Does anyone feel like the current DSM needs urgent updating?
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Anonymous
Because some of us have level 2 or 3 kids. My kid wouldn't get into that class |
Anonymous
but what is annoying about it, or about parents telling you about it? |
Anonymous
+1 until my 8 year old starting wishing he was dead, I didn’t believe in pathologizing either. I still don’t. But it’s the ASD diagnosis that gives access to the therapy. What’s the alternative? |
Anonymous
So, I wasn't complaining, yet you are annoyed at me anyways...frankly, you have no right to be annoyed at me and my child-we have nothing to do with you and your dc's situation. Autism is a spectrum, and people are at different places on it. |
Anonymous
Maybe not putting it all under the same umbrella? There are different problems, more nuanced categories can be made to describe those categories, and more tailored therapies for those problems. Lots of children have suicidal ideation without being autistic. The pertinent question is… are they suicidal *because* they are autistic and not receiving supports. Thinking of these issues clearly, and not emotionally, is better for everyone in the long run. Currently, official guidelines for severity classification of asd level states that asd level one should require *daily* support to function. There are plenty of people who can *seem* fairly typical at first, who still need *daily support* to function. It also should be noted that in the debate to put Asperger’s, Pdd is, asd under the same category, they cited research that said critical factors related to adult functioning (employment, marriage, independent living, criminality) had surprisingly similar statistics across the three subtypes, AND the three subtypes shared the two core difficulties. And those statistics were poor, even for Asperger’s. It certainly wasn’t meant to include everyone who needs intensive therapy for one reason or another. |
Anonymous
But those statistics are meaningless bc most of the ppl who are old enough to work were severe enough to be dx when you had to be significantly ‘autistic’ |
Anonymous
Do you honestly not understand? |
Anonymous
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Massively hot take - I think they should take the word ‘social’ out of it. It’s totally subjective.
Asd level 2: severely over and under reactive to external and internal stimuli, severe difficulties with verbal communication, developmentally delayed in gross and fine motor, severely delayed in cognitive flexibility, requires specialized education Asd level 1: moderately over and under reactive to external and internal stimuli, moderate difficulties with verbal communication, moderate challenges with cognitive flexibility, moderately delayed in gross and fine motor, may be mainstreamed with supports Other thing: marked difficulty with theory of mind, marked difficulty with inference, perseveration and special interests like present - can attend mainstream school with limited support. Sensory issues may or may not be present. Cognitive flexibility may or may not be present. Recommendations for this group include educational setting with access to other x individuals Other thing - deficient in emotional regulation, deficient in cognitive flexibility, deficient in executive functioning abilities. Sensory issues may or may not be present, challenges with inference may or may not be present Not exactly this but some version of it would be so much better |
Anonymous
NP and I don’t. My mom has cancer but I don’t get annoyed when others tell me their mom has a cold. They are both sick but no one thinks our experiences are very similar. |
Anonymous
“Theory of mind” has been debunked. |
Anonymous
If your mom had pancreatic cancer and someone was complaining nonstop about their precancerous mole … yes you would be annoyed. |
Anonymous
If we go with this analogy it is more like your mom has stage 4+ ovarian cancer and someone is complaining about losing their hair with chemo for stage one breast cancer. Both need treatment, one is more tragic. Or someone who lost a baby 22 weeks vs someone who miscarried at 6 weeks. There are plenty of things where one person is worse off than another. It should be okay for someone to vent no matter where they are on the spectrum. |
Anonymous
Dp. I think you missed her point. If you have precancerous cells, you don’t really have cancer. There’s a legitimate question if what is happening with the asd expansion (probably an issue of over diagnosing than of actual DSM guidelines) is the equivalent of calling precancerous cells, actual cancer. Also, even assuming legitimate diagnoses along the spectrum, if people are under the illusion that level 1 affected people should be able to vent like level 3 affected people…then this is why there’s controversy. It’s just not in the same universe and validates OP’s original concerns. |
Anonymous
Nooo… maybe I wasn’t clear. It’s commonly accepted that Asperger’s was changed to level 1, Pdd nos to level 2, autism to level 3. The study (pre DSM 5, making the argument to update the disorder as it is presented in the DSM 5) was saying that Asperger persons didn’t actually fair that much better than their more severely affected counterparts when looking at factors such as being able to be employed, having a marital relationship, etc. this makes sense when you read medical literature that says with this group of people, the deficits will usually outweigh the strengths. It’s the nature of the disorder. if you look at Hans Asperger’s original clinical descriptions of his patients, they DO NOT AT all look like what we have started colloquially calling “Aspergers” or “level 1”; certainly they weren’t just kids with emotional regulation issues and subpar social skills. They honestly looked more like what this board considers level 2. Hans Asperger was trying to save their LIVES because nazis wanted to kill them. They weren’t just “quirky.” They had significant problems that required DAILY support, even to the point the parents left the kids with Asperger in an institution. The point of the study arguing to make the changes that the DSM 5 ultimately made was to say, “look, all these patients have similar issues, varying in severity, that impact daily functioning to the point that they really struggle being employable or marriage material. Also more likely to get in trouble with the law. They are related.” So to your point, the stats might be “meaningless” in the sense that now, if you have classic Asperger’s you’re considered “severe,” but that wasn’t the original intention of the DSM 5. The way it’s been APPLIED is to make it So that the umbrella of autism has expanded to include… just quirky people, or people with emotional reg issues. But the original intent was NOT really to include more people. It was to clarify that it was all the same disorder- a DEVELOPMENTAL DISORDER (and legally, a similar disability!). The fact that classic Asperger’s is now considered severe, and that quirky people are called “level 1” seems to be evidence that they either muddled the diagnostic criteria or that clinicians have been to liberal with diagnoses. Leading to the frustration you see on this board. |
Anonymous
Clinicians have been muddled bc the criteria is so subjective. I manage many creatives and many many of them behave often in highly non optimal ways. I cannot imagine most of them could get through a day without offending someone and these are not the core autism population and in fact by far the most prevalent thing most of them have is adhd. If I were to describe many on this board they would ‘sound’ autistic. My point is the potential for subjective interpretation in this group is too broad |