As many of you will be aware that American Psychiatric Association (APA) recently announced the publication in May 2013 of their new diagnostic manual which will remove Aspergers Syndrome as an independently listed condition (as well as Pervasive Development Disorder – Not Otherwise Specified) and instead replace it with a sole diagnosis of Autistic Spectrum Disorder (ASD). This has generated a significant range of opinions and also worried many people who fear their diagnosis or that of a loved one will no longer be recognised. In this article, we try and address some of those concerns and attempt to clearly explain what DSM-V will really mean for those affected by Aspergers Syndrome in Ireland, now and in the future.
Why is Aspergers Syndrome being removed?
The decision was passed by a vote of the APA, on the basis that it made sense both clinically and in real-world terms to classify all types of conditions on the autistic spectrum as autism, as in the behavioral sense they are deeply connected though autism in all its forms affects each person in a different way. In particular, it was pointed out that the existence of a separate diagnosis for a condition which was also on the Autistic Spectrum has caused confusion and misdiagnosis in the past. One reprieve for Aspergers Syndrome was that while it will no longer remain as a diagnosis it can continue as a label for people who wish to describe the condition as such, though all diagnosis will now be under the new sole term. Under this term the classification system will include 3 levels for the varying levels of severity of the condition.
For further information on the decision see the following video link:
Will the new criteria affect existing diagnosis
No, those currently diagnosed should expect to remain diagnosed whether it is decided to continue to use the term “Aspergers” or “ASD”. In truth, many doctors are likely to continue to use the term for many years to come and those currently holding a diagnosis can rest assured that their condition will continue to be recognised and that their statutory entitlements should remain the same.
What about diagnosis rates, will people who would have met the AS criteria qualify for the new criteria
In truth this is a question which only time will answer. It was the intention of the APA that anyone likely to have been affected by what we now know as Aspergers Syndrome who does not meet the new criteria for ASD and a study by a leading architect of DSM-V, Dr. Catherine Lord, found that 91% in this bracket would continue to qualify automatically for the new ASD criteria and that the majority of the remaining 9% would quality with additional imput from doctors. This 9% includes those affected by Pervasive Development Disorder- Not Otherwise Specified which is also being removed from the manual, though it is hoped that those affected by PDD will instead quality for a diagnosis of Social Communication Disorder.
However, there have been other studies which indicate between 10-55% (its varies greatly!) of those who would currently meet an Aspergers Syndrome or PSS-NOS diagnosis would not meet the new ASD criteria. I think the vast array of percentages in it self shows the uncertainty and in truth we will have to wait and watch to see how doctors interpret the manual before we can truly pass judgement.
How will this affect the AS community
This is a question which arises again and again, as many people fear they will be viewed differently if seen as “autistic” instead of having AS as well as those who fear the unique culture and identity which has grown around the AS diagnosis may be affected.
While there are some who would argue that the “Aspergers-like” label which Doctors may continue to use when diagnosing ASD as well as they severity level system should dispel these fears, however others still see the removal of a condition which for several decades has had its own unique characteristics and research as a negative development which will reduce funding in research and affect public perception.
In truth, we must wait and see how things work out in practise and also remember that it is not without question that the diagnosis may be resurrected in a future manual. However it is the view of this website that during this important teething period that we continue to discuss developments in the forum so that we can keep tabs on how people are feeling and are being affected by the manual upon it implementation in May.
For further information please see the following websites (our sources for this piece):