Don't like Asperger's classed same as low functioning autism.

[Judge]

It’s pretty difficult to be awarded “entitlements” (benefits, or law suits) f high functioning. At least in the USA. Wanting to know for “peace of mind,” is looked upon the same as having cosmetic surgery.....not necessary for insurance to pay. I understand that.

No, I was referring to the entire spectrum of those who would seek a formal diagnosis. Not just those who may consider themselves high functioning. Though imagine being turned down for a positive diagnosis alone with no intention of seeking government entitlements, simply because one is capable of supporting themselves. Even if they pay for such a diagnosis without insurance being involved. A diagnostic implying that one can't have a neurological condition only because they are self-sufficient. It's an absurd premise.

Again, it's a medical protocol designed to favor monetary considerations. It's no secret that the DSM-V was enacted in the middle of the timeline of the development of the Affordable Care Act. A medical protocol tampered with through the influence of in$urers and politician$ in both parties to control losses and government subsidies for healthcare insurance. Coincidental? I think not.

The DSM-V just reflects yet another aspect of political compromise of politicians and special interests that was needed at the time for the ACA to be later passed into law in the first place.

Otherwise we'll just have to agree to disagree.

 

[AO1501]

So, really, this is nothing new. Insurance companies don’t pay for everything. Why should we expect a high functioning person to have insurance pay for something many would believe is not neccessary?

I think my problem with that is that it isn't whether 'many believe it is not necessary' but whether the individual and that individual's healthcare professional thinks treatment is necessary that should be the arbiter of choice, not wider opinion, and really not an insurance company either.

Of course I'm a Brit, so I view the US healthcare system as a bad way of providing healthcare, so while what you say is certainly a reflection of how it is, I philosophically object to it being that way.

 

[Judge]

I think my problem with that is that it isn't whether 'many believe it is not necessary' but whether the individual and that individual's healthcare professional thinks treatment is necessary that should be the arbiter of choice, not wider opinion, and really not an insurance company either.

Of course I'm a Brit, so I view the US healthcare system as a bad way of providing healthcare, so while what you say is certainly a reflection of how it is, I philosophically object to it being that way.

Agreed. One should be able to seek a positive diagnosis without any restriction of having to qualify based on the amount of support one requires. Especially if they opt to pay for it themselves. Without any terms and conditions reflecting fiscal restraint from politicians and insurers.

Though imagine trying to explain to most NTs what drives one to want to know for certain whether or not they are on the spectrum of autism. Something they likely cannot truly relate to.

 

[Mary Anne]

You are encouraging conspiracy theories. Have you read the explanations from those on the DSM Boards that actually created the new combination?

 

[GrownupGirl]

I thought Asperger's was supposed to be similar to *high*-functioning autism, since being aspie has been described as having just a "dash" of autism, as if someone asked me, "Would you like some autism on your french fries?" and I answered "Okay, but just a dash".
But I really shouldn't be surprised if the US thinks aspies are the opposite, and I have no clue about what my own country thinks, if at all.
But I hate the functioning label, anyway. If you're high-functioning society assumes you have no challenges due to your disability, but they still have unreasonably high expectations of you.

 

[Judge]

You are encouraging conspiracy theories. Have you read the explanations from those on the DSM Boards that actually created the new combination?

Conspiracy theory? I just consider it a form of public policy development. Where both the public and private sectors project and leverage their influence. Where official explanations of their results are likely sanitized for public consumption.

- Business and politics as usual. Unlike conspiracy this isn't a crime.

The three levels of diagnostics all specify "required support". That's a fact- not a conspiracy. It can effectively filter out those who could be on the spectrum, yet require no such support in the most literal sense.

Now, if you want conspiracy theories, I'll give you two of them. One involves those who supported the Affordable Care Act knowing it would fail, though in the interim boost shareholder equity of both healthcare providers and healthcare insurers. The other involves those who supported the Affordable Healthcare Act knowing it would fail, so that national healthcare became so degraded that the only way out of it would be to adopt a single payer healthcare system out of desperation rather than through conventional political debate and compromise.

Two opposing conspiracy theories which ideologically correspond to the more extreme elements of both major political parties. And yet both appear quite viable given the present circumstances of healthcare in America. Another coincidence?

Like I said, we agree to disagree. I'm both a pragmatist and a cynic. My bad.

