Anecdotal Traits & Diagnostic Criteria

[bentHnau]

There are a number of traits that seem to be associated with Asperger's Syndrome that are not a part of the diagnostic criteria. I call them "anecdotal traits" because they come up in casual conversations (such as on this forum), or in several cases that doctors notice, although some are more commonly reported than others.

They are, for example, not being able to ascertain song lyrics, being unable to remember multiple verbal instructions, social exhaustion, looking younger than one's age, oblivious to/poorly socialized into/not identifying with gender roles, poor sense of time, asking "too many" questions in school/work settings, etc.

There are some that are even widely recognized by doctors, but somehow still not in the diagnostic criteria: clumsiness and poor muscle tone, for example.

Should any of these be incorporated into the diagnostic criteria and/or assessment procedures, why/why not, and if so, how?

 

[King_Oni]

The thing is, if you include these, that you would exclude people who are very well in need of a diagnosis for support, but would miss the criteria, that (I'm assuming) are the ones that matter most throughout life.

Plenty of these anecdotal traits might be important, however they're not backbreaking and crippling in a large scope... yes, they might give some individuals a handful of issues, but they're clearly not THAT common.

The examples you bring up don't manifest that strongly in all of us. And some are probably even a result of how others perceive us, which IMO has little to do with my personal struggles in a vaccuum (asking "too much" does widely depend on what one defines as too much for example).

Though, I will say, that I feel these things could be a anecdotal sideline when looking into someones issues and understanding difficulties from being on the spectrum. Just because social exhaustion doesn't get mentioned explicitly, doesn't mean that it cannot be the cause of the occaisional burn out for someone on the spectrum for example. Some of these traits could benefit more if they're being seen as a "cause and effect" type of thing. As long as there's no blatant abuse by the ones who are being diagnosed just to appear more "aspie".

 

[AsheSkyler]

I think they should be considered as supporting evidence, but not as a hard-and-fast diagnosis rule. In example, there are the extrovert Aspies that thrive on social interaction, social exhaustion would be a disqualifier for them.

 

[bentHnau]

The thing is, if you include these, that you would exclude people who are very well in need of a diagnosis for support, but would miss the criteria, that (I'm assuming) are the ones that matter most throughout life.

In example, there are the extrovert Aspies that thrive on social interaction, social exhaustion would be a disqualifier for them.

To both of you, I ask: why would this result in exclusion? Already there is awareness that not everyone on the spectrum has every symptom; the DSM-5, for example, specifies that a diagnosis for Autism Spectrum Disorder can be made with some subset of the listed symptoms.

 

[King_Oni]

To both of you, I ask: why would this result in exclusion? Already there is awareness that not everyone on the spectrum has every symptom; the DSM-5, for example, specifies that a diagnosis for Autism Spectrum Disorder can be made with some subset of the listed symptoms.

The more traits one looks for, the smaller the group gets I would suspect.

 

[ZackSkylar101]

From what I understand about the DSM-V (I may be wrong, haven't looked at it too much) you still need a number of characteristics from each category to fulfil the criteria (and then later one you just need to not fulfil certain criteria). So if you add those things in, you would probably have to put them into a new category, and you'd probably have to sort them down into different subcategories, and if you do that too much then that would exclude people who may get the diagnosis with the DSM-V guidelines.

You could do it so you have a category for anecdotal evidence and have all of it in it, but that would work as a double edged sword as you would probably identify lots of people who go into that category who may not be autistic, as you will probably find some of the anecdotal traits in the general population (I'm sure I could find a neurotypical who cannot remember song lyrics, however I know (and experience) that there are a lot of aspies who cannot remember song lyrics. I also know some autistic people who can remember them extremely well).

Overall, I think including those things would potentially skew the results a bit, and that would cause more false positives/false negatives. However if you don't include them in the DSM-V and if the DSM-V allows the clinicians to be able to note an amount of supporting material, as King_Oni and AsheSkyler suggested, then this could go towards the big picture of a diagnosis and if they are having difficulty making a decision based on the normal criteria, then if they have a large amount of evidence in the supporting material then they could use that to help make a diagnosis.

 

[NothingToSeeHere]

I think these factors are important as supporting evidence, but I don't see any reason for them to be put in the diagnostic criteria, as surely anyone with experience diagnosing AS/ASD will take them into account in their diagnosis anyway. And as people above have said it may both exclude AS people and include NT people, result in false positives and negatives.