Sunday, February 26, 2012

Volkmar Says Many Intellectually Disabled May Be Excluded from DSM-5 Autism Spectrum Disorder Diagnosis

When I first pointed out that the DSM-5 New Autism Disorder would exclude intellectually disabled I was ignored by most, insulted and mocked by others.  Some were annoyed. When Catherine Lord confessed that the intellectually disabled were the real target for exclusion very few mentioned the exclusion of the intellectually disabled from the DSM-5 autism definition.  Certainly not the New York Times and other prominent Mainstream Media institutions that have wrung their hands over the possible exclusion of the very high functioning Autism ruling class.  

When Fred Volkmar, who kick started the current uproar over the possible exclusion of some with high functioning autism and Aspergers, mentioned in a Yale Daily News interview the possible DSM-5 exclusion of many of the intellectually disabled it did not merit any response from the MSM:

"In its next manual on mental disorders, the American Psychiatric Association plans to issue a single set of diagnostic criteria that will merge the four types of disorders on the autism spectrum, which include autism and Asperger syndrome. Although no current patient will be affected by the new rules, research by Yale Child Study Center Director Fred Volkmar suggests that the revision may disqualify a large number of intellectually disabled patients from receiving a diagnosis of autism spectrum disorder in the future."  [Underlining added for emphasis - HLD]

The autism spectrum is not just a spectrum. It is a caste system with the intellectually disabled occupying the lowest rung unworthy of concern or comment from the mainstream media or feel good, autism is beautiful, Neurodiversity variety autism advocates.


Observer said...

With all due respect -- and I'm not assuming you're wrong about their goals -- you haven't made a strong case. I'm no fan of Cathy Lord or some of the other committee members. However, the quotes you've provided in this and previous posts describe the intention not to automatically conflate ID and autism, rather than to remove the autism dx from people with ID and autism.
The study you've quoted about sub-types of autism involving ID is not necessarily incompatible with what the committee members are saying now (perhaps the subtypes the researchers identified included one or more that didn't seem truly autistic).
I understand your concern, nevertheless, and I appreciate Volkmar's. There is good reason to see cynicism in the APA on the issue of the autism revisions in general, and I'm willing to believe they have looked for ways to significantly reduce the known prevalence of autism -- possibly across the spectrum.
I sympathize too with your sense of exclusion from the debate. Nevertheless I wish you and everyone else would use less bitter and inflammatory language to describe each other. I don't believe it is impossible for the current autism factions to find common ground (with more effective results); but it is impossible when the tone of the dialogue is contemptuous and accusatory. This applies to some in each camp.

Unknown said...

Observer I can understand your argument if my position is based solely on this last post. It is not. I have commented many times looking at the history of Autistic Disorder and Aspergers in the DSM-III and DSM-IV and the exclusionary language employed in the DSM-IV in particular. There is no doubt in my mind, even without the admissions by DSM-5 committee members Catherine Lord and Fred Volkmar that the exclusionary language adopted after numerous discussions was done intentionally. There is also absolutely no doubt that the modern MSM, Hollywood and now the APA DSM Neurodevelopmental Committee have substituted Aspergers in place of Autistic Disorder.

The motives can be speculated on but not the intent to exclude. The committee knows that the language they have employed will result in exclusion of the Intellectually Disabled from future Autism Spectrum Disorder diagnoses.