Autism Spectrum Diagnostic Categories

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The concept of abnormality changes with knowledge and the prevailing social attitudes, therefore it is difficult to define an individuals' mental state or behaviour as abnormal.
Adam King
AGRE is now using the following 3 computer-scored affected status categories: "Autism," "Not Quite Autism (NQA),” and "Broad Spectrum," which are based on the Autism Diagnostic Interview – Revised (ADI-R) domain scores. We provide these categorizations not to limit analyses or impose them upon researchers, but to facilitate analysis by those who may not be comfortable interpreting the ADI-R data to formulate their own diagnoses.
Although subgroups were identified which bore some relationship to clinical differentiation of autistic, Asperger syndrome, and PDD-NOS, the nature of the differences between them appeared strongly related to ability variables.
Margot Prior et al
Although the differences between AS and ADHD can be noted and may lead to some different initial treatment approaches, eventually you must focus on your individual child's behavior and not a diagnosis.
Jed Baker
Many children with autism display signs of hyperactivity and inattention when they start school. However, experts are very clear that as the child becomes older the apparent similarities between the two conditions will separate out.
Nell Munro
Time and again, parents have told me that they have been urged to allow their late-talking children to be labeled 'autistic' so that they would be eligible to get government money that can be used for speech therapy or whatever else the child might need.
Thomas Sowell
Recent autism and autism-related research from Gothenburg is surveyed. In indigenous families, typical autism seems no more common now than 10 years ago. Genetic factors play a part in causing autism and Asperger syndrome. Certain medical syndromes carry a relatively high risk of concomitant autistic symptoms. Evidence for nonspecific brain dysfunction is often found in autism and autistic-like conditions. The search for the underlying clue to the riddle of autism may be futile. Autism might be best conceptualized as a behavioral syndrome reflecting underlying brain dysfunction which shades into other clinical syndromes. A new class of disorders of empathy is proposed.
Christopher Gillberg
Children exhibiting the triad of autistic impairments can be seen as suffering from disorders on a PDD continuum.
Gail Myhr, MD
57-point list of behaviors
Krug, Arick, Almond
Most children diagnosed with autism at 2 years of age will still have that diagnosis at age 9, investigators report. In contrast, many young children first diagnosed with pervasive developmental disorder not otherwise specified (PDD-NOS) or with autism spectrum disorder (ASD) later have their diagnoses changed to autism. Dr. Catherine Lord, from the University of Michigan Autism and Communication Disorders Center in Ann Arbor, and her associates report that clinicians have been questioning the stability of these diagnoses, with clinical studies yielding divergent outcomes.
Reuters, Medscape
A diagnosis of autism in a two-year old child stands a pretty good chance of holding up when that child is nine, according to researchers here. On the other hand, a two-year-old diagnosed with pervasive developmental disorder not otherwise specified (PDD-NOS) is more likely to be re-classified as having autism or another disorder seven years down the road, according to Catherine Lord, Ph.D., and colleagues in North Carolina, England, and Israel.
Neil Osterweil, MedPage Today
As autism cases increase across the country, some experts say a legitimate disorder is being hijacked as an excuse for other ills, including simple rudeness... "I think people now use the label of autism to justify socially inappropriate behavior."
Karen Gutierrez
It is not the determination of the small medical diagnostic category into which a child falls which determines educational programming. Educational programming is developed from good educational assessment, not from a diagnostic label.
Edna Smith-Herron
Just imagine . . . That there was such a thing as the blindness spectrum (BS). Originally, blindness was very strictly defined, as being totally blind, or with severe visual impairment. Then, in the 1990's the new concept of the blindness spectrum came into use. Since there was no clear distinction separating those having severe visual impairment and those who needed thick glasses, the terms BS came to include all those people who had any kind of visual impairment.
Dad of Cameron
Rather than thinking in terms of rigid diagnostic categories, we should recognise that the core syndrome of autism shades into other milder forms of disorder in which language or non-verbal behaviour may be disproportionately impaired.
D.V.M. Bishop
To avoid confusion, the term autistic spectrum disorders should only be used as the collective term for a group of defined disorders.
