Asperger's change in the 5th Edition DSM?

[Chris]

It is a form of autism - high functioning autism. The reason it has a seperate diagnosis is because the criteria differentiate so much from the typical autism diagnosis.

 

[Ruby_Aspergic]

If aspergers is high functioning autism, why is that a separate diagnosis from high functioning autism? There is a perception that there is a concrete difference in that people with aspergers do not have a speech delay and people with HFA do, but that is not necessarily true at all. I was still diagnosed and I was verbally precocious from a very young age and hit all my developmental milestones on time. What is the difference between me and you?

I am not trying to be argumentative or anything, don't take my debate as disrespect, I just don't understand your point of view.

 

[Chris]

Same from me - I don't mean to be argumentitive/disrespectful etc. I just prefer the classification/labelling of 'Aspergers Syndrome' to having 'high functioning autism'. In most people's heads the second you mention autism, they're going to assume the worst. Do you see what I mean or am i talking rubbish?

 

[Ruby_Aspergic]

I do understand why one would prefer it for that reason, but that doesn't make it an accurate classification, just a preferable one. I just don't think we should make medical classifications based on the misconceptions of the public. Not only is that a slippery slope to hell, I think it damages people who do have HFA. Keeping the classifications separate regardless of accuracy strengthens that misconception of the public, and while you can get away with that free and clear because your doctors chose to go with the word "aspergers," I can't just because mine decided to go with "high functioning autism" when they are essentially talking about the same thing. That is not science, and that is not what the writers of the DSM are supposed to be doing.

And I mean, it's like you're saying that you don't want to say that you have what I have, even though you pretty much do, just because it sounds worse. What am I supposed to think of that?

 

[Chris]

I'm confused? It is a form of autism...

 

[Ruby_Aspergic]

Then why the separate diagnosis? Your justification was because it is HIGH FUNCTIONING autism-- which is in fact, at this moment, a separate disorder from aspergers. While I understand why one would prefer to say they have aspergers than autism, if aspergers IS high functioning autism why in the world would doctors perpetuate these inaccurate diagnoses for the sake of your feelings? That isn't what medical researchers are for. I understand and am sympathetic to the fact that it makes you feel better to use the aspergers label instead, but it is not a doctors job to confound diagnostic criteria to mislead the public so half the people with high functioning autism can hide and the other half cannot. That's completely arbitrary. Which is why the change was proposed in the first place. Having both high functioning autism and aspergers as diagnoses is redundant and needlessly confusing, there is no basis for the redundancy in science or in medical practice.

 

[Chris]

http://autism.about.com/od/whatisautism/f/whatishfa.htm

To my knowledge, they're are more or less the same thing, pointless seperate diagnosis'. Whilst I realise medical researchers aren't here to satisfy my or our feelings, I'm still free to state my opinion - which stands and you understand me for it - I would rather have a label of AS than HFA...

 

[Willow]

There is an Autistic Spectrum. On that spectrum there is Autism and Aspergers Syndrome. There are different severities of each, hence why we get High Functioning Autism. The reason they are separate but on the same spectrum is because they have the same basic tendencies. To be on the spectrum you need to have issues with Social Imagination, Social Communication and Social Integration. Typically people with Autism have learning difficulties and a speech delay when younger. So the differences between HFA and AS aren't all that noticeable:


http://www.autism.org.uk/nas/jsp/polopoly.jsp?d=2493&a=3337

I think the reason they are separate is just because there is a difference, even if it is slight, and so for scientific reasons or whatever, they have different terms.

 

[Ruby_Aspergic]

"Typically people with Autism have learning difficulties and a speech delay when younger"

But that is not required for diagnosis, that is just typical, and as time goes on the lines blur more and more and different diagnosticians are interpreting these subtle differences in different ways, there is no standard as it is, doctors are confused because it does not make sense as it is written. All that is required is that they have some sort of a marked behavior that is typical of the autistic spectrum in a "communication" category, which is incredibly vague. I got autism instead of aspergers because my speech is more formal than is typical for my age and even my IQ despite being above average, and because there isn't much variation in my tone. That isn't even an impairment by any stretch of the imagination and it would not even be noticeable if you weren't looking for it. If it is not maladaptive, what difference does it make? You can argue about the letter of the diagnostic criteria as it is written now, but that isn't very logical at all. That's like saying you can't amend a constitution when there's been a mistake because it's not written into the constitution that there's been a mistake. That doesn't make any sense. You can't say they are separate because DSM IV says so, DSM IV is about to become obsolete, that's the point.

