Proposed changes to autism and Asperger syndrome diagnostic criteria - | autism | Asper... - 0 views
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NAS welcomes the overall proposed approach to streamline diagnostic criteria and make them simpler, to develop dimensional measures of severity and recognise the range of full health problems someone is experiencing, as well as any other factors that impact on their diagnosis.
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the proposed severity levels are not fit for purpose and potentially very unhelpful as they are currently drafted
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The minimum criteria for level 1 severity “Needs support” are considerably higher than the minimum criteria for a diagnosis
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DSM is an American publication. Most diagnoses in the UK are based on the International Classification of Diseases (ICD), published by the World Health organisation, or other criteria, such as those developed by Professor Christopher Gillberg.
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Creating a direct link between a clinical decision over diagnosis and a recommendation for support could affect clinical impartiality. In the UK we are aware of situations where clinical professionals have felt under pressure from their employers to under-assess needs in order to ration limited resources.
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Dr Lorna Wing and Dr Judith Gould have submitted a paper to the American Psychiatric Association, jointly written with Professor Christopher Gillberg. This article has been published in the journal Research in Developmental Disabilities. It calls for a stronger focus on social imagination, diagnosis in infancy and adulthood, and on the possible under-diagnosis of girls and women with autism
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They recommend that sub-group names for particular autism spectrum disorders are kept in the new diagnostic criteria, including a description of Asperger syndrome, to make it very clear that this continues to be a part of the autism spectrum.
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APA propose creating a new diagnosis of social communication disorder. This would be given where someone exhibits the social communication and interaction aspects of an autism spectrum disorder diagnosis, but does not show restricted, repetitive patterns of behaviour, interests or activities.
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linking of a clinical diagnosis to recommendations of support may create expectations for people on the autism spectrum that services will be provided when this will not always be the case (at least in the UK), due to high eligibility thresholds or because decisions about such support may be taken by professionals who have no relation to the diagnostic process.
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The current ICD (ICD-10) is virtually the same as DSM. The next version of the International Classification of Diseases (ICD-11) is due to be published in 2015. They will consider the changes made to DSM-5, but their descriptions are often slightly different. For example, the diagnostic names in ICD-10 are different to those in DSM-4.
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Diagnoses should always be based on a clinical decision about whether someone has an impairment which has a disabling effect on their daily life. Diagnoses will be given where symptoms cause an impairment to everyday functioning.
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Overall, we believe that the changes to the diagnostic criteria are helpful. They are clearer and simpler than the previous DSM-4 criteria.
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The diagnostic manuals are updated every so often to reflect the latest research. The last change to the DSM was in 2000, and before that in 1994.
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How long have autism and Asperger syndrome been in the DSM? Autism was first included as a separate category in DSM-3 in 1980 when it was called 'infantile autism'. This was later changed to 'autistic disorder' in 1987. 'Asperger’s disorder' (syndrome) was added into the next version, DSM-4, in 1994.