 

[55853]

Conspiracy theory? I just consider it a form of public policy development. Where both the public and private sectors project and leverage their influence. Where official explanations of their results are likely sanitized for public consumption.

- Business and politics as usual.

The three levels of diagnostics all specify "required support". That's a fact- not a conspiracy. It can effectively filter out those who could be on the spectrum, yet require no such support in the most literal sense.

Now, if you want conspiracy theories, I'll give you two of them. One involves those who supported the Affordable Care Act knowing it would fail, though in the interim boost shareholder equity of both healthcare providers and healthcare insurers. The other involves those who supported the Affordable Healthcare Act knowing it would fail, so that national healthcare became so degraded that the only way out of it would be to adopt a single payer healthcare system out of desperation rather than through conventional political debate and compromise.

Two opposing conspiracy theories which ideologically correspond to the more extreme elements of both major political parties. And yet both appear quite viable given the present circumstances of healthcare in America. Another coincidence?

Like I said, we agree to disagree. I'm both a pragmatist and a cynic. My bad.

So do you believe that when the ICD 11 comes out, it won't have these support levels?

 

[Judge]

So do you believe that when the ICD 11 comes out, it won't have these support levels?

I have no idea whether it will or won't. Though it wouldn't surprise me if it does.

Other nations' public and private sectors are likely have the same fiscal concerns as would the US given the global impact of the great recession. More so perhaps given socialized medicine abroad. Besides, neither our public or private sectors have a monopoly on fiscal expediency regarding medical protocols in general.

 

[Progster]

One thing that surprises me is the fact that there is so little comment on the DSM's new diagnosis of Social Communication Disorder. The NAS website states that this is part of the autism spectrum, but on this website for all those on the spectrum I have yet to see any member saying they were diagnosed with it, and there seems to be little or no comment on it.

 

[Mary Anne]

Conspiracy theory? I just consider it a form of public policy development. Where both the public and private sectors project and leverage their influence. Where official explanations of their results are likely sanitized for public consumption.

- Business and politics as usual. Unlike conspiracy this isn't a crime.

The three levels of diagnostics all specify "required support". That's a fact- not a conspiracy. It can effectively filter out those who could be on the spectrum, yet require no such support in the most literal sense.

Now, if you want conspiracy theories, I'll give you two of them. One involves those who supported the Affordable Care Act knowing it would fail, though in the interim boost shareholder equity of both healthcare providers and healthcare insurers. The other involves those who supported the Affordable Healthcare Act knowing it would fail, so that national healthcare became so degraded that the only way out of it would be to adopt a single payer healthcare system out of desperation rather than through conventional political debate and compromise.

Two opposing conspiracy theories which ideologically correspond to the more extreme elements of both major political parties. And yet both appear quite viable given the present circumstances of healthcare in America. Another coincidence?

Like I said, we agree to disagree. I'm both a pragmatist and a cynic. My bad.

Everyone I know (low paid, independent contractors, artists, and all the rest working without benefits, really LOVE and NEED their affordable care...so why is it “failing?” They get excellant care. The only ones Complaining about it are anti- Obama staunch Republicans, and I easily get bored by this sort of political discussion. I do not understand discussions of fiscal politics, or some of the scholarly debates of public policies. Finance is not understood by this aspie! I do know that my political party strongly fights to keep the Affordable Care Act. Insurance companies make billions of dollars in profits. They have no right to complain, but of course they have the right to decide what they will pay for or not.

Do you work in the insurance sector? I do not understand how you explain things). I am not smart on economics, though I have tried. It sounds like you are speaking from the Republican economic standpoint rather than from the human social needs sector. That’s where I come from and thus might be where the confusion lies. I am not up for debate (I like you Judge) but I AM willing to understand if you can simplify the explanation. (I could not understand your post on the DSM V changes as you tend to write in a scholarly intellectualized way and I have never been able to understand that sort of thing). I read some of your posts up to three times over. Most of the time I finally get it, but on that one I could not. It’s part of my own learning disabilities, I guess.

 

[Fridgemagnetman]

I have no idea whether it will or won't. Though it wouldn't surprise me if it does.

Other nations' public and private sectors are likely have the same fiscal concerns as would the US given the global impact of the great recession. More so perhaps given socialized medicine abroad. Besides, neither our public or private sectors have a monopoly on fiscal expediency regarding medical protocols in general.