"
To my knowledge, they're are more or less the same thing, pointless seperate diagnosis'. Whilst I realise medical researchers aren't here to satisfy my or our feelings, I'm still free to state my opinion - which stands and you understand me for it - I would rather have a label of AS than HFA..."

I didn't intend to tell you what you should feel personally, I was more trying to understand why one would say the change shouldn't happen ( vs why you personally wouldn't want it to happen.) I agree to disagree.

 

[Willow]

Because if they merge it all so that there isn't any HFA or AS, then they are smashing through the boundaries they put up to define the differences. The difference between the most severe Autistic and the highest functioning Aspie will be catastrophic, to put those two people under the same label would be ridiculous.

 

[Chris]

Well, my basis for not wanting the change happen is based on personal preference - no solid facts or such.

Willow made a good point just now, which I will quote her on.

"They are talking about merging the everything on the spectrum - this means the most severely autistic person will have the same diagnosis as the highest possible functioning person with Aspergers. They're tearing down the boundaries they put up in the first place to define the differences between them. It's like saying someone with cancer has a headache."

Wasn't word for word, but the jist of it.

 

[Calvert]

Because if they merge it all so that there isn't any HFA or AS, then they are smashing through the boundaries they put up to define the differences. The difference between the most severe Autistic and the highest functioning Aspie will be catastrophic, to put those two people under the same label would be ridiculous.

I agree with this.


What are your thoughts on merging HFA into Aspergers and still having Autism? Wouldn't that solve the problem because then you would have one high functioning and one low functioning diagnoses?

 

[Chris]

What are your thoughts on merging HFA into Aspergers and still having Autism? Wouldn't that solve the problem because then you would have one high functioning and one low functioning diagnoses?

That's exactly my opinion. Merging two diagnosis' with practically identical definitions is logical, merging the whole spectrum is a dick move.

 

[Ruby_Aspergic]

"Because if they merge it all so that there isn't any HFA or AS, then they are smashing through the boundaries they put up to define the differences. The difference between the most severe Autistic and the highest functioning Aspie will be catastrophic, to put those two people under the same label would be ridiculous."

You misunderstand. Your diagnosis would not change that broadly to just autism, it would change to HFA. They are not going to stop distinguishing between different levels of severity at all, they are just not going to give a different disorder name to each severity of the same general disorder.

And why is it ridiculous to call you HFA and not me? What is the grand distinction you are trying to make? I do not have any kind of delay or impairment in my speech or communication nor in my intelligence, I am so incredibly high functioning that according to my doctors some would not have even given me any diagnosis, what makes you so different? You are likely not more high functioning than me. I don't see what distinction you think you are drawing. Nobody is going to say you will be lumped in with the severely autistic, you would just simply have the same label as those with HFA-- and we have already conceded that there is very little difference between the two, and arguably none at all.

I hope this is all in the spirit of friendly debate. I have tried out a few different forums and I really like this one the best and am grateful to have it, I hope that I will be welcomed here. I am not trying to tell you that you all are wrong, I just don't understand where you are coming from and would like to.


ETA:

"What are your thoughts on merging HFA into Aspergers and still having Autism? Wouldn't that solve the problem because then you would have one high functioning and one low functioning diagnoses?"

I considered that, but I think it would be a very strange move-- then you are separating aspergers from autism altogether and are essentially breaking it off the autistic spectrum, I don't know if there is a body of research to support doing that.

"That's exactly my opinion. Merging two diagnosis' with practically identical definitions is logical, merging the whole spectrum is a dick move."

Do we not draw distinction between high fever and low fever, though we accept that they are BOTH fever? Why do you assume we would not draw a distinction between mild or high functioning and severe or low functioning autism just because they use the same word for the overall condition itself? Severe, moderate, and minor are words used throughout practically any diagnosis. What makes autism so unique that it needs separate disorders for varying levels of severity-- including two that mean the same thing? The only thing I can think of is stigma, which is not a valid justification for making medical conditions-- especially not with the existence of HFA as a diagnosis.