Bruce Tonge
These were patients, like Down's in 1887, and like Kanner's 50 years later, who began to regress after a period of normal development. These constituted roughly 25 percent of our cases, I would say. In each and every case, the mothers identified some event as the trigger for the regression. I remember distinctly one mother tying the regression to the child falling off the pier and nearly drowning; another tied it to when the child was hospitalized for tonsils-and-adenoids surgery; another to the time the child got trapped in the silo.
Darold Treffert, neurodiversity.com
The term autism as a disease should not be used to describe one disorder characterized by a certain core deficit, but rather should be considered an umbrella term to be used to describe a variety of associated disorders.
Darren Brucken
I support wholeheartedly all those whose children need to be helped, but autism should not be hijacked and turned into a woolly generic term. It should retain its diagnostic integrity. The condition exists and as a society we need to deal with it. But, faced with a massive statistical increase in autism, we have a duty to examine all the causes of children's behavioural difficulties. If sceptics about official statistics are shouted down, there can be no debate... “Over-inclusion” — making autism a catch-all for various complaints — cannot help those children or their families whose plight is genuine. As Berney says, putting somebody on the autistic spectrum cannot become the default option, since once a label becomes meaningless, help is far less likely to be forthcoming. When figures for those on the autistic spectrum rise dramatically we must be as certain as we can be that each diagnosis not only is completely legitimate, but is recognised as such so that when help is needed, we all listen attentively.
Katie Grant, Times Online
Parents need an answer to their questions: they want to know the why of their child's difficulties and behaviour. Until the child is diagnosed, many parents fear that the problems of the child are a result of bad upbringing and education.
H. De Ciercq
Autism is a disorder with many possible symptom variants. Because of this, individuals diagnosed with Autism in the past have been heterogeneous. This has made it difficult to conduct research.
Meredyth Goldberg Edelson
The revolution in the capacity of autistic citizens to communicate their experiences, needs and desires renders outmoded concepts of autism that focus only on incapacity rather than development and constructive adaptation through the lifespan, and that are based solely on observation of individuals who have been subject to lifelong professional scrutiny and speculative interpretation.
Kathleen Seidel, neurodiversity.com
More mildly affected children and adults, some of whom are gifted, need to have the nature of their difficulties recognised as constitutionally determined, so that their symptoms are not erroneously attributed to faulty upbringing.
Sula Wolff
Children with autistic disorder (AD), mixed receptive-expressive language disorder (RELD), or developmental coordination disorder (DCD) have impairments in common. We assess which abilities differentiate the disorders. Children aged 3-13 years diagnosed with AD (n = 30), RELD (n = 30), or DCD (n = 22) were tested on measures of language, intelligence, social cognition, motor coordination, and executive functioning. Results indicate that the AD and DCD groups have poorer fine and gross motor coordination and better response inhibition than the RELD group. The AD and DCD groups differ in fine and gross motor coordination, emotion understanding, and theory of mind scores (AD always lower), but discriminant function analysis yielded a non-significant function and more classification errors for these groups. In terms of ability scores, the AD and DCD groups appear to differ more in severity than in kind.
SN Wisdom
The majority of COS patients meet one or more criteria for pervasive developmental disorder, such as lack of interest in peers, poor eye contact, motor stereotypes, and odd speech or echolalia; but children do not meet full criteria for PDD or autism.
Peter Kramer
I review the historical development of the classification of PDD, summarize recent empirical data on issues of reliability and validity, and suggest a new approach to classification and understanding.
Peter Szatmari
(We) argue that a categorical model of diagnosis based simply on operationism falls short of providing the understanding we seek in the important field of psychopathology, and that a better model would be a dimensional one deriving from the notion that psychodiagnostic concepts are matters of degree.
