Wednesday, December 28, 2011

FOX News Autism Experts Worry About DSM5 Impact on High Functioning Autistic Children, No Concern for Low Functioning Autistic Children

FOX News has published a report, Some Experts Worried Over Revised Autism Guidelines, in which two autism experts, Dr. Keith Ablow, a psychiatrist and Fox News contributor, and Dr. Thomas Frazier, who treats children with autism at the Cleveland Clinic Children’s Hospital, express their concerns about the possible impact of the DSM-5`s new Autism Spectrum Disorder category on high functioning autistic children. They are concerned that some high functioning autistic children might lose their diagnoses, and access to autism specific education services, although the FOX report does not provide much detail on the basis for their concerns:

These new guidelines would place an emphasis on preservative and repetitive behaviors – but many children who were originally diagnosed with autism may be reclassified. Ablow said this can leave some people who are still suffering with some of the symptoms or less severe symptoms out in the cold. “If we don’t loosen it a little bit, I suspect that some of these high-functioning kids may actually either get shifted into a different diagnosis,” said Dr. Thomas Frazier.” 

There is no mention however of the possible negative impact on low functioning autistic children, those with intellectual disabilities who might be excluded by the DSM5 Autism Spectrum Disorder mandatory criterion A which excludes an autism diagnosis where a person is also intellectually disabled:

A.    Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:.....`

Like so many autism experts and professionals the FOX experts are concerned about high functioning autistic persons but not about low functioning autistic persons who remain the invisible autistics abandoned by health care professionals and the mainstream media alike.


Bullet said...

Well my youngest son has what might be termed low functioning autism. And he also has severe learning difficulties, although it is difficult to know WHY he has them. Ie whether it is because he cannot comprehend what is asked of him, or because he has processing difficulties that means he cannot respond to show what is asked of him or whether he sees no need to show what is asked for him. And honestly, because I do not know the reasons, I cannot say whether it is, or is not, as a result of him being autistic.
However, there are enough other signs which indicate his autism. There are his routines and compulsions, his interaction difficulties and the way that he communicates. When he was assessed and diagnosed they did not just look at, for example, his speech, which on its own might have been put down to "general developmental delays" but in how he communicated and interacted with others and how he behaved.
As for the article, well, I do think they are jumping the gun a bit. Having strong routines/rituals and/or obsessions has always been a criteria for either autism or aspergers. With myself I have had the same obsession since I was 8 or 9 and of course did have obsessions before then. Thomas, my older son, also has very strong obsessions. Ironically Jacob has got less obsessions, but is very fixated on things needing to be done a set way.

farmwifetwo said...

So, you're worried b/c your son doesn't have the other issues or b/c ID isn't in the list.

Anyone with the issues on that list will fail an IQ test. Therefore all will be labelled as MR/ID whether they truly are or aren't. Removing the test from the criteria is important. Stops professionals from assuming the children/adults cannot learn. According to my son's IQ test in Gr 3 (he's now in Gr 5) he's severely ID and I should have tossed him into a corner and ignored him. According to his reading, writing, spelling and speach.... he's learning as fast as he can be taught. YET, he'd still very much fail that IQ test AND in public he can barely say "hello" when someone says the same to him.

I think instead of all the ABA training and believing a test that is useless... maybe the push should be on communication. My ABA workers refused... speech - bad, OT - bad, unending sorting - good. I've pushed communication for the last 6yrs. Learning potential - infinite.

We start piano lessons after Xmas. As I told the teacher, if you can get him to make eye contact and talk to you (very basic 1 to 3 words at a time) you've made a friend.

Adrianna said...

Concern for LF autistics? Teehee, you're so funny!

In all seriousness, who cares if some high-functioning autistics lose their autism label? If they have legitimate problems, they will be reclassified as something else and might get help that is better suited to them. This is what happened for me fairly recently, and I can't believe the difference it makes. I was very autistic-like as a young child and needed early intervention to develop normally, but my condition was not true autism, high- or low-functioning.

Anyway, I think some people will be happy with the change. I am thinking of the webmaster of the now-defunct "Whose Planet is it Anyway?" Such people believe that autism should not even be in the DSM in any form since it is just a natural difference anyway.

As for me, I could not imagine being the parent of a low-functioning autistic child and have to wonder what will happen when I die. I hate it when people say that all kids have issues and that all parents worry and that this is part of life. Not like this! They act as thought they are talking to five-year-olds explaining why they can't have everything they want!

Bullet said...

"I hate it when people say that all kids have issues and that all parents worry and that this is part of life"

Thank you. I hate this also.

Usethebrains Godgiveyou said...

Dr. Persico had been "struck on the road to Damascus" regarding autism. I am fixated on this 1 hour presentation. It makes sense. We have the earlier example of rubella infection prenatally which used to be considered a primary cause...I remember hearing this in highschool in the 1970'. He also says up to 80% are "mentally retarded", his words.

This interests me because he lets go of all the psycho-babble, and we have to look at our children as survivors of an insult. Which has historical precedent that we just "kind of " forgot!!!

I so appreciate the way you think. I hope you don't find this too boring, but you have such a wide variety of influence in your thought that if you have time, I might help add one more. It's way over my head, but some things stick.

It also considers the autism/epilepsy connection, which is usually totally forgotten in mild cases. It's a damn miracle our kids develop as well as they do. We don't give them credit for that.