Asperger's diagnosis may be history
Thursday, February 11, 2010
Asperger's syndrome may disappear as a diagnosis under new recommendations released Wednesday by the American Psychiatric Association.
Asperger's, which is a milder and more high-functioning form of autism, would be replaced by a single diagnosis of autism spectrum disorder, with doctors indicating the severity. The same would go for "pervasive developmental disorder, not otherwise specified," a category for children who exhibit some symptoms of autism, but not enough to warrant a diagnosis.
The proposed changes would appear in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, due out in May 2013.
As autism has come to be viewed as a broad spectrum of developmental disorders, many doctors see Asperger's as medical hair-splitting. Its causes, symptoms and treatments are nearly identical to mild forms of diagnosed autism.
"To me, the label is less important than the underlying developmental issues and how to treat them," says Dr. Alan Rosenblatt, a developmental pediatrician in Chicago.
Many practitioners say the change just reinforces what they've known for years.
"From a scientific and clinical standpoint, the change is certainly justified," says Dr. Geri Dawson, chief medical officer with Autism Speaks, the country's largest autism advocacy group. "It's time we start recognizing autism for what it is -- a broad spectrum of disorders."
While the changes are being welcomed by doctors, it will likely draw fire from some segments of the autism community. Many self-described "Aspies" celebrate their diagnoses.
"A whole culture has developed around the Asperger's label," says Rosenblatt, a member of Chicago Special Parent magazine's advisory board. "And now, all of a sudden, an organized body of medicine comes in and puts them back in the same ballpark as many people who are much lower functioning."
In other cases, parents have embraced the Asperger's label because they find it less stigmatizing than a diagnosis of autism.
"I think this will be a very good temperature check" for gauging public perceptions of autism, Dawson says. "It's important to be sensitive to the fact that ... there are people who identify strongly with this label."
What's in a name?
The change isn't merely cosmetic. The DSM serves as a bible for mental health professionals, determining what disorders are worthy of an official diagnosis and affecting how diseases are treated, covered by insurance policies and in some cases, perceived by society.
For example, homosexuality appeared in the DSM as a mental illness until 1973 and ADHD was added in 1987, both highly politicized moves.
And in this case, a streamlined diagnosis of autism may give some children access to services that would have been out of reach with an Asperger's diagnosis.
"By creating this broad category, it's likely to help some
people get access to services" that they otherwise would be denied,
In some states, she says, early intervention services and specialized education programs require an official autism diagnosis.
Have an opinion? The American Psychiatric Association is accepting public input online through April 20.