Fwd: Fw: Very Important DSM-5 Update

[Guest guest]

FYI---

____________________________________

From: DDudasik@...

Sent: 1/29/2012 2:58:34 P.M. Central Standard Time

Subj: Fwd: Fw: Very Important DSM-5 Update

FYI - PASSAGE is passing along this information for you to review.

PASSAGE is not encouraging or discouraging you from signing this petition, but

rather keeping you informed of current events regarding the issues

surrounding the DSM-5.

Many thanks to Lynette for helping us keep current on this issue, once

again, Lynette is sharing this information with all of us for educational

purposes only.

Take care,

Teri

____________________________________

----- Forwarded Message ----

From: GRASP Press Office <press@...>

Subject: Very Important DSM-5 Update

Please forward to anyone and everyone you deem appropriate, especially if

they’ve been following the DSM-5 debate closely . . .

Dear all:

A second study that has just come to light claims that the DSM-5 will

significantly reduce the amount of people (by 32.3%) who will qualify for an

autism spectrum diagnosis. Furthermore, this study indicates that those

whose diagnoses are eliminated by the newer criteria will include the more

challenged, and not just the end of the spectrum that is better able to mirror

greater society.

Given the statements of many DSM-5 Committee members since the story broke

last Thursday, this study corroborates many fears, but it also raises new

questions (our summations will follow the study’s excerpts).

GRASP is grateful to authors, Dr. A Worley and Dr. ny L. Matson

of Louisiana State University, along with their representatives, for giving

GRASP permission to post quotes from " Comparing Symptoms of Autism

Spectrum Disorders using the Current DSM-IV-TR Diagnostic Criteria and the

Proposed DSM-5 Diagnostic Criteria " (in press for " Research in Autism Spectrum

Disorders " ).

Excerpts (2) from the final " Discussion " section of the study are as

follows:

1. “The proposed revisions to the diagnostic category of ASD are

significant . . . It was hypothesized that children meeting only DSM-IV-TR

diagnostic criteria (APA, 2000) for ASD would score significantly higher (i.e.,

indicating more symptom severity) than children who were typically developing

and significantly lower than those who met future diagnostic criteria for

ASD on a measure of autism symptoms (i.e., ASD-DC; Matson & González, 2007).

This hypothesis was only partially supported. That is, participants

meeting only DSM-IV-TR criteria for ASD scored significantly higher than the

typically developing children, but not significantly different than children

meeting DSM-5 diagnostic criteria (APA, 2011). Thus, children and adolescents

that no longer met criteria still had significant symptoms of ASD when

compared to children who were typically developing. Even more concerning is

that children and adolescents who met current, but not future diagnostic

criteria had similar symptom severity of ASD when compared to children and

adolescents who continued to meet diagnostic criteria. Therefore, the subset of

children who met DSM-IV-TR, but not DSM-5 diagnostic criteria are

experiencing significant impairments related to the core symptom domains of

ASD.

Thus, the proposed revisions may be decreasing sensitivity, suggesting that

that the broader symptom definition utilized in the current diagnostic

manual (i.e., DSM-IV-TR, APA, 2000) may be a superior classification system.

“

2. “Ongoing research examining the impact of continued service delivery

after early intervention services subside is urgent given the changing

diagnostic categories and criteria of ASD proposed for the DSM-5 (APA, 2011).

However, if ongoing treatment is necessary, who will pay for these services?

Interventions currently utilized to treat individuals diagnosed with various

ASDs are largely consistent and similar treatment methodologies should

remain despite the newly proposed diagnostic category. However, payment

coverage for these children will likely become an obstacle. About a decade ago,

the majority of insurance companies had exclusions for autism (Peele,

Lave, Kelleher, 2002), but most now cover services for those diagnosed.

However, it is probable that insurance companies will not provide treatment

coverage for children who still exhibit significant symptoms of ASD, but no

longer meet diagnostic criteria under the DSM-V definition of the disorder.