Slightly side bar : there is or was recently a vote on the categorisation of which meds could be legalised.
A softening of standards allowing durgs through which would not otherwise have been.
Ie. Under the new proposed rules formaldehyde would have still been allowable.
Thought you would have an interesting take or mnow more about this than I - either to put into this discussion or a separate one.

 

[Mary Anne]

Slightly side bar : there is or was recently a vote on the categorisation of which meds could be legalised.
A softening of standards allowing durgs through which would not otherwise have been.
Ie. Under the new proposed rules formaldehyde would have still been allowable.
Thought you would have an interesting take or mnow more about this than I - either to put into this discussion or a separate one.

Do you have a link to that? I expect there is going to be tightening of controls on availability of opioid pain meds. Formaldehyde is regularly used in biology, so I don’t understand why it would be denied except that it is an environment toxic chemical. Dry cleaning fluids are also.

 

[Judge]

Do you work in the insurance sector? I do not understand how you explain things). I am not smart on economics, though I have tried. It sounds like you are speaking from the Republican economic standpoint rather than from the human social needs sector. That’s where I come from and thus might be where the confusion lies. I am not up for debate (I like you Judge) but I AM willing to understand if you can simplify the explanation. (I could not understand your post on the DSM V changes as you tend to write in a scholarly intellectualized way and I have never been able to understand that sort of thing). I read some of your posts up to three times over. Most of the time I finally get it, but on that one I could not. It’s part of my own learning disabilities, I guess.

I was a property/casualty and finance insurance underwriter for nearly two decades. And a personal investor after that. I am a registered non-partisan, and review issues on their own merit without ideological bias. So you may perceive me to be all over the political spectrum depending on the issue. I'm what you could call a "number-cruncher", and am professionally accustomed to explaining things in a somewhat legal fashion.

From my own perspective, I see many of us on the spectrum as "square pegs" in so many ways. But then we didn't create the DSM-V either. A protocol that appears quite flawed given the apparent restrictions of only three support levels. And why do they all have to be construed as support levels? Why can't the lowest tier reflect "no support applicable" ?

I would ask board-certified medical professionals the following:

If they apply the protocols of the DSM-V, would they be compelled to work only within the confines of the three levels of support as indicated, or would they feel they had the latitude to "freelance" such protocols? Would they be prepared to document in a diagnosis that while their patient did not meet level one support, that they felt that they were in fact on the spectrum of autism?

Or would they simply abide by the limitations of the three levels of support and conclude a person is not on the spectrum because they are relatively self-sufficient? The way this is crafted makes no sense to me in terms of assessing autism. However it makes all the sense in the world if it was designed to limit the number of positive diagnoses and parallel the intent of the Affordable Care Act. To conform to political and fiscal compromise far more than neurological considerations. Where good intentions in creating a horse result in the creation of a camel. The common result of reaching a consensus between political adversaries and special interests. Business and politics- as usual.

Sadly I also wonder if medical professionals would simply lament that while they may acknowledge a patient's high-functioning autism, that they feel they have no choice but to at best offer them to be categorized using the level one support definition just to confirm a positive diagnosis? Which from my perspective would be adding insult to injury. Especially given the legal nature of medical records. That whatever is documented, becomes a matter of record.

Though it would amuse me to no end if a Neurotypical neurologist or psychiatrist were to tell me that the DSM-V is merely a guideline, not intended to be interpreted in such a pedantic, autistic manner.

I would pose this one question to anyone here. Would you be willing to accept a formally documented level one diagnosis, even if it wasn't entirely accurate? "Painting" you as someone who is not completely in control of their adult lives, even if in fact you are?

I accept the DSM-V's perspective of autism as a spectrum of traits and behaviors. However dictating only three levels of "required support" makes no sense. It effectively filters out the most functional of people on the spectrum who require no level of support period. Which IMO also implies that we are collectively malfunctioning. Patently untrue! People living independently should have the right to be positively diagnosed without any formal premise of implying that we are in need of help and support.

 

[Sid Delicious]

"I'm nothing like those people who can't speak, have a low mental ability and go into rages banging their head and everything. How can the people who need to wear a helmet from self harm be the same as others they say have Asperger's like Einstein or Bill Gates? It isn't the same thing and there are more differences than similarities."

