diagnosis for their child inevitably go through a period of mourning. The child they had is gone and has been replaced by a child with a "disorder." As D. W. Winnicott so wisely observed, a child develops a healthy sense of self when the people who care for him recognize the meaning of his behavior, rather than substituting their own adult meaning.
First of all they aren't problem children. It's not as if just because a child has austism that they automatically have behavioral issues. There are other things that goes along with it, such as socializing problems. For your answer as to where these "problem" children were, maybe you should become educated about autism and then you will find your answer. This disorder has been around for a long time, just society use to chose to ignore these children, and pushed them to the side, because they didn't fit into it's neat little box. Children, and adults alike with austism are able to be functioning members of society, that have their own unique ideas, traits, and abilities. My advice to anyone who wants to "label" them as problem children, or unproductive should get educated and then spend sometime with these children before you prematuraly make conclusions about them. The DSM changes every so often. This is not new news, the DSM-V has been in the works for years now, and the changes to the Autism disorders have been a highlight of the new version for most of that time. GREENVILLE, N.C. (WNCT) - Millions of people are diagnosed with autism each year, but that could soon change. Dr. Vanderbuilt believes much of that is driven by the focus to identify new cases. If the new way of categorizing autism is adopted, he doesn't think it will change the number of kids diagnosed. This would be the first major revision on autism in 17 years.
"So we need to remember that the autism spectrum is just that -- a spectrum." Duncan was in sixth grade when he was diagnosed. He made the transition from a student who couldn't change tasks to a student who is thriving at the Norman Howard School in Henrietta. The new guidelines are designed make the diagnostic criteria clearer and more consistent for autism disorders. The new designation folds in six existing individual conditions and places them on a scale, called autism spectrum disorders.
Applying the current diagnostic criteria for Asperger syndrome to children can even be tricky. Gernsbacher references a recent study of over 2000 children in various locations around the U.S. which showed that fifty well-trained professionals disagreed in their use of Asperger syndrome diagnoses. This study also showed wide disagreement in the use of the diagnosis of PDD-NOS (Pervasive Developmental Disorder-Not Otherwise Specified). "There are a group of people who previously had Asperger Syndrome or high-functioning autism who are now no longer meeting the criteria." Some say although change is needed it may affect many of the 40,000 people in New Zealand who live with autism and Asperger's syndrome. The changes combine all forms of autism -- including Asperger's Syndrome -- under one umbrella.
Under the new definition of autism, Asperger syndrome, which generally describes a higher functioning individual, would be eliminated, as would PDD-NOS, a sort of catch-all category. We met Julie Wright, parent of 16-year-old Duncan, who has Asperger syndrome. Wright is also optimistic that the new definition won't push cases like Duncan's off the spectrum, but she'll be watching closely. "A lot of students -- especially kids on the high end of the spectrum -- don't look like they have anything going on," she explains. More on that in a moment. Their new parameters remove some of the insistence on categorical definitions within the spectrum, such as as Asperger syndrome.
"I'm very concerned about the change in diagnosis, because I wonder if my daughter would even qualify," said MsMary Meyer of Ramsey, New Jersey. 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." "Having a diagnosis helps people understand why we process thoughts and emotions differently and make positive changes", said Michael John Carley, who is Director of the Global and Regional Asperger Syndrome Partnership. "For example, a diagnosis of Asperger syndrome requires documenting that the individual didn't have a very early delay in using language. Many adults needing diagnoses don't have detailed language development documentation from their infancy," she says.
As currently proposed the new definition won't be final until later this year the diagnosis of Asperger's disorder will go away. I am a classroom teacher & have had students in my classroom who have been identified with Aspergers & others on the spectrum. Not once, & I've done this for 18 years, have I questioned the numbers of students identified. Their diagnosis is imperative in order to adequately meet their educational, social, & emotional needs. I would be concerned if suddenly half of my students on the spectrum would no longer qualify for services. Meanwhile the new study suggests that it may be harder for people who would no longer meet the criteria to get health, educational, and social services. The changes could affect the number of people eligible for health, educational and social services. The issue isn't semantic, Dawson said in a telephone interview. Patients need to be diagnosed to get access to treatment such a behavioral intervention, social skills training and support services, she said. "From the scientific side, the changes make a lot of sense," she said. "It's a question of how this might impact services. We need to think through the implications for a well- reasoned change or the real people who are in the real world trying to obtain the services they need."
"Autism is vastly different in each individual case," Dr. Silverman says. "It makes sense to look at who is getting what kind of service and why. The goal is to make it more transparent what kind of services people need and to make sure that the kids who get those services all have some similarities." Some experts think the current criteria for diagnosing Autism needs to be narrowed to include less people. Jennifer Pinto-Martin, director of the Center for Autism and Developmental Disabilities at the University of Pennsylvania, notes that the current version of the DSM -- the fourth edition -- broadened the criteria for autism, in effect contributing to more children receiving diagnoses. Recently the number of autism diagnoses has increased among children and adults. The high number of diagnoses of autism could be due to the vagueness of its definition.