G. Scott Acton
No single gene, environmental factor, combination of genes and/or environment, or other risk factors, can consistently cause autism. I doubt that we will find such a gene or agent but we will most certainly continue to identify new causes, potential treatments, comorbidities, categories, and labels cleaved from the idiopathic autism realm. There's a lot to sort out before we can say that one thing is caused by another so our only option for now is to ignore symptoms that may or may not be associated with being autistic, or continue to discuss these things as potential comorbid conditions. Humans will always sort, catalog, and label all we encounter. We need to exercise great caution when we approach categorizing humans by comorbidities.
NotMercury
In this clinical sample of 18 cases, the 'aloof'' and 'passive'' children had a pure triad of autistic difficulties and no comorbidity with DAMP (deficit in attention, motor control or perception), which was present in the ``odd '' group only.
E. Bonde
Our clinical experience shows the usefulness of DSM-III-R, DSM-IV and ICD-10 for initial screening, in view of their high sensitivity.
G. Lanzy, C.A. Zambrino, U. Balottin, Bettaglio
The results emphasize the differences between the two diagnostic systems. They also question the value of defining a separate subgroup and suggest that a dimensional view of the autistic spectrum is more appropriate than a categorical approach.
Susan Leekham et al
Thus it's quite clear that the most widely accepted definition of AS is fundamentally broken. However, since people are quite obviously being diagnosed with DSM-IV 299.80 Asperger's disorder, it follows that the diagnosticians have created their own ad hoc definitions and interpretations of what AS is. This has also been confirmed by studies, as well as the fact that these home made definitions vary from person to person... It's the same group of people, getting different diagnoses depending on a number of arbitrary factors, mostly the parents' memories and the whims of the diagnostician.
elmindreda
Without commitment to see the whole person we remain vulnerable to the power of labeling systems like the DSM, all too easily mistaking their transient categories for concrete reality and their classifications of disorders for classifications of people.
CSS is a renaming or realigning of a group of persons who have been labelled in the recent past as Asperger's Syndrome (AS) or High Functioning Autistic (HFA) or Pervasive Developmental Disorder (PDD) or who have otherwise gone undiagnosed.
Anonymous
We must acknowledge the possibility that apparently disordered behavior, which receives a DSM diagnosis, can be produced by a psychological endowment functioning exactly as it was designed to, in just the environment it was picked to work in.
Dominic Murphy, Stephen Stich
A label needs to be a starting point rather than an end in itself. It should be considered as a signpost to an understanding of the individual rather than a limiting stereotype.
Mike Blamires
The concept of DAMP (deficits in attention, motor control, and perception) has been in clinical use in Scandinavia for about 20 years. DAMP is diagnosed on the basis of concomitant attention deficit/hyperactivity disorder and developmental coordination disorder in children who do not have severe learning disability or cerebral palsy. In clinically severe form it affects about 1.5% of the general population of school age children; another few per cent are affected by more moderate variants. ..The DAMP construct has been helpful in identifying a group of children with ADHD and multiple needs that will not be self evident if the diagnosis is just ADHD or just DCD.
Christopher Gillbert
However, amidst all this confusion, it is very important to remember that, regardless of whether a child's diagnostic label is autism, PDDNOS, or MSDD, his or her treatment is similar.
Luke Tsai
In this paper, we give an overview of the diagnostic categories of autism and other pervasive developmental disorders (PDDs) and discuss the changes in the DSM classification system over the past 20 years. We describe each subtype of PDD, along with comorbid psychiatric conditions, assessment guidelines, and tools for diagnosis. The epidemiology of autism has generated much discussion and research; we report the most recent data, as well as recent findings about controversial issues purporting to cause the increased prevalence rate observed in the past decade. Finally, we discuss the prognosis for individuals with autism, indicating the challenges faced by patients, families, and professionals aiming to optimize their outcome.
Lee Tidmarsh, Fred Volkmar
DC: 0-3 offers a comprehensive, multi-axial framework for diagnosing emotional and developmental problems in the first three years of life. (Introduces the diagnostic category of Multisystem Developmental Disorder.)
Misdiagnosis, both in favour of Asperger syndrome and against, are common, due to other possibilities not being examined and ruled out.
Thtere are many cases of language-delayed people that catch-up very quickly, and soon fit the AS pattern better than the HFA pattern. They should not be prevented from having an AS diagnosis if that better fits the pattern of impairments.
