Friday, July 15, 2011

Confirmation DSM-5's New Autism Spectrum Disorder Will Exclude Intellectually Disabled

I have written previously that persons who presently have autistic disorder or PDD-NOS and who are also intellectually disabled will be removed from the DSM-5's New Autism Spectrum Disorder. Whereas those with intellectual disability once constituted autism's vast majority as described by CDC autism expert Dr. Marshalyn Yeargin-Allsopp the 1994 addition of Asperger's Disorder reduced their numerical weight on the autism spectrum.  With the new DSM-5 wording has intentionally been added to the definition of autism to exclude persons with intellectual disability from autism diagnoses. To be diagnosed with autism a person must meet all 4 criteria, A, B, C and D.  Criteria A requires the presence of "persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays."  Now, an email exchange between Lisa Jo Rudy of autism spectrum disorders and Dr. Bryan King of the APA's DSM-5's Neurodevelopmental Work Group confirms that the effect of the DSM's New ASD will be to exclude at least some persons with intellectual disability from an autism spectrum disorder diagnosis:

"My Question for Dr. King

There seems to be a desire to remove people with "Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays" from the ASD category. Does this mean that a child with Mental Retardation (also called Intellectual Delays) no longer qualify for an Autism Spectrum diagnosis? Would that person wind up dually diagnosed with Intellectual Development Disorder and social communication disorder rather than with an ASD diagnosis?

His Response

There is no explicit desire , however, by creating more specificity we believe that people may be given diagnoses that better capture their individual conditions. The qualifier above about general developmental delays ensures that the social communication deficits are more specific, and also potentially allows for earlier diagnosis if appropriate.

Just as typically developing infants and toddlers are able to engage in very rich social communication and interaction across contexts, appropriate to their developmental level, so too most individuals with intellectual delays or disabilities are also able to communicate. On the other hand, significant deficits in social communication in toddlers may suggest the presence of autism. What the criterion above is meant to ensure is that clinicians take into account what is typical in terms of social communication abilities at a given age or developmental level, and not assume, for example, that a lack of social perception in a teenager with intellectual disability not automatically suggest the presence of autism. As is currently the case, some individuals with Down Syndrome may also meet criteria for autism; but most will not."

There may or may not be an "explicit desire  to move anyone in to or out of specific diagnostic groups" but the wording is being added intentionally to achieve a specific result and it is clear that the intended result is that social communication deficits be more specific that is .... not part of social communication deficits arising in cases of general developmental delay.

The DSM-5's New Autism Spectrum Disorder will add more persons on the high functioning Asperger's end of the spectrum and will reduce the numbers at the lower intellectually disabled end of the spectrum. The vast majority of the original autism described by Dr. Marshalyn Yeargin-Allsoop has been given the boot, kicked off the autism spectrum entirely, or nearly entirely.

There will be no Intellectually Disabled allowed on the DSM-5's New Autism Spectrum.


Autism Mom said...

I removed the autism sticker from my car years ago. When I hear a politician say "the American people" He or she doesn't speak for me just as the current autism organizations don't speak for my child.

Usethebrains Godgiveyou said...

No more ABA for ID kids, more drugs for ASD kids.

I'm sorry your doubts of inclusion were realized.

John Best said...

This means Neurodiversity wins the propaganda game. Too bad more parents didn't bother opposing their deception.

Anonymous said...

This, quite simply, idiotic. I say, again: the APA has no business speaking authoritatively on ASD. ASD is physiological. APA members, by and large, are not doctors. Behavioral Interventionists formed their own professional group - because the APA refused to recognize anything BUT analytical cognitive therapies. As one of my old law profs used to say: follow the money...

farmwifetwo said...

Autism Mom... mine's been sitting on the side of the washing machine for the last couple of years... same opinion on Autism groups.

Harold are they removing the ID kids or the ID/Autism kids?? There are just as many at the lower end of the spectrum as at the higher that shouldn't be there but are b/c school systems refuse to give services to other dx's. It's a HUGE issue in Ontario.

The reason I ask is that your son and mine on testing come up with ID. BUT, per the dx of "significant communication delay" they are ASD. How can you prove ID with SCD??

Not questioning your post... just hoping you can ask or know how they are going to differentiate. There are verbal ID, like those with Down's.

Too many questions, too few answers. Both have ASD on their dx's so I'm not anticipating any issues, atleast in the short-term.