A new study has proposed a new definition for autism which has sparked controversy and has raised concerns among parents and many experts. A study that has proposed the change has led to controversy in which parents and health experts have called the change to be unneeded.
"Changing everything the opposite way is making so I won't be at KATC (Kansas City Autism Training Center)," said Rooks. How soon services and funding could change is anyone's guess, but one thing's certain - the children at the center show improvement almost daily, and parents worry that progression will slow if their children are financially forced out of the specialized classrooms. SPRINGFIELD, Mass. (WGGB) The way autism is defined could soon change. That might mean fewer children are diagnosed. A proposed change in the way autism is diagnosed in the United States is being closely watched in New Zealand.
Thank you. Pull your heads out of where the sun doesn't shine! There's still going to be an epidemic of medical conditions out there that will go unexplained and untreated thanks to this. Changing the criteria of autism does NOTHING to change the fact that these kids still have serious problems and need all the help they can get to help them function in society. All you're going to do is make it far more difficult for these families to get the help they need, put more stress on the inner workings of these families, create more of a financial burden to these families, create more heartbreak and heartache than there already is. The APA is not going just change something that will dump an entire category of people on the streets with no supports. I promise that is not their goal, nor will they allow that to be an unintended consequence. There will be a place for these kids, and the new criteria will make sense on a clinical level. Trust me- as a therapist, please know that we all have our tricks for getting people the help they need.
A new definition does nothing but limit the needed services of those who's bracket was not close enough to the stricter definition, you still have kids that need help, that does not change because the definition changes. Estimated costs to families can range from $39,000 to nearly $130,000 a year. The fact that these children need extra help will not change regardless of what label is put on them.
Now the fight may get even harder. It's estimated that about ¾ of those with Asberger Syndrome and 85% of those with Pervasive Development Disorder would be left out under the new definition. That's what worries the Burtons most. "If they do change the definition then none of our children will be classified as autistic," said Erin Burton. A change to the definition of the disorder could have a wide-ranging impact on those who suffer from it, a study shows.
A proposal to change the definition of autism could affect thousands of families. In the midst of redefining autism, psychiatrists are battling over what is considered unusual versus abnormal. These definitions will determine which families will receive state-backed services and will enter into a community of families sharing similar experiences. Las Vegas, NV (KTNV)-The definition of autism could be changing, and that could affect the services available to families with autistic kids.
An American Psychiatry Association expert panel is reassessing the definition of autism. Experts estimate half of autism patients who have a normal I.Q. and considered "high-functioning," like Griffin, would no longer be considered autistic under the new definition. Experts said a new definition won't put a stop to the climbing rate of autism.
Getting an autism diagnosis could be more difficult in 2013 when a revised diagnostic definition goes into effect. The current criteria for a diagnosis of Autism under the DSM-4 indicates that a person can qualify for an autism diagnosis by exhibiting 6 or more of 12 behaviors in three categories and at least one additional delay or deficit in three areas. The draft DSM-5 reduces this dramatically. The Times said under the manual's current criteria, a person may qualify for the diagnosis by exhibiting six or more of 12 behaviors.
The bible of psychiatry is the Diagnostic and Statistical Manual or DSM. The DSM lists every allowable psychiatric diagnosis and spells out the criteria for each diagnosis.
By tightening the criteria for autism, the rate of diagnosis will likely drop. There are ways to get around it. "There are other diagnoses that could be applied to them such as a learning disability, sometimes even a mild mental retardation that could be applied to some kids that would get them equal services without necessarily fitting the criteria for autism," said Boutilier. Unlike DSM-IV, when the race was on to add diagnoses for everything, concern about DSM-V is in making things more scientific and less social interest or advocacy-based. If 80 percent of people are something, for example, it isn't a psychological condition, and autism has been extrapolated so far that virtually anyone can be considered 'on the spectrum' or one of its derivatives if they want to be. That's bad for people who actually have it because limited treatment resources are stretched beyond control. There's no definitive dividing line between the several current diagnoses that are part of the autism spectrum.
One major factor is a huge increase in funding for special education and treatment programs. Others feel that the current broad definition of autism is catching many children whose developmental issues might otherwise not have been addressed. That's why Volkmar told the NYT that the DSM-V's more restricted autism definition would end the so-called autism epidemic. There has been an explosion of autism cases since the early 1990s. It could be that something in the environment has changed, affecting children with some genetic susceptibility to developmental disorders. Or it could be that families and doctors are more aware of autism, and are looking more closely for signs of developmental issues. Smoking during pregnancy has been considered a possible cause of autism in children due to known links between smoking and behavioral disorders and obstetric complications, but previous studies of a connection between smoking during pregnancy and autism have had mixed results. The results showed that 19.8 percent of the children in the autism group and 18.4 percent of those in the control group had mothers who smoked during pregnancy.
