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Revision would eliminate Asperger's as a diagnosis and replace it with autism spectrum disorder
James T. Mulder / The Post-Standard
Published: Tuesday, September 27, 2011, 8:44 AM
Asperger's syndrome, a form of autism being diagnosed in a growing number of children, may soon disappear from the official psychiatric diagnostic manual.
Under a proposed revision, Asperger's would be eliminated as a diagnosis and be replaced by autism spectrum disorder -- a label that would apply to all types of autism, from the mildest form to the most severe. The proposal also would eliminate another autism diagnosis -- pervasive development disorder -- not otherwise specified.
The proposed change is generating controversy. Experts revising the manual for the American Psychiatric Association say the Asperger's diagnosis is confusing and that the distinction between Asperger's and "high-functioning" autism is often meaningless. Some patients and their families, however, want Asperger's to remain in the manual because they believe the diagnosis is part of their identity and differentiates them from more severely disabled autistic people.
"I see lots of young adults who enjoy this label and diagnosis," says Dr. Kevin Antshel, a clinical psychologist at Upstate Medical University. "They say, 'So what if I'm quirky? I'm an Aspy.'"
The revised edition of the American Psychiatric Association's diagnostic manual is due out in 2013.
The various forms of autism affect about 1 of 110 U.S. children, according to federal estimates.
There are now three different autism diagnoses:
*Autistic disorder or classic autism, characterized by significant language delays, social and communication challenges, and unusual behaviors and interests. Some individuals in this category also have intellectual disabilities.
*Asperger's, characterized by milder symptoms of autism, but typically no problems with language or intellectual disability.
*Pervasive developmental disorder -- not otherwise specified. Individuals in this category have some, but not all of the symptoms that accompany the other two diagnoses.
Under the proposed revision, clinicians making the diagnosis of autism spectrum disorder would rank the symptoms by severity.
Asperger's has been an official diagnosis since 1994, 50 years after the condition was first described by Austrian pediatrician Hans Asperger.
Antshel believes getting rid of the Asperger's diagnosis is a good move. Research shows there's a lot of overlap between the different forms of autism, he says. "Some people who have an autism diagnosis eventually morph into Asperger's and vice versa," Antshel says. "I think it would help reduce some confusion."
The autism spectrum disorder diagnosis may make it easier for some youngsters with Asperger's to get services in school. "There are a lot of individuals with Asperger's I see who are not getting services in school because they are considered too high functioning," he says. "They may be doing well academically, but they are not functioning well socially."
Marylee McClaskey of Baldwinsville has 13-year-old twin sons -- one with Asperger's, the other with autism. She believes getting rid of the Asperger's diagnosis would be a big mistake.
"In my experience, the minute educators hear 'autism' they say, 'OK. This kid is not going to amount to much. We will just do the best we can with him,'" she says. McClaskey fears children with Asperger's won't get the support they need if the diagnosis is discarded.
Carroll Grant, director of Upstate Medical University's Margaret L. Williams Developmental Evaluation Center, which sees many children with autism, said it is important that any changes made in the diagnostic label account for differences in each child's learning style and the way they process information.
Grant said the debate over eliminating the Asperger's diagnosis reminds her of the catch phrase popular among disability rights groups: "Label jars, not people."
"You don't want a label at all, but it may be the evil you need to access services, not to say you are damaged goods," Grant says.
Original article: here