5 ms·

> It's a label that helps people. Yes, that's very likely true. But some will argue that it's more than a label, that it has an independent reality, whether or

by lutusp 11y ago

> It's a label that helps people. Yes, that's very likely true. But some will argue that it's more than a label, that it has an independent reality, whether or not people find it helpful. Such people are trying to class autism with biological conditions, and they may turn out to be right. We won't know until someone uses science to link an actual objective cause to the symptoms -- a pathogen or an unambiguous organic source that can be objectively diagnosed without expert opinion playing any part at all. We're nowhere near that goal. > When I finally had a psychologist tell me about Asperger's, and I went to some of the online communities and read about all of the other people with such similar experiences, it really helped. How did you feel when Asperger's was abandoned, after an epidemic of phony diagnoses? Did it matter that many of the diagnoses were just opinion with no objective basis? This is not to claim that those with the Asperger's diagnosis were faking, but that their true subjective mental state wasn't being accurately assessed, and many smart people were being grouped with people who actually had one or another mental condition. I point this out only to show that we have no idea what Asperger's is, or Autism is, and the necessary science is not being done.

dogma1138 11y ago
Asperger is no longer considered an actual condition by the APA. Sadly in the UK it's running out of control, it's also now part of the new benefit package new PIP (DLA replacement) for working adults. The UK now has the 2nd highest autism rate in the world with over 1% of the population being diagnosed (not by doctors, nor by NHS but by "speech and developmental professionals" working for private institutions) with autism the vast majority in the recent 5 years Adult Asperger Syndrome. Japan also has very skewed numbers with nearly 2% of the population diagnosed with some form of autism, in late allot of the Japanese specific psychiatric/psychological conditions like Hikikomori are also being associated with autism.
- ScottBurson 11y ago
  > Asperger is not longer considered an actual condition by the APA. All that's happened is that the terminology has been changed: In 2013, the DSM-5 replaced Autistic Disorder, Asperger’s Disorder and other pervasive developmental disorders with the umbrella diagnosis of autism spectrum disorder. [0] This simply codifies the conclusion that Asperger syndrome differs in degree, but not in kind, from more severe forms of autism. It doesn't mean that people who were formerly diagnosed with Asperger are now considered normal. [0] http://www.autism-society.org/what-is/aspergers-syndrome/ http://www.autism-society.org/what-is/aspergers-syndrome/
  - dogma1138 11y ago
    That's not correct it pretty much excluded all Asperger related symptoms that are predominantly expressed in Autism cases and mandated that all previous Asperger diagnosis should be reevaluated: "Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder." SPCD itself is not considered part of the Autism spectrum and has quite stringent requirements to ensure that only really edge cases that are neither autism nor a classic referral to a therapist get caught by it.
- DanBC 11y ago
  > Sadly in the UK it's running out of control, it's also now part of the new benefit package new PIP (DLA replacement) for working adults. This is bollocks. 1) PIP is not an "in work" benefit. Being in work doesn't exclude a claimant from getting PIP, but it's not a requirement. 2) PIP requires a long term illness or disability - You must have had it for 3 months, and expect it to last for at least 9 months. 3) PIP doesn't use just diagnoses, it also uses an assessment of your ability. Two people could have the same diagnosis and one person could get PIP while the other could be excluded from PIP. https://www.gov.uk/pip/eligibility https://www.gov.uk/pip/eligibility > Daily living difficulties > You may get the daily living component of PIP if you need help with things like: > preparing or eating food > washing, bathing and using the toilet > dressing and undressing > reading and communicating > managing your medicines or treatments > making decisions about money > engaging with other people From that list it's pretty clear that most people with ASD aren't covered, or would get the minimum amount. And you mention DLA - people with ASD would have been entitled to the care or mobility component of DLA.
sudosteph 11y ago
Aspergers was abandoned because the autism spectrum isn't cut-and-dry, and the difference between "high-functioning" autism and Aspergers was mostly arbitrary. If you have evidence citing that it was because of phony diagnoses, I'd be interested in seeing it. Anyhow, that change doesn't bother me in the slightest. As far as the scientific need for strict classification goes, I can see how high-functioning people could potentially throw a wrench in things, because milder cases can be confused with other conditions. Nevertheless, that type of confusion is hardly unique to autism, and the diagnosis many mental illnesses and neurological disorders can be problematic due to comorbidity. Anyhow, saying the science is not being done is just absurd. Just because the science is difficult and results are not easy to generalize, does not mean that it's not happening. The priority on severe autism (which is usually harder to misdiagnose) is understandable, and there's a possibility that findings related to severe autism may end up applying to milder cases as well. Either way, the label is helping many people, and I think you are over-estimating the negative impact of having a broader diagnosis spectrum.
- lutusp 11y ago
  > If you have evidence citing that it was because of phony diagnoses, I'd be interested in seeing it. Here's an article by Allen Frances, who you may recognize as the editor of DSM-IV: http://nypost.com/2012/04/24/americas-false-autism-epidemic/ http://nypost.com/2012/04/24/americas-false-autism-epidemic/ Frances is very outspoken about this issue, and interestingly, he was one of the primary advocates for the inclusion of Asperger's in DSM-IV. His outlook has, needless to day, changed completely, and the expression "phony epidemic" originates with him. > Anyhow, saying the science is not being done is just absurd. Not at all. Many people and organizations are still treating Autism as though it's a mental condition. Evidence strongly suggests that it's a physical condition with mental symptoms. Once we accept that it's an organic ailment, real scientific progress will begin, and people will be less likely to unfairly stigmatize those suffering from it as though they're "mental". As I said above, this process has scarcely begun. And "diagnosing" many bright people with Asperger's (including Isaac Newton, Albert Einstein, Thomas Jefferson and Bill Gates) perversely turned the condition into a status symbol among impressionable young people. > I think you are over-estimating the negative impact of having a broader diagnosis spectrum. The issue is whether we're focusing on evidence instead of anecdotes. At the moment, opinion rules. Remember that the content of DSM-5 was established with votes, not scientific study outcomes. This is one of the reasons the DSM is being abandoned by the N.I.M.H.: http://www.newyorker.com/tech/elements/the-rats-of-n-i-m-h http://www.newyorker.com/tech/elements/the-rats-of-n-i-m-h