Autism is a neural developmental disorder that leads to impairments in behavior and communication. Dr. Niamh Doyle works with patients with autism at Upstate. He says, "It's a difficult diagnosis to make often because it has such a wide spectrum of behaviors and characteristics." An autism diagnosis in DSM-III was not the same as IV and a IV will not be the same as V. The status quo can't remain, of course, DSM-IV had too many flaws, but the social sciences have a hard time maintaining science rigor and most (Four Horsemen of the Questionable like Stapel, Hauser, Kanazawa, etc., aside) in the field want that to improve. People with Asperger's or P.D.D. -N.O.S. experience similar social struggles as people with autism. Many people in the field are concerned that the new definition of autism maybe be too narrow for the condition and will exclude a portion of patients with the condition. Many feel the new definition will narrow the criteria for autism, the question is how sharply. "There was concern that by tightening the criteria we would drop the bottom out from people with previously diagnosed autism," said Regier, who is also vice chairman of the task force weighing the new guidelines. "Every autism is very unique. I mean our three daughters, none of them are the same," said Erin Burton. Erin and Corey Burton knew something was off with their daughters but say it took years before they were ever diagnosed. "It is very hard when they don't fit what people think is autism and people still picture non-verbal, aggressive, frustrated angry kids and that's not the case," said Erin Burton. "When they're higher functioning a lot of people are just going to think well they're just hyperactive kids," said her husband Corey Burton. Bryson Stuart, 4, has made great strides in therapy since being diagnosed with autism two years ago.
There has been an argument raging for years with one faction claiming that the numbers are merely the results of better diagnoses, while many experts still hold that that still doesn't account for the fact that one child in a hundred is now diagnosed with ASD. For years, many experts have privately contended that the vagueness of the current criteria was contributing to the increase in the rate of diagnoses - which has ballooned to one child in 100, according to some estimates.
The results of the new analysis, presented on Thursday at a scientific meeting in Reykjavik, are still preliminary, but they suggest that tightening the criteria for autism could have dramatic repercussions. James C. McPartland, an assistant professor in the Child Study Center at Yale University, is one of the authors of the new analysis, and he has agreed to answer some questions from readers about how it was done and what it indicates. Please submit your questions in the comments section below and look for his answers there later on Friday. Please remember that Dr. McPartland cannot offer individualized advice and that he cannot answer every question. "We would nip it in the bud," said Dr Volkmar. In the new analysis, Dr Volkmar, along with Brian Reichow and James McPartland, both at Yale, used data from a large 1993 study that served as the basis for the current criteria. They focused on 372 children and adults who were among the highest functioning and found that overall, only 45 per cent of them would qualify for the diagnosis under the changed criteria. Volkmar's study uses data from the 1993 study on which the current autism diagnosis is based.
Washington, Jan. 22 (BNA) - Children born to women who smoke during pregnancy are not at increased risk for autism, according to a new study. There are many families that struggle with finances," said Elizabeth Obrey, a mother of children with autism.
Molloy said even if the definition of autism is changed, it will not make the condition go away. There is a view in the U.S. that Asperger's is over-diagnosed but Molloy does not think this happens in New Zealand. "There are some fairly robust tests that diagnosticians would use, but observation is the key part of the diagnosis," she said. Autism New Zealand chief executive Alison Molloy said while the proposed re-classification will help some, many are already missing out on essential services and even more will do so. According to some proponents of the change, the proposed redefinition would virtually end the apparent surge of autism diagnoses. The autism change, first proposed in February, 2010, would be included in that edition, if it is approved.
The proposed changes would probably exclude people with a diagnosis who were higher functioning. The proposed change has some families and health care providers concerned that it will block some people from getting necessary care.
The proposed definition would require people to exhibit three deficits in social interaction and communication and at least two repetitive behaviors--a narrower interpretation. The new proposal breaks the guideposts down into two distinct areas, communication and repetitive behavior. Under communication, autistic people are those who will have trouble with relationships, non-verbal communication such as making eye contact or using gestures, and with social reciprocity, such as taking turns or holding a conversation. They must exhibit symptoms in each of these areas to be diagnosed under the new plan. With behavior, patients may have to meet only two of the criteria among actions such as having limited interests, getting stuck on repetitive activities, having strong or muted responses to sensory stimulation like sound and taste, or developing rituals. With the new definition, one would have to exhibit three deficits in social interaction and communication and at least two repetitive behaviors much narrower criteria," according to experts, UPI reported.
