Educate me: what is the difference between MERLD and HFA?

[Anonymous]

This. MERLD isn't "real" anymore.

[Anonymous]

PP: what's your point? Are you saying it never existed?

[Anonymous]

MERLD is like Sensory Processing Disorder. It still exists but is no longer a stand alone diagnosis.

[Anonymous]

Anonymous wrote:This. MERLD isn't "real" anymore.

Wrong. MERLD still diagnosed every day. It's plenty real.

[Anonymous]

http://www.icd10data.com/ICD10CM/Codes/F01-F99/F80-F89/F80-


Home > 2015 ICD-10-CM Diagnosis Codes > Mental, Behavioral and Neurodevelopmental disorders F01-F99 > Pervasive and specific developmental disorders F80-F89 >
Specific developmental disorders of speech and language F80- >
F80 Specific developmental disorders of speech and language
F80.0 is a billable ICD-10-CM diagnosis code F80.0 Phonological disorder
F80.1 is a billable ICD-10-CM diagnosis code F80.1 Expressive language disorder
F80.2 is a billable ICD-10-CM diagnosis code F80.2 Mixed receptive-expressive language disorder
F80.4 is a billable ICD-10-CM diagnosis code F80.4 Speech and language development delay due to hearing loss
F80.8 Other developmental disorders of speech and language
F80.81 is a billable ICD-10-CM diagnosis code F80.81 Childhood onset fluency disorder
F80.89 is a billable ICD-10-CM diagnosis code F80.89 Other developmental disorders of speech and language
F80.9 is a billable ICD-10-CM diagnosis code F80.9 Developmental disorder of speech and language, unspecified

[Anonymous]

Anonymous wrote:PP: what's your point? Are you saying it never existed?

I'm not the PP (I am the PP who posted that, by definition, you can't have MERLD and ASD).

There are some disabilities or diseases that are discrete, where the lines between them are very clear, and where diagnostic categories change because research gives us new examples. An example of this would be the line between Rett Syndrome and ASD. Once it was thought that girls with Rett had a particularly severe variation of autism. Now we know that girls with Rett have a mutation on the MECP2 gene that is distinct, and does not exist in kids with ASD. With that knowledge it makes sense to go back and "rediagnose" them. If I was talking about an individual who once had an autism diagnosis and currently has a Rett diagnosis, I wouldn't think of them as a person who used to have ASD, or as a person who used to fit the ASD criteria. I'd think of them as a person who always had Rett but who used to be misdiagnosed, and their autism never existed, it was a mistake.

MERLD isn't like that. The lines between MERLD and PDD-NOS, and Aspergers, and Autism, and Nonverbal Learning Disabilities and ADHD under the DSM IV were social contructs. The reality is that there are many many kids who struggle with language, and attention, and social communication, and that that group is so large and so varied, that it makes sense to divide it up into more manageable groups, so that the labels would be more specific. So, more specific diagnoses were developed, dividing individuals into groups with shared features. But there were also a lot of kids who sat on the line between two or more conditions, who might have looked PDD when they were little and then developed into looking more like ADHD-PI, or had early language delays that lead to an Autism label, but looked a whole lot like Aspergers when they got a little older. Or who were diagnosed with MERLD by one specialist and PDD-NOS by another.

Now, with the new DSM V, they've redrawn the borders. They've decided that the question of whether you had early language delays is not as important as we might have thought, and that the line between Aspergers and Autism isn't that important, and that maybe some of the kids who were captured under MERLD or PDD-NOS are better described as coming under ASD, while others might fall under the new category of Social Pragmatic Communication Disorder. The kids haven't changed. Their struggles haven't changed, and our understanding of their strengths and weaknesses didn't change. The only thing that changed is the lines and the labels. It wasn't a mistake to say that they had MERLD, it's just that we use a different words now. As someone who talks about diagnoses professionally, we might include both in talking about a kid and say "he used to have MERLD diagnosis, and language is definitely a primary weakness for him, but he does have enough difficulty with . . . . that under the new criteria, he also fits in the autism category." Or "His official diagnosis is still MERLD, but if we evaluated him today we'd probably say SCPD and ADHD - C." The old diagnosis is still relevant to describing him, and still holds a lot of truth.

[Anonymous]

^^this is a very good post! diagnosis in the DSM are based on clusters of symptoms and different boxes are drawn around them in different versions of the DSM.

[Anonymous]

Anonymous wrote:^^this is a very good post! diagnosis in the DSM are based on clusters of symptoms and different boxes are drawn around them in different versions of the DSM.

+1000

Terrific post! Thank you!

[Anonymous]

MERLD and HFA are pretty much the exact opposites. HFAs do not have significant language impairments.