by lutusp 11y ago

dogma1138 11y ago

Asperger is no longer considered an actual condition by the APA. Sadly in the UK it's running out of control, it's also now part of the new benefit package new PIP (DLA replacement) for working adults. The UK now has the 2nd highest autism rate in the world with over 1% of the population being diagnosed (not by doctors, nor by NHS but by "speech and developmental professionals" working for private institutions) with autism the vast majority in the recent 5 years Adult Asperger Syndrome. Japan also has very skewed numbers with nearly 2% of the population diagnosed with some form of autism, in late allot of the Japanese specific psychiatric/psychological conditions like Hikikomori are also being associated with autism.

ScottBurson 11y ago
> Asperger is not longer considered an actual condition by the APA. All that's happened is that the terminology has been changed: In 2013, the DSM-5 replaced Autistic Disorder, Asperger’s Disorder and other pervasive developmental disorders with the umbrella diagnosis of autism spectrum disorder. [0] This simply codifies the conclusion that Asperger syndrome differs in degree, but not in kind, from more severe forms of autism. It doesn't mean that people who were formerly diagnosed with Asperger are now considered normal. [0] http://www.autism-society.org/what-is/aspergers-syndrome/ http://www.autism-society.org/what-is/aspergers-syndrome/
- dogma1138 11y ago
  That's not correct it pretty much excluded all Asperger related symptoms that are predominantly expressed in Autism cases and mandated that all previous Asperger diagnosis should be reevaluated: "Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder." SPCD itself is not considered part of the Autism spectrum and has quite stringent requirements to ensure that only really edge cases that are neither autism nor a classic referral to a therapist get caught by it.
DanBC 11y ago
> Sadly in the UK it's running out of control, it's also now part of the new benefit package new PIP (DLA replacement) for working adults. This is bollocks. 1) PIP is not an "in work" benefit. Being in work doesn't exclude a claimant from getting PIP, but it's not a requirement. 2) PIP requires a long term illness or disability - You must have had it for 3 months, and expect it to last for at least 9 months. 3) PIP doesn't use just diagnoses, it also uses an assessment of your ability. Two people could have the same diagnosis and one person could get PIP while the other could be excluded from PIP. https://www.gov.uk/pip/eligibility https://www.gov.uk/pip/eligibility > Daily living difficulties > You may get the daily living component of PIP if you need help with things like: > preparing or eating food > washing, bathing and using the toilet > dressing and undressing > reading and communicating > managing your medicines or treatments > making decisions about money > engaging with other people From that list it's pretty clear that most people with ASD aren't covered, or would get the minimum amount. And you mention DLA - people with ASD would have been entitled to the care or mobility component of DLA.

sudosteph 11y ago

Aspergers was abandoned because the autism spectrum isn't cut-and-dry, and the difference between "high-functioning" autism and Aspergers was mostly arbitrary. If you have evidence citing that it was because of phony diagnoses, I'd be interested in seeing it. Anyhow, that change doesn't bother me in the slightest. As far as the scientific need for strict classification goes, I can see how high-functioning people could potentially throw a wrench in things, because milder cases can be confused with other conditions. Nevertheless, that type of confusion is hardly unique to autism, and the diagnosis many mental illnesses and neurological disorders can be problematic due to comorbidity. Anyhow, saying the science is not being done is just absurd. Just because the science is difficult and results are not easy to generalize, does not mean that it's not happening. The priority on severe autism (which is usually harder to misdiagnose) is understandable, and there's a possibility that findings related to severe autism may end up applying to milder cases as well. Either way, the label is helping many people, and I think you are over-estimating the negative impact of having a broader diagnosis spectrum.

lutusp 11y ago
> If you have evidence citing that it was because of phony diagnoses, I'd be interested in seeing it. Here's an article by Allen Frances, who you may recognize as the editor of DSM-IV: http://nypost.com/2012/04/24/americas-false-autism-epidemic/ http://nypost.com/2012/04/24/americas-false-autism-epidemic/ Frances is very outspoken about this issue, and interestingly, he was one of the primary advocates for the inclusion of Asperger's in DSM-IV. His outlook has, needless to day, changed completely, and the expression "phony epidemic" originates with him. > Anyhow, saying the science is not being done is just absurd. Not at all. Many people and organizations are still treating Autism as though it's a mental condition. Evidence strongly suggests that it's a physical condition with mental symptoms. Once we accept that it's an organic ailment, real scientific progress will begin, and people will be less likely to unfairly stigmatize those suffering from it as though they're "mental". As I said above, this process has scarcely begun. And "diagnosing" many bright people with Asperger's (including Isaac Newton, Albert Einstein, Thomas Jefferson and Bill Gates) perversely turned the condition into a status symbol among impressionable young people. > I think you are over-estimating the negative impact of having a broader diagnosis spectrum. The issue is whether we're focusing on evidence instead of anecdotes. At the moment, opinion rules. Remember that the content of DSM-5 was established with votes, not scientific study outcomes. This is one of the reasons the DSM is being abandoned by the N.I.M.H.: http://www.newyorker.com/tech/elements/the-rats-of-n-i-m-h http://www.newyorker.com/tech/elements/the-rats-of-n-i-m-h