I would guess because those kids that don't speak, go into rages, bang their head, smash things, and self harm grow into adults that manage to develop enough coping mechanisms with therapy and medication that they can hide those impulses enough to keep a basic job, etc with continued support. As far as I know, the only difference is having a high enough IQ that you are able to train yourself (or be trained) in those coping mechanisms. Without that higher IQ, you would be stuck at the mute, raging, head banging, self harming stage continuously. Even with a higher IQ, most still can't function at a high enough level to stay employed or manage basic life skills effectively. I'm not aware of Einstein or Bill Gates officially having autism/apergers or what they were like as children, so can't really comment there.

I remember how I must have seemed to an outsider as a child versus how I am now, and on the surface I appear like a different person. But that is after years of therapy, a very supportive family/teachers, sheer luck in terms of available educational opportunities close to home, and a variety of (mostly not-so-healthy) coping mechanisms that get me through the day. I think a lot of slightly nerdy or shy kids/adults are labelled as 'autistic' or 'aspergers' when they probably shouldn't be, which perhaps skews things a bit. But I don't see much difference between low and high functioning ASD/autism aside from IQ.

 

[Judge]

But I don't see much difference between low and high functioning ASD/autism aside from IQ.

Point taken in terms of traits, behaviors and how intense or not they may be to an individual. However from my own perspective I see one issue alone that more likely separates the two.

- The degree of one living an independent life.

Though I'd also have to concede that there will always be a few exceptions to this dynamic. That it's possible to be low functioning and live independently, but not probable.

 

[Sid Delicious]

I agree it isn't an all or nothing situation and, as you said, there will be some supposedly 'low functioning' people with autism living independently. Although I probably wouldn't consider them low functioning if they are managing to function at a similar level to a someone labelled 'high functioning' who is clearly still struggling with basic things. I see it as a sliding scale. I guess I tend to use IQ as a distinguishing factor, as without huge amounts of support it would be very difficult for someone with a low IQ and autism to learn enough coping methods to live independently.

 

[Mary Anne]

I was a property/casualty and finance insurance underwriter for nearly two decades. And a personal investor after that. I am a registered non-partisan, and review issues on their own merit without ideological bias. So you may perceive me to be all over the political spectrum depending on the issue. I'm what you could call a "number-cruncher", and am professionally accustomed to explaining things in a somewhat legal fashion.

Thank you! This explains oh so much about the way you write...I used to think you were a lawyer.

[/QUOTE] I would ask board-certified medical professionals the following:
If they apply the protocols of the DSM-V, would they be compelled to work only within the confines of the three levels of support as indicated, or would they feel they had the latitude to "freelance" such protocols? Would they be prepared to document in a diagnosis that while their patient did not meet level one support, that they felt that they were in fact on the spectrum of autism? [/QUOTE]

I think the answer is very clearly, absolutely YES - and it would be written exactly how you stated it: “while their patient did not meet level one support, that they felt that they were in fact on the spectrum of autism.”

[/QUOTE]Or would they simply abide by the limitations of the three levels of support and conclude a person is not on the spectrum because they are relatively self-sufficient? [/QUOTE]

No, there is always some leeway, for a doctor to document why he is diagnosing what. I actually did mental health assessments, while in training. Of course the assessments were looked over by the doctor with a Ph.d. I saw a lot of leeway, due to most people NOT BEING CLASSIC COOKIE CUTTER COPIES OF DSM descriptions. These people do NOT fall through the cracks. Any person that is not quite identified exactly in the DSM can be notated in ways to describe the differences (NOS “not otherwise specified.”), and still be under that same diagnostic category. Or, some people have combinations of 2 or 3 different diagnosis, and that can also be professionally notated.

[/QUOTE]Sadly I also wonder if medical professionals would simply lament that while they may acknowledge a patient's high-functioning autism, that they feel they have no choice but to at best offer them to be categorized using the level one support definition just to confirm a positive diagnosis? [/QUOTE]. The answer would be a big NO!

[/QUOTE]I would pose this one question to anyone here. Would you be willing to accept a formally documented level one diagnosis, even if it wasn't entirely accurate? "Painting" you as someone who is not completely in control of their adult lives, even if in fact you are? [/QUOTE]

People have been known do this to receive governmental benefits. Otherwise, can you think of reasons why else anyone would decide to do this?

 

[Aeolienne]

I'm proud of my autism; it is what has made me a champion golfer.

I wonder why mine hasn't given me a comparable sporting talent. I can't even bounce a tennis ball on a racket.