Frank Klein
In the proposed class of illness, an individual might be diagnosed as healthy except when it comes to certain relationships. For the moment, the new category of mental illness would apply only to family relationships.
Shankar Vedantam, Washington Post
Our paper provides an historical review of the origin and evolution of Asperger's syndrome, and our study attempts to investigate the validity of Asperger's disorder as defined by DSM-IV.
Susan Dickerson Mayes et al
Autistic Disorder, Pervasive Developmental Disorder, Not Otherwise Specified, Asperger's Disorder, Rett's Disorder, Childhood Disintegrative Disorder
Diagnostic, Statistical Manual, 4th Edition
This study compared 23 children with high-functioning autism with 12 children with Asperger syndrome, both defined according to strict DSM-IV diagnostic criteria. The groups were well matched on chronological age, gender and intellectual ability. Three possible sources of difference between Asperger syndrome and high-functioning autism were examined: cognitive function, current symptomatology and early history. We found few group differences in current presentation and cognitive function, but many early history differences. The Asperger syndrome group generally demonstrated less severe early symptoms, a milder developmental course and better outcome than the high-functioning autism group. Many of the group differences appeared secondary to the initial group definition process, however. Overall, the results suggest that Asperger syndrome and high-functioning autism involve the same fundamental symptomatology, differing only in degree or severity.
S. Ozonoff et al
Only a functional approach to what the person actually does in his or her environment, to strengths, competencies and potential rather than a superficial list of deficiencies, can give us the strategies and the answers we need.
Autism National Committee
This study compared 23 children with high-functioning autism with 12 children with Asperger syndrome, both defined according to strict DSM-IV diagnostic criteria. Overall, the results suggest that Asperger syndrome and high-functioning autism involve the same fundamental symptomatology, differing only in degree or severity.
Sally Ozonoff et al
Journal of Autism and Childhood Schizophrenia 1971 Jan-Mar;1(1):82-6
D. Arn van Krevelen
We are here confronted with a worldview where everything is a symptom and the predominant color is a shade of therapeutic gray. This has the advantage of making the therapist's job both remarkably simple and remarkably lucrative.
L.J. Davis
Complex autism consists of individuals in whom there is evidence of some abnormality of early morphogenesis, manifested by either significant dysmorphology or microcephaly. Essential autism defines the more heritable group with higher sib recurrence (4% vs. 0%), more relatives with autism (20% vs. 9%),and higher male to female ratio (6.5:1vs.3.2:1). Their outcome was better with higher Iqs (P ¼ 0.02) and fewer seizures (P ¼ 0.0008). They were more apt to develop autism with a regressive onset.
J.H. Miles, T.N. Takahashi, S. Bagby, P.K. Sahota, D.F. Vaslow, C.H. Wang, R.E. Hillman, J.E. Farmer
Misuse of systems of classification include: confusing the person with the label; using the diagnosis as an explanation, or to obscure lack of knowledge; stigmatization.
Rik Haslam
Nurit Yirmiya et al
Let's get one thing straight, there may be lots more diagnosed auties today but auties always existed. Many of them were 'accommodated' by society as 'eccentrics', 'hobos', 'bag ladies' and 'simple folk'.
Donna Williams
So why use the labels? Because they are signposts, I guess. They describe some of where I've been, some of what I've learned. It's a kind of shorthand, and a way of positioning myself with respect to some aspects of culture that interest me.
Jane Meyerding
About half of all Americans will have a mental illness during their lifetime, with symptoms beginning in the teen years for many, according to the results of a survey published in the June issue of the Archives of General Psychiatry. A second study suggests that treatment is not usually initiated when patients first present. "These studies confirm a growing understanding about the nature of mental illness across the lifespan," Thomas Insel, MD, director of the National Institute of Mental Health (NIMH) in Rockville, Maryland, said in a news release. "There are many important messages from this study, but perhaps none as important as the recognition that mental disorders are the chronic disorders of young people in the U.S."
