The DSM-5 revisions to what will now be officially known as the Autism Spectrum Disorders are not without merit. The American Psychiatric Association's DSM-V Neurodevelopmental Disorders Work Group April 2009 Report emphasizes for the first time that there are different degrees of severity on the autism "spectrum" of disorders. That is a good thing, one that many parents of severely autistic children will appreciate as the public consumes movie after movie about brilliant, talented persons with High Functioning Autism and Aspergers.
Having handed out that token of recognition of reality at the severe end of the autism spectrum, however, the Report then goes on to take it back by intentionally hiding the fact that approximately 80% of persons with what are currently known as Autistic Disorder also have intellectual disabilities or cognitive impairments. It is true that intellectual disability and cognitive impairment do not receive much overt recognition in the current edition of the DSM but they are there in the description of Aspergers Disorder:
The description of Asperger's Disorder in the current DSM-IV results in a division between Aspergers and Autistic Disorder based on cognitive delays. This division is not expressly mentioned at all in the proposed DSM-5. But the 80% of persons with Autistic Disorder and intellectual disabilities or cognitive impairment will still be there ... hidden without any express mention in the severe ASD category. There just won't be any mention of intellectual disabilities and autism in polite company ... in the New Yorker Magazine ... in Hollywood movies ... in society generally ... or in the Autism Spectrum Disorders category of the DSM-5.
The Report also appears to broaden the Autism Spectrum, yet again, at the high functioning end of the spectrum, by including a category called Subclinical AS Symptoms and, in what could have been drawn directly from a Neurodiversity ideological manual, a category called Normal Variation.
The Subclinical category expressly states that the category is comprised of persons with no significant interference or impairment while the Normal Variation simply refers to socially isolated or "awkward". There is no explanation why such categories are included in a description of neurodevelopment disorders if there is no significant interference or impairment; if they are just normal variations of behavior.
The DSM-5 removes any express reference to intellectual disability or cognitive impairment and adds new sub-clinical categories of high functioning persons with no significant impairment or interference. Autism, once a neuro-developmental disorder as set out in the DSM-III, will become increasingly seen as a mild condition full of Temple Grandins, Ari Ne'emans and Alex Planks and a host of talented and quirky historical geniuses.
The DSM-5 has succumbed to Neurodiversity ideology, Hollywood movies and a form of discrimination by omission against the most severely affected by autism disorders - those with intellectual disabilities requiring the most attention and assistance. They are the invisible autistics, the ghosts of the new Autism Spectrum of Disorders about whom the DSM-5 Autism Spectrum Disorders category will make no mention.
The DSM-5 may become a useful tool ... at concealing the reality that intellectual disability and cognitive impairment are more than just co-morbid conditions associated with autism in some instances ... they are part of what it means to be severely autistic. Unfortunately the DSM-5 Neurodevelopmental Disorders Work Group has chosen to sweep intellectual disability and cognitive impairment under the Autism Spectrum Disorder carpet.