 

[Mary Anne]

"I'm nothing like those people who can't speak, have a low mental ability and go into rages banging their head and everything. How can the people who need to wear a helmet from self harm be the same as others they say have Asperger's like Einstein or Bill Gates? It isn't the same thing and there are more differences than similarities."

I would guess because those kids that don't speak, go into rages, bang their head, smash things, and self harm grow into adults that manage to develop enough coping mechanisms with therapy and medication that they can hide those impulses enough to keep a basic job, etc with continued support. As far as I know, the only difference is having a high enough IQ that you are able to train yourself (or be trained) in those coping mechanisms. Without that higher IQ, you would be stuck at the mute, raging, head banging, self harming stage continuously. Even with a higher IQ, most still can't function at a high enough level to stay employed or manage basic life skills effectively. I'm not aware of Einstein or Bill Gates officially having autism/apergers or what they were like as children, so can't really comment there.

I remember how I must have seemed to an outsider as a child versus how I am now, and on the surface I appear like a different person. But that is after years of therapy, a very supportive family/teachers, sheer luck in terms of available educational opportunities close to home, and a variety of (mostly not-so-healthy) coping mechanisms that get me through the day. I think a lot of slightly nerdy or shy kids/adults are labelled as 'autistic' or 'aspergers' when they probably shouldn't be, which perhaps skews things a bit. But I don't see much difference between low and high functioning ASD/autism aside from IQ.

This is where I am completely ignorant on the subject of autism. Are you saying that most children with a diagnosis of “ high functioning” autism did engage in the same screaming self harming, visual stimming, head banging, (and perhaps violent to others) meltdowns as the diagnosed “low functioning” ones?

I had a completely different understanding.

 

[Mary Anne]

I was a property/casualty and finance insurance underwriter for nearly two decades. And a personal investor after that. I am a registered non-partisan, and review issues on their own merit without ideological bias. So you may perceive me to be all over the political spectrum depending on the issue. I'm what you could call a "number-cruncher", and am professionally accustomed to explaining things in a somewhat legal fashion.

From my own perspective, I see many of us on the spectrum as "square pegs" in so many ways. But then we didn't create the DSM-V either. A protocol that appears quite flawed given the apparent restrictions of only three support levels. And why do they all have to be construed as support levels? Why can't the lowest tier reflect "no support applicable" ?

I would ask board-certified medical professionals the following:

If they apply the protocols of the DSM-V, would they be compelled to work only within the confines of the three levels of support as indicated, or would they feel they had the latitude to "freelance" such protocols? Would they be prepared to document in a diagnosis that while their patient did not meet level one support, that they felt that they were in fact on the spectrum of autism?

Or would they simply abide by the limitations of the three levels of support and conclude a person is not on the spectrum because they are relatively self-sufficient? The way this is crafted makes no sense to me in terms of assessing autism. However it makes all the sense in the world if it was designed to limit the number of positive diagnoses and parallel the intent of the Affordable Care Act. To conform to political and fiscal compromise far more than neurological considerations. Where good intentions in creating a horse result in the creation of a camel. The common result of reaching a consensus between political adversaries and special interests. Business and politics- as usual.

Sadly I also wonder if medical professionals would simply lament that while they may acknowledge a patient's high-functioning autism, that they feel they have no choice but to at best offer them to be categorized using the level one support definition just to confirm a positive diagnosis? Which from my perspective would be adding insult to injury. Especially given the legal nature of medical records. That whatever is documented, becomes a matter of record.

Though it would amuse me to no end if a Neurotypical neurologist or psychiatrist were to tell me that the DSM-V is merely a guideline, not intended to be interpreted in such a pedantic, autistic manner.

I would pose this one question to anyone here. Would you be willing to accept a formally documented level one diagnosis, even if it wasn't entirely accurate? "Painting" you as someone who is not completely in control of their adult lives, even if in fact you are?

I accept the DSM-V's perspective of autism as a spectrum of traits and behaviors. However dictating only three levels of "required support" makes no sense. It effectively filters out the most functional of people on the spectrum who require no level of support period. Which IMO also implies that we are collectively malfunctioning. Patently untrue! People living independently should have the right to be positively diagnosed without any formal premise of implying that we are in need of help and support.

Have you read this? Of interest https://blogs.scientificamerican.co...e-up-on-a-single-diagnostic-label-for-autism/