Most experts are predicting that the new manual will narrow the criteria for autism. Experts said the changes would reduce the number of cases of autism, but critics said the point isn't to cut down the number. Experts say autism is like putting together a big puzzle, and so is figuring out how to come up with the money for treatment. DSM-V is NOT going to be an activist controlled argument surrounding the spectrum of Autism. It will be a new(er) reality to people everywhere -- Just like Alcoholics Anonymous SHOULD be. Only those who are affected by said 'disease' are the only ones who understand it. mostly. There are those out there that LOVE to have their blinders on and ear plugs in when the topic comes up. Sorry, you can't make autism go away by re-defining it." Says Peacock: "In the short term, this could actually cause some stress and trauma, and that's the last thing these people need." You don't know what the hell you are talking about. Do you think people go through all of the hours and treatments to help autistic people people because its some kind of joke? Or because its fun? The problem with autism isn't the people who have it. the problem is YOU and how YOU deal with it. Today's talker: Can gossip be good? Busybodies of the world get a scientific pat on the back in a new study that shows people who spread news of bad behavior may make themselves feel better -- and help maintain social order. "The intention isn't to exclude people who meet the criteria for any of the conditions," said Lord, who is also on the task force considering the change, in a telephone interview. "It's just to be sure we aren't including everyone who has any kind of behavior problem."
"The new criteria are somewhat stricter," said Geraldine Dawson, chief science officer of Autism Speaks, an advocacy group based in New York. An analysis of the new definition surfaced in the New York Times that indicated the new definition is likely to reduce the number of diagnosed cases. That story can be found here. Experts working on the manual strongly disagree with the study's findings, the New York Times reports. Warner, a former contributing columnist for the New York Times, is the author, most recently, of We've Got Issues: Children and Parents in the Age of Medication. The views expressed are solely her own.
Under the current system, parents of children with PDDNOS or Asperger's could potentially be denied services. "For children it will potential make quite a significant difference, particularly around behaviour support, respite, getting extra help at schools," told TVNZ7 News at 8 last night. "(But) adults don't really get services or support at all in New Zealand - it's very difficult to get even a disability benefit if you've got Asperger's."
Currently, state-backed services help offset the disorders' disabling effects, including severe learning and social problems. Health experts look for the common factors like communication, social and repetitive delays to pin-point the disorder. The cases that might not be covered now are not cognitively disabled people. They may instead be like a lot of people who are casually diagnosed. In science and math, they may be like a lot of people who suddenly find themselves being labeled autistic for not liking to drink or socialize. Basically, the problem DSM-IV ran into was that they wanted to call everything a disorder, which meant to the public and insurance companies it really meant nothing so coverage was inconsistent. Many times odd movements, an inability to relate to people, and obsessive interests add up to a diagnosis of the disorder. Molloy agrees that diagnosis is currently inconsistent and imprecise, but should not be standardised in the way proposed which would take away support from people who need it. Might I. Hopefully in 2014 the diagnosis will be more rigorous but the APA has to make sure it is reining in the false positives and not excluding people incorrectly; that requires some diagnostic flexibility because there is no cookbook in neuroscience. It can't be completely arbitrary either, like much of it is now. "The goal with the diagnostic changes is to make the diagnosis clearer, but not to take services away from families," says Dr. Laura Silverman. Dr. Frances's assessment may be valid. It's hard to get around the fact that a changed diagnosis is going to change lives, and probably not for the better. James C. McPartland, an assistant professor in the Child Study Center at Yale University, is one of the authors of the new analysis, and he has agreed to answer some questions from readers about how it was done and what it indicates on the Consults blog (today only). Many children with ASD, regardless of high or low function, can have difficulty learning with several underlying learning disabilities. Without a diagnosis, if a homeschooled child falls too far behind their peers would they be forced back into public schools in spite of what's best for them? If a child falls behind in public schools, teachers don't lose their jobs and the school doesn't "lose the child." The child is just one more to fall into the cracks until he's old enough to drop out. Making a problem go away by pretending it doesn't exist may be a very old and well-used remedy, but it's one that has never worked.
Not exactly, Sonja Trainor, a senior staff attorney at the National School Boards Association, told me. She said to keep in mind that medical or other diagnoses are different from a determination about whether a student needs special education services at school. News reports from around the country say that the definition of the disability is being reassessed by a panel appointed by the American Psychiatric Association. The preliminary analysis was presented on Thursday at a meeting of the Icelandic Medical Association by Dr. Fred R. Volkmar, who recently resigned from his position on the APA expert panel. Volkmar used data from a 1993 study, focusing on 372 autistic patients among the highest functioning, and found that only 45 percent of them would qualify under the new definition. The experts remaining on the APA panel disagree with Volkmar's assertion that the new definition would have such drastic impact.
"Under the current definition, a person can qualify for the diagnosis by exhibiting six or more of 12 behaviors. Experts are worried a change could make it harder for children to receive health benefits. They're concerned that some will not be eligible for treatments, even if they have a mild case.