Be happy it wasn’t removed all together because it’s often over-diagnosed or seen as a personality oddity. What would that do to children in schools or insurance policies?
Aspberger’s is also treated very differently around the world.
True Auspies are only found in Austria or Australia. But the history of diagnosing the “[del]condition[/del]” “[del]syndrome[/del]” “[del]disease[/del]” whatever is recent. “Asperger Syndrome” was first described (and thus the name) by Austrian pediatrician Dr. Hans Asperger in 1944, but did not become a diagnosis unto itself until DSM-IV in the 1990’s. Prior to that, it was classified under the rather generic diagnosis of “Pervasive Developmental Disorder” (PDD).
During the whole era of DSM-IV, I think it was always controversial and never really settled whether Asperger-as-Autism was a good idea, as the treatment needs of the higher-functioning Asperger kiddies was clearly very different from the treatment needs of more severely autistic kiddies. (And nearly all discussion of treatments has focused on children, to the point of making a big industry of it, as with ADD and ADHD, etc. – Adults just somehow fall off the radar and are left to fend for themselves, there being no money in that, unless they are so severely autistic that they need to be institutionalized.) But by this same argument, the proposed DSM-V idea of putting autism and Asperger’s disorder on one “Autism Spectrum” can hardly be seen as an improvement.
I guess what I was thinking is that I’m more concerned about what this does to the autism diagnosis than the Aspberger’s one. Autism needs to be taken seriously by medical professionals and so I’ve seen way too many kids with autism who haven’t even seen a neurologist. 
The thing with DSM is that when disorders are removed or re-classified, the law and your health care coverage can get fucked with.
Getting diagnoses or not, getting some kind of insurance coverage or not (and for what treatment?), legal issues, etc., etc., is and has always been an utter crap-shoot. Re-shuffling the DSM order of things will just add to the disarray.
When does an “odd” kid get a Dx? When is intervention indicated, and what intervention? What about “odd” adults? Just how “odd” is odd enough for adults to be unable to work, and can they get on disability? It’s all a crap-shoot now and with DSM-V it’s just going to get worse (that is, more arbitrary, confused, and disorganized) than it is already.
Why do you think it will get worse? I’m just wondering, since sometimes insurance companies need a diagnosis to continue to pay for treatment. If Aspberger’s is in the DSM, it’s clearly a mental condition that warrants treatment. I don’t know why it’s a friggin condition at all, but hey, them’s the rules.
My first Google hit - 504 plan. Obviously parents would be mad if the condition were removed all together.
I seriously do think that Asp is over-diagnosed to the point where new doctors should be re-evaluating previous diagnoses.
That’s just it. People currently getting some kind of insurance-covered treatment, or people who qualify for disability benefits, could end up losing that.
I’m confused. How come? It just means the classification is different. It’s not dropped entirely. If you don’t meet the new criteria, maybe you don’t have a disorder. I’ve seen very horribly misbhaving kids with the Aspie diagnosis. It’s like their parents don’t want them to be diagnosed with being anything else, so this works because it’s so nuanced and non-threatening.
I think it’s not really a bad thing. Aspberger’s is over-diagnosed and it needs to stop. As far as autism goes, that’s a diagnosis that needs more medical attention.
Thanks, DSeid, for your insight and input as a person with actual training in developmental and behavioral pediatrics, and as a physician who works with autistic patients.
One should always question authority, but when authority answers, one should at least listen.
To ecolaliate* DSied, one marked difference between Autism and Aspergers is that Aspergers have speech acquisition. In other words, they learn to speak generally in line with the neurotypical population. Whereas, Autism Spectrum Disorder (ASD) have big issues with speech and by extension with communication, especially in the early years. And can be combined with physical issues that makes things like fine motor skills for pointing at pictures or typing problematic.
Take for example my daughter. Who at age 5 could speak about 20 words. She would learn a new word and then lose an existing word. She’s made remarkable progress since then and has a vocabulary well over a thousand words, can speak sentences unprompted, but is still pretty challenged on a conversation. Well, for 5 years, she had a ton of behavior problems (and still does to a lesser degree) because she couldn’t explain what she wanted to do, and would just try to do something that seemed totally logical to her but looked dangerous to us. For example, trying to climb out the window at midnight, when what she wanted was a book in the library. She couldn’t explain it, and we couldn’t understand it. Someone that is “Aspergers” probably didn’t go through many formative years without being able to communicate.