Laurie Barclay, Medscape
An article using sarcastic humor to describe the (lack of) difference between autism and Asperger's syndrome.
Amanda Baggs
The social problems of PDD-NOS children can be positively formulated and described as at least including severe social interaction problems, withdrawn behaviours and communication problems.
E.F. Luteijn, M. Serra, S. Jackson, M.P. Steenhuis, M. Althaus, F. Volkmar, R. Minderaa
The first thing to be said is that there is no difference, in principle, between autistic disorder and Asperger's syndrome. Lots of studies have shown that there is considerable overlap. Clearly, in some general way, people with Asperger's syndrome are less severely affected, but it is really hard even to specify that. If you are going to restrict autistic disorder to people with a generalised learning difficulty, or people with significant language problems over and above their autistic impairment, as the diagnostic manuals say, then you can divide people into two groups. But it is an arbitrary division. In Britain, what has happened is that people use Asperger's syndrome in a much more functional way. Essentially, they use it, I think, for people who are self-aware. The big thing about people with Asperger's syndrome is that they are aware of themselves and their situation and they make demands on the world, like everyone else. People with autistic disorders in the low-functioning group tend not to be self-aware. And as a result, they go along with whatever their carers provide to them.
Adam Feinstein
Society might reflect that the medicalisation of life, which has gathered pace in this century, tends to mean that distress is relocated from the social arena to the clinical arena.
Derek Summerfield
This is a reflection on how aspies cope with the inconsistencies of diagnostic guidelines. If you are looking for a reassuring simple explanation of Asperger's you may prefer not to read this.
Maurice Frank
There is currently some debate in the academic literature and between clinicians as to whether Asperger's syndrome is a unique disorder with a profile of abilities that does not occur in any other syndrome or simply a form of autism with a high IQ.
Tony Attwood
Labeling people just for the sake of categories makes no sense and can do a lot of harm. Unfortunately, they can't get their entitlements if their diagnosis doesn't fit the language in the regulations.
Charles Hart
Asperger's folks call themselves autistic because they share the same deficit/difference - a disconnect from the human race. It was what led both Hans Asperger and Leo Kanner to independently call their patients 'autistic'.
Alyric
Every family has its challenges and every family is unique. Every family has a different attitude towards disability. It is only destructive and divisive to make assumptions about anyone's experience based on a diagnostic label, or on the extent of a parent's willingness to portray their parenting experience in the most devastating terms.
Kathleen Seidel, neurodiversity.com
Society, particularly the autism community, seems to be comfortable with high-functioning autism and "Rainman," but apparently not so comfortable with low-functioning autistics who do not have the abilities of the HFA crowd. An imposed clique.
Use of the DSM reflects 'a growing tendency in our society to medicalize problems that are not medical, to find pathology where there is only pathos, and to pretend to understand phenomena by merely giving them a label and a code number.'
Dorothy Rowe
DSM-III-R, the standard psychological diagnostic manual, distinguishes between 'Mental Retardation' and 'Dementia' solely on the basis of age of onset. A similar clinical picture arising before the age of three constitutes one condition, one arising between the ages of three and eighteen both conditions, and one arising after the age of 18 the other condition. The other criteria for the two conditions have little in common and are in some aspects contradictory. The question arises whether a condition with such protean presentation can be said to constitute an entity, and it is suggested that the category of 'Mental Retardation' be discarded in favour of descriptors that are both more precise and do not attempt the function of a universal explanation for all behaviours.
Chris Borthwick
Schizophrenia is not a disease of childhood. Its onset is in adolescence and pre-adolescence. Studies of childhood behaviour of definite adult cases of schizophrenia show that they are, as a rule, model children, inconspicuous, and quite different from the cases described as childhood schizophrenics. Child psychiatry is still in the pre-Kraepelinian stage. No valid classification of mental diseases in children has yet been worked out. For the study of schizophrenia in childhood we have to take into account the progress made since Kraepelin and Bleuler in the refinement of diagnosis. This progress has been in two main areas, in the sifting out of other diseases, and in the development of tests. (American Journal of Psychiatry. 1958 Mar;114(9):791-4)
H.L. Mosse
DSM represents a major way of organising psychiatric knowledge. research efforts, and treatment approaches. At the same time, DSM is a prominent bid by psychiatrists for professional legitimacy and influence.