[Anonymous]

Anonymous wrote:MERLD and HFA are pretty much the exact opposites. HFAs do not have significant language impairments.

1. They both can have problems with pragmatics.

2. This original post is from 2012 so not sure why the PP resurrected it.

[Anonymous]

Anonymous wrote:MERLD and HFA are pretty much the exact opposites. HFAs do not have significant language impairments.

HFA has never been an official diagnosis. It's a term that people use to specify that they think their child who meets the criteria for autism has more skills than some other kids with autism.

When DSM IV was in effect, people generally used the term aspergers for people who did not show significant language impairments at an early age, since not doing so was a diagnostic criteria, and HFA was generally used for individuals who had had significant language impairment but went on to have substantial language, although that language might still be significantly impaired.

Now that the Asperger's diagnosis is removed from the DSM V, people sometimes use the term HFA to refer to people who have autism but have more skills, and so include people who would have previously been classified as Asperger's, and who never had significant global language impairments, but they also include people who do have significant global language impairments.

[Anonymous]

Anonymous wrote:

Anonymous wrote:PP: what's your point? Are you saying it never existed?

I'm not the PP (I am the PP who posted that, by definition, you can't have MERLD and ASD).

There are some disabilities or diseases that are discrete, where the lines between them are very clear, and where diagnostic categories change because research gives us new examples. An example of this would be the line between Rett Syndrome and ASD. Once it was thought that girls with Rett had a particularly severe variation of autism. Now we know that girls with Rett have a mutation on the MECP2 gene that is distinct, and does not exist in kids with ASD. With that knowledge it makes sense to go back and "rediagnose" them. If I was talking about an individual who once had an autism diagnosis and currently has a Rett diagnosis, I wouldn't think of them as a person who used to have ASD, or as a person who used to fit the ASD criteria. I'd think of them as a person who always had Rett but who used to be misdiagnosed, and their autism never existed, it was a mistake.

MERLD isn't like that. The lines between MERLD and PDD-NOS, and Aspergers, and Autism, and Nonverbal Learning Disabilities and ADHD under the DSM IV were social contructs. The reality is that there are many many kids who struggle with language, and attention, and social communication, and that that group is so large and so varied, that it makes sense to divide it up into more manageable groups, so that the labels would be more specific. So, more specific diagnoses were developed, dividing individuals into groups with shared features. But there were also a lot of kids who sat on the line between two or more conditions, who might have looked PDD when they were little and then developed into looking more like ADHD-PI, or had early language delays that lead to an Autism label, but looked a whole lot like Aspergers when they got a little older. Or who were diagnosed with MERLD by one specialist and PDD-NOS by another.

Now, with the new DSM V, they've redrawn the borders. They've decided that the question of whether you had early language delays is not as important as we might have thought, and that the line between Aspergers and Autism isn't that important, and that maybe some of the kids who were captured under MERLD or PDD-NOS are better described as coming under ASD, while others might fall under the new category of Social Pragmatic Communication Disorder. The kids haven't changed. Their struggles haven't changed, and our understanding of their strengths and weaknesses didn't change. The only thing that changed is the lines and the labels. It wasn't a mistake to say that they had MERLD, it's just that we use a different words now. As someone who talks about diagnoses professionally, we might include both in talking about a kid and say "he used to have MERLD diagnosis, and language is definitely a primary weakness for him, but he does have enough difficulty with . . . . that under the new criteria, he also fits in the autism category." Or "His official diagnosis is still MERLD, but if we evaluated him today we'd probably say SCPD and ADHD - C." The old diagnosis is still relevant to describing him, and still holds a lot of truth.

Who are you to diagnose MERLD children with autism? What are your credentials?

[Anonymous]

Who are you to diagnose MERLD children with autism? What are your credentials?

She's not diagnosing. She's explaining and did a very good job of it. Why are you so antagonistic and defensive?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PP: what's your point? Are you saying it never existed?

I'm not the PP (I am the PP who posted that, by definition, you can't have MERLD and ASD).

There are some disabilities or diseases that are discrete, where the lines between them are very clear, and where diagnostic categories change because research gives us new examples. An example of this would be the line between Rett Syndrome and ASD. Once it was thought that girls with Rett had a particularly severe variation of autism. Now we know that girls with Rett have a mutation on the MECP2 gene that is distinct, and does not exist in kids with ASD. With that knowledge it makes sense to go back and "rediagnose" them. If I was talking about an individual who once had an autism diagnosis and currently has a Rett diagnosis, I wouldn't think of them as a person who used to have ASD, or as a person who used to fit the ASD criteria. I'd think of them as a person who always had Rett but who used to be misdiagnosed, and their autism never existed, it was a mistake.