Even now, we have to be careful to really understand some of the vocabulary she uses for non standard things. For example, last summer we visited Grandpa and had a trip to build a bear (Which we had never visited before although there is one in the mall within walking distance). When we got home, there was a couple of weeks when my daughter said something like “I want fluffy wind.” What the hey? I had this weird feeling but not very strong. A few weeks of this and finally I was pushing the jogging stroller around the mall, and she directed me to Build-a-Bear (that we had never been to). “Fluffy wind” turned out to be the fluff that gets put into a big holding tank, and then vacuumed over to each bear stuffing machine. My daughter could care less about the bears, but she loves putting the fluff into the holding tank, which has a vacuum suction, and loves stuffing the bears. An Aspergers kid probably would be able to say “build a bear” or have the speech to describe “the store we went with Grandpa.” My daughter has great communication skills but lacks the basic building blocks. (Note: I told the manager at build a bear this story and she told her staff that my daughter could come by any time and add fluff to the machine. And we do - a lot.)
*That’s an ASD joke I just made up. I slay me. 
Sure, the differences in language development are wide, but the new criteria is still general enough to include both parties:
Back to the op:
In what ways do you understand the treatment needs of high functioning autism (normal IQ) and AS (those with significant enough social disability and restricted range of interests as to be disabled) differ greatly?
12/01/2012 – I don’t see a new thread about this today, so I’ll just bump this one.
They’ve been kicking around the idea for some time now, about dropping the Asperger’s Syndrome diagnosis.
The word is out now. Yes, they’ve announced that they are going to do this. Asperger’s Syndrome will no longer be a diagnosis. It will be lumped into Autism Spectrum Disorder.
From Associated Press, today: Asperger’s dropped from revised diagnosis manual by Lindsey Tanner.
(And it appears that the proposed new book, formerly called DSM-V, will now be called DSM-5.)
You know, it appears to me that some of the problem in what’s being discussed is the use of the word “spectrum” in describing these conditions. To say that two (or more) things are on the same spectrum usually implies that there is a single one-dimensional scale connecting them. This seems to say that the relationship between these conditions can be characterized by saying that any one of them is just a more intense or a less intense version of any other one of them. What’s going on here seems to me to be more like a multi-dimensional cloud of a number of conditions, where none of the dimensions should really be thought of as describing how intense the condition is.
Fuck those Romans!
It is not just AS that is being disappeared. So are the personality disorders and the subtypes of schizophrenia. That is to say, they will no longer be conceptualized as discrete categories but rather represented by component traits. “Schizoid”, just like “Asperger’s Syndrome”, will be obsolete–the former merged with the “schizotypal” prototype.
As someone who has been diagnosed as both schizoid and AS (rolly eyes to the googol power), I applaud both of these revisions. I believe the proposed system will result in easier diagnosis for the vast majority of people, and that it will facilitate more precise communication between different professionals.
It is interesting to me that there has been little hue and cry over the changes in the personality disorder categories, like there has for the ASD categories. I’m guessing it’s because the PD’s largely affect adults, who are afforded little tangible benefit for being diagnosed as “borderline” or “narcissistic”, while ASD’s affect children who do receive services. But many AS adults are also wound up too, it seems. It’s like there are some weird identity politics going on.
(I do understand how much of a relief it is to find a label that describes you to a T. But I guess I don’t understand why people think something is being taken away from them. “I have some autistic traits” is just as easy to say as “I have Asperger’s Syndrome.” If “autistic” doesn’t seem befitting, then there’s always “eccentric”. Which is the one I have chosen to roll with.)
Almost anyone could say they have some autistic traits.
Even nereotypical people may have some autistic traits. Heck, there are some kids who are severely nereologically/mentally affected who may have some autistic traits, but not full blown autism. I still think that Asperger’s is DISTINCT from autism.
Under your reasoning you could say " I have some mental retardation traits" for " I have a learning disability"
Asthma - debilitating condition requiring large doses of steroids, or something that makes you wheeze once every few years?