Stuart A. Kirk, Herb Kutchins
Examines patterns of behavioural disturbance which do not currently figure in descriptions of autism spectrum disorders, including dissociation of maturation syndrome, semantic-pragmatic disorder, quasi-autistic severe global privation disorder,
Lawrence Bartak
The "disorder rush" has worried many. The response of Stephen Longworth, a GP in Leicester, England, is typical: "Could someone please tell me where shyness ends and 'social anxiety disorder' begins?" he wrote in the British Medical Journal. "Isn't this just another appalling example of the creeping (galloping?) medicalisation of everyday life? Would it be written about at all if suggested treatments didn't include expensive SSRIs?"
Rowan Hooper
According to the DSM-IV, children with Asperger's disorder do not have significant cognitive or speech delays, whereas children with autistic disorder may or may not. In our study, children with normal intelligence who had clinical diagnoses of autism or Asperger syndrome were divided into two groups: those with and without a significant speech delay. The purpose was to determine if clinically meaningful differences existed between the two groups that would support absence of speech delay as a DSM-IV criterion for Asperger's disorder. No significant differences were found between the 23 children with a speech delay and the 24 children without a speech delay on any of the 71 variables analyzed, including autistic symptoms and expressive language. Results suggest that early speech delay may be irrelevant to later functioning in children who have normal intelligence and clinical diagnoses of autism or Asperger syndrome and that speech delay as a DSM-IV distinction between Asperger's disorder and autism may not be justified.
Susan Dickerson Mayes, Susan L. Calhoun
Effective human communication and interaction requires more than simply words. Facial expression, posture, gaze, and body movement (gesture) are as important as words in communicating correct information to another individual.
Roger Brumback, Caryn R. Harper, Warren Weinberg
The present article comments on the format and use of the diagnostic classification recently developed by Zero to Three/National Center for Clinical Infant Programs (1994).
J. Martin Maldonado-Duran et al
New York had just come down with a task force report that stated in no uncertain terms that the type of treatment you provide, sensory integration, has no documented empirical evidence for children with autism.
Bobby Newman, Skeptical Inquirer
Clinicians who have a strong authoritarian bent favor ODD. Any time a patient disagrees with them or fails to follow their direction or instruction they have a propensity to take autistic resistance and label it with a DSM diagnosis. HFA/AS children and adults are prone to resisting direction, since that is a defining diagnostic criterion of this Autistic Spectrum Disorder. Adding ODD to the shopping list of co-morbid diagnoses does the patient no good, fails to enlighten anyone reading this characterization, and puts the stamp of self-satisfied approval to the clinician's arrogance in the face of something he or she does not understand or is interested in learning about.
Roger N. Meyer
The initial impetus for systematic classification came from outside the mental health profession, but later revisions reflected intraprofessional struggles and experiences.
Eric D. Jackson
Although there were some differences noted during early childhood, most particularly around age of onset of developmental concerns and reaching of milestones, the differences faded with the onset of adulthood. This study could not conclude that High Functioning Autism and Asperger syndrome are distinct conditions. The author concludes that all people with High Functioning Autism and Asperger syndrome need the same kinds of community supports.
Patricia Howlin
The poor performance on language tests also challenges the assumption that early language development in Asperger syndrome is essentially normal.
Patricia Howlin
It would seem regrettable if new syndromes were to be used in clinical practice without consideration of whether an established psychiatric diagnosis would have been appropriate, as this will create confusion for parents and others involved.
M. Garralda, ADC Online
If you think about the content of verbal and nonverbal skills and the level of social perception and don't jump to conclusions, children with hyperlexia can be identified under a system of coexisting diagnoses.
Lynn Richman
In addition to lack of development of cognitive and language skills, children with this disorder have significant problems in social interaction. They seem detached and unable to become involved emotionally with those around them.
