Anonymous wrote:

Anonymous wrote:That may all be very true for the DSM-IV criteria, but those criteria were published in 1994. The current understanding of ASD is that it can be mild. The National Institute of Health says in multiple publications that a person with ASD may only have mild symptoms, but still has ASD. The DSM-V criteria clarifies severity levels pretty well, and those criteria are more reflective of our current knowledge of ASD.

First, the above info is from the DSM IV update in 2000. Actually, the DSM 5 is a lot more stringent on severity levels. Most of the PDD-NOS kids won't qualify under an ASD under it, early studies are showing.

NP, yes, but now the language is "persistent deficits" and then severity level 1, 2, 3. I agree about PDD-NOS because these kids didn't meet all the areas for the other ASD disorders, but there are kids with high-functioning autism diagnosis which I would consider Level 1, also Asperger's. The language implies mild in comparison to Level 3 and with support, these kids can function.

Anonymous wrote:That may all be very true for the DSM-IV criteria, but those criteria were published in 1994. The current understanding of ASD is that it can be mild. The National Institute of Health says in multiple publications that a person with ASD may only have mild symptoms, but still has ASD. The DSM-V criteria clarifies severity levels pretty well, and those criteria are more reflective of our current knowledge of ASD.

First, the above info is from the DSM IV update in 2000. Actually, the DSM 5 is a lot more stringent on severity levels. Most of the PDD-NOS kids won't qualify under an ASD under it, early studies are showing.

That may all be very true for the DSM-IV criteria, but those criteria were published in 1994. The current understanding of ASD is that it can be mild. The National Institute of Health says in multiple publications that a person with ASD may only have mild symptoms, but still has ASD. The DSM-V criteria clarifies severity levels pretty well, and those criteria are more reflective of our current knowledge of ASD.

Anonymous wrote:

Anonymous wrote:Actually, the DSM IV does say it needs to be severe, but many people miss this:

From the DSM IV

PDD NOS
This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills or when stereotyped behavior, interests, and activities are present but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. For example, this category includes "atypical autism" ? presentations that do not meet the criteria for autistic disorder because of late age at onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

My son is diagnosed with high functioning autism, not PDD-NOS. He has all of the impairments, but they are mild. The relatives that I described were all the spitting image of my child when they were child. My grandmother was very puzzled by her quirky kid. Under the new DSM-V standards, my son will have a diagnosis of Autism Spectrum Disorder, Level 1.

I agree that PDD-NOS requires some severity. When all of the deficits are showing up, the kid should only get a DX when there is a clear problem shown by a severe impairment.

For Asperger's, the DSM-IV standard is the child must show "clinically significant impairment."

For autism, the DSM-IV standard doesn't require either one. The assumption is that if a kid has all of the symptoms of autism, there is clinically significant impairment.

DSM-V has different levels (1-3) to diagnose severity.

Field testing on the DSM-V shows that many kids currently diagnosed with PDD-NOS do not get a diagnosis of ASD under the DSM-V.

Actually, the wording above is directly from the DSM-IV, saying that ALL the Pervasive Developmental Orders are severe. The problem is, too many doctors and laypeople go straight to the Autistic Disorder description, without reading the requirements that start the chapter:

Diagnostic and Statistical Manual of Mental Disorders

DSM-IV-TR, 2000

Pervasive Developmental Disorders

Pervasive Developmental Disorders are characterized by severe and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests, and activities. The qualitative impairments that define these conditions are distinctly deviant relative to the individual’s developmental level or mental age. Information is contained here on Autistic Disorder, Rett’s Disorder, Childhood Disintegrative Disorder, Asperger’s Disorder, and Pervasive Development Disorder Not Otherwise Specified. These disorders are usually evident in the first years of life and are often associated with some degree of Mental Retardation, which, if present, should be coded on Axis II. The Pervasive Developmental Disorders are sometimes observed with a diverse group of other general medical conditions (e.g., chromosomal abnormalities, congenital infections, structural abnormalities of the central nervous system). If such conditions are present, they should be noted on Axis III. Although terms like “psychosis” and “childhood schizophrenia” were once used to refer to individuals with these conditions, there is considerable evidence to suggest that the Pervasive Developmental Disorders are distinct from Schizophrenia (however, an individual with Pervasive Developmental Disorder may occasionally later develop Schizophrenia).

But very few people seem familiar with the overall chapter. Perhaps the DSM V, with its severity levels, can correct this.

Anonymous wrote:Why would someone with ASD be likely to be obese, per the study cited above???

Lack of exercise and poor eating habits. People with ASD aren't the best about doing things they don't like. They often don't participate in group sports. They are frequently clumsy and avoid solo sports. Parents have a hard time directing ASD kids to sports that might work for them. (Swimming and cross-country are often ideal.)

People with ASD also often eat an unbalanced diet and have poor self-care skills. If they feel like eating nothing but mashed potatoes and potato chips, that's what they'll do.