Another implication of the proposed diagnostic changes will be

apparent in incidence and prevalence rates of ASD. With the proposal to

narrow the symptom definition, fewer children will meet diagnostic criteria

upon the publication of the DSM-5 (APA, 2011). Thus, a decreasing trend of

incidence and prevalence rates should be observed once the DSM-5 is utilized

diagnostically. A decrease in prevalence rates for ASD was observed in the

current study when utilizing the DSM-5 diagnostic criteria compared to the

DSM-IV-TR (APA, 2000). In the current study, the prevalence of ASD

decreased by 32.3% when using the DSM-5 instead of the DSM-IV-TR. Although

lower

rates of both prevalence and incidence are pleasing, it may come at the cost

of providing services to those who still require them.

In closing, the proposed revisions to the diagnostic category

of ASD are supposed to increase the specificity of the diagnosis. However,

as observed in the current study, children and adolescents who met current,

but not future criteria still exhibited significant symptoms. “

End excerpts.

GRASP’s commentary (and not necessarily the views of the study's authors)

is as follows:

This study backs up some of the numbers that Yale's Dr. Fred Volkmar cited

in his study _as reported in the New York Times_

(http://t.ymlp282.net/eeeyavaebmyaoaujmapajjsj/click.php) when this story

broke last Thursday. Dr.

Volkmar, who earlier resigned from the DSM-5 Committee, has had his study

attacked by proponents of the newer criteria since then who seek to

invalidate his findings. Two studies remotely corroborating each other (as we

believe these two do) will be hard to attack.

GRASP has cited the disparity, and sometimes contradictory nature of

damage control attempts by several DSM-5 Committee members in several media

articles. But now that the evidence is quite strong that changes will be as

drastic as feared, if not more so, it paints many in a negative light who

have tried to downplay the level of change forthcoming, but it especially

paints Dr. H. Hunter in a poor manner. In what was a suspicious article

to begin with (no contrary opinion provided—shame on author, Deborah

Brauser), Dr. King's comments in _last week's MedScape article_

(http://t.ymlp282.net/eemsavaebmyapaujmagajjsj/click.php) should now be looked

upon in the

light of, at best, misrepresentation. Wethinks those who reassuringly tell us

" No one will be left behind " really mean " No one will be left behind who

deserves a diagnosis under the DSM-5 criteria. "

PDF files of the entire Worley/Matson study are available to clinical or

media professionals. You can request a copy by emailing _press@..._

(mailto:press@...)

What can you do if reducing the criteria threatens your child's special

education funding, your services as an adult, or your self-esteem as an

adult? Please maintain the following outline without letup:

1. Sign the petition found _here_

(http://t.ymlp282.net/eemuaaaebmyagaujmapajjsj/click.php) , and forward the link

with your appeal for people to

sign everywhere and anywhere. Again: forwarding (especially through any and

all appropriate social media sites) is arguably more important than signing.

2. Call the American Psychiatric Association (APA)—during normal business

hours; once every day, if possible, at 703.907.7300. Yes, they are telling

you to email instead. But we ask that you please instead be the articulate,

impassioned, and peaceful nuisance that is needed in this debate, and not

adhere to their instructions.

3. Email the your letters to apa@... and to dsm5@...

4. Check _our Facebook page_

(http://t.ymlp282.net/eemeagaebmyanaujmatajjsj/click.php) for updates, as well

as to view the history and prior

articles surrounding this issue since it broke 9 days ago. This is especially

helpful for those of you who feel you need talking points for your emails to

the APA.

Want extra credit?

Email angry but not irrational letters regarding H. King’s comments

and Deborah Brauser’s reporting techniques to Medscape at

_news@..._ (mailto:news@...) . The people who comprise the

DSM-5 Committee

are probably smarter than 90% of us. But that doesn’t give them the right

to insult whatever intelligence we have.

It’s one thing for the DSM to change in ways we don’t like. It’s another

to be elusive or dishonest. They may have backed themselves into a

conversation about their motives, that we need to initiate.

All we can do is facilitate. It’s you who do all the work. It’s up to

you, not GRASP, to stop this.

Best,

The folks at GRASP

GRASP

The Global and Regional Asperger Syndrome Partnership, Inc.

666 Broadway, Suite 825

New York, NY 10012

p + f = 1.888.474.7277

www.grasp.org

Help GRASP make a difference. Donate now by clicking the link below:

_http://www.nycharities.org/donate/charitydonate.asp?ID=2223_

(http://www.nycharities.org/donate/charitydonate.asp?ID=2223)

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