It's 6:30 am in the good old US of A, so I need to go to bed now. XD I look forward to reading your responses in a few hours.

 

[Calvert]

I hope this is all in the spirit of friendly debate.  I have tried out a few different forums and I really like this one the best and am grateful to have it, I hope that I will be welcomed here.  I am not trying to tell you that you all are wrong, I just don't understand where you are coming from and would like to.

Don't worry, you are welcome here and I do understand your point of view. I think what the problem here is that the article the OP posted didn't explain it properly - either that or I (and possibly others) read it wrong. Upon reading the article posted, I was under the impression that they were going to do away with Asperger Syndrome, High Functioning Autism & PDD-NOS - merging it all into just Autism. In my opinion I think there should be at least one low functioning and one high functioning group to distinguish between them. Taking into account that the Autism spectrum is so wide, merging everything together would in a sense make it bigger and more confusing as two people with the same label could be at completely opposite ends. I wouldn't mind if AS and HFA got merged because they are practically the same bar a few minor differences. As for the "label" I would prefer to keep AS as this is what I have come to accept and be familiar with. I also think that people in general have a negative view of the word Autism and hence I prefer the term Aspergers (no offense to you or anyone else).

"What are your thoughts on merging HFA into Aspergers and still having Autism? Wouldn't that solve the problem because then you would have one high functioning and one low functioning diagnoses?"

I considered that, but I think it would be a very strange move-- then you are separating aspergers from autism altogether and are essentially breaking it off the autistic spectrum, I don't know if there is a body of research to support doing that.

Actually, what I meant was to merge HFA into AS but keep it on the Autism spectrum. So, Autism for low functioning (also referred to as Classic Autism) and Aspergers (with HFA merged) for high functioning.  Together, being known as the Autism Spectrum.

 

[Emor]

What an ignorant F'ing C#nt.   

(+1).
EMZ=]

 

[Chris]

Don't worry about it Ruby, of course you'll remain welcome.

Okay, to summarize my points in a way that would suit me (and I'm sure others would agree):

HFA and AS should be merged as a HF form of autism group (still on the spectrum, just the high end), then autism should remain at the other end and similar conditions merged into that - two distinct low and high functioning groups at each end of the spectrum. In an ideal world, I'd prefer it to remain 'Aspergers' over 'HFA' for the reasons I've stated previously - don't want discriminative behaviour from others due to the common stereotypes of the autistic population.

If anything needs removing it's the official diagnosis of 'ASD'. It is a completely useless and incomplete diagnosis.

 

[142857]

At times it is confusing to have separate terms for much the same thing. I had significant speech delay and I definitely qualify better for HFA than I do for Aspergers. But at the same time, as an adult, I have pretty much all of the same issues that the average Aspie has.

So when we are having a discussion and someone is talking about Aspie issues, and they are the same issues as I am having, should I therefore talk about my "HFA" issues or my "Aspie" issues? For now I will try to stick with referring to these things as HFA/Aspergers.

 

[Ruby_Aspergic]

"Actually, what I meant was to merge HFA into AS but keep it on the Autism spectrum. So, Autism for low functioning (also referred to as Classic Autism) and Aspergers (with HFA merged) for high functioning. Together, being known as the Autism Spectrum."

Based on the knowledge I have, I wouldn't object to that. I think for further clarity we should change the name of the autism spectrum, if we are able to make such a distinction, so that there aren't two entirely different things that are still "autistic."

"At times it is confusing to have separate terms for much the same thing. I had significant speech delay and I definitely qualify better for HFA than I do for Aspergers. But at the same time, as an adult, I have pretty much all of the same issues that the average Aspie has.

So when we are having a discussion and someone is talking about Aspie issues, and they are the same issues as I am having, should I therefore talk about my "HFA" issues or my "Aspie" issues? For now I will try to stick with referring to these things as HFA/Aspergers. "

I understand what you are saying. My diagnosis is HFA but I actually don't have anything except aspie issues, so it gets confusing.

 

[Calvert]

so it gets confusing.

I've been there before.   All of the forms of Autism Spectrum Disorder (Autism, HFA, AS) overlap with each other anyway. HFA and AS are very much the same, so yes it does get confusing. I was confused when I first started doing my research on it. I found that Wikipedia was a good source of information. You can read more  here and here.