4 ms·

The diagnostic distinction between Asperger’s and HFA was arbitrary and depending on the diagnosis one received as a child would lead to vastly different outcom

The diagnostic distinction between Asperger’s and HFA was arbitrary and depending on the diagnosis one received as a child would lead to vastly different outcomes (i.e. it meant the difference between staying in a normal school, with academic support, and hopefully getting to go to university versus losing academic options due to being railroaded into a special-school with less course options and so never getting into HE at all - all on the basis of a single childhood assessment). If the worse that comes out of the DSM-V’s reconceptualisation of autism is just muddied conversations then I’ll gladly take that over the old system where highly-capable people were being denied opportunities like going to uni. Also, Asperger was a child-killing Nazi (yes, literally). I’m glad we don’t use his name anymore.

mrangle 4y ago
It isn't arbitrary. Asperger's and HFA are not the same. One is language impaired and one isn't, as the bare minimum clinical difference. That being said, I don't doubt that the history of differential diagnosis is marked with widespread incompetence. And I obviously agree that being denied opportunity based on either diagnosis is a social crime. But what you mention is not the worst outcome of the DSM-V reclassification. What they are now moving toward / doing is still classifying HFA people as Type 1 autistic. But for (former) asperger's patients they are tending to do is diagnose a social skills disorder instead. Essentially removing anyone without a language impairment, at minimum, from the autism funded-services pool. Ignoring the arguable utility of services for HFA or Asperger's clients for one second, beyond the psychological and developmental benefits of simple social interaction. What this also does is remove a population from the autism category that, to all but the patient and clinical professionals themselves, are often only detectable as different due to factors centered on how (often more capable) intelligence is cognitively distributed and manifests. Ignoring comorbidities. Aside from affecting the important identity issue for the patient: essentially what they did was to remove any intelligence difference from being able to be a primary clinical marker for autism. Or sometimes the only obvious marker, depending on the individual's masking skill and ability to handle fatigue from it.

mrangle 4y ago

It isn't arbitrary. Asperger's and HFA are not the same. One is language impaired and one isn't, as the bare minimum clinical difference. That being said, I don't doubt that the history of differential diagnosis is marked with widespread incompetence. And I obviously agree that being denied opportunity based on either diagnosis is a social crime. But what you mention is not the worst outcome of the DSM-V reclassification. What they are now moving toward / doing is still classifying HFA people as Type 1 autistic. But for (former) asperger's patients they are tending to do is diagnose a social skills disorder instead. Essentially removing anyone without a language impairment, at minimum, from the autism funded-services pool. Ignoring the arguable utility of services for HFA or Asperger's clients for one second, beyond the psychological and developmental benefits of simple social interaction. What this also does is remove a population from the autism category that, to all but the patient and clinical professionals themselves, are often only detectable as different due to factors centered on how (often more capable) intelligence is cognitively distributed and manifests. Ignoring comorbidities. Aside from affecting the important identity issue for the patient: essentially what they did was to remove any intelligence difference from being able to be a primary clinical marker for autism. Or sometimes the only obvious marker, depending on the individual's masking skill and ability to handle fatigue from it.