Autismland completely blew up after The New York Times published their piece about a study indicating that many people currently diagnosed with Asperger's syndrome or autism would not receive a diagnosis under new proposed standards and might face the loss of vital services.  People are in a panic, and it is overwhelming to me.  I hope you will read my first piece about this.

In it I explain that the panic is legitimate but misplaced:  people are already losing diagnoses and services because of economic pressure.  The chairman of the committee making the changes has admitted that this is one of the purposes for the change:

“We have to make sure not everybody who is a little odd gets a diagnosis of autism or Asperger disorder,” said Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions, which are still subject to change. “It involves a use of treatment resources. It becomes a cost issue.”

That quote comes from an excellent article by Amy Harmon, who explains the conflicts and concerns clearly.  I want to be clear that I think there are legitimate worries about the changes, but I share Melody Latimer's frustration with the study Fred Volkmar is using to scare people:

Hey look! We have some apples.

Red Delicious (Autism), Granny Smiths (Asperger’s), Yellow Apples (PDD-NOS), and Others (Rett’s and CDD)

Data:

Red Delicious Apples are: Red, Have a Peel, Have a stem, Has several seeds at core.

Granny Smith Apples are: Green, Have a Peel, Have a stem.

Yellow Apples are: Red and Yellow, Have a Peel, Have a stem.

(I can’t tell you data used has not been released.)

Diagnostic criteria match the above.

Diagnostic criteria change.

To be an apple:

1. You must have a peel and a stem. (You have to have communication challenges.)
2. You must have seeds. (You must have social challenges.)
3. You can either be tart, sweet, or somewhere in the middle. (You may have restrictive behaviors, interests or activities.)

Oh dear. It seems that Granny Smith Apples and Yellow Apples no longer meet the criteria to be called apples.

I also like very much what Michael Forbes Wilcox says about the problems inherent to a behavioral diagnosis for autism:

We are in the trap of buying into the behavioral model. Autism is a neurological condition, not a behavioral one. Since there is no widely-accepted objective test that will identify someone as autistic, we are left with a behavioral, subjective diagnostic process. This is, I suppose, how the APA retains a toehold. And, of course, to uphold the tradition/myth that only psychiatrists are qualified to prescribe psychotropic medications.

Perhaps we are fighting the wrong fight. Why argue with the APA? Why not work in other areas to ensure that Asperger’s and related learning differences are recognized in the world at large as disabilities that need to be treated on a par with any other disability that creates a barrier to full inclusion or to gaining full potential?

Yes, I realize my suggestion raises a whole host of other questions and challenges. Who, then, defines what is autism/Asperger’s etc.? Who is qualified to diagnose? I have a non-clinical view (my chief qualification in this field being that I am autistic), and I’m sure there are many complications of which I’m not aware, but I have faith that, if properly worked out, things should not be all that much different from the way they are today.

For those of you who are inclined to sign it, there is a petition at Change.org to request that the proposed changes be abandoned.

And my friend Jacob shares this:

Call the APA directly at 703.907.7300 (a Virginia phone number) AND email them at dsm5@psych.org or apa@psych.org