This has been on my list of things to write about since I started my blog, but I’m kind of intimidated to write about it. Plus, it’s a topic that I honestly don’t really know what to think of, and I haven’t properly managed to form an opinion yet. Also, I apologize ahead of time for the fact that this post is not going to be fully cited – I’ve been reading articles for months, but have failed to save the links and now I can’t seem to find them again. hrmph.
So, as you may or may not know, a new version of the DSM is due to be coming out in a few months. The entire process has been surrounded by controversy right from the start, with a large number of people unhappy with how it’s been handled, both generally and regarding specific things. One of those specific things is the fact that a number of disorders are now going to be consolidated under the “autism spectrum disorder” umbrella, which will have one set of criteria.
Reactions have been varied, but largely negative. Some people fear that many people will be excluded and will thus not have access to services they need (and others disagree). Some people fear that having it all lumped together will cause those on the more severe end of the spectrum to be even more invisible than they already are.
I have a hard time figuring out where I stand on it. Once I was diagnosed, I finally allowed myself to really start researching into Asperger’s syndrome (AS). I learned very quickly that information about AS was often blended together with information about autism. Shortly thereafter, I learned that the reason for this was because the line between AS and autism was blurred and confusing, and no one seemed to be entirely clear on where it was. I have heard a number of different ideas (some say the difference is in language delay vs not, other people in whether or not there is a desire for social contact, etc) but always with the idea that at best, it’s a rough, general distinction. I cannot directly speak for diagnoses like PDD-NOS or childhood disintegrative disorder, but I would not be surprised if the same thing holds true for them as well. So it seems clear to me that the distinctions are flawed and as such, probably not very useful. Plus, people have already been referring to all these diagnoses together as autism spectrum disorders (ASD), so making it official could be useful.
On the other hand, we are talking about a very broad spectrum, which contains people who are very low functioning and people who are very high functioning. I have a hard time with the idea that one set of criteria will cover everyone. Plus, people with different levels of functioning will obviously need different services. I wonder how having only one diagnosis will change how services will work. I can see the argument that lower-functioning people will have a harder time getting much-needed services, simply because the diagnosis of ASD will not indicate how severe they are. Will there be a concept of trying to indicate where people are on the spectrum? Will diagnoses include functional severity ratings?
Ultimately, I don’t think I can form an opinion until I see what happens. I have always been rather bad at prognostication, so I’d rather gather more data than forecast doom and gloom based on speculation. Though I will admit, on reading over the proposed new criteria, it is rather a relief to me that I would still qualify.
And hey, look at that. I managed to find most of my links!