HealthCentral.com
In this article, I would like to expand on the differences between autism and these other, atypical forms of pervasive developmental disorders.
Peter Szatmari
Results support the clinical validity of various types of PDD, give credence to subtyping of PDD as in current classificatory systems, and generate a database on PDD from India.
Savita Malhotra, Subho Chakrabarti, Nitin Gupta, Parmod Kumar, Sapna Gill
Comparative chart
Far from being an objective, scientific notion, abnormality is a fundamentally ideological, socially constructed, culturally relative concept... whose unconscious function is to reduce anxiety in the face of others' difference.
Richard House
This essay deals with the nosological, methodological, and logical issues in trying to identify the relevant disorders or personality dimensions or trait configurations which may be useful to the clinician and to the aetiologist.
Irving I Gottesman
Exclusion of less affected individuals from the category of autism artificially diminishes the estimated prevalence of this condition. Individuals presenting a clinical picture resembling autism should be described in relation to a consensual syndrome.
Louise Gagon et al
The single faceted approach of diagnosticians attempting to make sense of what they perceive to be an individual deficiencies look only at the strongest manifestations of a thing and furthermore, human relativists that they are, colour there perceptions according to preconceived schemata. Thus one may be diagnosed with obsessive compulsive disorder, one with semantic pragmatic disorder, some with central auditory processing disorder, another with dyspraxia and another perhaps with dyslexia according to whatever present strongest, whereas to me they are all mathematical shapes within the multi-axial model, islands in the neurodiverse landscape as it were. (Revised version of paper presented at the 2002 World of Difference Conference)
Larry Arnold
Assigning a different prognosis to children with autism than to those with atypical autism does not appear warranted. If it is important to differentiate PDD subtypes, much more work needs to be done on refining the criteria for atypical autism. (JAACAP)
William Mahoney
There have been numerous reports of aberrations (e.g., deletions, translocations, and inversions) on nearly every chromosome in autism; however, the rates of these abnormalities vary widely across studies.
David J. Kupfer, Michael First, Darrel A. Regier
The need for a diagnostic nosology and improved and validated intervention techniques is stressed as is early identification of these types of specific nonverbal learning disabilities.
Margaret Semrud-Clikeman
Since the introduction of the term Semantic-Pragmatic Disorder (S-P) in 1983, there has been a controversy about whether this condition is a disorder in itself, or if it is merely a descriptive term for a condition which appears in many Autistic children.
Floyd Tilton
The continuing need to combine information from multiple sources and to resist efforts to reify diagnostic categories or elevated symptom scores as superior one to another is of paramount importance.
Peter S. Jensen
To the great distress of parents whose children really are on the autistic spectrum, the condition has been adopted by many other parents on behalf of children who are not ill, just badly behaved. If a child is described as "autistic," nobody can be angry if he or, more rarely, she throws a tantrum at school or consistently irritates the neighbours. Children know that if they suffer from some kind of behaviour "ism", good things result: reduced expectation, indulgence instead of punishment, safety from even the gentlest rebuke. At the first sign of a teacher's impatience, the child can rush home and cry "abuse". Autism, a serious condition when real, is being exploited by others for all it's worth.
Katie Grant, Times Online
When I was diagnosed with Asperger's autism, I was advised to be careful: no one wants that stigma! Imagine the problems with being labeled! I couldn't believe the exclamation points I was hearing from these doctors.
Antonio Hernandez
The validity and usefulness of subgrouping ASD children by level of functioning. Consistent with previous research, nonverbal IQ, receptive language, and adaptive functioning are the most predictive variables.
Michael Stevens
In the final analysis, a problem is only a problem because someone says it is. Who? On what basis? For what reason? A good theory of psychiatric problems must distinguish the thoughts, feelings, and behaviors addressed by psychiatry from the psychiatric view of them.
John Mirowsky
The three-factor solution found provided evidence for restructuring major DSM-IV criteria. A two-factor solution seemed more substantial however, and showed that subjects differed in severity rather than in profile.
