Autism Awareness: Research, Characteristics and Diagnosis

Host Tony Fappiano discusses the latest research into autism – including the placenta study that may allow for much earlier detection – as well as the impact of the DSM-V. Featured guests include:

  • Dr. George M. Anderson, senior research scientist at the Yale Child Study Center
  • Sara Reed, Autism Services and Resources of Connecticut

Video produced by Tony Fappiano and directed by Donald Baechler for Guilford Community Television.

Autism spectrum diagnoses: The DSM-5 eliminates Asperger’s and PDD-NOS

Nice breakdown of the controversy – and parental concerns – surrounding the rollout of the DSM-5:

Certain states provide services for children diagnosed with autism but not for those diagnosed with Asperger’s. “It was difficult to get kids with Asperger’s services because their deficits can be subtle, so they were left on their own to some degree,” says Matthew Siegel, director of the Developmental Disorders Program at Spring Harbor Hospital in Maine. And it’s not just those with Asperger’s who have been shortchanged by the current system, says Stewart Newman, who treats kids from all parts of the spectrum at Mind Matters PC in Oregon. He has spent many hours advocating for his patients with educators who had “a lack of clarity about what the diagnosis of PDD-NOS in particular meant, and how the children should be characterized for special services.” Newman says the DSM-5 criteria “will create a common language we can use when we talk with school systems, parents, and other doctors, and it will mean the same thing for everyone, which will be really helpful.”

But outside the psychiatric field, many people defend the current diagnostic distinctions. Simon Baron-Cohen, director of the Autism Research Center at Cambridge University, wrote in a 2009 editorial in the New York Times that Asperger’s may be a biologically distinct syndrome; his team identified 14 genes that might be associated with the condition. A 2012 study of more than 540 Australian health and education professionals found that 93 percent thought there was a real difference between autism and Asperger’s. Just over half of the respondents were opposed to the consolidation of the diagnoses, while less than a quarter supported it.

And the parents I spoke to all felt that the old system worked just fine. There is real mistrust on the part of some, who suspect the new criteria were designed to exclude higher-functioning kids from a diagnosis and thereby deny them services.

via Autism spectrum diagnoses: The DSM-5 eliminates Asperger’s and PDD-NOS. – Slate Magazine.

Why French Kids Don’t Have ADHD

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological–psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.

via Why French Kids Don’t Have ADHD | Psychology Today.

The NIMH Withdraws Support for DSM-5 | Psychology Today

It will be very interesting to see what impact this will have on the classification of Autism Spectrum disorders.

Just two weeks before DSM-5 is due to appear, the National Institute of Mental Health, the world’s largest mental health research institute, has announced that it is withdrawing support for the manual.

In a humiliating blow to the American Psychiatric Association, Thomas R. Insel, M.D., Director of the NIMH, made clear the agency would no longer fund research projects that rely exclusively on DSM criteria. Henceforth, the NIMH, which had thrown its weight and funding behind earlier editions of the manual, would be “re-orienting its research away from DSM categories.” “The weakness” of the manual, he explained in a sharply worded statement, “is its lack of validity.” “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.”

via The NIMH Withdraws Support for DSM-5 | Psychology Today.

DSM-5 Update from IMFAR

An update on DSM-5 from Geri Dawson of Autism Speaks:

Rather than three categories of symptoms (social, communication and repetitive behaviors), only two types of symptoms will be required (social communication and repetitive behaviors). “Pervasive developmental disorder” will now be simply called “autism spectrum disorder.” In fact, all subtypes will be collapsed under the one broad category of autism spectrum disorders.

Why? Because even expert clinicians cannot reliably distinguish among the different subtypes when they make their diagnoses. What one clinician calls high functioning autism, another calls Asperger syndrome. This lack of consistency occurs because the diagnosis of Asperger syndrome, as defined in the DSM-IV, is based on recall of early language acquisition. Such recall can prove difficult, especially when a diagnosis is being made later in life.

Also worth noting: according to Dr. Sue Swedo, the concern that the DSM-V would lead to some higher-functioning individuals would be de-classified raised by Dr. Fred Volkmar and others may be unfounded, because those studies were based on diagnoses using the DSM-IV.

The DSM-V includes a number of symptoms that were not part of previous iterations.

via Geri’s DSM-5 Update from IMFAR | Blog | Autism Speaks.

Asperger’s Association of New England Seeks Comment on DSM-5

Earlier today, Autism Speaks released some preliminary findings showing how the new DSM-5 may impact the diagnosis of autism spectrum disorders.

If you’re concerned about the new diagnostic standards, the Asperger’s Association of New England would like to hear from you.

Attention! Members, friends, allies — we urgently need your help in what is currently our most important advocacy effort. Please put aside ten minutes to call or email the APA and provide your views on their proposed new criteria for ASD. In this email, I outline our concerns as an organization, suggest points you can raise, and provide contact information for the APA. Please give them your feedback. Ask your friends, families and co-workers to do the same. The APA has invited comments for the next four weeks until June 15.

For more information on the DSM-5, check out GCTV’s interview with Dr. Fred Volkmar of Yale University.

Findings from DSM-5 Field Testing

There has been a lot of concern about how the new DSM-5 diagnosis criteria would impact the diagnosis of autism and autism spectrum disorders; many parents are concerned that the new standards will prevent some children from being classified – which could mean they’d miss out on much-needed services.

Autism Speaks chief science officer Geri Dawson is tracking that issue, and released some preliminary results today:

This week brought the first results of field trials conducted with nearly 300 children at four pediatric autism clinics to assess differences in diagnosis rates using DSM-IV versus DMS-5 criteria. The encouraging news is that the vast majority of children diagnosed with ASD using the old criteria retained their diagnosis under the proposed new criteria.

Approximately 5 to 10 percent received a different diagnosis. Some of these received the new diagnosis of “social communication disorder.” Others received a primary diagnosis of attention deficit and hyperactivity disorder (ADHD).

Notably, the proposed DSM-5 criteria also “captured” some children who did not meet the definition of autism using the old DSM-IV criteria. This could be because there are some symptoms included in the new criteria (e.g. sensory sensitivities) that were not included in the old criteria. As a result, the overall rate of ASD diagnosis did not change between the DSM-IV and DSM-5 definitions of ASD.

via Findings from DSM-5 Field Testing | Science News | Autism Speaks.

For more information on the DSM-5 and how it impacts the diagnosis of autism and related disorders, check out GCTV’s interview with Dr. Fred Volkmar of the Yale Child Study Center.

Autism Awareness: Dr. Fred Volkmar

Ninth in a series of Autism Awareness programs produced by Guilford Community Television. This program features interviews with:

  • Dr. Fred Volkmar, Director of the Yale University Child Study Center
  • Sara Reed, ASCONN

Topics include:

  • Changes in the DSM-V
  • The ABLE Act
  • General discussion of autism spectrum disorders and their characteristics