New autism definition excludes many

new definition of autism — renamed autism spectrum disorder — proposed by the American Psychiatric Association could exclude 45 percent of those now diagnosed as high-functioning, reports the New York Times. People with Asperger’s Syndrome, Pervasive Developmental Disorder and mild autism could find it harder to qualify for health, educational and social services.

Autism spectrum diagnoses have skyrocketed in recent years. The new definition could end the surge, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine.


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  1. Instead of figuring out the cause(s) of the autism epidemic, the medical establishment wants to pretend to make it going away. High-functioning Autism, Asperger’s Syndrome, and Pervasive Developmental Disorder are very real conditions that cause significant problems and deserve treatment.

    The cynic in me thinks that this change is being primarily driven by cost considerations rather than what is best for children. Schools, health insurers, and Regional Centers have legal mandates to serve children labeled as “autistic”. In this day and age of tight budgets, the fewer children who receive the all-important label, the fewer they will have to provide services to 🙁

    • Roger Sweeny says:

      If you read the article carefully, you see that there is a lot of disagreement about how many people who qualify now will be excluded under the proposed DSM-V.

      The big change in DSM-V is to say that there is no “disorder” unless the list of symptoms leads to “impaired functioning.” This may well mean that a person could have the disorder for a while, get help, and no longer have it–the same way people often have a “disease,” get help, and are cured. Eventually, many DSM diagnoses may cease to be lifelong labels of the person. I find this hopeful. It may mean that, after a while, a person will lose their “disabled” label and cease to qualify for money, housing, services, etc. But that seems fair to me. Good for the person who is no longer an unproductive, possibly stigmatized, dependent, and good for his or her fellow citizens.

  2. There is a follow-up article in the NYT where the chairman of the task force reviewing the criteria admits that it is all about cost considerations:

    Boo, hiss!

  3. Roger Sweeny says:

    The relevant paragraph in the follow-up article says,

    “We have to make sure not everybody who is a little odd gets a diagnosis of autism or Asperger’s Syndrome, said Dr. David J. Kupfer, a professor of psychiatry at the University of PIttsburgh and chairman of the task force making the revisions, which are still subject to change. “It involves a use of treatment resources. It becomes a cost issue.”

    In context (and even out of context) I don’t read that as “admit[ing] that it is all about cost considerations.” The statement refreshingly admits that it is impossible to provide free therapy for evey problem. But it hardly says that this is the only consideration or even the major consideration for the change in diagnostic criteria. I read it as saying that “oddness is not a disability.”

  4. It is all about cost savings… not only for schools but for insurance companies.

    There probably are cases of “over-diagnosis.” However, that shouldn’t preclude people, especially children, who need treatment from getting it. Ever since my daughter was diagnosed with Aspergers, all I’ve heard was how important “early treatment” was for her. I guess it really wasn’t eh? Since she really doesn’t have any issues…

  5. Richard Aubrey says:

    You will recall that, having no connection to looming Obamacare, the necessity for regular mammograms at early ages has been revised.
    Nope. No connection.