N.van Lang, S.Sytema, A.de Bildt, D.Kraijer, C.Ketelaars, R.Minderaa
The primary reason for developing a specific diagnostic category for hyperlexia is to assure that hyperlexia is well understood so that appropriate treatment strategies can be developed.
Phyllis Kupperman, Sally Bligh, Kathy Barouski
What constitutes a disorder? Do mental disorders reflect failures of biological systems to perform naturally selected functions or are they defined by somewhat arbitrary distinctions derived from social values?
Theodore Beauchaine
It is important not to think of them as discrete (diagnostic) categories. It seems to make much more sense to think of them as different developmental pathways that potentially overlap at key points in development.
Peter Szatmari
"High Functioning," Asperger Syndrome," Non-Verbal Learning Disorder." I am just as confused as many of you. Frankly, when it comes to getting services for our kids, except in the case of gross mislabeling, it really doesn't make any difference what the distinction is. What does make a difference is what we do with the label. If we know how important one label may be as opposed to another later on in life, maybe our choices early on would be easier to make.
Roger N. Meyer
...we appear have two quite different forms of "autism", which deserve different labels in the nomenclature. Differential diagnosis of these conditions will not be based on symptoms, but rather will be based on the results of laboratory tests
John F. Kihlstrom
After a five-year study involving a sample of 260 autistic children, the researchers concluded that 30 percent of the autistic population has complex autism. These children have a small head size or a collection of at least six abnormal physical features, as well as the common symptoms found in all children with autism. These include impaired social interaction, language difficulty and a tendency for repetitive behaviors. "We found that the children with complex autism were different genetically," Miles said. "Their recurrence risk with their siblings was less and they had a more normal male-to-female ratio. You generally read that the sex ratio is four or five males to every female."
Monica Watrous
While current statistics might seem cause for alarm -- 1 in 5 children has a diagnosable mental, emotional or behavioral disorder -- Bowen emphasized that kids have always wrestled with anger control, stress and anxiety and persistent feelings of sadness.
Gretchen McKay, Pittsburgh Post-Gazette
Why do some people want to deny that Asperger's syndrome is a form of autism? Why would they say that there is no such thing as "high functioning" autism. What's at stake here?
oddizm
Bruce Pennington, Professor of Psychology at University of Denver, discusses dyslexia, ADHD and speech/language disorders.
Bruce Pennington
A tiered diagnostic work-up can double the rate of diagnosis of the syndromes and conditions associated with early-childhood autism.. The reported incidence of autism has increased fourfold, to 4-5 per 1,000... Despite this dramatic increase, only about 20% of patients are now identified with a known syndrome or condition as the underlying cause of the autism. But that can be increased to 40% of patients if a tiered system of diagnosis is used, he said. His group applied the diagnostic system to all children with autism in University of Nebraska clinics over a 3-year period.
Clinical Psychiatry News
The significant divergence of neuropsychological profiles suggests that intervention strategies for AS (from HFA) should be of a different nature, directly addressing specific neuropsychological deficits and building on neuropsychological assets.
Ami Klin, Fred Volkmar, Sara Sparrow, Domenic Cicchetti, Byron Rourke
Legally a student has educational autism, or he doesn't, but he doesn't have tendencies. An old friend of mine once responded to questions about tendencies by asking, How many retarded-like students do you have? That really clarified the issue for me!
Susan Hawkins
Both people with HFA and AS are affected by the triad of impairments common to all people with autism. Both groups are likely to be of average or above average intelligence. The debate as to whether we need two diagnostic terms is ongoing.
Nell Munro
A wade through the sea of diagnostic categories.
Sally Bligh
Like 'high functioning autism,' 'low functioning autism' has no concrete definition. The term is offensive to many parents since it can be very damaging to the children labeled with it.
Richard Irwin
Since the primary difference between AS and HFA seems to be one of severity, I can see no reason why a separate diagnosis is warranted. Outcome is usually better with those with AS, but that is related to the level of affliction with autism.
Frank Klein
As more and more kids live with labels, diagnoses and disorders, a growing number of experts are beginning to use antiquated terms like 'eccentric' and 'odd'.
David Noonan

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