MERLD isn't like that. The lines between MERLD and PDD-NOS, and Aspergers, and Autism, and Nonverbal Learning Disabilities and ADHD under the DSM IV were social contructs. The reality is that there are many many kids who struggle with language, and attention, and social communication, and that that group is so large and so varied, that it makes sense to divide it up into more manageable groups, so that the labels would be more specific. So, more specific diagnoses were developed, dividing individuals into groups with shared features. But there were also a lot of kids who sat on the line between two or more conditions, who might have looked PDD when they were little and then developed into looking more like ADHD-PI, or had early language delays that lead to an Autism label, but looked a whole lot like Aspergers when they got a little older. Or who were diagnosed with MERLD by one specialist and PDD-NOS by another.

Now, with the new DSM V, they've redrawn the borders. They've decided that the question of whether you had early language delays is not as important as we might have thought, and that the line between Aspergers and Autism isn't that important, and that maybe some of the kids who were captured under MERLD or PDD-NOS are better described as coming under ASD, while others might fall under the new category of Social Pragmatic Communication Disorder. The kids haven't changed. Their struggles haven't changed, and our understanding of their strengths and weaknesses didn't change. The only thing that changed is the lines and the labels. It wasn't a mistake to say that they had MERLD, it's just that we use a different words now. As someone who talks about diagnoses professionally, we might include both in talking about a kid and say "he used to have MERLD diagnosis, and language is definitely a primary weakness for him, but he does have enough difficulty with . . . . that under the new criteria, he also fits in the autism category." Or "His official diagnosis is still MERLD, but if we evaluated him today we'd probably say SCPD and ADHD - C." The old diagnosis is still relevant to describing him, and still holds a lot of truth.

Who are you to diagnose MERLD children with autism? What are your credentials?

You are correct in that I don't diagnose children with autism according the DSM, because I work in a school setting and we use the IDEA classifications. I am explaining a situation in which I might be reviewing the report of a psychologist or developmental pediatrician who has given that diagnosis.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PP: what's your point? Are you saying it never existed?

I'm not the PP (I am the PP who posted that, by definition, you can't have MERLD and ASD).

There are some disabilities or diseases that are discrete, where the lines between them are very clear, and where diagnostic categories change because research gives us new examples. An example of this would be the line between Rett Syndrome and ASD. Once it was thought that girls with Rett had a particularly severe variation of autism. Now we know that girls with Rett have a mutation on the MECP2 gene that is distinct, and does not exist in kids with ASD. With that knowledge it makes sense to go back and "rediagnose" them. If I was talking about an individual who once had an autism diagnosis and currently has a Rett diagnosis, I wouldn't think of them as a person who used to have ASD, or as a person who used to fit the ASD criteria. I'd think of them as a person who always had Rett but who used to be misdiagnosed, and their autism never existed, it was a mistake.

MERLD isn't like that. The lines between MERLD and PDD-NOS, and Aspergers, and Autism, and Nonverbal Learning Disabilities and ADHD under the DSM IV were social contructs. The reality is that there are many many kids who struggle with language, and attention, and social communication, and that that group is so large and so varied, that it makes sense to divide it up into more manageable groups, so that the labels would be more specific. So, more specific diagnoses were developed, dividing individuals into groups with shared features. But there were also a lot of kids who sat on the line between two or more conditions, who might have looked PDD when they were little and then developed into looking more like ADHD-PI, or had early language delays that lead to an Autism label, but looked a whole lot like Aspergers when they got a little older. Or who were diagnosed with MERLD by one specialist and PDD-NOS by another.

Now, with the new DSM V, they've redrawn the borders. They've decided that the question of whether you had early language delays is not as important as we might have thought, and that the line between Aspergers and Autism isn't that important, and that maybe some of the kids who were captured under MERLD or PDD-NOS are better described as coming under ASD, while others might fall under the new category of Social Pragmatic Communication Disorder. The kids haven't changed. Their struggles haven't changed, and our understanding of their strengths and weaknesses didn't change. The only thing that changed is the lines and the labels. It wasn't a mistake to say that they had MERLD, it's just that we use a different words now. As someone who talks about diagnoses professionally, we might include both in talking about a kid and say "he used to have MERLD diagnosis, and language is definitely a primary weakness for him, but he does have enough difficulty with . . . . that under the new criteria, he also fits in the autism category." Or "His official diagnosis is still MERLD, but if we evaluated him today we'd probably say SCPD and ADHD - C." The old diagnosis is still relevant to describing him, and still holds a lot of truth.

Who are you to diagnose MERLD children with autism? What are your credentials?

You are correct in that I don't diagnose children with autism according the DSM, because I work in a school setting and we use the IDEA classifications. I am explaining a situation in which I might be reviewing the report of a psychologist or developmental pediatrician who has given that diagnosis.

It figures. School personnel don't understand MERLD at all.